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    Clinical Trial Results:
    A Phase I/II, Randomised, Double-blind, Placebo-controlled, Parallel Group Study to Evaluate the Efficacy, Systemic Absorption and Dihydropyrimidine Dehydrogenase (DPD) Enzyme Activity Following Repeated Topical Applications of Brivudin Cream 0.5% and 1.0% in Patients with Herpes Simplex Labialis (HSL)

    Summary
    EudraCT number
    2006-002213-13
    Trial protocol
    DE  
    Global end of trial date
    03 Dec 2007

    Results information
    Results version number
    v1(current)
    This version publication date
    19 Jul 2019
    First version publication date
    19 Jul 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    6 BT
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    MENARINI RICERCHE S.P.A.
    Sponsor organisation address
    Via Sette Santi 1, Florence, Italy, 50131
    Public contact
    Angela Capriati , MENARINI RICERCHE S.P.A., Corporate Clinical Sciences, 0039 055 56809933, acapriati@menarini-ricerche.it
    Scientific contact
    Angela Capriati , MENARINI RICERCHE S.P.A., Corporate Clinical Sciences, 0039 055 56809933, acapriati@menarini-ricerche.it
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    03 Dec 2007
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    03 Dec 2007
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Dec 2007
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Primary objective of this study is to investigate the efficacy of repeated topical applications of brivudin cream 0.5% and 1.0% versus placebo cream in the treatment of HSL as measured by the duration of the HSL episode, defined as time from start of treatment to: a) Complete loss of hard crusts in classical HSL lesions. b) Time to resolution of sign(s) and symptom(s) in aborted lesions (defined as lesions not developing beyond the papula stage).
    Protection of trial subjects
    If any event(s) related to the conduct of the study or the development of the IMP would have affected the safety of the study participants, the Sponsor and the Investigator would have taken appropriate urgent safety measures to protect the patients against any immediate hazard. The CAs and IRB/ECs would be informed forthwith about these new events and the measures taken. For patients participating in the study, Menarini Ricerche S.p.A. had stipulated an insurance policy in accordance with local regulatory requirements. Details on the insurance company, the insurance number and conditions were made available to patients in the ICF and/or provided as a separate document, in accordance with national requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Oct 2006
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 100
    Worldwide total number of subjects
    100
    EEA total number of subjects
    100
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    92
    From 65 to 84 years
    8
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted in 1 site in Germany. The first patient was enroled on 18 October 2006 and the last patient completed the study on 04 March 2007.

    Pre-assignment
    Screening details
    After screening on Day 1 patients were randomized the same day to either the Brivudin (0.5% cream or 1.0% cream) or placebo arm of the study in a 2:2:1 ratio.

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Carer

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    0.5% Brivudin Cream
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    0.5% Brivudin Cream
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    0.5 cm of 0.5% Brivudin cream applied twice daily from Day 1 to Day 3 and once in the morning of Day 4, using a standard spatula.

    Arm title
    1.0% Brivudin Cream
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    1.0% Brivudin Cream
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    0.5 cm of 1.0% Brivudin cream applied twice daily from Day 1 to Day 3 and once in the morning of Day 4, using a standard spatula.

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    0.5 cm of Placebo cream applied twice daily from Day 1 to Day 3 and once in the morning of Day 4, using a standard spatula.

    Number of subjects in period 1
    0.5% Brivudin Cream 1.0% Brivudin Cream Placebo
    Started
    40
    40
    20
    Completed
    40
    40
    19
    Not completed
    0
    0
    1
         Consent withdrawn by subject
    -
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    0.5% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    1.0% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group values
    0.5% Brivudin Cream 1.0% Brivudin Cream Placebo Total
    Number of subjects
    40 40 20 100
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        85 years and over
    0 0 0 0
        Adults (18-84)
    40 40 20 100
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    40.4 ( 12.5 ) 38.0 ( 15.6 ) 35.8 ( 9.8 ) -
    Gender categorical
    Units: Subjects
        Female
    32 26 13 71
        Male
    8 14 7 29

