Esta página foi traduzida automaticamente e a precisão da tradução não é garantida. Por favor, consulte o versão em inglês para um texto fonte.

Botulinum Toxin Blockade of Neuronal Signals to Immune Cells as a Novel Treatment for Hidradenitis Suppurativa (Botox in HS)

8 de setembro de 2026 atualizado por: Sarah Whitley, University of Massachusetts, Worcester
This study will build on data from mice and humans implicating TRPV1 nociceptors in the pathogenesis of the type-17 chronic inflammatory skin disease hidradenitis suppurativa (HS). In this study, the investigators will extend data from a 12-week pilot study to rigorously test the hypothesis that botulinum toxin (BoNT) therapy reduces disease severity and relieves HS pain symptoms..

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

This study will recruit 40 HS patients with an abscess and inflammatory nodule (AN) count ≥5 at a single body site (ex. bilateral axillae, medial thighs). Participants will be randomized 1:1 to receive placebo or 50U of BoNT per 100cm2 of skin (100U total) administered twice over a 6-month study period. Randomization will be stratified by disease stage (Hurley stage <III, III). At baseline and weeks 4, 12, and 24 disease activity and pain symptom burden will be measured using percent change from baseline in abscess and inflammatory nodule (AN) count and draining tunnel (dT) count as primary outcomes and achievement of ≥ 30% reduction from baseline in the Patient's Global Assessment of Skin Pain Numeric Rating Scale (NRS)-30 as a secondary outcome. The investigators will conduct high-frequency ultrasound measurement of HS tunnel area at baseline and weeks 4,12, and 24 to determine if BoNT therapy can reduce tunnel size. The study team will also collect punch biopsies of lesional skin from HS patients before, and 4 weeks after BoNT treatment then perform flow cytometric, transcriptomic, and microscopic analysis of skin to determine if and how nonselective inhibition of neuropeptide release diminishes HS inflammation.

Tipo de estudo

Intervencional

Inscrição (Estimado)

40

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

Locais de estudo

    • Massachusetts
      • Worcester, Massachusetts, Estados Unidos, 01605
        • UMass Chan Medical School
        • Contato:
        • Contato:
        • Investigador principal:
          • Sarah K Whitley, MD, PhD
        • Subinvestigador:
          • Jessica St. John, MD, MPH
        • Subinvestigador:
          • Sidney Leno, MD

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Filho
  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

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

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Quadruplicar

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / 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:
  • salina
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

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

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

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Sarah K Whitley, MD, PhD, UMass Chan Medical School

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de outubro de 2026

Conclusão Primária (Estimado)

1 de setembro de 2028

Conclusão do estudo (Estimado)

1 de abril de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

4 de agosto de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

4 de agosto de 2026

Primeira postagem (Real)

10 de agosto de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

10 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

8 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este 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)?

SIM

Descrição do plano IPD

Research team will share data and samples from this study with other investigators who are interested in skin diseases, but in that case no patient identifying information will be shared.

Prazo de Compartilhamento de IPD

starting at time of publication of results, ending 7 years following study endpoint

Critérios de acesso de compartilhamento IPD

Proposals should be directed to sarah.whitley@umassmed.edu.To gain access to data, requesters will have to sign a data access agreement.

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

Sim

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

produto fabricado e exportado dos EUA

Não

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 .