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| ID | Type | Description | Link |
|---|---|---|---|
| 2018-002945-12 | EudraCT Number |
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| Name | Class |
|---|---|
| University of Sheffield | OTHER |
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Atopic dermatitis (AD) is among the most common chronic types of inflammatory skin disease and it is characterised by exacerbations or relapses over years. The patients have a genetically impaired skin barrier that can be evaluated by measuring the transepidermal water loss (TEWL), which is increased in both dry skin and clinically normal skin in AD patients. Moisturisers are first line treatment for AD patients and moisturisers are the most prescribed products in dermatology. The use of moisturisers have been found to reduce the need for steroids.
The newly developed moisturizing cream 1107.57 is intended for people with dry skin symptoms, such as dryness, itching, and flaking. As most people with dry skin of different origin have an impaired skin barrier function, it is important to investigate the possible influence on the skin barrier after long-term (several weeks') treatment. It is of utmost importance to evaluate different moisturisers head-to-head in order to facilitate an evidence-based choice of moisturiser.
The primary objective of the trial is to determine whether applying the test cream 1107.57 for 4 weeks is superior in terms of skin barrier strengthening, when compared with (1) no treatment and (2) two reference creams in adults with a predisposition to a skin barrier defect. Secondary objectives are to determine whether there is a difference between 1107.57 and (1) no treatment and (2) the two reference creams in skin moisturization, tolerability, cream consumption and safety.
Participants will treat their lower volar forearms for 28 days with three different creams (test cream and two reference creams) and leave one area untreated as a control. Each forearm will have two different treatment areas and treatment allocation will be randomized. One Finger Tip Unit (FTU) of each cream will be applied twice daily on the designated study area for 28 days. On day 1 and 29 the transepidermal water loss (TEWL) and skin capacitance is measured on their forearms to evaluate the effect on skin barrier function and skin hydration. Furthermore, on day 31, after challenge with 1 % sodium lauryl sulphate (SLS) on day 29, the susceptibility to irritation caused by SLS will be evaluated visually and by measuring TEWL on their forearms. Study participants will attend visits at the start of randomised therapy and on day 5, 15, 29 and 31. During the study period the participants will also grade and evaluate the tolerability of the different creams.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Test cream (2% urea/20% glycerol) | Experimental | Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days |
|
| Reference cream 1: Miniderm® 20% cream (20% glycerol) | Active Comparator | Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days |
|
| Reference cream 2: Diprobase® cream (cream without humectants) | Active Comparator | Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days |
|
| Untreated | No Intervention | Untreated skin area on the volar forearm |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 2% urea/20% glycerol cream | Drug | Moisturizing cream for topical application |
|
| Measure | Description | Time Frame |
|---|---|---|
| Skin Barrier Strengthening Effect by Measurement of Trans Epidermal Water Loss (TEWL) Before and After Induction of Skin Irritation | The change in TEWL from treated and untreated skin before and after induction of skin irritation with SLS. SLS increases TEWL. An effective treatment protects skin from irritation and less TEWL increase is anticipated compared to untreated skin | day 29 prior to irritant application and day 31 following application |
| Skin Barrier Strengthening Effect by Measurement of Skin Redness Before and After Induction of Skin Irritation as Assessed by the Erythema Index (Change From Day 29 to Day 31) | Skin redness measurement by Objective Erythema (2D Skin Imaging) on treated and untreated skin before (day 29) and after (day 31) induction of skin irritation with SLS. Captured 2D images are analysed to determine the skin erythema index (degree of redness, arbitrary numerical value), where a higher value denotes a stronger reaction/more redness. An effective treatment is anticipated to protect the skin from irritation, i.e. a weaker reaction from SLS/less redness compared to the untreated skin. Data is presented as change from day 29 to day 31 | The 2D Skin Imaging was performed on day 15, day 29 and on day 31. Only day 29 and 31 was included in the statistical analysis |
