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    Clinical Trial Results:
    A multi-centre, single-blind, parallel group, clinical evaluation of the efficacy and safety of clindamycin 1% / benzoyl peroxide 3% and azelaic acid 20% in the topical treatment of mild to moderate acne vulgaris

    Summary
    EudraCT number
    2013-004158-81
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    08 Sep 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Mar 2016
    First version publication date
    14 Mar 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    200398
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    GlaxoSmithKline
    Sponsor organisation address
    980 Great West Road, Brentford, Middlesex, United Kingdom,
    Public contact
    GSK Response Center, GlaxoSmithKline, 1 866-435-7343,
    Scientific contact
    GSK Response Center, GlaxoSmithKline, 1 866-435-7343,
    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
    17 Nov 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    08 Sep 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to compare the efficacy and safety of a gel formulation containing a combination of clindamycin 10mg/g + benzoyl peroxide 30mg/g with a cream containing azelaic acid 20%. Main Hypothesis to test: - clindamycin 1% /benezoyl peroxide 3% is more effective than azelaic acid 20% in treating inflammatory acne lesions; - clindamycin 1% /benezoyl peroxide 3% has faster speed of onset; - clindamycin 1% /benezoyl peroxide 3% results in higher patient satisfaction - Both treatment have an equal tolerability
    Protection of trial subjects
    Duac and Skinoren administered according to SPC. Hence, no specific measures that were put in place to protect trial participants.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Feb 2014
    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: 222
    Worldwide total number of subjects
    222
    EEA total number of subjects
    222
    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)
    106
    Adults (18-64 years)
    116
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Overall 222 participants (par.) with facial acne (vulgaris) were enrolled; of these, 111 par. were randomized in the combination treatment of 1.2% clindamycin phosphate (10mg/g) + 3% benzoyl peroxide [30mg/g]) (Duac) Arm and 110 par. in the 20% azelaic acid cream (Skinoren) Arm. A total of 217 randomized par. used study medication at least once.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Single blind
    Roles blinded
    Assessor [1]

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Duac
    Arm description
    Participants topically applied a thin film of Duac gel once daily in the evening for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.
    Arm type
    Experimental

    Investigational medicinal product name
    Duac
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Gel
    Routes of administration
    Topical use
    Dosage and administration details
    Once daily in the evening. Duac 10mg/g + 30mg/g Gel contains 1% clindamycin and 3% BPO in a gel vehicle consisting of carbomer, dimethicone, disodium lauryl sulfosuccinate, edetate disodium, glycerol, colloidal hydrated silica, poloxamer, purified water, and sodium hydroxide

    Arm title
    Skinoren
    Arm description
    Participants topically applied a thin film of Skinoren cream twice daily (once in the morning and once in the evening) for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.
    Arm type
    Active comparator

    Investigational medicinal product name
    Skinoren
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    Twice daily in the morning and evening. Skinoren Creme contains 20% azelaic acid in a cream vehicle consisting of Arlatone 983S (polyoxyethylene fatty acid ester), cutina CBS (mixture of mono-diglycerides, fatty alcohols, triglycerides and wax esters), cetearyl octanoate, propylene glycol, glycerol 85% (E422), benzoic acid (E210), purified water.

    Notes
    [1] - The roles blinded appear inconsistent with a simple blinded trial.
    Justification: This is an evaluator-blinded study; therefore, participants, study center staff responsible for drug accountability and distribution, and other individuals involved with the conduct, analysis, and reporting of clinical study data were not blinded to study product allocations. The acne lesion assessor was unaware of which study product was being used (blinded).
    Number of subjects in period 1 [2]
    Duac Skinoren
    Started
    108
    109
    Completed
    104
    102
    Not completed
    4
    7
         Not in Time Schedule
    -
    1
         Consent withdrawn by subject
    2
    2
         Non Compliance
    1
    -
         The Visit Date was not in Timeline
    -
    1
         Adverse event, non-fatal
    1
    -
         Lost to follow-up
    -
    3
    Notes
    [2] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Overall 222 participants (par.) with facial acne (vulgaris) were enrolled; of these, 111 par. were randomized in the combination treatment of 1.2% clindamycin phosphate (10mg/g) + 3% benzoyl peroxide [30mg/g]) (Duac) Arm and 110 par. in the 20% azelaic acid cream (Skinoren) Arm.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Duac
    Reporting group description
    Participants topically applied a thin film of Duac gel once daily in the evening for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Reporting group title
    Skinoren
    Reporting group description
    Participants topically applied a thin film of Skinoren cream twice daily (once in the morning and once in the evening) for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Reporting group values
    Duac Skinoren Total
    Number of subjects
    108 109 217
    Age categorical
    Units: Subjects
    Age continuous
    Participants presented include the Intent-to-Treat (ITT) Analysis Set, consisting of all randomized participants who used study medication at least once.
    Units: years
        arithmetic mean (standard deviation)
    20.1 ( 7.1 ) 20 ( 6.9 ) -
    Gender categorical
    Participants presented include the Intent-to-Treat (ITT) Analysis Set, consisting of all randomized participants who used study medication at least once.
    Units: Subjects
        Female
    47 51 98
        Male
    61 58 119
    Race
    Participants presented include the Intent-to-Treat (ITT) Analysis Set, consisting of all randomized participants who used study medication at least once.
    Units: Subjects
        Asian
    5 0 5
        Caucasian
    94 102 196
        African
    1 1 2
        Other
    8 6 14

    End points

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    End points reporting groups
    Reporting group title
    Duac
    Reporting group description
    Participants topically applied a thin film of Duac gel once daily in the evening for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Reporting group title
    Skinoren
    Reporting group description
    Participants topically applied a thin film of Skinoren cream twice daily (once in the morning and once in the evening) for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Primary: Percent change from Baseline in inflammatory lesion counts at Week 4

