Botulinum Toxin Blockade of Neuronal Signals to Immune Cells as a Novel Treatment for Hidradenitis Suppurativa (Botox in HS)
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Fase 2
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Sarah K Whitley, MD, PhD
- Número de telefone: 508-856-4086
- E-mail: sarah.whitley@umassmed.edu
Estude backup de contato
- Nome: Terrie LaMarche
- E-mail: terrie.lamarche@umassmed.edu
Locais de estudo
-
-
Massachusetts
-
Worcester, Massachusetts, Estados Unidos, 01605
- UMass Chan Medical School
-
Contato:
- Deborah White
- Número de telefone: (508)856-2664
- E-mail: deborah.white@umassmed.edu
-
Contato:
- Sidney Leno, MD
- Número de telefone: 714-455-4087
- E-mail: sidney.leno@umassmed.edu
-
Investigador principal:
- Sarah K Whitley, MD, PhD
-
Subinvestigador:
- Jessica St. John, MD, MPH
-
Subinvestigador:
- Sidney Leno, MD
-
-
Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Age >13 and <75
- established diagnosis of HS
- HS skin lesions of duration at least 1 year
- HS lesions in at least two distinct body areas
- inadequate response to a trial of an oral antibiotic or exhibited recurrence after discontinuation of antibiotics
- abscess and nodule (AN) count ≥ 5 at baseline
- draining tunnel count of <20 at baseline
- ability to provide written informed consent and/or assent
Exclusion Criteria:
- pregnant or breastfeeding
- history of neuromuscular disorder (ex. ALS, myasthenia gravis, Lambert-Eaton syndrome, myopathy
- medical co-morbidity ex. end stage congestive heart failure or coagulopathy that is a relative contradiction to skin biopsy procedure
- received systemic steroids or started a new systemic (biologic or non-biologic immunomodulator, oral retinoid) therapy with potential therapeutic impact for HS <12 weeks prior to baseline visit
- use of opioid or non-opioid oral analgesics within 14 days of baseline visit (exception: at a stable dose for at least 14 days prior to baseline)
- receiving anti-IL-17A/F, anti-IL-23, or anti-IL-1 biologic therapy or oral JAK inhibitor, TYK inhibitor
- active COVID-19 infection or history of COVID-19 infection within 4 weeks prior to baseline
- oral or IV antibiotic use during the treatment period (exception: stable dose of doxycycline or minocycline upto 100mg PO BID for 28 days prior to baseline and throughout the 6 month treatment and observation period
- initiation of topical therapies for HS within 14 days or baseline visit (may continue stable use of topical therapies started > 14 days prior to baseline visit), -laser surgery, laser hair removal, or elective surgery to treatment areas within 4 weeks prior to baseline visit
- current participation in another clinical study involving the administration of an investigative drug for the treatment of HS, or prior participation in such a study within 60 days prior to baseline visit,
- active bacterial, fungal, or viral infection in the treatment area at baseline visit, -immunocompromised state
- known hypersensitivity to botulinum toxin A preparations or any of their components (human albumin, saline, lactose, sodium succinate).
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Quadruplicar
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
|
Comparador de Placebo: placebo
Participants will be randomized 1:1 to receive placebo (saline) or botulinum toxin injections.
|
10 injections of 0.1mL of normal saline vehicle per laterality
Outros nomes:
|
|
Comparador Ativo: botulinum toxin
Participants will be randomized 1:1 to receive placebo (saline) or botulinum toxin injections.
|
50U per axilla in 10 injections of 0.1mL
|
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
percent change from baseline in abscess and inflammatory nodule (AN) count and draining tunnel (dT) count
Prazo: baseline and weeks 4, 12, and 24
|
All subjects will receive 2 treatments with onabotulinum toxin A OR placebo (saline) 3 months apart, over a 6-month study period.