| Skin Barrier Strengthening Effect by Measurement of Skin Redness Before and After Induction of Skin Irritation as Assessed by Mexameter (Change From Day 29 to Day 31) | Objective skin redness measurement by Mexameter on treated and untreated skin before (day 29) and after (day 31) induction of skin irritation with SLS. Skin redness is measured using a C&K Mexameter probe to quantify SLS-induced skin irritation (arbitrary numerical scale). An effective treatment is anticipated to protect the skin from irritation, i.e. a weaker reaction from SLS/less redness compared to the untreated skin. Data is presented as change from day 29 to day 31 | Measured on day 29 and 31 |
| Skin Barrier Strengthening Effect by Measurement of Skin Redness Before Induction of Skin Irritation as Assessed by Visual Scoring |
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Inclusion Criteria:
The participants have to meet all of the following criteria to be eligible to enter the study:
Exclusion Criteria:
Participants meeting any of the following criteria will not be permitted to enter the study:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Sheffield Medical School | Sheffield | S10 2RX | United Kingdom |
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Medications prohibited to use >28 Days, 28 Days, 14 Days and 7 Days, respectively, Prior to Baseline/Day 1 and throughout the study are listed in the Clinical Trial Protocol
Use of bland (non-medicated) emollients, moisturisers or sunscreen on the test areas, within 7 days prior to Visit 1 was also prohibited
Use of bland (non-medicated) emollient(s) was permitted during the study to manage dry skin in areas surrounding but not on or overlapping the test areas.
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| ID | Title | Description |
|---|---|---|
| FG000 | Test Cream (2% Urea/20% Glycerol) | All participants used 3 creams on their lower volar forearms and one area was left untreated. I Finger Tip Unit of each cream was applied every morning and evening for 28 days |
| FG001 | Reference Cream 1: Miniderm® 20% Cream (20% Glycerol) | All participants used 3 creams on their lower volar forearms and one area was left untreated. I Finger Tip Unit of each cream was applied every morning and evening for 28 days |
| FG002 | Reference Cream 2: Diprobase® Cream (Cream Without Humectants) | All participants used 3 creams on their lower volar forearms and one area was left untreated. I Finger Tip Unit of each cream was applied every morning and evening for 28 days |
| FG003 | Untreated | All participants used 3 creams on their lower volar forearms and one area was left untreated. No cream was applied on this area |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Each participant use all three creams and one skin area is untreated. 4 skin areas per subject was evaluated.
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| ID | Title | Description |
|---|---|---|
| BG000 | Subject Using 3 Creams | Each subject used three creams on their volar forearms and had one skin area untreated 4 treated skin areas: Test cream Glycerol cream Cream without humectants Untreated |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Skin Barrier Strengthening Effect by Measurement of Trans Epidermal Water Loss (TEWL) Before and After Induction of Skin Irritation | The change in TEWL from treated and untreated skin before and after induction of skin irritation with SLS. SLS increases TEWL. An effective treatment protects skin from irritation and less TEWL increase is anticipated compared to untreated skin | Each participant used three creams on their volar forearms and one skin area was left untreated. A skin irritant was applied on each treatment area (n=4) after end of cream treatment period. The irritant was left on the skin for 24h and the Trans Epidermal Water Loss (TEWL) was measured after another 24h and compared to TEWL measured after treatment but before application of irritant | Posted | Mean | Standard Deviation | TEWL (g/m^2·h) change from day 29 to 31 | day 29 prior to irritant application and day 31 following application | skin areas on volar forearms | skin areas on volar forearms |
|
Adverse events were recorded throughout duration of the study, i.e. from day 1 to day 31
Treatment emergent AEs were defined to be those starting on or after visit 1 treatment dispensing, or those without an onset date.
