Photodynamic Therapy (PDT) With Methyl Aminolevulinate (MAL) Cream in Moderate to Severe Acne

This multicenter study will be divided into 2 phases. The first phase will be an open label, dose-escalation phase, while the second will be a blinded, randomized, vehicle-controlled, parallel-group, dose-response phase. The second phase will only start if the first phase succeeds in establishing well tolerated dose(s). Patients with moderate to severe acne vulgaris in the face will be included.The results from part 2 has been presented in the result section.

Study Overview

• Status: Completed
• Conditions: Acne Vulgaris
• Intervention / Treatment: Drug: Methyl aminolevulinate (MAL) PDT

Detailed Description

For the second part: All patients will receive 4 PDT sessions 2 weeks apart using a light dose of 37 J/cm2. One treatment group will receive vehicle cream, while the other 2 groups will receive MAL cream with a concentration of 40 mg/g and 80 mg/g, respectively. The MAL and vehicle cream will be applied in a thin layer on clean skin and left for 1.5 hours under occlusion before illumination.

• Study Type: Interventional
• Enrollment (Actual): 150
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • California
    • San Diego, California, United States, 92123
      • Therapeutics Clinical Research
    • Vallejo, California, United States, 94589
      • Solano Clinical Research
  • Illinois
    • Naperville, Illinois, United States, 60563
      • DuPage Medical Group
  • Michigan
    • Clinton Twp, Michigan, United States, 48038
      • Michigan Center for Research Corp
  • New Mexico
    • Albuquerque, New Mexico, United States, 87106
      • Academic Dermatology Associates
  • New York
    • Rochester, New York, United States, 14623
      • Dermatology Associates of Rochester
  • Oklahoma
    • Norman, Oklahoma, United States, 73069
      • Central Sooner Research
  • Oregon
    • Portland, Oregon, United States, 97210
      • Oregon Dermatology and Research Center
  • Texas
    • Dallas, Texas, United States, 75230
      • Dermatology Treatment & Research
    • Houston, Texas, United States, 77056
      • Suzanne Bruce and Associates, PA
    • San Antonio, Texas, United States, 78229
      • The Dermatology Clinical Research Center of San Antonio
  • Utah
    • Salt Lake City, Utah, United States, 84124
      • Dermatology Research Center, Inc.
  • Virginia
    • Lynchburg, Virginia, United States, 24501-1604
      • The Education & Research Foundation, Inc.
    • Norfolk, Virginia, United States, 23507
      • Virginia Clinical Research, Inc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 40 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Female and male patients, age 15 to 40 years with moderate to severe facial acne vulgaris (IGA score 3-4).
2. Patients with skin type I to IV (Fitzpatrick).
3. Patients with 20 to 100 inflammatory lesions (papules, pustules, and nodules) on the face excluding lesions on the nose and in the peri-ocular area.
4. Patients with up to 200 noninflammatory lesions (open and closed comedones) on the face.
5. Patients with no more than 2 nodular lesions on the face.
6. Patients who are surgically sterile, postmenopausal, abstinent, or willing to use an adequate means of contraception including birth control pills, or barrier methods and spermicide for at least 14 days prior to Day 0. Patients using birth control pills must have used the same product and dose for at least 6 months and must agree to stay with the same product and dose for an additional 6 months.
7. Patients must be willing and capable of following study instructions to the extent and degree required by the protocol.
8. Patients must sign the approved informed consent form prior to any study procedures.
9. Patients must be willing to be photographed. Patients must be willing to sign a photography consent form.

Exclusion Criteria:

1. Known allergy to MAL, to a similar PDT compound, or to excipients of the cream.
2. Participation in other clinical studies either concurrently or within the last 30 days.
3. Patients who have a condition or who are in a situation, which, in the investigator's opinion, may put the patient at risk, may confound the study results, or may interfere with the patient's participation in the study.
4. Clinically significant sensitivity to visible light, or has porphyria or porphyrin sensitivity.
5. Exposure to ultraviolet radiation (UVB phototherapy, sun tanning salons) within the last 30 days.
6. Patients with a washout period for topical treatments for their acne of less than 14 days. Medicated cleansers may be used during the washout period and stopped before the treatment.
7. Patients with a washout period for oral antibiotics for treatment of their acne of less than 1 month.
8. Patients with a washout period for oral isotretinoin of less than 6 months.
9. Patients with a beard or other facial hair that might interfere with study assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; PDT using MAL concentration A	Drug: Methyl aminolevulinate (MAL) PDT; Cream application followed by illumination with red light
Experimental: 2; PDT using MAL concentration B	Drug: Methyl aminolevulinate (MAL) PDT; Cream application followed by illumination with red light
Placebo Comparator: 3; PDT using Placebo cream	Drug: Methyl aminolevulinate (MAL) PDT; Cream application followed by illumination with red light

