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    Clinical Trial Results:
    A Randomised, Multicentre, Investigator-Blind, Parallel-Group Trial to Evaluate the Efficacy and Safety of MC2-01 Cream Compared to Vehicle and Active Comparator in Subjects with Mild-to-Moderate Psoriasis Vulgaris

    Summary
    EudraCT number
    2018-001970-66
    Trial protocol
    CZ  
    Global end of trial date
    02 Oct 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Nov 2020
    First version publication date
    30 Nov 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MC2-01-C7
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03802344
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    IND number: 127152
    Sponsors
    Sponsor organisation name
    MC2 Therapeutics Ltd
    Sponsor organisation address
    C/O Agern Allé 24-26, Hørsholm, Denmark, 2970
    Public contact
    Senior Project Manager, Clinical Operations, MC2 Therapeutics Ltd, +45 20157033, isa@mc2Therapeutics.com
    Scientific contact
    Senior Project Manager, Clinical Operations, MC2 Therapeutics Ltd, +45 20157033, isa@mc2Therapeutics.com
    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
    02 Oct 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 Oct 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Oct 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to evaluate the efficacy of MC2-01 cream compared to active comparator in subjects with psoriasis vulgaris.
    Protection of trial subjects
    The MC2-01 cream contains two well-known active compounds (CAL/BDP) in a novel topical formulation. The efficacy and safety profile of the combination is well established and have proven to be safe and efficacious, and available data for MC2-01 cream suggest a very benign safety profile resembling that known from the approved CAL/BDP products. A cream formulation of CAL and BDP may benefit subjects by providing improved convenience and ease of use resulting in increased patient adherence to therapy which will improve real-life treatment outcome. Diavobet gel is used as comparator for this trial. The common AE (>1%) is pruritus. Other uncommon AEs are folliculitis, skin infections, exacerbation of psoriasis, dermatitis, erythema, rash, skin irritation, skin burning sensation, application site pain, as well as eye irritation (i.e. ≥0.1% and < 1%). It was thus considered that the benefit of obtaining clinical data for this trial outweighed any potential risks. AEs were collected/assessed from the time of the signature of the informed consent form by the subject and until the final follow-up visit. AEs that were considered related to the trial product would be followed until they were resolved, or until the medical condition of the subject was stable.
    Background therapy
    -
    Evidence for comparator
    Daivobet gel was used as comparator product. It is a approved product with a well known safety profile.
    Actual start date of recruitment
    12 Dec 2018
    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
    Poland: 129
    Country: Number of subjects enrolled
    Czech Republic: 147
    Country: Number of subjects enrolled
    Germany: 214
    Worldwide total number of subjects
    490
    EEA total number of subjects
    490
    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)
    407
    From 65 to 84 years
    83
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    All subjects approached for the study were either ongoing or new patients referred to the clinics with the diagnosis Psoriasis Vulgaris.

    Pre-assignment
    Screening details
    Prior to randomization, the subject entered a washout period (if required) where anti-psoriatic treatment and other relevant medication/treatments were discontinued as defined by the exclusion criteria. The washout/ screening period could last for up to 30 days, depending on which disallowed treatments the subject received.

    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, Monitor, Assessor
    Blinding implementation details
    Due to difference in formulation and packaging, the investigator and staff could not see the IP. Several precautions was taken to maintain the blind. To keep the staff blinded, packing and labelling of the outer box was be identical for all IPs, but the content varied. Handling of individual IPs was therefore be handled by a designated third unblinded person. This person was only involved in the handling of IP and did not perform any trial related assessment.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    MC2-01 Cream
    Arm description
    MC2-01 (calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    MC2-01 Cream
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    MC2-01 (calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream

    Arm title
    Active Comparator
    Arm description
    Calcipotriene/betamethasone (Calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.
    Arm type
    Active comparator

    Investigational medicinal product name
    Devobet/Devobet gel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Gel
    Routes of administration
    Topical use
    Dosage and administration details
    Devobet / Devobet gel: (calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%)

    Arm title
    Vehicle
    Arm description
    Vehicle One application daily for 8 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    Vehicle
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream
    Routes of administration
    Topical use
    Dosage and administration details
    One application daily for 8 weeks.

    Number of subjects in period 1
    MC2-01 Cream Active Comparator Vehicle
    Started
    213
    209
    68
    Completed
    205
    203
    55
    Not completed
    8
    6
    13
         Consent withdrawn by subject
    2
    3
    9
         Adverse event, non-fatal
    1
    2
    2
         Withdrew consent, did not make any IP
    -
    -
    1
         Lost to follow-up
    5
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    MC2-01 Cream
    Reporting group description
    MC2-01 (calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.

