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| Name | Class |
|---|---|
| South Florida Family Health and Research Centers | NETWORK |
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The purpose of this study is to evaluate the safety and efficacy of Vamousse Spray 'n' Go, compared to a 1% Permethrin control shampoo, in the treatment of head lice.
This is a Study to Evaluate the Safety and Efficacy of Alliance Pharmaceutical Product in Subjects Infested with Pediculosis Capitis. The subject population includes healthy male and female subjects aged 2 years and up who are infested with Pediculus humanus capitis. Household members infestation with an active head lice, defined as at least 1 live louse (adult and/or nymph) present on the scalp and/or hair as determined by a trained evaluator, will receive treatment with study product at baseline.
The planned overall sample size for this clinical trial is approximately n=58 subjects, equally divided between treatment and control groups. Potential subjects will be screened for eligibility and if eligible to participate, their infestation level will be rated. Eligible subjects at each infestation level will be assigned alternately to the treatment or control group to ensure that the two groups have approximately equal representations of infestation severity levels. Level of infestation will be rated as heavy, moderate or light described by how quickly lice were found during combing: heavy infestation = >1 louse with one stroke of the comb; moderate infestation =1 louse with one stroke of the comb; light infestation = first louse found only after several strokes of the comb.
Randomly assign subjects to treatment or control group based on infestation severity alternation system (i.e., randomly assign pairs of equal severity levels to treatment and control groups, a form of stratified random sampling) to achieve balanced representation of severity in the two groups.
After assignment to a study group, each eligible subject will receive the application of either the Alliance Pharmaceutical Product Vamousse Spray 'n' Go drug or the Permethrin-based control drug. Infested household members will be treated with the Vamousse Spray 'n' Go or Permethrin lotion on-site (i.e., the household members should be assigned to the same treatment as the index case). During the baseline visit (Day 0), the Investigator and clinical staff members will record subject's demographics; elicit informed consent; obtain medical history; review concomitant medication to identify any prohibited therapies the subject may be receiving; collect vital signs; conduct visual assessment of head lice, specifically counting live lice and nits with stages noted, using a 15 inch led 5x magnifying procedure lamp and if needed for confirmation, laboratory microscopes; perform physical examination; assess local skin/ scalp irritation; assess ocular irritation; perform urine pregnancy test on females; and conduct an adverse event assessment.
At day 7, if live lice are still present, a repeat treatment will be administered. After day 7 if a subject reports clear signs of infestation ( i.e., the presence of live lice), they will be regarded as a treatment failure and they will be offered treatment with an alternative product (viz., Vamousse Mousse ) by clinical staff.
For the treatment group, Clinical staff will apply Vamousse Spray 'n' Go to fully coat dry hair and scalp, avoiding the eyes and mucus membranes. The Treatment will be left on the hair and scalp for 8 hours, then standard at home shampoo and rinsed off with warm water, followed by combing. The Treatment spray bottle is intended for a single use although it contains a sufficient quantity for two treatments. All household members will be instructed on an overall lice management program, which includes:
For the control group, Clinical staff will first shampoo the hair and scalp using regular shampoo. They will then thoroughly rinse and towel dry the hair and scalp, and allow hair to air dry for a few minutes. Shaking the permethrin lotion well before applying, they will proceed to thoroughly wet the hair and scalp with the permethrin lotion, being sure also to cover the areas behind the ears and on the back of the neck. After allowing the lotion to remain in place for 10 minutes, they will then rinse the hair and scalp thoroughly and dry with a clean towel.
The site will provide Subject with lice management instructions. Subjects will return for post-baseline visits assessments at Day 2, Day 7, and Day 14.
Day 2: The Investigator and medical staff will collect medical history, collect vital signs, perform physical examination, scalp irritation assessment, ocular irritation assessment and adverse events assessment, perform a visual assessment for the presence or absence of head lice, (Lice will be counted, each stage examined and noted live or dead; 15in led 5x magnifying procedure lamp or laboratory microscopes are used for confirmation if needed, Without clipping hair strands, nits will also be examined, each stage examined and noted hatched or unhatched), and adverse events assessment Urine pregnancy testing will be performed on each Visit, with interim visits confirming pregnancy has not occurred through questioning participating subject and legal guardian.