At baseline and at week 12 each patient will receive 50 units of Botox per 100cm2 of skin, injected intradermally in 10 injections of 0.1mL spaced 1 cm apart to one HS-affected body site (ex.
bilateral axillae, inguinal, medial thighs, inframammary chest) for a total of 100U per treatment.
|
baseline and weeks 4, 12, and 24
|
|
Microscopy Analyses of Skin Lesions
Prazo: baseline and day 7
|
The study team will perform punch biopsies of lesions and non-lesional skin and perform direct immunohistochemistry and immunofluoresce microscopy analysis
|
baseline and day 7
|
|
Ultrasound monitoring of skin lesions
Prazo: baseline and weeks 1, 12, 24
|
Ultra-high frequency ultrasound (UHFU): This non- invasive imaging technique will be used to quantify HS tunnel area and cutaneous blood flow rate in treatment areas using an established protocol as detailed in Oranges T Skin Res Technology 2020).
|
baseline and weeks 1, 12, 24
|
Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Dermatology Quality of Life Index
Prazo: baseline and weeks 1, 12, 24
|
Assesses the degree of pain, the number of flares, and the impact on daily life .
Dermatology disease agnostic, not specific for HS
|
baseline and weeks 1, 12, 24
|
|
Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA)
Prazo: baseline and weeks 1, 12 ,24
|
Response is defined as at least a 2-point reduction in HS-IGA score relative to baseline.
|
baseline and weeks 1, 12 ,24
|
|
Central sensitization Index (CSI)
Prazo: baseline and weeks 1, 12, 24
|
measures centrally processed pain signals.
The participant scores each answer on a scale of 0 (never) to 4 (always).
A score of more than 40 indicates the presence of central sensitization.
|
baseline and weeks 1, 12, 24
|
|
Numeric Rating Scale -30
Prazo: baseline and weeks 1, 12, 24
|
The numeric rating scale (NRS) is a pain scale that asks a patient to rate their pain on a scale of 0 to 10 where a higher score indicates a higher pain level.
It's a common tool used in healthcare to assess pain severity.
|
baseline and weeks 1, 12, 24
|
|
Hidradenitis Suppurativa Clinical Response (HiSCR)-50
Prazo: baseline and weeks 1, 12, 24
|
defined as a 50% reduction in inflammatory lesion count (abscesses + inflammatory nodules) with no increase in abscesses or draining fistulas when compared with baseline.
|
baseline and weeks 1, 12, 24
|
|
Hidradenitis Suppurativa Physician Global Assessment (HS-PGA)
Prazo: baseline and weeks 1, 12, 24
|
The six-point Hidradenitis Suppurativa Physician Global Assessment (PGA) ranges from clear to very severe where a higher score indicates more severe disease.
It is used in clinical trials to measure clinical improvement in inflammatory nodules,abscesses and draining fistulae
|
baseline and weeks 1, 12, 24
|
|
Hidradenitis Suppurativa Quality of Life (HiSQOL)
Prazo: baseline and weeks 1, 12, 24
|
A 17-item questionnaire designed to measure quality of life for people with HS.
Scores range from 0-68 where higher scores indicate a worse impact on quality of life.
|
baseline and weeks 1, 12, 24
|
|
International Hidradenitis Suppurativa Severity Score (IHS-4)
Prazo: baseline and weeks 1, 12, 24
|
The International Hidradenitis Suppurativa Severity Score (IHS4) is a validated tool that measures the severity of hidradenitis suppurativa (HS).
The IHS4 score is calculated by adding the number of nodules, abscesses, and draining tunnels, each multiplied by a weight A score of 3 or less indicates mild HS, 4-10 indicates moderate HS, and 11 or higher indicates severe HS.
The IHS4 is used to assess the severity of HS and to measure inflammatory lesions, such as draining tunnels.
|
baseline and weeks 1, 12, 24
|
|
Hidradenitis Suppurativa Area and Severity Index Revised
Prazo: baseline and weeks 1, 12, 24
|
The HASI-R method assesses HS severity in a manner that incorporates signs of inflammation and body surface area involved.
Scores range from 0-720 where a higher score indicates worse disease.
|
baseline and weeks 1, 12, 24
|
|
Numeric Rating Scale - Itch
Prazo: baseline and weeks 1, 12, 24
|
rates itch score as 1-10, 10 indicating most severe itch.
similar to NRS pain instrument
|
baseline and weeks 1, 12, 24
|
|
PainDETECT
Prazo: baseline and weeks 1, 12, 24
|
an assessment tool for neuropathic pain.
Scores range from -1 to 38.
A score of 19 or higher indicates neuropathic pain is likely.
|
baseline and weeks 1, 12, 24
|
|
Generalized Anxiety Disorder-7 (GAD-7)
Prazo: baseline
|
The GAD-7 (General Anxiety Disorder-7) measures severity of anxiety over a 2 week period.