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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 | Test Cream (2% Urea/20% Glycerol) | 1 Finger Tip Unit of cream was applied to 1 of 4 skin areas on the lower volar forearm of the participant every morning and evening for 28 days |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Melanocytic naevus | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 10.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Tina Holm | Perrigo/ACO Hud Nordic | +46732744113 | tina.holm@perrigo.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 15, 2019 | Aug 19, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 4, 2019 | Aug 19, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D003876 | Dermatitis, Atopic |
| ID | Term |
|---|---|
| D012873 | Skin Diseases, Genetic |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003872 | Dermatitis |
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Every patient use three different creams (1 test cream, 2 reference creams) and one untreated area. They are their own controls
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| Miniderm® 20% cream | Drug | Moisturizing cream for topical application |
|
| Diprobase® cream | Drug | Emollient cream for topical application |
|
Skin redness by visual scoring on treated and untreated skin before induction of skin irritation with SLS. Skin redness was evaluated on a 4-point visual scale from 0 to 3, where 0 indicates no redness/reaction and 3 indicates strong erythema. |
| Skin redness was scored on day 29 |
| Skin Barrier Strengthening Effect by Measurement of Skin Redness After Induction of Skin Irritation as Assessed by Visual Scoring | Skin redness by visual scoring on treated and untreated skin after induction of skin irritation with SLS. Skin redness was evaluated on a 4-point visual scale from 0 to 3, where 0 indicates no redness/reaction and 3 indicates strong erythema. | Skin redness was scored on day 31 |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days Test cream: Moisturizing cream for topical application |
| OG001 | Reference Cream 1: Miniderm® 20% Cream (20% Glycerol) | Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days Glycerol cream: Moisturizing cream for topical application |
| OG002 | Reference Cream 2: Diprobase® Cream (Cream Without Humectants) | Topical cream, 1 Finger Tip Unit per treatment area on the lower volar forearms twice daily for 28 days Cream without humectants: Emollient cream for topical application |
| OG003 | Untreated | Untreated are on the volar forearm |
|
|
|
| Primary | Skin Barrier Strengthening Effect by Measurement of Skin Redness Before and After Induction of Skin Irritation as Assessed by the Erythema Index (Change From Day 29 to Day 31) | Skin redness measurement by Objective Erythema (2D Skin Imaging) on treated and untreated skin before (day 29) and after (day 31) induction of skin irritation with SLS. Captured 2D images are analysed to determine the skin erythema index (degree of redness, arbitrary numerical value), where a higher value denotes a stronger reaction/more redness. An effective treatment is anticipated to protect the skin from irritation, i.e. a weaker reaction from SLS/less redness compared to the untreated skin. Data is presented as change from day 29 to day 31 | In some participants it was not possible to analyze all images, therefore the Overall Number of Participants Analyzed in this outcome measure differs compared to the total number of participants included in the study | Posted | Mean | Standard Deviation | Arbitrary Units | The 2D Skin Imaging was performed on day 15, day 29 and on day 31. Only day 29 and 31 was included in the statistical analysis | skin areas on volar forearms | skin areas on volar forearms |
|
|
|
|
| Primary | Skin Barrier Strengthening Effect by Measurement of Skin Redness Before and After Induction of Skin Irritation as Assessed by Mexameter (Change From Day 29 to Day 31) | Objective skin redness measurement by Mexameter on treated and untreated skin before (day 29) and after (day 31) induction of skin irritation with SLS. Skin redness is measured using a C&K Mexameter probe to quantify SLS-induced skin irritation (arbitrary numerical scale). An effective treatment is anticipated to protect the skin from irritation, i.e. a weaker reaction from SLS/less redness compared to the untreated skin. Data is presented as change from day 29 to day 31 | In some participants it was not possible to analyze all images, therefore the Overall Number of Participants Analyzed in this outcome measure differs compared to the total number of participants included in the study | Posted | Mean | Standard Deviation | Arbitrary Units | Measured on day 29 and 31 | skin areas on volar forearms | skin areas on volar forearms |
