Clinical Trial Results:
An International, Multicenter, Randomized, Double-Blind, Parallel-Group Phase 2 Study Evaluating the Safety and Efficacy of Diacerein 1% Ointment Topical Formulation in Subjects with Epidermolysis Bullosa Simplex (EBS) [DELIVERS Study]
Summary
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EudraCT number |
2016-004427-24 |
Trial protocol |
DE AT NL GB FR |
Global end of trial date |
31 Oct 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
30 Oct 2019
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First version publication date |
30 Oct 2019
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
CCP-020-301
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Additional study identifiers
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ISRCTN number |
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US NCT number |
NCT03154333 | ||
WHO universal trial number (UTN) |
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Other trial identifiers |
IND: 131 384 | ||
Sponsors
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Sponsor organisation name |
Castle Creek Pharmaceuticals, LLC
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Sponsor organisation address |
6 Century Drive , Parsippany, NJ , United States, NJ 07054
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Public contact |
Dr. Mary Spellman, Castle Creek Pharmaceuticals, LLC , 001 8622860400, mspellman@castlecreekpharma.com
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Scientific contact |
Dr. Mary Spellman, Castle Creek Pharmaceuticals, LLC , 001 8622860400, mspellman@castlecreekpharma.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
17 Jan 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
15 Oct 2018
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Global end of trial reached? |
Yes
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Global end of trial date |
31 Oct 2018
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
The main objective of this study was to compare the efficacy of diacerein 1% ointment to control ointment when applied once daily for 8 weeks in subjects with epidermolysis bullosa simplex (EBS).
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Protection of trial subjects |
The study was performed in accordance with ethical principles that have their origin in the Declaration of Helsinki and are consistent with International Council for Harmonization (ICH)/Good Clinical Practice (GCP), applicable regulatory requirements.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
01 Jun 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Netherlands: 4
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Country: Number of subjects enrolled |
United Kingdom: 7
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Country: Number of subjects enrolled |
Austria: 2
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Country: Number of subjects enrolled |
France: 9
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Country: Number of subjects enrolled |
Germany: 2
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Country: Number of subjects enrolled |
Australia: 2
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Country: Number of subjects enrolled |
Israel: 5
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Country: Number of subjects enrolled |
United States: 23
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Worldwide total number of subjects |
54
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EEA total number of subjects |
24
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
37
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Adolescents (12-17 years) |
5
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Adults (18-64 years) |
12
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
- | ||||||||||||||||||
Pre-assignment
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Screening details |
Subjects were screened for inclusion and exclusion criteria at Visit 1 (Week -6). Subjects must have had a genotypic confirmation of an EBS protocol-defined mutation through prior genetic testing or via a blood or saliva genetic assessment as part of the study. | ||||||||||||||||||
Period 1
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Period 1 title |
Overall Trial (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||
Roles blinded |
Subject, Investigator, Monitor | ||||||||||||||||||
Blinding implementation details |
This study used a double-blind design. The study drugs were indistinguishable in appearance, packaging, and labeling.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Diacerein 1% | ||||||||||||||||||
Arm description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive diacerein 1% ointment to all EBS lesions in the Assessment Area. | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
Diacerein
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Investigational medicinal product code |
CCP-020
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Other name |
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Pharmaceutical forms |
Ointment
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Routes of administration |
Topical use
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Dosage and administration details |
During the 8-week Treatment Period, Diacerein was administered from Visit 2 (Week 0) to Visit 6 (Week 8) once daily in the evening to EBS lesions in the Assessment Area (regardless of lesion resolution) and Treatment Area (until lesion(s) resolution). The subject/caregiver applied sufficient quantity of Diacerein to cover all EBS lesions and to approximately ¾ inch (2 cm) of uninvolved skin surrounding each lesion with a thin layer and gently rubbed it in.
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Arm title
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Control | ||||||||||||||||||
Arm description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive control ointment to all EBS lesions in the Assessment Area. | ||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||
Investigational medicinal product name |
Control
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Investigational medicinal product code |
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Other name |
Vehicle
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Pharmaceutical forms |
Ointment
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Routes of administration |
Topical use
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Dosage and administration details |
During the 8-week Treatment Period, the control ointment was administered from Visit 2 (Week 0) to Visit 6 (Week 8) once daily in the evening to EBS lesions in the Assessment Area (regardless of lesion resolution) and Treatment Area (until lesion(s) resolution). The subject/caregiver applied sufficient quantity of the control ointment to cover all EBS lesions and to approximately ¾ inch (2 cm) of uninvolved skin surrounding each lesion with a thin layer and gently rubbed it in.