Answers are scored from 0 to 3 ("not at all" = 0, "several days" = 1, "more than half the days" = 2, and "nearly every day"=3).
A score of 10 or higher is considered positive for anxiety.
|
baseline
|
|
Patient Health Questionnaire-9 (PHQ-9)
Prazo: baseline and weeks 1, 12, 24
|
The PHQ-9 (Patient Health Questionnaire-9) objectifies and assesses degree of depression severity via questionnaire.
Nine questions indicate how often the symptom occurred over a 2-week period.
A score of 10 or higher is considered clinically significant.
|
baseline and weeks 1, 12, 24
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Investigadores
Investigadores
- Investigador principal: Sarah K Whitley, MD, PhD, UMass Chan Medical School
Publicações e links úteis
Publicações Gerais
- Kimball AB, Sobell JM, Zouboulis CC, Gu Y, Williams DA, Sundaram M, Teixeira HD, Jemec GB. HiSCR (Hidradenitis Suppurativa Clinical Response): a novel clinical endpoint to evaluate therapeutic outcomes in patients with hidradenitis suppurativa from the placebo-controlled portion of a phase 2 adalimumab study. J Eur Acad Dermatol Venereol. 2016 Jun;30(6):989-94. doi: 10.1111/jdv.13216. Epub 2015 Jul 22.
- Campanati A, Martina E, Giuliodori K, Bobyr I, Consales V, Offidani A. Two cases of Hidradenitis suppurativa and botulinum toxin type a therapy: A novel approach for a pathology that is still difficult to manage. Dermatol Ther. 2019 May;32(3):e12841. doi: 10.1111/dth.12841. Epub 2019 Feb 10.
- Grimstad O, Kvammen BO, Swartling C. Botulinum Toxin Type B for Hidradenitis Suppurativa: A Randomised, Double-Blind, Placebo-Controlled Pilot Study. Am J Clin Dermatol. 2020 Oct;21(5):741-748. doi: 10.1007/s40257-020-00537-9.
- Shih T, Lee K, Seivright JR, De DR, Shi VY, Hsiao JL. Hyperhidrosis treatments in hidradenitis suppurativa: A systematic review. Dermatol Ther. 2022 Jan;35(1):e15210. doi: 10.1111/dth.15210. Epub 2021 Nov 30.
- Campanati A, Martina E, Giuliodori K, Consales V, Bobyr I, Offidani A. Botulinum Toxin Off-Label Use in Dermatology: A Review. Skin Appendage Disord. 2017 Mar;3(1):39-56. doi: 10.1159/000452341. Epub 2017 Feb 1.
- Kim YS, Hong ES, Kim HS. Botulinum Toxin in the Field of Dermatology: Novel Indications. Toxins (Basel). 2017 Dec 16;9(12):403. doi: 10.3390/toxins9120403.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Infecções
- Doenças de pele
- Infecções bacterianas
- Infecções Bacterianas e Micoses
- Doenças das glândulas sudoríparas
- Doenças de pele, bacterianas
- Doenças de Pele Infecciosas
- Supuração
- Hidradenite
- Doenças da Pele e do Tecido Conjuntivo
- Hidradenite supurativa
- Aminoácidos, peptídeos e proteínas
- Proteínas
- Fatores biológicos
- Hidrolases
- Enzimas
- Enzimas e coenzimas
- Produtos químicos inorgânicos
- Compostos de cloro
- Toxinas botulínicas
- Metaloendopeptidases
- Endopeptidases
- Hidrolases peptídicas
- Metaloproteases
- Proteínas bacterianas
- Toxinas bacterianas
- Toxinas, biológicas
- Compostos de sódio
- Cloretos
- Ácido clorídrico
- Toxinas Botulínicas, Tipo A
- Cloreto de sódio
Outros números de identificação do estudo
Outros números de identificação do estudo
- STUDY00003339
- 1R61AR087105-01A1 (Número de outro subsídio/financiamento: NIAMS/NIH)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Prazo de Compartilhamento de IPD
Critérios de acesso de compartilhamento IPD
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
- CIF
- ANALYTIC_CODE
- CSR
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
produto fabricado e exportado dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .