- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02319616
Topical Clobetasol for the Treatment of Toxic Epidermal Necrolysis (TEN)
A Randomized Placebo Controlled Split-body Double-blind Phase II Clinical Trial to Investigate the Safety and Efficacy of Clobetasol 0.05% Ointment for the Treatment of Toxic Epidermal Necrolysis (TEN)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The experimental focus of this trial is thus to evaluate the safety and clinical outcomes of topical steroid (clobetasol 0.05% ointment) for treatment of the cutaneous manifestations of toxic epidermal necrolysis (TEN).
The design of the study is a randomized, placebo-controlled, double-blind split-body Phase II clinical trial in which clobetasol 0.05% or placebo ointment will be topically applied to opposite arms for a period of fourteen days. The primary endpoints of the study are to determine the time to cessation of skin detachment in both groups as well as the safety of topical clobetasol to treat the cutaneous manifestations of TEN. Secondary outcome measures will evaluate efficacy by comparing the time to re-epithelialization and the percentage of affected skin between the clobetasol and placebo arms at various time points.
An additional aim of the study is to characterize the genes expressed during the TEN disease state and any changes in gene expression following treatment with topical steroids, particularly those genes involved in the regulation of programmed cell death (apoptosis). This will be accomplished though molecular analysis of skin biopsy specimens obtained after treatment with clobetasol and placebo ointments. The specific hypothesis being tested is that two weeks of topical clobetasol will promote epidermal keratinocyte survival through suppression of TNF signaling, decreased granulysin expression and inhibition of other pro-apoptotic pathways resulting in shorter disease duration and decreased time to re-epithelialization.
IRB number: 642415-5
Study Type
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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California
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Sacramento, California, United States, 95816
- University of California, Davis Department of Dermatology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Characteristic histological findings on diagnostic biopsy
- Clinical diagnosis verified by two independent physicians
- Greater than 10% affected body surface area (BSA)
- Ability to start treatment within seven days or less from the onset of erosions
- Actively worsening disease (enlarging area of involvement or new erosions occurring over the last 24 hours)
- Patient Body Surface Area (BSA) > 1.0 m2
- Reproductive age female patients must have a negative pregnancy test prior to enrollment
Exclusion Criteria:
- Patients will be excluded if they are < 7 or > 85 years of age.
Patients who have documented:
- Uncontrolled infection (e.g. documented bacteremia)
- Malignancy
- Known prior immunodeficiency
- Pregnancy
- Concurrent use of systemic corticosteroids in the burn center greater than or equal to 0.5 mg/kg/day of prednisone or equivalent dose of similar medication.
- Greater than 70% eroded skin
- SCORETEN score >3 on hospital admission
- Patients will also be excluded if they have: active hepatitis and/or an ALT or AST greater than four times the normal limits, or renal insufficiency with an estimated GFR<50 mL/min/1.73m2.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Clobetasol 0.05% ointment
All patients will have one arm assigned to receive the experimental treatment (topical clobetasol 0.05% ointment) applied daily for a period of fourteen days.
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Blinded, daily application to one arm for a period of fourteen (14) days
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PLACEBO_COMPARATOR: Placebo
All patients will have one arm assigned to receive the placebo treatment (topical petrolatum ointment) applied daily for a period of fourteen days.
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Blinded, daily application to one arm for a period of fourteen (14) days
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety (numeric cellulitis score)
Time Frame: 14 days
|
Local infection (cellulitis) is a potential complication of treatment with topical steroid ointment.
A primary outcome measure of the study will be to determine if any difference in local infection rate exists between between control and clobetasol-treated skin in patients with toxic epidermal necrolysis, determined by daily assessments and assignment of a numeric cellulitis score.
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14 days
|
Time to Cessation of Skin Detachment
Time Frame: 14 days
|
The time until cessation of skin detachment (measured in days) will be determined though daily skin examinations and compared between the clobetasol and placebo-treated skin of patients with toxic epidermal necrolysis.
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14 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to 90% re-epithelialization
Time Frame: 14 days
|
The time to 90% re-epithelialization will be determined by daily skin examinations and recorded in days to determine if a significant difference exists between control and clobetasol treated skin.
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14 days
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Percent Affected Surface Area
Time Frame: 14 days
|
Percent affected surface area will be measured with daily skin examinations and compared between the placebo and steroid treated skin in patients with TEN
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14 days
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Percent Affected Surface Area Detached Skin
Time Frame: 14 days
|
The percent body surface area affected by detached skin will be monitored through daily skin examinations and compared between the clobetasol and placebo treated skin in patients with toxic epidermal necrolysis.
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14 days
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Chemically-Induced Disorders
- Skin Diseases
- Immune System Diseases
- Stomatognathic Diseases
- Mouth Diseases
- Hypersensitivity
- Erythema
- Skin Diseases, Vesiculobullous
- Dermatitis
- Drug-Related Side Effects and Adverse Reactions
- Stomatitis
- Drug Eruptions
- Erythema Multiforme
- Drug Hypersensitivity
- Stevens-Johnson Syndrome
- Physiological Effects of Drugs
- Anti-Inflammatory Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Clobetasol
Other Study ID Numbers
- 804284
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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