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This Study is to comparison of Efficacy and Consistency of Action of Levocetirizine 5 mg once daily with Fexofenadine 60 mg twice daily in the histamine induced wheal, flare and itch Response.
This will be a randomized, double-blind, placebo-controlled study with intra-individual comparison of the histamine induced wheal and flare reaction. In September 2009, Fexofenadine was approved as an antihistamine against allergies in Japan and it is currently used widely. It has been approved in 120 countries, including the US, UK, France and Germany [11]. In Europe and the United States, fexofenadine is marketed at 120 mg once daily for allergic rhinitis and 180mg once daily for urticaria. In Japan, fexofenadine is marketed at 60 mg twice daily for both conditions. But is this dosage regimen as effective as levocetirizine, 5 mg once daily? The above described study from Takahashi et al, comparing 60 mg twice daily versus cetirizine 10 mg once daily suggests that it is not [4]. The aim of the study is to compare the efficacy and consistency of action of levocetirizine 5 mg once daily with fexofenadine 60 mg twice daily over a 24 hour period in the histamine induced wheal, flare and itch response. Furthermore, we would like to investigate whether a different between Japanese and Caucasian exists or not. Each volunteer will receive the study medication at time point 0 and 12 hour later. Skin Prick Test (SPT) will be performed in each volunteer using histamine (10 mg/ml), 15 minutes before drug admission (baseline) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours afterwards. Volumetric optical scanning system and infrared camera will be used for objective evaluation of the wheal- and flare reduction. Additionally, measurement of the erythema diameter with a transparent ruler will be performed. The subjective intensity of itching will be assessed using a Visual Analogue Scale (VAS). To relate the pharmacokinetics of the drugs to their pharmacodynamics, blood samples for assay of drug concentrations will be taken at baseline and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours later. Subjects will undergo the same procedure on three separate occasions to receive each treatment option. The options are: placebo at time 0 hours + placebo at 12 hours, Levocetirizine 5mg at time 0 hours + placebo at 12 hours or fexofenadine 60mg at time 0 hours + fexofenadine 60mg at 12 hours. There will be a washout period of at least 6 days between the treatments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | Placebo per os at time 0 hours + placebo per os at 12 hours. |
|
| Levocetirizin | Active Comparator | Levocetirizin 5mg at time 0 and placebo per os at 12 hours |
|
| Fexofenadine | Active Comparator | Fexofenadine 60mg per os at time 0 hours + fexofenadine 60mg per os at 12 hours |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Levocetirizine Oral Tablet | Drug |
| ||
| Fexofenadine 60 Mg Oral Tablet |
| Measure | Description | Time Frame |
|---|---|---|
| Pruritus as Assessed by the VAS Score | We measured drug concentrations and various aspects of skin provocation testing such as itch intensity and wheal size. Measurements made at each time point were as followed: Pruritus was assessed every 30 s for 10 min after SPT using a visual analogue scale (VAS) score with a "0" and "100" at the two ex- tremes of an unmarked 100 mm line with higher values indicating greater puritus. The mean VAS for each 10 min was calculated and used as a primary end Point. | up to 10 minutes after skin prick test performed 24 hours after drug administration |
| Flaire Diameter (mm) | Flaire diameter was measured with a transparent ruler as the mean of the largest diameter and the diameter at right angles to this. | 24 hours per treatment |
| Wheal Volume (cm3) | Wheal volume was measured by a non-contact three dimensional measurement system (PRIMOS contact, GFM Messtechnik GmbH, Teltow, Germany). | 24 hours per treatment |
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Inclusion Criteria:
Eighteen (18) healthy male volunteers, including at least 6 persons of Japanese origin, will be recruited for this study
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marcus Maurer, MD | Charite Universitätsmedizin Berlin | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Berlin Charité, Department of Dermatology and Allergy | Berlin | 10117 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23147964 | Derived | Schoepke N, Church MK, Maurer M. The inhibition by levocetirizine and fexofenadine of the histamine-induced wheal and flare response in healthy Caucasian and Japanese volunteers. Acta Derm Venereol. 2013 May;93(3):286-93. doi: 10.2340/00015555-1490. |
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Individual participant data will not be available.