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    End point title
    Percent change from Baseline in inflammatory lesion counts at Week 4
    End point description
    Lesions were counted confined to the face; inflammatory lesions (ILs) (considering nasal lesions) included papules and pustules. A papule is a small, raised, red, dome-shaped palpable lesion while a pustule is a raised, dome-shaped palpable lesion containing yellow fluid (pus). Percent change from Baseline was calculated as the value at Week 4 minus the value at Baseline (Day 1) divided by the Baseline value*100. The Modified Intent-to-Treat (mITT) Analysis Set included all participants in the ITT Analysis Set who had a Baseline measurement of the number of ILs and who had at least one post-Baseline measurement of the number of ILs.
    End point type
    Primary
    End point timeframe
    Baseline and Week 4
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [1]
    108 [2]
    Units: Percent change in lesions
        arithmetic mean (standard deviation)
    -51.9 ( 27.6 )
    -38.1 ( 30.9 )
    Notes
    [1] - mITT Analysis Set
    [2] - mITT Analysis Set
    Statistical analysis title
    Analysis 1
    Comparison groups
    Skinoren v Duac
    Number of subjects included in analysis
    215
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0004 [3]
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval
    Notes
    [3] - Two-sided Mann-Whitney U-test for independent samples - normal approximation

    Secondary: Absolute change from Baseline in ILs, NILs and total lesion count at Weeks 2, 4, 8 and 12

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    End point title
    Absolute change from Baseline in ILs, NILs and total lesion count at Weeks 2, 4, 8 and 12
    End point description
    Lesions were counted confined to the face; ILs (considering nasal lesions) included papules and pustules. NILs included open comedones and closed comedones. An open comedo is an open, widely dilated follicle with black-coloured sebum, due to melanin and oxidation, and keratinous material that forms a plug, thereby obstructing the pilosebaceous duct. A closed comedo is a closed follicle filled with impacted sebum covered by keratin that has a whitish color. A papule is a small, raised, red, dome-shaped palpable lesion while a pustule is a raised, dome-shaped palpable lesion containing yellow fluid (pus). The total lesion (TLs) count was calculated as the sum of ILs and NILs. Change from Baseline was calculated as the values at Weeks 2,4,8 and 12 minus the value at Baseline (Day 1).
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [4]
    108 [5]
    Units: Absolute change in lesions
    arithmetic mean (standard deviation)
        IL, Week 2, n=105,108
    -10.3 ( 8.3 )
    -6.3 ( 7.8 )
        IL, Week 4, n=105,107
    -14.2 ( 9.1 )
    -9.7 ( 8.6 )
        IL, Week 8, n=104,102
    -17.7 ( 9.7 )
    -12.7 ( 8.6 )
        IL, Week 12 or early withdrawal, n=107,104
    -19.6 ( 10.1 )
    -14.2 ( 8.9 )
        NIL, Week 2, n=105,108
    -13.7 ( 19 )
    -8.5 ( 13.3 )
        NIL, Week 4, n=105,107
    -21.2 ( 21.5 )
    -16 ( 19.1 )
        NIL, Week 8, n=104,102
    -26.8 ( 27.1 )
    -20.9 ( 23.6 )
        NIL, Week 12 or early withdrawal, n=107,104
    -32 ( 27.2 )
    -23.3 ( 24.9 )
        TL, Week 2, n=105,108
    -23.9 ( 22.3 )
    -14.8 ( 16.7 )
        TL, Week 4, n=105,107
    -35.4 ( 25 )
    -25.7 ( 22.3 )
        TL, Week 8, n=104,102
    -44.4 ( 31.3 )
    -33.6 ( 27.5 )
        TL, Week 12 or early withdrawal, n=107,104
    -51.6 ( 30.9 )
    -37.5 ( 29 )
    Notes
    [4] - mITT Analysis Set
    [5] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Percent change from Baseline in ILs, NILs and total lesion count at Weeks 2, 4, 8 and 12

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    End point title
    Percent change from Baseline in ILs, NILs and total lesion count at Weeks 2, 4, 8 and 12
    End point description
    Lesions were counted confined to the face; ILs (considering nasal lesions) included papules and pustules. NILs included open comedones and closed comedones. An open comedo is an open, widely dilated follicle with black-coloured sebum, due to melanin and oxidation, and keratinous material that forms a plug, thereby obstructing the pilosebaceous duct. A closed comedo is a closed follicle filled with impacted sebum covered by keratin that has a whitish color. A papule is a small, raised, red, dome-shaped palpable lesion while a pustule is a raised, dome-shaped palpable lesion containing yellow fluid (pus). The total lesion count was calculated as the sum of ILs and NILs. Percent change from Baseline was calculated as the values at Weeks 2,4,8 and 12 minus the value at Baseline (Day 1) divided by Baseline value*100.
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [6]
    108 [7]
    Units: Percent change in lesions
    arithmetic mean (standard deviation)
        IL, Week 2, n=105,108
    -37.3 ( 27.7 )
    -24.2 ( 30.3 )
        IL, Week 8, n=104,102
    -65 ( 26.3 )
    -49.1 ( 30.9 )
        IL, Week 12 or early withdrawal, n=107,104
    -72.3 ( 25 )
    -55 ( 29.8 )
        NIL, Week 2, n=105,108
    -23.5 ( 25.3 )
    -14.9 ( 23.4 )
        NIL, Week 4, n=105,107
    -38.1 ( 27.8 )
    -27 ( 28.2 )
        NIL, Week 8, n=104,102
    -48.5 ( 39.8 )
    -35.5 ( 31.2 )
        NIL, Week 12 or early withdrawal, n=107,104
    -60.6 ( 35.3 )
    -42.1 ( 37.5 )
        TL, Week 2, n=105,108
    -28.7 ( 22.3 )
    -18.4 ( 20.3 )
        TL, Week 4, n=105,107
    -43.8 ( 23.3 )
    -30.8 ( 23 )
        TL, Week 8, n=104,102
    -55.2 ( 30.5 )
    -40.1 ( 27.4 )
        TL, Week 12 or early withdrawal, n=107,104
    -64.6 ( 26.9 )
    -46.1 ( 31.8 )
    Notes
    [6] - mITT Analysis Set
    [7] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Shift change from Baseline in total lesions count by the Investigator’s Static Global Assessment (ISGA) at Weeks 2, 4, 8 and 12