Day 7: The Investigator and medical staff will collect medical history, collect vital signs, perform a physical examination, assess scalp irritation, assess ocular irritation and adverse events, perform a visual assessment for the presence of head lice (lice will be counted, each stage identified, and noted live or dead; 15in led 5x magnifying procedure lamp or laboratory microscopes will be used for confirmation if needed; without clipping hair strands, nits will also be examined, each stage examined, and noted hatched or unhatched). Urine pregnancy testing of females will be performed on each visit, with interim visits confirming pregnancy has not occurred through questioning participating subject and legal guardian. If, at day 7, live lice are still present, a repeat Vamousse Spray 'n' Go or Permethrin (depending on study group) shampoo treatment will be administered.
Day 14: The Investigator and medical staff will collect medical history, concomitant and prohibited medication review, perform vital signs, urine pregnancy testing if applicable, perform physical examination, record local application site reactions, ocular irritation assessment, perform a visual assessment for the presence of head lice (lice will be removed, counted, each stage examined and noted live or dead; 15 inch led 5x magnifying procedure lamp or laboratory microscopes are used for confirmation; nits will also be removed by clipping hair strands, examined, each stage counted, and noted as hatched or unhatched) and adverse events assessment. By day 14 if a subject reports clear signs of infestation (i.e., the presence of live lice) they will be regarded as a treatment failure and will be offered treatment with an alternative product (Vamousse Mousse) by clinical staff.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vamousse Spray 'n' Go | Experimental | Clinical staff will apply Vamousse Spray 'n' Go during the baseline visit (Day 0) to fully coat the hair and scalp. The treatment will be left on for 8 hours, then standard at home shampoo will be used and rinsed off with warm water, followed by combing. At day 7, if live lice are still present, a repeat treatment will be administered. |
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| Nix Creme Rinse Lice Treatment | Active Comparator | During the baseline visit (Day 0) clinical staff will first shampoo the hair and scalp using regular shampoo. They will then thoroughly rinse and towel dry the hair and scalp, and allow hair to air dry for a few minutes. Staff will shake Nix Creme Rinse Lice Treatment (1% permethrin lotion) well before applying, they will then proceed to thoroughly wet the hair and scalp with the lotion, being sure to cover the areas behind the ears and on the back of the neck. After allowing the lotion to remain in place for 10 minutes, they will rinse the hair and scalp thoroughly and dry with a clean towel. At day 7, if live lice are still present, a repeat treatment will be administered. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vamousse Spray 'n' Go | Other | Pediculicide for topical application, active ingredient Natrum Muriaticum 2X (HPUS). |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Participants Who Are Completely Free of Live Lice | The total numbers of subjects in each group free of live lice at Days 2, 7, and 14, where 'live lice free" is defined as no presence of live adult or nymph lice. Zero subjects in each group were free of live lice at baseline. Since the two groups differed substantially in size, the numbers of live lice free subjects in each group at Days 2, 7, and 14 were transformed for analytical purposes to proportions of the respective group's participant totals on the respective days in order to achieve a metric that reflects commensurate degrees of difference between the two groups. | 2, 7, and 14 days from baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Change in Total Number of Live Adult Lice and Nymphs From the Baseline | The counts of live lice at Days 2, 7, and 14 for were subtracted from the respective each participant's baseline count for the respective day. The resulting raw differences were transformed for analytical purposes to proportions of the respective participant's baseline live lice count in order to achieve a metric that reflected commensurate degrees of change, the means of which could be compared between the two groups for each interval from baseline. All proportions of change from baseline are negatively signed to reflect a reduction in the count from baseline, which occurred for both groups on all 3 post-baseline assessment days. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Susel L Gonzalez Acosta, APRN | South Florida Family Health and Research Centers | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South Florida Family Health and Research Centers, LLC. | Miami | Florida | 33186 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22715834 | Background | Barker SC, Burgess I, Meinking TL, Mumcuoglu KY. International guidelines for clinical trials with pediculicides. Int J Dermatol. 2012 Jul;51(7):853-8. doi: 10.1111/j.1365-4632.2011.05446.x. | |
| 26511728 | Background | Birkemoe T, Lindstedt HH, Ottesen P, Soleng A, Naess O, Rukke BA. Head lice predictors and infestation dynamics among primary school children in Norway. Fam Pract. 2016 Feb;33(1):23-9. doi: 10.1093/fampra/cmv081. Epub 2015 Oct 28. |
| Label | URL |
|---|---|
| Head Lice Infestation: Developing Drugs for Topical Treatment - Guidance for Industry. U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research October 2016 | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Vamousse Spray 'n' Go |
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| FG001 | Nix Creme Rinse Lice Treatment |
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| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2 Day Treatment Effectiveness |
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| 7 Day Treatment Effectiveness |
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| 14 Day Treatment Effectiveness |
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The pattern of infestation levels of the primary participant in each household and the sizes of the households that were encountered in the sequential enrollment process resulted in an imbalance between the numbers of participants in the two treatment groups by the time that the study total of 58 participants was reached. Resources did not permit further enlargement of the sample to reduce this imbalance, but the power of the study to detect the difference that occurred remained high at .95.
