- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05072821
Botulinum Toxin Type A Injection to Prevent Keloid Recurrence
Immediate Injection of Botulinum Toxin Type A After Keloid Scar Revision to Prevent Keloid Recurrence: a Prospective, Split-scar, Double-blind, Randomized Controlled Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Continuous variables will be reported as the mean ± standard deviation(SD). Each aspect of the VSS score, POSAS score, and the Cutometer parameters of each scar half between the BTA and control groups will be analyzed longitudinally using the paired t test. The interrater consistency will be evaluated using the Spearman rho. All analyses will be performed with IBM SPSS Version 23.0 (IBM Corp., Redmond, Wash.). A value of p < 0.05 is considered to indicate statistical significance.
The sample size was calculated based on the results of the investigators' aforementioned study published in 2019. Thirty patients underwent keloid revision and then received radiation therapy based on our treatment protocol. The postoperative Vancouver Scar Scale score was 4.15 ± 1.74. If treatment could improve VSS score by 1, which was considered clinically significant, approximately 26 patients would have been necessary to provide a result with a real significance (using the same SD and considering the standard α error of 0.05 and a power of 0.8). Assuming a 20% non-compliance rate for follow-up evaluation, the sample size was increased to 32 patients.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
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Tainan, Taiwan
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult (20 years or older)
- Progressive keloid lesion that is bilaterally symmetric, mandibular area, anterior chest or suprapubic area, for example
- At least 4 cm in length
- Repeated or uncontrolled recurrence, and unendurable symptoms with poor response to conservative modalities
- Valid written informed consent provided for surgery and trial inclusion
Exclusion Criteria:
- Allergy to botulinum toxin
- Previous botulinum toxin injection at the lesion within 6 months before enrollment
- Myasthenia gravis
- Focal infection signs
- Pregnant or breastfeeding woman
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Botulinum Toxin type A injection side
The Botulinum Toxin type A will be injected into the dermal layer before skin closure in keloid excision surgery.
The concentration of Botulinum Toxin type A is 100 units in 2 mL and dosage is 8 units/cm.
The maximal dose is 100 units for each participant.
|
After the whole surgical procedures of keloid revision are done, the participants will receive Botulinum Toxin type A (BTA) injection.
The investigators split the scar into the right side and the left side.
BTA and 0.9% saline, respectively, are used for the two arms of the study.
Vials containing 100 units of BTA (BotoxⓇ, Allergan) are mixed with 2mL 0.9% injectable saline.
The injection depth will be the intradermal layer.
Injections will be performed with a 30-gauge needle and 1 mL syringe.
Just before skin closure, the entire scar was treated, with sides randomized to receive treatment with either BTA or 0.9% normal saline.
The dosage is 8 units / cm based on aforementioned studies.
The maximal dose won't exceed 100 units.
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Placebo Comparator: 0.9% saline injection side
The 0.9% saline will be injected into the dermal layer before skin closure in keloid excision surgery.
The dosage is 0.16 mL/cm.
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After the whole surgical procedures of keloid revision are done, the participants will receive 0.9% saline injection.
The investigators split the scar into the right side and the left side.
BTA and 0.9% saline, respectively, are used for the two arms of the study.
Only 0.9% saline is injected on the control side.
The injection depth will be the intradermal layer.
Injections will be performed with a 30-gauge needle and 1 mL syringe.
Just before skin closure, the entire scar was injected, with sides randomized to receive treatment with either BTA or 0.9% normal saline.
The dosage is 0.16 mL / cm.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Keloid recurrence
Time Frame: One year
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The recurrence of keloid will be determined by clinical examination evaluated by a dermatologist.
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One year
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Subjective symptoms
Time Frame: 3, 6, 9 and 12 months
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The subjective symptoms will be measured by the Patient Scale of the Patient and Observer Scar Assessment Scale.
The Patient Scale consists six items and scores from 1 to 10 for each items.
The score of 1 means much alike the normal skin and the score of 10 means worst imaginable scar.
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3, 6, 9 and 12 months
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Objective symptoms
Time Frame: 3, 6, 9 and 12 months
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The subjective symptoms will be measured by the Observer Scale of the Patient and Observer Scar Assessment Scale.
The Observer Scale consists six items and scores from 1 to 10 for each items.
The score of 1 means much alike the normal skin and the score of 10 means worst imaginable scar.
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3, 6, 9 and 12 months
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Vancouver Scar Scale
Time Frame: 6 and 12 months
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One dermatologist will evaluate the scar with the Vancouver Scar Scale.
The Vancouver Scar Scale consists 4 items.
The minimum score is 0, which means the scar is much alike normal skin.
The maximal score is 13, which means purple, hyperpigmentation, contracture and elevated scar.
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6 and 12 months
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Scar firmness
Time Frame: 6 and 12 months
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The scar firmness is determined by the Cutometer parameter R0.
R0 is maximum amplitude of the curve (the total elongation).
The larger R0 is, the softer the scar is.
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6 and 12 months
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Yuan-Yu Hsueh, MD PhD, National Cheng-Kung University and Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Disease Attributes
- Connective Tissue Diseases
- Fibrosis
- Cicatrix
- Collagen Diseases
- Recurrence
- Keloid
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Cholinergic Agents
- Membrane Transport Modulators
- Acetylcholine Release Inhibitors
- Neuromuscular Agents
- Botulinum Toxins
- Botulinum Toxins, Type A
- abobotulinumtoxinA
Other Study ID Numbers
- MOHW109-TDU-B-211-114003
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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