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    End point title
    Shift change from Baseline in total lesions count by the Investigator’s Static Global Assessment (ISGA) at Weeks 2, 4, 8 and 12
    End point description
    Investigator evaluated the acne severity (S) of the participant's face using the ISGA scale, ranging from 0 to 5: 0=clear skin with no ILs or NILs; 1=almost clear: rare NIL with no more than one small ILs; 2=mild S: >G 1, some NILs with no more than a few ILs (papules/ pustules only, no nodular lesions [NLs]); 3=moderate S: >G 2, up to many NILs and may have some ILs, but no more than one small NL; 4=severe: greater than G 3, up to many NILs and ILs, but no more than a few NLs; 5=very severe: many NILs and ILs and more than a few NLs, may have cystic lesions. A shift table was provided to deduce how the number of participants were varying from the Baseline visit to the post-Baseline visits. Week 12 represents Week 12 or early withdrawal.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [8]
    108 [9]
    Units: Participants
        Mild (Baseline) to Almost clear (Week 2)
    4
    1
        Mild (Baseline) to Mild (Week 2)
    27
    28
        Mild (Baseline) to Moderate (Week 2)
    3
    8
        Moderate (Baseline) to Almost Clear (Week 2)
    1
    1
        Moderate (Baseline) to Mild (Week 2)
    26
    14
        Moderate (Baseline) to Moderate (Week 2)
    44
    56
        Moderate (Baseline) to Missing (Week 2)
    2
    0
        Mild (Baseline) to Almost clear (Week 4)
    8
    8
        Mild (Baseline) to Mild (Week 4)
    25
    24
        Mild (Baseline) to Moderate (Week 4)
    1
    4
        Mild (Baseline) to Missing (Week 4)
    0
    1
        Moderate (Baseline) to Almost Clear (Week 4)
    11
    3
        Moderate (Baseline) to Mild (Week 4)
    29
    24
        Moderate (Baseline) to Moderate (Week 4)
    31
    43
        Moderate (Baseline) to Severe (Week 4)
    0
    1
        Moderate (Baseline) to Missing (Week 4)
    2
    1
        Mild (Baseline) to Clear (Week 8)
    2
    0
        Mild (Baseline) to Almost Clear (Week 8)
    10
    10
        Mild (Baseline) to Mild (Week 8)
    19
    15
        Mild (Baseline) to Moderate (Week 8)
    3
    8
        Mild (Baseline) to Missing (Week 8)
    0
    4
        Moderate (Baseline) to Clear (Week 8)
    1
    0
        Moderate (Baseline) to Almost Clear (Week 8)
    15
    5
        Moderate (Baseline) to Mild (Week 8)
    32
    27
        Moderate (Baseline) to Moderate (Week 8)
    22
    37
        Moderate (Baseline) to Missing (Week 8)
    3
    2
        Mild (Baseline) to Clear (Week 12)
    3
    1
        Mild (Baseline) to Almost Clear (Week 12)
    12
    9
        Mild (Baseline) to Mild (Week 12)
    17
    17
        Mild (Baseline) to Moderate (Week 12)
    2
    8
        Mild (Baseline) to Missing (Week 12)
    0
    2
        Moderate (Baseline) to Clear (Week 12)
    2
    0
        Moderate (Baseline) to Almost Clear (Week 12)
    19
    9
        Moderate (Baseline) to Mild (Week 12)
    33
    26
        Moderate (Baseline) to Moderate (Week 12)
    19
    32
        Moderate (Baseline) to Severe (Week 12)
    0
    2
        Moderate (Baseline) to Missing (Week 12)
    0
    2
    Notes
    [8] - mITT Analysis Set
    [9] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Time from Baseline to a 50% reduction in TL count

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    End point title
    Time from Baseline to a 50% reduction in TL count
    End point description
    Time to a 50% reduction in TL count (sum of ILs and NILs) was the time difference between Baseline and the time to a 50% reduction in LC.
    End point type
    Secondary
    End point timeframe
    From Baseline up to Week 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    91 [10]
    60 [11]
    Units: Days
        median (full range (min-max))
    52 (11 to 104)
    55 (12 to 97)
    Notes
    [10] - mITT Analysis Set. Only those participants with a 50% reduction were included in this analysis.
    [11] - mITT Analysis Set. Only those participants with a 50% reduction were included in this analysis.
    No statistical analyses for this end point

    Secondary: Number of participants reported for the indicated Subject’s Global Change Assessment (SGCA) category at Weeks 2, 4, 8 and 12