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| ID | Title | Description |
|---|---|---|
| BG000 | Vamousse Spray 'n' Go | The Vamousse Spray 'n' Go group is defined as the group of lice infected subjects who were treated with the Vamousse Spray 'n' Go product at baseline and if needed, on Day 7 following baseline. Treatment with this product consisted of fully coating the hair and scalp with the product, leaving it on for 8 hours and then shampooing at home by the subject with the subject's usual shampoo, and rinsed off with warm water followed by combing. |
| Units | Counts |
|---|---|
| Participants |
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| 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 | Proportion of Participants Who Are Completely Free of Live Lice | The total numbers of subjects in each group free of live lice at Days 2, 7, and 14, where 'live lice free" is defined as no presence of live adult or nymph lice. Zero subjects in each group were free of live lice at baseline. Since the two groups differed substantially in size, the numbers of live lice free subjects in each group at Days 2, 7, and 14 were transformed for analytical purposes to proportions of the respective group's participant totals on the respective days in order to achieve a metric that reflects commensurate degrees of difference between the two groups. | The 58 subjects who completed one or more of the three post-baseline assessments. | Posted | Number | proportion of subjects free of live lice | 2, 7, and 14 days from baseline |
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Day 0 through Day 14 for each participant.
Systematic assessment was conducted by onsite clinical research staff members through collection of patient history, physical examination, and laboratory tests at baseline, Day 2, Day 7, and Day 14. This assessment was sufficiently thorough to have detected the onset or effects of any adverse reactions to the treatments and or excessive infestation due to insufficient mitigation by the treatments.
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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 | Vamousse Spray 'n' Go |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| R&D Director | Alliance Pharmaceuticals | 01249 466966 | +44 | medaffairs@allianceph.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 27, 2022 | Aug 14, 2023 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D010373 | Lice Infestations |
| D010272 | Parasitic Diseases |
| ID | Term |
|---|---|
| D004478 | Ectoparasitic Infestations |
| D012876 | Skin Diseases, Parasitic |
| D007239 | Infections |
| D012874 | Skin Diseases, Infectious |
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Parallel group design with participants randomised, Randomly assign subjects to treatment or control group based on infestation severity alternation system, to Vamousse Spray 'n' Go or 1% Permethrin control.
