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A multi-center, prospective, open-label, controlled study of the pharmacokinetics and safety of the LicartTM topical system in pediatric and adult participants with minor soft tissue injuries. 150 male and female participants aged 6-16 and 18-45 with soft tissue injuries meeting the following criteria will be enrolled to evaluate the pharmacokinetics and safety of the Licart topical system in pediatric and adult participants with minor soft tissue injuries over a 14-day treatment course. The analgesic effects will also be evaluated of the topical system in pediatric and adult participants with minor soft tissue injuries over a 14-day treatment course. To collect principal investigator-reported global response to therapy.
Open-label, controlled study in pediatric and adult participants with minor soft tissue injuries. One-hundred fifty (150) participants between 6 and 11years old; 12 and 16 years old; and 18 and 45 years old will be enrolled, with equal numbers in each of the three age groups. The 50 adults enrolled will serve as the control. Participants will be seen by the principal investigator (PI) or designee at the clinical site, at entry and Visits 2 and 5 following the first topical system application, with the last visit scheduled on either Day 14 or the day after the participant experiences pain resolution. Visits 3 and 4 will be conducted via telehealth. At each study visit, adverse events (AEs) and concomitant medications will be recorded, local tolerability at the application site scored on a 7-point scale, and pain assessed by participants using the Wong-Baker FACES scale. Vital signs will be measured at the screening visit and Visits 2 and 5.
Participants will also assess pain twice daily (morning and evening) at home in the Participant Diary using the same Wong-Baker FACES scale. Blood samples will be obtained from each participant at Visit 2, 24 hours (± 1 hour) after initial topical system application at Visit 1, and at the time of study discontinuation (with a topical system in place) for determination of plasma diclofenac concentration and plasma activated partial thromboplastin time (aPTT). At the End-of-Study (EOS) Visit the principal investigator will provide an assessment of global response to therapy on a 5-point scale.
Participants will be asked to apply the Licart topical system once per day for a maximum of 14 days or until pain resolution, whichever occurs first.
This study will assess efficacy by the following assessments: Plasma diclofenac concentration, 24 hours (± 1 hour) after initial application (Visit 2) and EOS Visit; Pain score assessment by participant using the Wong-Baker FACES scale: every day (Participant Diary) and study visits on Visits 2, 3, 4 and 5; and Principal investigator assessment of global response to therapy on a 5-point scale.
This study will assess safety by the following assessments: Vital signs will be measured at the screening visit and Visit 2 and 5; AE reporting at each study visit; Local tolerability on a 7-point scale at Visits 2, 3, 4 and 5, or the day after pain resolution, with a topical system applied to the injured area; Plasma diclofenac concentration, 24 hours (±1 hour) after initial topical system application (Visit 2) and EOS Visit; and Plasma activated partial thromboplastin time (aPTT), 24 hours (±1 hour) after initial topical system application (Visit 2) and EOS Visit.
The primary endpoints of the study are: Diclofenac pharmacokinetic profile (Pediatric population vs Adult population; Two-sided 90% confidence interval (CI) <4 ng/mL); Local tolerability; AEs; and Activated partial thromboplastin time (aPTT).
The secondary endpoints of the study are: Participant-reported pain scores; Global response to therapy; and Vital signs.
All participants who receive at least one topical system will be subjected to classic safety and efficacy analyses. All participants who receive at least one topical system and have at least one blood draw to support determination of plasma diclofenac concentration will be subjected to the pharmacokinetic analysis. An evaluable participant population with adequate compliance and follow- up may also be analyzed.
Continuous variables will be presented as sample size, means, medians, standard deviations, range and 90% CI. Categorical variables will be presented as sample size, number of observations, percentages and exact 90% CI.
The participant population will be stratified by appropriate age categories and the effects of age may be analyzed using Analysis of Variance (ANOVA) or multiple regression methods.