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    End point title
    Number of participants reported for the indicated Subject’s Global Change Assessment (SGCA) category at Weeks 2, 4, 8 and 12
    End point description
    Participant reported change in the following categories: “very much improved, much improved, minimally improved, no change, minimally worse, much worse and very much worse". Week 12 represents Week 12 or early withdrawal.
    End point type
    Secondary
    End point timeframe
    Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [12]
    108 [13]
    Units: Participants
        Week 2, Very Much Improved
    4
    2
        Week 4, Very Much Improved
    5
    0
        Week 8, Very Much Improved
    9
    1
        Week 12, Very Much Improved
    14
    8
        Week 2, Much Improved
    51
    30
        Week 4, Much Improved
    48
    39
        Week 8, Much Improved
    54
    44
        Week 12, Much Improved
    48
    38
        Week 2, Minimally Improved
    44
    56
        Week 4, Minimally Improved
    44
    49
        Week 8, Minimally Improved
    30
    32
        Week 12, Minimally Improved
    29
    33
        Week 2, No change
    6
    14
        Week 4, No change
    2
    12
        Week 8, No change
    7
    15
        Week 12, No change
    10
    17
        Week 2, Minimally Worse
    0
    6
        Week 4, Minimally Worse
    6
    7
        Week 8, Minimally Worse
    3
    8
        Week 12, Minimally Worse
    4
    5
        Week 2, Much Worse
    0
    0
        Week 4, Much Worse
    0
    0
        Week 8, Much Worse
    1
    1
        Week 12, Much Worse
    0
    2
        Week 2, Very Much Worse
    0
    0
        Week 4, Very Much Worse
    0
    0
        Week 8, Very Much Worse
    0
    1
        Week 12, Very Much Worse
    2
    1
        Week 2, Missing
    2
    0
        Week 4, Missing
    2
    1
        Week 8, Missing
    3
    6
        Week 12, Missing
    0
    4
    Notes
    [12] - mITT Analysis Set
    [13] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Number of participants with a shift change from Baseline for erythema, peeling and dryness at Weeks 2, 4, 8 and 12, as assessed by the Investigator

