Clinical Trial Results:
The effects of topical corticosteroid use on insulin sensitivity and bone turnover
Summary
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EudraCT number |
2018-004370-96 |
Trial protocol |
DK |
Global end of trial date |
15 Mar 2021
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Results information
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Results version number |
v1 |
This version publication date |
27 Apr 2022
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First version publication date |
27 Apr 2022
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Other versions |
v2 |
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 |
LG-TCS-AD
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04114097 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Gentofte Hospital
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Sponsor organisation address |
Gentofte Hospitalsvej 15, 1. sal, Hellerup, Denmark, 2900
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Public contact |
Department of Dermatology, Gentofte Hospital, lise.gether.01@regionh.dk
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Scientific contact |
Department of Dermatology, Gentofte Hospital, lise.gether.01@regionh.dk
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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 |
Interim
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Date of interim/final analysis |
15 Mar 2022
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
15 Mar 2021
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
We hypothesise that use of TCS elicits insulin resistance and increases bone resorption (indicating increased risk of osteoporosis) in AD patients.
The aim is, therefore, to explore the adverse systemic drug reactions of TCS. Specifically, we aim to
1. evaluate whether full-body TCS treatment results in hepatic and/or whole-body insulin resistance (the forerunner of T2D) as well as increased bone resorption (indicating increased risk of osteoporosis) in patients with AD
2. evaluate the effect of TCS on skin and serum biomarkers of skin barrier function as well as skin microbiome composition
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Protection of trial subjects |
none
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Background therapy |
- | ||
Evidence for comparator |
Approved and internationally recommended treatment of atopic dermatitis through many years | ||
Actual start date of recruitment |
04 Feb 2019
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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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 |
Denmark: 36
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Worldwide total number of subjects |
36
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EEA total number of subjects |
36
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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) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
36
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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 |
Patients were recruited from the outpatient clinic at Department of Dermatology and Allergy, Herlev-Gentofte Hospital, other Departments of Dermatology in the region of Copenhagen and Zealand, private dermatologic clinics in the area of Copenhagen, or by advertising. | |||||||||
Pre-assignment
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Screening details |
Criteria: BMI < 30, AD at least 3 years, no prediabetes or diabetes, no other chronic inflammatory diseases (including but not limited to rheumatoid arthritis, inflammatory bowel disease etc) beside AD and non-treatment demanding rhinitis or asthma Two weeks wash-out without any topical anti-inflammatory treatment of atopic dermatitis | |||||||||
Period 1
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Period 1 title |
Baseline
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Is this the baseline period? |
Yes | |||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | |||||||||
Arms
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Arm title
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Pooled baseline | |||||||||
Arm description |
- | |||||||||
Arm type |
pooled baseline (no intervention yet) | |||||||||
Investigational medicinal product name |
NONE
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Ointment
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Routes of administration |
Other use
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Dosage and administration details |
NONE
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Period 2
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Period 2 title |
After two weeks of treatment
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Is this the baseline period? |
No | |||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||
Roles blinded |
Subject, Investigator, Monitor | |||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Betamethasone 17-valerate | |||||||||
Arm description |
- | |||||||||
Arm type |
Experimental | |||||||||
Investigational medicinal product name |
Betnovate
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Investigational medicinal product code |
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Other name |
Betamethasone 17-valerate
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Pharmaceutical forms |
Ointment
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Betnovate once daily plus a placebo once daily (2 weeks daily treatment + 4 weeks of twice weekly treatment)
Betnovate (Betamethasone) 0.1% ointment (% (W/W) percent weight/weight)
Cutaneous maximal use: 30 g * 1/day * 14 days + 30 g * 1/day * 2/week * 4 weeks = 660 gram(s)
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Arm title
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Tacrolimus | |||||||||
Arm description |
- | |||||||||
Arm type |
Active comparator | |||||||||
Investigational medicinal product name |
Protopic
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Investigational medicinal product code |
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Other name |
tacrolimus
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Pharmaceutical forms |
Ointment
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Protopic twice daily (2 weeks daily treatment + 4 weeks of twice weekly treatment)
Protopic (Tacrolimus) 0.1 % ointment
Cutaneous maximal use: 30 g * 2/day * 14 days + 30 g * 2/day * 2/week * 4 weeks = 1320 gram(s)