Plasma diclofenac concentration in pediatric participants will be compared with those of adults using repeated measures mixed models (participants will have reached steady-state blood concentration by the time of the first blood draw).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Investigational | Experimental | LicartTM topical system application once per day for a maximum of 14 days or until pain resolution, whichever occurs first. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Licartâ„¢ (diclofenac epolamine) topical system | Drug | The Licartâ„¢ (diclofenac epolamine) topical system was designed to deliver the nonsteroidal anti-inflammatory drug (NSAID) diclofenac to the site of a minor soft tissue injury through topical application. This investigational product (IP) is a 10 cm x 14 cm topical system comprised of an adhesive material containing 1.3% diclofenac epolamine that is bound to a non-woven polyester felt backing and covered with a polypropylene film release liner. The release liner is removed prior to topical application to the skin. |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma diclofenac concentration of the Licart topical system as assessed by the Diclofenac pharmacokinetic profile. | Plasma diclofenac concentration, 24hours after initial topical system application (V2 and V5/EOS) | 14-day treatment course |
| Local tolerability of the Licart topical system as assessed by a 7-point scale. | Local tolerability assessed via a 7-point scale by the PI or designee at V2, V3, V4 and V5/EOS. The 7-point scale is: Grade 0 = Absent Response with No Visible Change. Grade 1 = Vascular Dilation Stage Response with Visible Change of Faint Redness (not considered clinically relevant). Grade 2 = Vascular Dilation Stage Response with Visible Change of Moderate Redness. Grade 3 = Vascular Dilation Stage Response with Visible Change of Intense Redness. Grade 4 = Infiltration Stage Response with Visible Change of Redness with Edema or Papules. Grade 5 = Infiltration Stage Response with Visible Change of Redness with Weeping Vesicles, Blisters or Bullae. Grade 6 = Infiltration Stage Response with Visible Change of Redness with Extension of Effect Beyond Margin of Contact Site. | 14 days treatment course |
| Adverse Events as assessed by the study team | Adverse Events for all participants as assessed by the study team during each visit throughout the duration of the study. | 14 days treatment course |
| Pharmacokinetics of the Licart topical system as assessed by the activated partial thromboplastin time. | Plasma activated partial thromboplastin time (aPTT), 24hours after initial topical system application (V2 and V5/EOS). | 14-day treatment course |
| Measure | Description | Time Frame |
|---|---|---|
| Analgesic Effect of the Licart topical system as assessed by the Wong-Baker FACES pain score assessment scale | Analgesic Effect of the Licart topical system as assessed by the Wong-Baker FACES pain score assessment scale every day (via participant's diary) and study visits on V2, V3, V4, V5/EOS. The pain score options are as followed: 0 = No Hurt, 2 = Hurts Little Big, 4 = Hurts Little More, 6 = Hurts Even More, 8 = Hurts Whole Lot, 10 = Hurts Worst. The lower the score, the better the outcome; the higher the score, the worse the outcome. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Giuseppe Mautone, MD | IBSA R&D Scientific Affairs | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Applied Research Center | Little Rock | Arkansas | 72212 | United States | ||
| Atella Clinical Research, LLC. |
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Open-label, controlled study in pediatric and adult participants with minor soft tissue injuries. One-hundred fifty (150) participants between 6 and 11years old; 12 and 16 years old; and 18 and 45 years old will be enrolled, with equal numbers in each of the three age groups. The 50 adults enrolled will serve as the control.
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| 14-day treatment course |
| Global Response to Licart topical system as assessed by the Global Response to Therapy Investigator-reported questionnaire. | Global Response to Licart topical system as assessed by the Global Response to Therapy Investigator-reported questionnaire at V5/EOS. | 14-day treatment course |
| Safety as assessed by vital signs - blood pressure. | Safety as assessed by vital signs - blood pressure (mm HG). Safety assessed by blood pressure (systolic and diastolic in mm HG) during each visit: V1, V2, V5/EOS. | 14 days treatment course |
| Safety as assessed by vital signs - heart rate. | Safety assessed by heart rate (beats per minute) during each visit: V1, V2, V5/EOS. | 14 days treatment course |
| La Palma |
| California |
| 90623 |
| United States |
| University Clinical Research - Deland, LLC | DeLand | Florida | 32720 | United States |
| My Community Research, Inc. | Miami | Florida | 33155 | United States |
| D & H Tamarac Research Centers, Inc. | Tamarac | Florida | 33321 | United States |
| Research Integrity | Owensboro | Kentucky | 42303 | United States |
| Ascendant Research Clinic, LLC. | Alamogordo | New Mexico | 88310 | United States |
| Prime Global Research Inc. | The Bronx | New York | 10456 | United States |
| Ascendant Research Clinic, LLC. | Marion | South Carolina | 29571 | United States |
| Next Level Urgent Care | Houston | Texas | 77057 | United States |
| AIM Trials | Plano | Texas | 75093 | United States |
| ID | Term |
|---|---|
| D017695 | Soft Tissue Injuries |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| C064142 | diclofenac hydroxyethylpyrrolidine |
| D016503 | Drug Delivery Systems |
| ID | Term |
|---|---|
| D004358 | Drug Therapy |
| D013812 | Therapeutics |
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