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    End point title
    Number of participants with a shift change from Baseline for erythema, peeling and dryness at Weeks 2, 4, 8 and 12, as assessed by the Investigator
    End point description
    Erythema (Er) is a skin condition characterized by redness or rash; peeling (Pl) skin is damage to and loss of the upper layer of skin; and dry skin (dry) is an uncomfortable condition marked by scaling, itching, and cracking. Local tolerability assessments were performed by the Investigator at each study visit and were graded based on severity as 0 to 3: 0=none; 1=slight; 2=some (erythema and dry skin)/moderate(peeling); 3=very red (erythema)/very dry (dry skin)/strong (peeling). Week 12 represents Week 12 or early withdrawal.
    End point type
    Secondary
    End point timeframe
    Weeks 2, 4 ,8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [14]
    108 [15]
    Units: Participants
        Er, None (Baseline) to None (Week 2)
    39
    33
        Er, None (Baseline) to Slight (Week 2)
    11
    18
        Er, None (Baseline) to Some (Week 2)
    0
    1
        Er, None (Baseline) to Missing (Week 2)
    1
    0
        Er, None (Baseline) to None (Week 4)
    40
    36
        Er, None (Baseline) to Slight (Week 4)
    9
    13
        Er, None (Baseline) to Some (Week 4)
    1
    3
        Er, None (Baseline) to Missing (Week 4)
    1
    0
        Er, None (Baseline) to None (Week 8)
    40
    29
        Er, None (Baseline) to Slight (Week 8)
    10
    19
        Er, None (Baseline) to Some (Week 8)
    0
    2
        Er, None (Baseline) to Missing (Week 8)
    1
    2
        Er, None (Baseline) to None (Week 12)
    45
    32
        Er, None (Baseline) to Slight (Week 12)
    6
    18
        Er, None (Baseline) to Missing (Week 12)
    0
    2
        Er, Slight (Baseline) to None (Week 2)
    12
    12
        Er, Slight (Baseline) to Slight (Week 2)
    19
    18
        Er, Slight (Baseline) to Some (Week 2)
    1
    8
        Er, Slight (Baseline) to Missing (Week 2)
    1
    0
        Er, Slight (Baseline)to None (Week 4)
    18
    19
        Er, Slight (Baseline) to Slight (Week 4)
    11
    17
        Er, Slight (Baseline) to Some (Week 4)
    3
    1
        Er, Slight (Baseline) to Missing (Week 4)
    1
    1
        Er, Slight (Baseline) to None (Week 8)
    15
    17
        Er, Slight (Baseline) to Slight (Week 8)
    11
    17
        Er, Slight (Baseline) to Some (Week 8)
    5
    1
        Er, Slight (Baseline) to Missing (Week 8)
    2
    3
        Er, Slight (Baseline) to None (Week 12)
    21
    22
        Er, Slight (Baseline) to Slight (Week 12)
    11
    13
        Er, Slight (Baseline) to Some (Week 12)
    0
    2
        Er, Slight (Baseline) to Very red (Week 12)
    1
    0
        Er, Slight (Baseline) to Missing (Week 12)
    0
    1
        Er, Some (Baseline) to None (Week 2)
    3
    1
        Er, Some (Baseline) to Slight (Week 2)
    10
    11
        Er, Some (Baseline) to Some (Week 2)
    6
    3
        Er, Some (Baseline)to None (Week 4)
    5
    3
        Er, Some (Baseline) to Slight (Week 4)
    11
    9
        Er, Some (Baseline) to Some (Week 4)
    3
    2
        Er, Some (Baseline) to Missing (Week 4)
    0
    1
        Er, Some (Baseline) to None (Week 8)
    8
    1
        Er, Some (Baseline) to Slight (Week 8)
    9
    12
        Er, Some (Baseline) to Some (Week 8)
    1
    1
        Er, Some (Baseline) to Very red (Week 8)
    1
    0
        Er, Some (Baseline) to Missing (Week 8)
    0
    1
        Er, Some (Baseline) to None (Week 12)
    9
    4
        Er, Some (Baseline) to Slight (Week 12)
    8
    9
        Er, Some (Baseline) to Some (Week 12)
    2
    1
        Er, Some (Baseline) to Missing (Week 12)
    0
    1
        Er, Very red (Baseline) to Slight (Week 2)
    1
    1
        Er, Very red (Baseline) to Some (Week 2)
    2
    2
        Er, Very red (Baseline) to Slight (Week 4)
    2
    2
        Er, Very red (Baseline) to Some (Week 4)
    1
    1
        Er, Very red (Baseline) to None (Week 8)
    2
    0
        Er, Very red (Baseline) to Slight (Week 8)
    1
    3
        Er, Very red (Baseline) to None (Week 12)
    0
    2
        Er, Very red (Baseline) to Slight (Week 12)
    1
    1
        Er, Very red (Baseline) to Some (Week 12)
    2
    0
        Pl, None (Baseline) to None (Week 2)
    65
    73
        Pl, None (Baseline) to Slight (Week 2)
    13
    11
        Pl, None (Baseline) to Moderate (Week 2)
    1
    0
        Pl, None (Baseline) to Missing (Week 2)
    2
    0
        Pl, None (Baseline) to None (Week 4)
    70
    72
        Pl, None (Baseline) to Slight (Week 4)
    9
    11
        Pl, None (Baseline) to Missing (Week 4)
    2
    1
        Pl, None (Baseline) to None (Week 8)
    69
    69
        Pl, None (Baseline) to Slight (Week 8)
    9
    10
        Pl, None (Baseline) to Missing (Week 8)
    3
    5
        Pl, None (Baseline) to None (Week 12)
    74
    70
        Pl, None (Baseline) to Slight (Week 12)
    7
    11
        Pl, None (Baseline) to Missing (Week 12)
    0
    3
        Pl, Slight (Baseline) to None (Week 2)
    8
    8
        Pl, Slight (Baseline) to Slight (Week 2)
    10
    13
        Pl, Slight (Baseline) to Moderate (Week 2)
    3
    2
        Pl, Slight (Baseline)to None (Week 4)
    15
    13
        Pl, Slight (Baseline) to Slight (Week 4)
    5
    9
        Pl, Slight (Baseline) to Moderate (Week 4)
    1
    1
        Pl, Slight (Baseline) to None (Week 8)
    18
    12
        Pl, Slight (Baseline) to Slight (Week 8)
    3
    10
        Pl, Slight (Baseline) to Missing (Week 8)
    0
    1
        Pl, Slight (Baseline) to None (Week 12)
    14
    15
        Pl, Slight (Baseline) to Slight (Week 12)
    7
    7
        Pl, Slight (Baseline) to Missing (Week 12)
    0
    1
        Pl, Moderate (Baseline) to None (Week 2)
    2
    0
        Pl, Moderate (Baseline) to Slight (Week 2)
    2
    1
        Pl, Moderate (Baseline)to None (Week 4)
    2
    1
        Pl, Moderate (Baseline) to Slight (Week 4)
    1
    0
        Pl, Moderate (Baseline) to Moderate (Week 4)
    1
    0
        Pl, Moderate (Baseline) to None (Week 8)
    3
    1
        Pl, Moderate (Baseline) to Slight (Week 8)
    1
    0
        Pl, Moderate (Baseline) to None (Week 12)
    2
    0
        Pl, Moderate (Baseline) to Slight (Week 12)
    2
    1
        Dry, None (Baseline) to None (Week 2)
    55
    65
        Dry, None (Baseline) to Slight (Week 2)
    14
    9
        Dry, None (Baseline) to Some (Week 2)
    1
    3
        Dry, None (Baseline) to Missing (Week 2)
    2
    0
        Dry, None (Baseline)to None (Week 4)
    61
    64
        Dry, None (Baseline) to Slight (Week 4)
    9
    12
        Dry, None (Baseline) to Missing (Week 4)
    2
    1
        Dry, None (Baseline) to None (Week 8)
    61
    61
        Dry, None (Baseline) to Slight (Week 8)
    8
    11
        Dry, None (Baseline) to Missing (Week 8)
    3
    5
        Dry, None (Baseline) to None (Week 12)
    69
    66
        Dry, None (Baseline) to Slight (Week 12)
    2
    8
        Dry, None (Baseline) to Some (Week 12)
    1
    0
        Dry, None (Baseline) to Missing (Week 12)
    0
    3
        Dry, Slight (Baseline) to None (Week 2)
    11
    7
        Dry, Slight (Baseline) to Slight (Week 2)
    11
    12
        Dry, Slight (Baseline) to Some (Week 2)
    3
    6
        Dry, Slight (Baseline)to None (Week 4)
    14
    10
        Dry, Slight (Baseline) to Slight (Week 4)
    9
    12
        Dry, Slight (Baseline) to Some (Week 4)
    2
    3
        Dry, Slight (Baseline) to None (Week 8)
    19
    12
        Dry, Slight (Baseline) to Slight (Week 8)
    6
    11
        Dry, Slight (Baseline) to Some (Week 8)
    0
    1
        Dry, Slight (Baseline) to Missing (Week 8)
    0
    1
        Dry, Slight (Baseline) to None (Week 12)
    14
    15
        Dry, Slight (Baseline) to Slight (Week 12)
    11
    8
        Dry, Slight (Baseline) to Some (Week 12)
    0
    1
        Dry, Slight (Baseline) to Missing (Week 12)
    0
    1
        Dry, Some (Baseline) to None (Week 2)
    4
    2
        Dry, Some (Baseline) to Slight (Week 2)
    1
    2
        Dry, Some (Baseline) to Some (Week 2)
    4
    2
        Dry, Some (Baseline)to None (Week 4)
    4
    1
        Dry, Some (Baseline) to Slight (Week 4)
    3
    5
        Dry, Some (Baseline) to Some (Week 4)
    2
    0
        Dry, Some (Baseline) to None (Week 8)
    5
    1
        Dry, Some (Baseline) to Slight (Week 8)
    4
    5
        Dry, Some (Baseline) to None (Week 12)
    6
    3
        Dry, Some (Baseline) to Slight (Week 12)
    3
    3
    Notes
    [14] - mITT Analysis Set
    [15] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Number of participants with a shift change from Baseline for pruritis and burning/stinging at Weeks 2, 4, 8 and 12