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Baseline characteristics reporting groups
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Reporting group title |
Diacerein 1%
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Reporting group description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive diacerein 1% ointment to all EBS lesions in the Assessment Area. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Control
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Reporting group description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive control ointment to all EBS lesions in the Assessment Area. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Diacerein 1%
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Reporting group description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive diacerein 1% ointment to all EBS lesions in the Assessment Area. | ||
Reporting group title |
Control
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Reporting group description |
At Visit 2 (Week 0), eligible subjects randomized in a 1:1 ratio to receive control ointment to all EBS lesions in the Assessment Area. |
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End point title |
Achievement ≥60% reduction in BSA of EBS in the assessment area | |||||||||
End point description |
The primary efficacy endpoint of this study was the proportion of subjects who achieved ≥60% reduction in body surface area (BSA) of Epidermolysis Bullosa Simplex (EBS) lesions within the Assessment Area from Baseline to Week 8.
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End point type |
Primary
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End point timeframe |
The primary efficacy endpoint was examined from Baseline/Visit 2 (Week 0) to Visit 6 (Week 8).
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Statistical analysis title |
Comparison in ≥60% reduction in BSA of EBS | |||||||||
Comparison groups |
Diacerein 1% v Control
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Number of subjects included in analysis |
54
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Analysis specification |
Pre-specified
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Analysis type |
superiority [1] | |||||||||
P-value |
= 0.9666 | |||||||||
Method |
Cochran-Mantel-Haenszel | |||||||||
Confidence interval |
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95% | |||||||||
sides |
2-sided
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lower limit |
0.63 | |||||||||
upper limit |
1.62 | |||||||||
Notes [1] - Subjects who achieved ≥60% reduction in BSA of EBS lesions within the Assessment Area from Baseline to Week 8 for the diacerein 1% group compared to the control group for the ITT Population. |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events were collected from Week 0 Day 1 through the study until the end.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
Diacerein 1%
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Reporting group description |
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Reporting group title |
Control
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Reporting group description |
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||||||
Date |
Amendment |
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17 Mar 2017 |
Global Protocol Amendment 1, dated 17 March 2017. The key changes to the primary endpoint were as follows:
- Removal of the LSA and addition of the IGA at Visit 8 (Week 16).
- Inclusion Criterion 1 was updated to reflect an increase in the subject’s minimum age from 6 months to 4 years.
- Inclusion Criterion 5 was revised to the minimum IGA score of 3.
- PK sampling was removed from the protocol.
- Genotyping criteria were expanded.
- Sample size was recalculated. |
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08 Jun 2017 |
Global Protocol Amendment 2. The key changes were as follows:
- Clarification of BSA of an EBS lesion and LSA Area.
- Inclusion Criterion 2, clarification of eligibility criteria.
- Inclusion Criterion 3, clarification of eligibility criteria.
- Treatment Area clarified (not to exceed 30% BSA).
- Inclusion Criterion 5 and 6,clarification of eligibility criteria.
- An IDMC added to conduct interim analysis.
- Exclusion Criterion 11 clarification of eligibility criteria.
- Exclusion Criterion 12 clarification of eligibility criteria.
- PK was added to protocol .
- Subject withdrawals clarified.
- Clarified study procedures and safety reporting, where necessary. |
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02 Jan 2018 |
Global Protocol Amendment 3a.
- Clarification dose and treatment rationale.
- Clarification risk and/or benefits to subjects.
- Primary objective updated to include reduction in BSA of EBS lesions.
- Secondary objective updated to include changes in IGA scores.
- Primary endpoint updated.
- Key secondary endpoint was added and other secondary endpoints were updated.
- PK endpoints clarified.
- eDiary instructions clarified and updated.
- Number of sites were updated.
- The list of permitted topical products and therapies was further updated.
- Siblings of those enrolled were not allowed in the study, was removed.
- Clarification on exclusion of subjects with controlled diabetes and HbA1c<6.5% .
- Describing prohibited therapies was removed.
- Instructions for treatment of EBS were clarified.
- Laboratory tests updated.
- Use of body charts to record the location of EBS lesion revised.
- Definitions of occluded lesions clarified.
- Pruritus and pain scales updated.
- SAEs and AESI clarified.
- Contraception methods clarified.
- Safety methods updated to include ECG. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? Yes | |||||||
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Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||||||
None reported |