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Period 3
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Period 3 title |
After six weeks of treatment
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Is this the baseline period? |
No | |||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||
Roles blinded |
Subject, Investigator, Monitor | |||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Betamethasone 17-valerate | |||||||||
Arm description |
- | |||||||||
Arm type |
Experimental | |||||||||
Investigational medicinal product name |
Betnovate
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Investigational medicinal product code |
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Other name |
Betamethasone 17-valerate
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Pharmaceutical forms |
Ointment
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Betnovate once daily plus a placebo once daily (2 weeks daily treatment + 4 weeks of twice weekly treatment)
Betnovate (Betamethasone) 0.1% ointment (% (W/W) percent weight/weight)
Cutaneous maximal use: 30 g * 1/day * 14 days + 30 g * 1/day * 2/week * 4 weeks = 660 gram(s)
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Arm title
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Tacrolimus | |||||||||
Arm description |
- | |||||||||
Arm type |
Active comparator | |||||||||
Investigational medicinal product name |
Protopic
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Investigational medicinal product code |
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Other name |
tacrolimus
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Pharmaceutical forms |
Ointment
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Routes of administration |
Cutaneous use
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Dosage and administration details |
Protopic twice daily (2 weeks daily treatment + 4 weeks of twice weekly treatment)
Protopic (Tacrolimus) 0.1 % ointment
Cutaneous maximal use: 30 g * 2/day * 14 days + 30 g * 2/day * 2/week * 4 weeks = 1320 gram(s)
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Notes [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period. Justification: It is an impossible site to enter results. I have three timepoints, a pooled baseline (as it is a randomized study!) and two arms with two visits beside baseline. It is impossible to enter results correctly.... One patient did not continue to week 6, but was there at baseline at after two weeks. |
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Baseline characteristics reporting groups
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Reporting group title |
Pooled baseline
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Pooled baseline
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Reporting group description |
- | ||
Reporting group title |
Betamethasone 17-valerate
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Reporting group description |
- | ||
Reporting group title |
Tacrolimus
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Reporting group description |
- | ||
Reporting group title |
Betamethasone 17-valerate
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Reporting group description |
- | ||
Reporting group title |
Tacrolimus
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Reporting group description |
- |
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End point title |
M-value [1] | ||||||||
End point description |
Insulin Sensitivity
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End point type |
Primary
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End point timeframe |
Baseline, week 2 and week 6
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Baseline descriptive statistics |
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No statistical analyses for this end point |
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End point title |
M-value after 2 weeks | ||||||||||||
End point description |
change from baseline
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End point type |
Primary
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End point timeframe |
after two weeks of treatment
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Statistical analysis title |
Repeated measures ANOVA (mixed model) | ||||||||||||
Comparison groups |
Tacrolimus v Betamethasone 17-valerate
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Number of subjects included in analysis |
36
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||
P-value |
< 0.05 | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
Mean difference (final values) | ||||||||||||
Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
- | ||||||||||||
upper limit |
- |
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End point title |
M-value after 6 weeks | ||||||||||||
End point description |
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End point type |
Primary
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End point timeframe |
after 6 weeks of treatment
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Statistical analysis title |
Repeated measures ANOVA (mixed model) | ||||||||||||
Comparison groups |
Betamethasone 17-valerate v Tacrolimus
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Number of subjects included in analysis |
35
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||
P-value |
< 0.05 | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
Mean difference (final values) | ||||||||||||
Confidence interval |
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level |
95% |
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Adverse events information [1]
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Timeframe for reporting adverse events |
recorded until 5 times 75 hours after ended treatment (375 hours ~ 16 days)
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Assessment type |
Systematic | ||
Dictionary used for adverse event reporting
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Dictionary name |
REDCap | ||
Dictionary version |
1
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Frequency threshold for reporting non-serious adverse events: 5% | |||
Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: Stinging and burning are well-known side-effects from protopic and sometimes Betnovate, when applied to eczematous skin. |
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
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. | |||
These data are preliminary. Due to COVID-19, there was a delay in analysis of blood samples and data analysis. |