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    End point title
    Number of participants with a shift change from Baseline for pruritis and burning/stinging at Weeks 2, 4, 8 and 12
    End point description
    Itching or pruritis (Pr) is a sensation that causes the desire or reflex to scratch; burning/stinging (St/Bn) is a pain and burning sensation. Local tolerability assessments for burning/stinging and itching were performed by the participant and were graded based on severity as 0 to 3. 0=none; 1=slight; 2=moderate; 3=strong. Week 12 represents Week 12 or early withdrawal.
    End point type
    Secondary
    End point timeframe
    Weeks 2, 4 ,8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [16]
    108 [17]
    Units: Participants
        St/Bn, None (Baseline) to None (Week 2)
    63
    42
        St/Bn, None (Baseline) to Slight (Week 2)
    14
    23
        St/Bn, None (Baseline) to Moderate (Week 2)
    4
    8
        St/Bn, None (Baseline) to Strong (Week 2)
    1
    4
        St/Bn, None (Baseline) to Missing (Week 2)
    2
    0
        St/Bn, None (Baseline) to None (Week 4)
    70
    41
        St/Bn, None (Baseline) to Slight (Week 4)
    11
    29
        St/Bn, None (Baseline) to Moderate (Week 4)
    1
    6
        St/Bn, None (Baseline) to Missing (Week 4)
    2
    1
        St/Bn, None (Baseline) to None (Week 8)
    75
    46
        St/Bn, None (Baseline) to Slight (Week 8)
    5
    21
        St/Bn, None (Baseline) to Moderate (Week 8)
    1
    4
        St/Bn, None (Baseline) to Strong (Week 8)
    0
    1
        St/Bn, None (Baseline) to Missing (Week 8)
    3
    5
        St/Bn, None (Baseline) to None (Week 12)
    75
    47
        St/Bn, None (Baseline) to Slight (Week 12)
    6
    19
        St/Bn, None (Baseline) to Moderate (Week 12)
    1
    5
        St/Bn, None (Baseline) to Strong (Week 12)
    1
    2
        St/Bn, None (Baseline) to Missing (Week 12)
    1
    4
        St/Bn, Slight (Baseline) to None (Week 2)
    14
    10
        St/Bn, Slight (Baseline) to Slight (Week 2)
    4
    10
        St/Bn, Slight (Baseline) to Moderate (Week 2)
    3
    2
        St/Bn, Slight (Baseline) to Strong (Week 2)
    0
    2
        St/Bn, Slight (Baseline)to None (Week 4)
    12
    9
        St/Bn, Slight (Baseline) to Slight (Week 4)
    8
    13
        St/Bn, Slight (Baseline) to Moderate (Week 4)
    1
    1
        St/Bn, Slight (Baseline) to Strong (Week 4)
    0
    1
        St/Bn, Slight (Baseline) to None (Week 8)
    18
    10
        St/Bn, Slight (Baseline) to Slight (Week 8)
    2
    12
        St/Bn, Slight (Baseline) to Moderate (Week 8)
    1
    1
        St/Bn, Slight (Baseline) to Strong (Week 8)
    0
    1
        St/Bn, Slight (Baseline) to None (Week 12)
    18
    9
        St/Bn, Slight (Baseline) to Slight (Week 12)
    3
    11
        St/Bn, Slight (Baseline) to Moderate (Week 12)
    0
    3
        St/Bn, Slight (Baseline) to Strong (Week 12)
    0
    1
        St/Bn, Moderate (Baseline) to None (Week 2)
    0
    1
        St/Bn, Moderate (Baseline) to Slight (Week 2)
    1
    3
        St/Bn, Moderate (Baseline)to Moderate (Week 2)
    0
    2
        St/Bn, Moderate (Baseline) to None (Week 4)
    0
    2
        St/Bn, Moderate (Baseline) to Slight (Week 4)
    1
    3
        St/Bn, Moderate (Baseline) to Strong (Week 4)
    0
    1
        St/Bn, Moderate (Baseline) to None (Week 8)
    0
    1
        St/Bn, Moderate (Baseline) to Slight (Week 8)
    1
    2
        St/Bn, Moderate (Baseline) to Moderate (Week 8)
    0
    2
        St/Bn, Moderate (Baseline) to Missing (Week 8)
    0
    1
        St/Bn, Moderate (Baseline) to None (Week 12)
    1
    2
        St/Bn, Moderate (Baseline) to Slight (Week 12)
    0
    3
        St/Bn, Moderate (Baseline) to Moderate (Week 12)
    0
    1
        St/Bn, Strong (Baseline) to None (Week 2)
    0
    1
        St/Bn, Strong (Baseline) to None (Week 4)
    0
    1
        St/Bn, Strong (Baseline) to None (Week 8)
    0
    1
        St/Bn, Strong (Baseline) to Slight (Week 12)
    0
    1
        Pr, None (Baseline) to None (Week 2)
    43
    28
        Pr, None (Baseline) to Slight (Week 2)
    14
    27
        Pr, None (Baseline) to Moderate (Week 2)
    4
    7
        Pr, None (Baseline) to Strong (Week 2)
    0
    1
        Pr, None (Baseline) to Missing (Week 2)
    2
    0
        Pr, None (Baseline) to None (Week 4)
    45
    27
        Pr, None (Baseline) to Slight (Week 4)
    14
    30
        Pr, None (Baseline) to Moderate (Week 4)
    2
    5
        Pr, None (Baseline) to Missing (Week 4)
    2
    1
        Pr, None (Baseline) to None (Week 8)
    47
    33
        Pr, None (Baseline) to Slight (Week 8)
    13
    26
        Pr, None (Baseline) to Strong (Week 8)
    0
    1
        Pr, None (Baseline) to Missing (Week 8)
    3
    3
        Pr, None (Baseline) to None (Week 12)
    51
    33
        Pr, None (Baseline) to Slight (Week 12)
    11
    22
        Pr, None (Baseline) to Moderate (Week 12)
    1
    3
        Pr, None (Baseline) to Strong (Week 12)
    0
    1
        Pr, None (Baseline) to Missing (Week 12)
    0
    4
        Pr, Slight (Baseline) to None (Week 2)
    13
    10
        Pr, Slight (Baseline) to Slight (Week 2)
    20
    15
        Pr, Slight (Baseline) to Moderate (Week 2)
    5
    9
        Pr, Slight (Baseline) to Strong (Week 2)
    1
    4
        Pr, Slight (Baseline)to None (Week 4)
    17
    12
        Pr, Slight (Baseline) to Slight (Week 4)
    20
    19
        Pr, Slight (Baseline) to Moderate (Week 4)
    2
    6
        Pr, Slight (Baseline) to Strong (Week 4)
    0
    1
        Pr, Slight (Baseline) to None (Week 8)
    21
    11
        Pr, Slight (Baseline) to Slight (Week 8)
    14
    18
        Pr, Slight (Baseline) to Moderate (Week 8)
    4
    4
        Pr, Slight (Baseline) to Strong (Week 8)
    0
    2
        Pr, Slight (Baseline) to Missing (Week 8)
    0
    3
        Pr, Slight (Baseline) to None (Week 12)
    22
    11
        Pr, Slight (Baseline) to Slight (Week 12)
    15
    19
        Pr, Slight (Baseline) to Moderate (Week 12)
    2
    6
        Slight (Baseline) to Strong (Week 12)
    0
    2
        Pr, Moderate (Baseline) to None (Week 2)
    2
    4
        Pr, Moderate (Baseline) to Slight (Week 2)
    1
    1
        Pr, Moderate (Baseline)to Moderate (Week 2)
    1
    0
        Pr, Moderate (Baseline) to None (Week 4)
    2
    2
        Pr, Moderate (Baseline) to Slight (Week 4)
    2
    2
        Pr, Moderate (Baseline) to Moderate (Week 4)
    0
    1
        Pr, Moderate (Baseline) to None (Week 8)
    3
    2
        Pr, Moderate (Baseline) to Slight (Week 8)
    1
    3
        Pr, Moderate (Baseline) to None (Week 12)
    3
    1
        Pr, Moderate (Baseline) to Slight (Week 12)
    1
    4
        Pr, Strong (Baseline) to Strong (Week 2)
    0
    2
        Pr, Strong (Baseline) to Strong (Week 4)
    0
    2
        Pr, Strong (Baseline) to Moderate (Week 8)
    0
    1
        Pr, Strong (Baseline) to Strong (Week 8)
    0
    1
        Pr, Strong (Baseline) to Slight (Week 12)
    0
    1
        Pr, Strong (Baseline) to Strong (Week 12)
    0
    1
    Notes
    [16] - mITT Analysis Set
    [17] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Absolute change in the Children’s Dermatology Life Quality Index (CDLQI) score from Baseline at Weeks 2, 4, 8 and 12 in participants 12 to 16 years of age