    End points

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    End points reporting groups
    Reporting group title
    0.5% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    1.0% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Primary: Duration of HSL lesion

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    End point title
    Duration of HSL lesion
    End point description
    End point type
    Primary
    End point timeframe
    Daily evaluation up to Day 4. In case HSL symptomes had not resolved by Day 4, every other day until Day 14.
    End point values
    0.5% Brivudin Cream 1.0% Brivudin Cream Placebo
    Number of subjects analysed
    40
    40
    20
    Units: day
        arithmetic mean (standard error)
    4.5 ( 0.4 )
    3.8 ( 0.4 )
    3.9 ( 0.4 )
    Statistical analysis title
    Duration of HSL lesion
    Statistical analysis description
    Cox proportional hazards model with treatment and baseline lesion stage as covariates .
    Comparison groups
    0.5% Brivudin Cream v 1.0% Brivudin Cream v Placebo
    Number of subjects included in analysis
    100
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    ≤ 0.05 [1]
    Method
    Regression, Cox
    Parameter type
    Cox proportional hazard
    Confidence interval
    Notes
    [1] - A Hochberg procedure will be used to achieve an overall significance level of 5 % (two-sided).

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From Day 1 (screening and first application) to Day 25 (Safety Follow Up)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    9.1
    Reporting groups
    Reporting group title
    0.5% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    1.0% Brivudin Cream
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    0.5% Brivudin Cream 1.0% Brivudin Cream Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 40 (0.00%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    0.5% Brivudin Cream 1.0% Brivudin Cream Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    20 / 40 (50.00%)
    16 / 40 (40.00%)
    9 / 20 (45.00%)
    Injury, poisoning and procedural complications
    Thermal burn
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Nervous system disorders
    Facial neuralgia
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Headache
         subjects affected / exposed
    4 / 40 (10.00%)
    5 / 40 (12.50%)
    1 / 20 (5.00%)
         occurrences all number
    4
    5
    2
    Hypoaesthesia oral
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    1
    0
    1
    Paraesthesia oral
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 40 (0.00%)
    0 / 40 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    0
    1
    Pyrexia
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Gastrointestinal disorders
    Cheilitis
         subjects affected / exposed
    1 / 40 (2.50%)
    2 / 40 (5.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    2
    0
    Diarrhoea
         subjects affected / exposed
    0 / 40 (0.00%)
    2 / 40 (5.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    2
    Dry mouth
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Lip dry
         subjects affected / exposed
    1 / 40 (2.50%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    1
    1
    0
    Nausea
         subjects affected / exposed
    1 / 40 (2.50%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    1
    1
    0
    Oral pruritus
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Oral pustule
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Toothache
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Reproductive system and breast disorders
    Ovulation pain
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Bronchitis
         subjects affected / exposed
    0 / 40 (0.00%)
    0 / 40 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    0
    1
    Cough
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Epistaxis
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Nasal congestion
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Nasopharyngitis
         subjects affected / exposed
    2 / 40 (5.00%)
    3 / 40 (7.50%)
    2 / 20 (10.00%)
         occurrences all number
    2
    3
    2
    Pharyngolaryngeal pain
         subjects affected / exposed
    2 / 40 (5.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    2
    1
    0
    Rhinorrhoea
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Herpes simplex
         subjects affected / exposed
    6 / 40 (15.00%)
    1 / 40 (2.50%)
    3 / 20 (15.00%)
         occurrences all number
    6
    1
    3
    Night sweats
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 40 (2.50%)
    0 / 20 (0.00%)
         occurrences all number
    0
    1
    0
    Pruritus generalised
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    skin laceration
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    2 / 40 (5.00%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    2
    0
    0
    Pain in extremity
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 40 (0.00%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Sep 2006
    Change of inclusion criterion 1: specification concerning women of childbearing potential Change of exclusion criterion 1: specification of "immunodeficient patients" Specification of prohibited concomitant medication: treatment with 5-FU forbidden within 4 weeks prior to the study

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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