|
|
|
|
| Primary | Skin Barrier Strengthening Effect by Measurement of Skin Redness Before Induction of Skin Irritation as Assessed by Visual Scoring | Skin redness by visual scoring on treated and untreated skin before induction of skin irritation with SLS. Skin redness was evaluated on a 4-point visual scale from 0 to 3, where 0 indicates no redness/reaction and 3 indicates strong erythema. | Posted | Mean | Standard Deviation | units on a scale | Skin redness was scored on day 29 | skin areas on volar forearms | skin areas on volar forearms |
|
|
|
| Primary | Skin Barrier Strengthening Effect by Measurement of Skin Redness After Induction of Skin Irritation as Assessed by Visual Scoring | Skin redness by visual scoring on treated and untreated skin after induction of skin irritation with SLS. Skin redness was evaluated on a 4-point visual scale from 0 to 3, where 0 indicates no redness/reaction and 3 indicates strong erythema. | Posted | Mean | Standard Deviation | units on a scale | Skin redness was scored on day 31 | skin areas on volar forearms | skin areas on volar forearms |
|
|
|
|
| 0 |
| 49 |
| 0 |
| 49 |
| 1 |
| 49 |
| EG001 | Reference Cream 1: Miniderm® 20% Cream (20% Glycerol) | 1 Finger Tip Unit of cream was applied to 1 of 4 skin areas on the lower volar forearm of the participant every morning and evening for 28 days | 0 | 49 | 0 | 49 | 6 | 49 |
| EG002 | Reference Cream 2: Diprobase® Cream (Cream Without Humectants) | 1 Finger Tip Unit of cream was applied to 1 of 4 skin areas on the lower volar forearm of the participant every morning and evening for 28 days | 0 | 49 | 0 | 49 | 15 | 49 |
| EG003 | Untreated | 1 of 4 skin areas on the lower volar forearm of the participant was left untreated | 0 | 49 | 0 | 49 | 0 | 49 |
| Eczema | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
|
| Rash macular | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site bruise | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site eczema | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site erythema | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site papules | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site pruritus | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site rash | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site reaction | General disorders | MedDRA 10.0 | Systematic Assessment |
|
| Application site urticaria | General disorders | MedDRA 10.0 | Systematic Assessment |
|
Clause 10 of the Clinical Trial Agreement:
The Sponsor agrees that the Principal Investigator shall be permitted to present at symposia, national and regional professional meetings and to publish in journals, theses or dissertations, or otherwise of their own choosing, the methods and Results of the Clinical Trial, subject to this Clause 10 and any publication policy described in the Protocol, provided any such policy is consistent with the Joint Position.
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D017443 | Skin Diseases, Eczematous |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| skin areas on volar forearms |
|
| ANCOVA |
| 0.031 |
| Mean Difference (Final Values) |
| -1.748 |
| 2-Sided |
| 95 |
| -3.332 |
| -0.164 |
| Superiority |
| Summary of Objective Erythema (2D Skin Imaging) change from day 29 to day 31 | ANCOVA | <0.001 | Mean Difference (Final Values) | -4.744 | 2-Sided | 95 | -6.332 | -3.156 | Superiority |
| skin areas on volar forearms |
|
| 0.471 |
| Mean Difference (Final Values) |
| -4.493 |
| 2-Sided |
| 95 |
| -16.787 |
| 7.801 |
| Superiority |
| Summary of Redness - Mexameter change from day 29 to day 31 | ANCOVA | <0.001 | Mean Difference (Final Values) | -27.035 | 2-Sided | 95 | -39.372 | -14.698 | Superiority |
| skin areas on volar forearms |
|
| skin areas on volar forearms |
|
| 0.392 |
| Mean Difference (Final Values) |
| -0.089 |
| 2-Sided |
| 95 |
| -0.292 |
| 0.115 |
| Superiority |
| Summary of Visual Redness at day 31 | ANCOVA | <0.001 | Mean Difference (Final Values) | -0.447 | 2-Sided | 95 | -0.652 | -0.242 | Superiority |