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    End point title
    Absolute change in the Children’s Dermatology Life Quality Index (CDLQI) score from Baseline at Weeks 2, 4, 8 and 12 in participants 12 to 16 years of age
    End point description
    The CDLQI was used in children 12 to 16 years of age. The CDLQI was used to measure how much the participant's skin problem had affected their life over the last week. The CDLQI total score ranges from 0 to 30 where 0-1=no effect at all on the participant’s life; 2-6=small effect on the participant’s life; 7-12=moderate effect on the participant’s life; 13-18=very large effect on the participant’s life; 19-30=extremely large effect on the participant’s life. The higher the score, the more quality of life was impaired. Absolute change from Baseline was calculated as the values at Weeks 2, 4, 8 and 12 minus the value at Baseline (Day 1).
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    45 [18]
    47 [19]
    Units: Absolute change of total score
    arithmetic mean (standard deviation)
        Week 2, n=38,42
    -2.61 ( 2.89 )
    -1.31 ( 2.29 )
        Week 4; n=38,42
    -2.55 ( 2.41 )
    -1.55 ( 2.01 )
        Week 8, n=38,42
    -2.68 ( 2.76 )
    -1.67 ( 2.34 )
        Week 12 or early withdrawal, n=38,42
    -2.87 ( 2.75 )
    -1.55 ( 2.56 )
    Notes
    [18] - mITT Analysis Set. Only those participants 12 to 16 years of age were included in the analysis.
    [19] - mITT Analysis Set. Only those participants 12 to 16 years of age were included in the analysis.
    No statistical analyses for this end point

    Secondary: Absolute change in the Dermatology Life Quality Index (DLQI) score from Baseline at Weeks 2, 4, 8 and 12 in participants 17 years of age or older

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    End point title
    Absolute change in the Dermatology Life Quality Index (DLQI) score from Baseline at Weeks 2, 4, 8 and 12 in participants 17 years of age or older
    End point description
    The DLQI was used in participants 17 years of age or older. The DLQI was used to measure how much the participant's skin problem had affected their life over the last week. The DLQI total score ranges from 0 to 30 where 0-1=no effect at all on the participant’s life; 2-5=small effect on the participant’s life; 6-10=moderate effect on the participant’s life; 11-20=very large effect on the participant’s life; 21-30=extremely large effect on the participant’s life. The higher the score, the more quality of life was impaired. Absolute change from Baseline was calculated as the values at Weeks 2, 4, 8 and 12 minus the value at Baseline (Day 1).
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 2, 4, 8 and 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    62 [20]
    61 [21]
    Units: Absolute change of total score
    arithmetic mean (standard deviation)
        Week 2, n=54,53
    -2.28 ( 2.81 )
    -2.17 ( 3.72 )
        Week 4, n=56,52
    -3.39 ( 3.33 )
    -3.15 ( 3.52 )
        Week 8, n=55,50
    -4.04 ( 3.7 )
    -3.38 ( 4.6 )
        Week 12 or early withdrawal, n=57,51
    -4.46 ( 3.8 )
    -3.12 ( 4.94 )
    Notes
    [20] - mITT Analysis Set. Only those participants 17 years or older were included in the analysis.
    [21] - mITT Analysis Set. Only those participants 17 years or older were included in the analysis.
    No statistical analyses for this end point