    Reporting group title
    Active Comparator
    Reporting group description
    Calcipotriene/betamethasone (Calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.

    Reporting group title
    Vehicle
    Reporting group description
    Vehicle One application daily for 8 weeks.

    Reporting group values
    MC2-01 Cream Active Comparator Vehicle Total
    Number of subjects
    213 209 68 490
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    48.6 ( 13.7 ) 51.5 ( 14.8 ) 50.8 ( 13.1 ) -
    Gender categorical
    Units: Subjects
        Female
    77 96 22 195
        Male
    136 113 46 295
    Fitzpatrick Skin Type
    Units: Subjects
        Skintype I
    6 2 0 8
        Skintype II
    104 103 29 236
        Skintype III
    77 76 25 178
        Skintype IV
    20 19 9 48
        Skintype V
    6 7 5 18
        Skintype VI
    0 2 0 2

    End points

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    End points reporting groups
    Reporting group title
    MC2-01 Cream
    Reporting group description
    MC2-01 (calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.

    Reporting group title
    Active Comparator
    Reporting group description
    Calcipotriene/betamethasone (Calcipotriene/betamethasone dipropionate, w/w 0,005%/0,064%) cream. One application daily for 8 weeks.

    Reporting group title
    Vehicle
    Reporting group description
    Vehicle One application daily for 8 weeks.

    Primary: mPASI

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    End point title
    mPASI
    End point description
    Percentage Change in mPASI (Modified Psoriasis Area and Severity Index) Score. The extent and severity of the participant’s psoriasis is assessed using a modified PASI scoring system (minus scalp, face, and flexures) at each 3 areas (arms, trunk and legs) using a scale from 0 - 6, where 0 = no psoriasis involvement and 6 = 90-100% involvement. The severity is assessed at the 3 areas for each of the sign redness, thickness and scaliness using a scale from 0 - 4, where 0 represents none and 4 represents very severe. The mPASI score is calculated from the individual scores by use of the following equation: Arms 0.2 (Redness + Thickness + Scaliness) E = X Trunk 0.3 (Redness + Thickness + Scaliness) E = Y Legs 0.4 (Redness + Thickness + Scaliness) E = Z The sum of X + Y + Z = m-PASI score resulting in a minimum score of 0 and a maximum score (worst possible) of 64.8.
    End point type
    Primary
    End point timeframe
    The percent change in mPASI score is defined as the Baseline minus the Week 8 divided by Baseline score multiplied by 100 (this value is negative)
    End point values
    MC2-01 Cream Active Comparator Vehicle
    Number of subjects analysed
    213
    209
    68
    Units: Percentage Change in mPASI Score
        arithmetic mean (standard deviation)
    -67.5 ( 20.8 )
    -63.5 ( 22.2 )
    -11.7 ( 21.9 )
    Statistical analysis title
    mPASI
    Comparison groups
    Active Comparator v MC2-01 Cream v Vehicle
    Number of subjects included in analysis
    490
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.05
    Method
    ANCOVA
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -
         upper limit
    -

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs were collected/assessed from the time of the signature of the informed consent form by the subject and until the final follow-up visit.
    Adverse event reporting additional description
    AEs that were considered related to the trial product would be followed until they were resolved, or until the medical condition was stable.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22
    Reporting groups
    Reporting group title
    MC2-01 Cream
    Reporting group description
    -

    Reporting group title
    Cal/BDP Combination
    Reporting group description
    -

    Reporting group title
    Vehicle
    Reporting group description
    -

    Serious adverse events
    MC2-01 Cream Cal/BDP Combination Vehicle
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 213 (0.47%)
    3 / 209 (1.44%)
    1 / 68 (1.47%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Testicular seminoma (pure)
         subjects affected / exposed
    1 / 213 (0.47%)
    0 / 209 (0.00%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Cholecystitis acute
         subjects affected / exposed
    0 / 213 (0.00%)
    0 / 209 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Humerus fracture
         subjects affected / exposed
    0 / 213 (0.00%)
    1 / 209 (0.48%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Herpes zoster meningitis
         subjects affected / exposed
    0 / 213 (0.00%)
    1 / 209 (0.48%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary tuberculosis
         subjects affected / exposed
    0 / 213 (0.00%)
    1 / 209 (0.48%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    MC2-01 Cream Cal/BDP Combination Vehicle
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 213 (4.69%)
    11 / 209 (5.26%)
    1 / 68 (1.47%)
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    10 / 213 (4.69%)
    11 / 209 (5.26%)
    1 / 68 (1.47%)
         occurrences all number
    10
    11
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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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