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| ID | Title | Description |
|---|---|---|
| FG000 | Day 1 | Intake of Placebo- Fexofenadine 6 mg - Levocetirizin 5 mg |
| FG001 | Day 2 | Intake of Fexofenadine 6 mg - Levocetirizin 5 mg - Placebo |
| FG002 | Day 3 | Intake of Placebo- Levocetirizin 5 mg- Fexofenadine 60 |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Day 2 | Intake on 0 hours and 12 hours Intake Levocetirizn |
| BG001 | Day 3 | Intake on 0 hours and 12 hours Intake Fexofenadine |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Pruritus as Assessed by the VAS Score | We measured drug concentrations and various aspects of skin provocation testing such as itch intensity and wheal size. Measurements made at each time point were as followed: Pruritus was assessed every 30 s for 10 min after SPT using a visual analogue scale (VAS) score with a "0" and "100" at the two ex- tremes of an unmarked 100 mm line with higher values indicating greater puritus. The mean VAS for each 10 min was calculated and used as a primary end Point. | Please see Outcome Measure Description. Itch was measured using a 10 point VAS. | Posted | Mean | Standard Error | mm | up to 10 minutes after skin prick test performed 24 hours after drug administration |
|
Adverse Events were collected on the following time points: 0 (baseline), 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Levocetirizine | 5 mg once daily |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| fatigue | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Professor Marcus Maurer | University of Charité Berlin; Dpt. of Dermatology and Allergy | +49 30 450 518 043 | marcus.maurer@charite.de |
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| ID | Term |
|---|---|
| D011537 | Pruritus |
| D000080223 | Chronic Urticaria |
| D065631 | Rhinitis, Allergic |
| ID | Term |
|---|---|
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012877 | Skin Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| C472067 | levocetirizine |
| C093230 | fexofenadine |
| D013607 | Tablets |
| ID | Term |
|---|---|
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
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| Drug |
|
|
| Placebo Oral Tablet | Drug |
|
|
| BG002 | Day 1 | Intake on 0 hours and 12 hours Intake Placebo |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | A total of 9 Patients (includes Asian and Caucasian) per Arm/Group were analysed. | Count of Participants | Participants |
|
| Region of Enrollment | Number | Participants |
|
| Fexofenadine |
60 mg twice daily |
| OG002 | Placebo | Placebo as comparison to Levocetirizin |
|
|
| Primary | Flaire Diameter (mm) | Flaire diameter was measured with a transparent ruler as the mean of the largest diameter and the diameter at right angles to this. | Please see Outcome measure description. Flair Diameter was measured in mm. | Posted | Mean | Standard Error | mm | 24 hours per treatment |
|
|
|
| Primary | Wheal Volume (cm3) | Wheal volume was measured by a non-contact three dimensional measurement system (PRIMOS contact, GFM Messtechnik GmbH, Teltow, Germany). | Please see Outcome Measure Description. Wheal volume was measured in cm3. The units of measure are provided in the report of the this study protocol. | Posted | Mean | Standard Error | cm3 | 24 hours per treatment |
|
|
|
| 0 |
| 18 |
| 2 |
| 18 |
| EG001 | Fexofenadine | 60 mg twice daily, oral | 0 | 18 | 3 | 18 |
| EG002 | Placebo | Placebo against Levocetirzine | 0 | 18 | 2 | 18 |
| pain at the puncture site of the intravenous catheter | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
|
| upper respiratory tract infection | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| bacterial inflammation of the finger | Infections and infestations | Non-systematic Assessment |
|
| pain in the knee joint | Social circumstances | Non-systematic Assessment |
|
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| D013568 | Pathological Conditions, Signs and Symptoms |
| D014581 | Urticaria |
| D017445 | Skin Diseases, Vascular |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D012220 | Rhinitis |
| D009668 | Nose Diseases |
| D012140 | Respiratory Tract Diseases |
| D012130 | Respiratory Hypersensitivity |
| D010038 | Otorhinolaryngologic Diseases |