    Secondary: Number of participants with the overall satisfaction score at Week 12, rated using the Product Acceptability and Preference Questionnaire

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    End point title
    Number of participants with the overall satisfaction score at Week 12, rated using the Product Acceptability and Preference Questionnaire
    End point description
    The Product Acceptability and Preference Questionnaire was completed by the participant at Week 12. The participant rated their overall satisfaction using the following scale: 1-very satisfied; 2- satisfied; 3-neutral; 4-unsatisfied; 5-very unsatisfied.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [22]
    108 [23]
    Units: Participants
        Very satisfied
    41
    26
        Satisfied
    61
    43
        Neutral
    4
    21
        Unsatisfied
    1
    11
        Very unsatisfied
    0
    3
    Notes
    [22] - mITT Analysis Set
    [23] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Number of participants with the number of missed applications of treatment medication from Baseline to Week 12

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    End point title
    Number of participants with the number of missed applications of treatment medication from Baseline to Week 12
    End point description
    Number of participants with the number of missed applications of treatment medication from Baseline to Week 12 was analyzed.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    107 [24]
    108 [25]
    Units: Participants
        0 missed application
    51
    38
        1 missed application
    21
    8
        2 missed application
    12
    4
        3 missed application
    4
    4
        4 missed application
    4
    5
        5 missed application
    1
    5
        6 missed application
    3
    7
        7 missed application
    2
    6
        8 missed application
    1
    3
        9 missed application
    1
    5
        10 missed application
    1
    2
        11 missed application
    1
    3
        12 missed application
    0
    1
        13 missed application
    1
    2
        14 missed application
    1
    5
        16 missed application
    1
    0
        17 missed application
    1
    1
        18 missed application
    1
    1
        19 missed application
    0
    1
        21 missed application
    0
    2
        22 missed application
    0
    1
        23 missed application
    0
    1
        31 missed application
    0
    1
        39 missed application
    0
    1
        Missing
    0
    1
    Notes
    [24] - mITT Analysis Set
    [25] - mITT Analysis Set
    No statistical analyses for this end point

    Secondary: Number of participants with any adverse event (AE) or serious adverse event (SAE)

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    End point title
    Number of participants with any adverse event (AE) or serious adverse event (SAE)
    End point description
    AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A SAE is defined as any untoward medical occurrence that, at any dose: results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability or incapacity, or is a congenital anomaly or birth defect. Medical or scientific judgment should be exercised in other situations. Refer to the general Adverse AE/SAE module for a complete list of AEs and SAEs.
    End point type
    Secondary
    End point timeframe
    From Treatment Day1 until Week 12
    End point values
    Duac Skinoren
    Number of subjects analysed
    108 [26]
    109 [27]
    Units: Participants
        Any AE
    62
    76
        Any SAE
    2
    3
    Notes
    [26] - ITT Analysis Set
    [27] - ITT Analysis Set
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    On-treatment SAEs and non-serious AEs were collected from the start of study medication until the follow-up visit (up to 12 weeks).
    Adverse event reporting additional description
    On-treatment SAEs and non-serious AEs are reported for members of the ITT Population, comprised of all participants who were randomized to treatment and received at least one dose of study medication.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Duac
    Reporting group description
    Participants topically applied a thin film of Duac gel once daily in the evening for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Reporting group title
    Skinoren
    Reporting group description
    Participants topically applied a thin film of Skinoren cream twice daily (once in the morning and once in the evening) for 12 weeks, over the entire face, avoiding the mouth and eyes. Prior to the application, participants were advised to wash their face with the soap free cleanser, rinse thoroughly with warm water, and pat the skin thoroughly dry with a soft towel. After application, the participants had to avoid washing face for 4 hours (preferably 8 hours). Oil free facial moisturizer was used, if required.

    Serious adverse events
    Duac Skinoren
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 108 (1.85%)
    3 / 109 (2.75%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Reproductive system and breast disorders
    Vulval haematoma
         subjects affected / exposed
    1 / 108 (0.93%)
    0 / 109 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Stress
         subjects affected / exposed
    1 / 108 (0.93%)
    0 / 109 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    0 / 108 (0.00%)
    1 / 109 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Brucellosis
         subjects affected / exposed
    1 / 108 (0.93%)
    0 / 109 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    0 / 108 (0.00%)
    1 / 109 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Type 1 diabetes mellitus
         subjects affected / exposed
    0 / 108 (0.00%)
    1 / 109 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Duac Skinoren
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    32 / 108 (29.63%)
    55 / 109 (50.46%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    16 / 108 (14.81%)
    18 / 109 (16.51%)
         occurrences all number
    26
    26
    General disorders and administration site conditions
    Application site pain
         subjects affected / exposed
    7 / 108 (6.48%)
    22 / 109 (20.18%)
         occurrences all number
    7
    24
    Application site pruritus
         subjects affected / exposed
    8 / 108 (7.41%)
    25 / 109 (22.94%)
         occurrences all number
    8
    27
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    10 / 108 (9.26%)
    20 / 109 (18.35%)
         occurrences all number
    12
    21

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Jan 2014
    4.3: Exclusion criteria 6, deletion of contraceptives; addition of exclusion criteria 9 -> to ensure consistency between exclusion criteria and section 5.7.1 permitted medications and non-drug therapies. 6.2.1.3, 6.2.2.2: Add assessment at week 0 -> to ensure consistency between time and events table and section 6.2.1.3, 6.2.2.2 6.3.8.2: Add respiratory rate -> to ensure consistency between time and events table and section 6.3.8.2

    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
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