E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10021531 |
E.1.2 | Term | Impetigo |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10041923 |
E.1.2 | Term | Staphylococcal impetigo |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10042178 |
E.1.2 | Term | Streptococcal impetigo |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10021535 |
E.1.2 | Term | Impetigo NOS |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10041939 |
E.1.2 | Term | Staphylococcus aureus impetigo |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10042200 |
E.1.2 | Term | Streptococcus pyogenes impetigo |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10021533 |
E.1.2 | Term | Impetigo contagious |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to assess whether the clinical efficacy and safety of Fusidic acid hydrophilic cream 20 mg/g, manufactured by Basic Pharma Manufacturing BV, and Fucidin® cream are equivalent in the treatment of impetigo patients. This primary efficacy endpoint can be measured by assessing the rate of “cure” after one week of treatment, which will be defined during the first follow up visit.
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E.2.2 | Secondary objectives of the trial |
1. The rate of “improvement”, and “failure” after one week 2. The rate of “cure”, “improvement”, and “failure” after two weeks 3. The rate of bacterial cure (elimination of causative pathogens in persisting lesions or the unavailability of a swab if lesions were cured) after one and two weeks 4. Safety analysis: comparison of tolerance and adverse event profiles
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subjects having a clinical diagnosis of localized impetigo contagiosa (not the extensive forms) 2. Skin Infection Score: more than 7 points 3. Subject age: ≥18 months of age 4. Subject (and/or parent or legal guardian) is willing to comply with the protocol, remain available for follow up visits, and provide informed consent
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E.4 | Principal exclusion criteria |
If a subject meets one of the stated exclusion criteria, he/she cannot participate in this study. The exclusion criteria will apply to all subjects at all study visits.
1. Subjects for whom no signed and dated informed consent is obtained 2. Subjects whose temperature is >38.5°C (higher than low grade fever) 3. Subjects who have extensive forms of impetigo, defined as: • More than 10 lesions • Total affected area >100 cm2 • The surrounding redness extends >2 cm from the edge of the lesions 4. Subjects with secondary impetigo, where the infection is secondary to some other underlying skin disease 5. Subjects that have used other medications or treatments prior to enrollment in the study, including: • For 24 hours prior to entry: subjects should not have been treated with topical steroids, topical retinoids, topical antibiotics or other ingredients considered as antibacterial, such as salicylic acid • For 1 week prior to entry: subjects should not have utilized medicated shampoos or medicated cleansers of any type. Non-medicated cleansers and emollients are permitted at the discretion of the investigator • For 1 month prior to entry: subjects should not have been treated with UV-lamp irradiation, oral antibiotics or parenteral corticosteroids 6. Subjects who have other significant skin infections, diseases or disorders of the skin, including: • Systemic erythema (skin redness), not related to impetigo • Psoriasis • Allergic rashes • Viral or fungal infections of the skin • Eczema • Contact dermatitis • Herpes simplex virus • Discoid lupus • Scabies • Necrotizing fasciitis • Other significant diseases of the skin 7. Subjects with a recent history of other severe systemic diseases within 3 months prior to enrollment, including: • Severely impaired liver or renal function • Severe cardiovascular disease • Severe neurological disease • Immunocompromised patient • Severe disease that may interfere with the study evaluations 8. Subjects with a serious disease that potentially could be life threatening (including laboratory testing results) or that may interfere with the objective of the study, according to the opinion of the investigator 9. Subjects requiring any significant concomitant medication that may affect the results of the study 10. Subjects with sunburn and those who may experience considerable exposure to sunlight during the study period (including UV lamps) 11. Subjects who have a history of hypersensitivity to fusidic acid or to any other component of the study medication 12. Pregnant subjects, female subjects planning pregnancy during the study and breast- feeding subjects 13. Subjects that participated in another clinical study within 3 months prior to the enrolment 14. Subjects who are considered as unreliable or unlikely to be available during the study 15. Subjects that previously participated in the present trial
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy parameter is clinical efficacy, which will be assessed at the follow up visit after 7 days. For the determination of this clinical efficacy, the overall impetigo condition will be assessed.
The supposition in planning the study is that Fusidic acid hydrophilic cream 20 mg/g will possess similar efficacy and tolerability/safety to the Fucidin® cream, since the two products are similarly formulated and the dose regimen, duration, study population and study design are all very similar to those used in the previous Koning et al. 2002 study. Given these facts, it will be very unlikely that Fusidic acid hydrophilic cream 20 mg/g will prove clinically superior to Fucidin® cream in either efficacy or tolerability. Therefore, the important objective in the present study is to demonstrate that the Fusidic acid hydrophilic cream 20 mg/g is not clinically inferior by a prespecified amount to Fucidin® cream, since in practice, these products are intended to be interchangeable. Fusidic acid hydrophilic cream (Basic Pharma Technologies) and comparing it to the rate of “cure” after one week of treatment with Fucidin® cream (Leo Pharma). Four possible endpoints are described: 1. Cured: defined as the complete absence of lesions or the lesions have become dry and without crusts. Remaining local erythema of the intact skin or such progress that no further antibiotic therapy is needed, is acceptable as well. 2. Improvement: defined as a decline in the affected area, number of lesions or in both, as compared to a previous visit (additional antibiotic therapy is still required). 3. Failure: insufficient improvement or deterioration (e.g. lesions remain crusted and/or have exudate, lesions have a yellow/honey colored crust or the area increases with or without an increase in the number of lesions), as compared to a previous visit (additional antibiotic therapy is required). 4. Unable to determine: the effect of the treatment is not assessable (e.g. subjects who refused informed consent or who are unable to follow up).
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. The rate of “improvement”, and “failure” after one week 2. The rate of “cure”, “improvement”, and “failure” after two weeks 3. The rate of bacterial cure (elimination of causative pathogens in persisting lesions or the unavailability of a swab if lesions were cured) after one and two weeks 4. Safety analysis: comparison of tolerance and adverse event profiles
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | Yes |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 20 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 13 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 13 |