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| Nix Creme Rinse Lice Treatment | Drug | 1% permethrin lotion for topical application. |
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| 2, 7, and 14 days from baseline |
| NOT COMPLETED |
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| NOT COMPLETED |
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| BG001 | Nix Creme Rinse Lice Treatment | The Nix Creme Rinse Lice Treatment group is defined as the group of lice infected subjects who were treated with the Nix Creme Rinse Lice Treatment at baseline and if needed, on Day 7 following baseline. Treatment with this product consisted of the clinical staff first shampooing the subject's hair and scalp using regular shampoo and then thoroughly rinsing and towel drying the person's hair and scalp. After allowing the hair to air dry for a few minutes, they then thoroughly wet the subject's hair and scalp with the Nix Creme Rinse Lice Treatment lotion, being sure to cover the areas behind the ears and on the back of the neck.The lotion was allowed to remain in place for 10 minutes, after which the hair and scalp were thoroughly rinsed and dried with a clean towel. |
| BG002 | Total | Total of all reporting groups |
| Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| Count of live lice | The count of live lice consisted of the number of live adult and nymph lice found anywhere above the shoulders on the subject. | Number | live lice |
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| OG001 | Nix Creme Rinse Lice Treatment | The Nix Creme Rinse Lice Treatment group is defined as the group of lice infected subjects who were treated with the Nix Creme Rinse Lice Treatment at baseline and if needed, on Day 7 following baseline. Treatment with this product consisted of the clinical staff first shampooing the subject's hair and scalp using regular shampoo and then thoroughly rinsing and towel drying the person's hair and scalp. After allowing the hair to air dry for a few minutes, they then thoroughly wet the subject's hair and scalp with the Nix Creme Rinse Lice Treatment lotion, being sure to cover the areas behind the ears and on the back of the neck.The lotion was allowed to remain in place for 10 minutes, after which the hair and scalp were thoroughly rinsed and dried with a clean towel. |
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| Secondary | Proportion of Change in Total Number of Live Adult Lice and Nymphs From the Baseline | The counts of live lice at Days 2, 7, and 14 for were subtracted from the respective each participant's baseline count for the respective day. The resulting raw differences were transformed for analytical purposes to proportions of the respective participant's baseline live lice count in order to achieve a metric that reflected commensurate degrees of change, the means of which could be compared between the two groups for each interval from baseline. All proportions of change from baseline are negatively signed to reflect a reduction in the count from baseline, which occurred for both groups on all 3 post-baseline assessment days. | All subjects who had completed one or more of the three assessments during the 14 day post-baseline portion of the study. | Posted | Mean | Standard Deviation | proportion of change in number live lice | 2, 7, and 14 days from baseline |
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| 0 |
| 43 |
| 0 |
| 43 |
| 0 |
| 43 |
| EG001 | Nix Creme Rinse Lice Treatment |
| 0 | 15 | 0 | 15 | 0 | 15 |
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| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| Day 7 proportion of change from baseline |
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| Day 14 proportion of change from baseline |
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Direction of comparison: Vamousse prop. reduction in live lice count from Day O - Nix prop. reduction in live lice count from Day O |
| Superiority |
To check on the effect of the non-normality of the change proportions, the nonparametric Mann-Whitney test was also performed. The null hypothesis is one-tailed. However, for consistency with the practice of reporting conservative p-values in clinical studies, the two-tailed p-value will be reported. |
| Null hypothesis: At Day 7 the proportion of decrease from baseline in the number of live lice in the Vamousse group does not exceed that in the Nix group. The distribution of the Day 0 to Day 7 change proportions deviated significantly from normality by the Shapiro-Wilk test for both the Vamousse and combined samples. However, the t-test is robust to such departures from normality for samples of this size and was used to compare the two groups on their mean change proportions. | t-test, 2 sided | Levine's test for violation of equality of variances nonsignificant; no df adjustment necessary. | .334 | Alpha = .05 t: .976 df: 54 Mann-Whitney Z: 3.021 p(2-tailed) of Mann-Whitney Z: .003 Cohen's d = .294 | Mean Difference (Final Values) | .178 | Standard Error of the Mean | .182 | 2-Sided | 95 | -.187 | .543 | Superiority | The nonparametric Mann-Whitney test was also conducted to check on the effect of the non-normality of the change proportions. The null hypothesis is one-tailed. However, for consistency with the practice of reporting conservative p-values in clinical studies, the two-tailed p-value will be reported. |
| Null hypothesis: At Day 14 the proportion of decrease from baseline in the number of live lice in the Vamousse group does not exceed that in the Nix group. The distribution of the Day 0 to Day 14 change proportion deviated significantly from normality by the Shapiro-Wilk test for both the Vamousse and combined samples. However, the t-test is robust to such departures from normality for samples of this size and was used to compare the two groups on the mean change proportions. | t-test, 2 sided | Degrees of freedom for the t-test were adjusted for inequality of variances between the groups using the Satterthwaite correction: df(adj) = 16.2 | .037 | Alpha = .05 t: 2.276 df(adjusted, see comment below): 16.2 Mann-Whitney Z: 2.478 p(2-tailed) of Mann-Whitney Z: .013 Cohen's d = .947 | Difference between proportions | .235 | Standard Error of the Mean | .1034 | 2-Sided | 95 | .016 | .454 | Superiority | The nonparametric Mann-Whitney test was also conducted to check on the effect of the non-normality of the change proportions. The null hypothesis is one-tailed. However, for consistency with the practice of reporting conservative p-values in clinical studies, the two-tailed p-value will be reported. |