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Proportion of Success, Defined as Improvement of at Least 2 Grades From Baseline According to the IGA Scale Based on Facial Assessment	12 weeks after last treatment
Change in Facial Inflammatory (Nodules, Papules, and Pustules) Lesion Counts	12 weeks after last treatment
Change in Facial Inflammatory (Nodules, Papules, and Pustules) Lesion Counts From Baseline	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Percentage Change in Facial Inflammatory (Nodules, Papules, and Pustules) Lesion Counts From Baseline		3 weeks after last treatment
Median Percentage Change in Facial Inflammatory (Nodules, Papules, and Pustules) Lesion Counts From Baseline		6 weeks after last treatment
Median Percentage Change in Facial Non Inflammatory Lesion Counts From Baseline		6 weeks after last treatment
Percent Reduction in Total Lesion Counts From Baseline		6 weeks after last treatment
Proportion of Success, Defined as Improvement of at Least 2 Grades From Baseline According to the IGA Scale Based on Facial Assessment		6 weeks after last treatment
The Proportion of Patients Rated as Clear or Almost Clear at 12 Weeks After Last Treatment		12 weeks after last treatment
Facial Pain Using Visual Analouge Scale From 0 to 10, Were 0 Indicates no Pain and 10 Indicates Worst Pain.	Measure was assessed on a Visual Analogue Scale from 0 to 10 cm	immediately after illumination-first treatment
Facial Pain Using Visual Analouge Scale From 0 to 10, Were 0 Indicates no Pain and 10 Indicates Worst Pain	Measure was assessed on a Visual Analogue Scale from 0 to 10 cm	immediately after second treatment
Facial Pain Using Visual Analouge Scale From 0 to 10, Were 0 Indicates no Pain and 10 Indicates Worst Pain.	Measure was assessed on a Visual Analogue Scale from 0 to 10 cm	immediately after third treatment
Facial Pain Using Visual Analouge Scale From 0 to 10, Were 0 Indicates no Pain and 10 Indicates Worst Pain.	Measure was assessed on a Visual Analogue Scale from 0 to 10 cm	immediately after illumination-fourth treatment treatment
Proportion of Patients With Mild and Moderate Erythema After First Treatment		immediately after first treatment
Proportion of Patients With Mild and Moderate Erythema After First Treatment		2 days after first treatment
Proportion of Patients With Mild and Moderate Erythema After Second Treatment		immediately after second treatment
Proportion of Patients With Mild and Moderate Erythema After Third Treatment		immediately after third treatment
Proportion of Patients With Mild and Moderate Erythema After Fourth Treatment		immediately after fourth treatment
Proportion of Patients With Severe Erythema After First Treatment		immediately after first treatment
Proportion of Patients With Severe Erythema 2 Days After First Treatment		2 days after first treatment
Proportion of Patients With Severe Erythema 7 Days After First Treatment		7 days after first treatment
Proportion of Patients With Severe Erythema After Second Treatment		immediately after second treatment
Proportion of Patients With Severe Erythema After Third Treatment		immediately after third treatment
Proportion of Patients With Severe Erythema After Fourth Treatment		immediately after fourth treatment
Proportion of Patients With Mild and Moderate Hyperpigmentation After First Treatment		2 days after treatment
Proportion of Patients With Mild and Moderate Hyperpigmentation After First Treatment		2 weeks after first treatment
Proportion of Patients With Mild and Moderate Hyperpigmentation After Last Treatment		2 weeks after last treatment
Proportion of Patients With Mild and Moderate Hyperpigmentation After Last Treatment		6 weeks after last treatment
Proportion of Patients With Mild and Moderate Hyperpigmentation After Last Treatment		12 weeks after last treatment
Proportion of Patients With Mild and Moderate Hypopigmentation After First Treatment		2 days after first treatment
Proportion of Patients With Mild and Moderate Hypopigmentation After Last Treatment		2 weeks after last treatment
Proportion of Patients With Mild and Moderate Hypopigmentation After First Treatment		2 weeks after first treatment
Proportion of Patients With Mild and Moderate Hypopigmentation After Last Treatment		6 weeks after last treatment
Proportion of Patients With Mild and Moderate Hypopigmentation After Last Treatment		12 weeks after last treatment

Collaborators and Investigators

• Sponsor: Photocure
• Investigators: Principal Investigator: David Pariser, MD, AAD

Study record dates

Study Major Dates

• Study Start: February 1, 2007
• Primary Completion (Actual): July 1, 2008
• Study Completion (Actual): September 1, 2008

Study Registration Dates

• First Submitted: January 3, 2008
• First Submitted That Met QC Criteria: January 14, 2008
• First Posted (Estimate): January 15, 2008

Study Record Updates

• Last Update Posted (Estimate): August 8, 2013
• Last Update Submitted That Met QC Criteria: August 7, 2013
• Last Verified: August 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Acneiform Eruptions; Sebaceous Gland Diseases; Acne Vulgaris; Photosensitizing Agents; Dermatologic Agents; Aminolevulinic Acid; Methyl 5-aminolevulinate
• Other Study ID Numbers: PC TA202B/06