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Phase 1 Single Centre, open-labeled Clinical Trial to Evaluate the Safety and Tolerability of Topical Nitric Oxide Releasing Mouthwash (NORM) for the Management of Oropharyngeal Candidiasis.
Participants that meet all inclusion and exclusion criteria will be enrolled to receive open label NORM 3 doses/day for three weeks.
This is a single-center, open-label phase 1 clinical trial to evaluate NORM safety, tolerance and ability to eliminate Candida sp from the oropharyngeal cavity.
Adult volunteer patients with dry mouth and confirmed presence of candida (by oral smear due to any cause will be eligible, including autoimmune disease, idiopathic (aging, tobacco, approved inhaled recreational drug, or alcohol use), and medical management including chemotherapy-induced, radiotherapy-induced, bone marrow transplantation-induced, medication use including antibiotics, anti-inflammatories, etc.
Sufficient participants will be enrolled to achieve 10 evaluable participants. Participants who are currently pursuing other forms of treatment (within 2 weeks prior to enrollment) will be excluded from the study (unless participant agrees to a two weeks wash out period).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nitric Oxide Releasing Mouthwash | Experimental | Nitric Oxide Releasing Mouthwash (NORM) liquid producing NO at 266 ppm*min in 20mL |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nitric Oxide | Drug | Nitric Oxide Releasing Mouthwash will be self-administered by the participant three times throughout the day for 21 days. The intervention solution will be poured into their mouth from a medication cup containing 20 mL of the solution. Total exposure to study intervention will be a maximum of 63 treatments totaling 1,260 mL. All participants will be monitored for 7 days post-last treatment dose (to Day 28). |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the tolerability of NORM in participants with candidiasis. | Intolerance (i.e., oral cavity, dental, and/or lingual irritation or sensitivity (pain, swelling, erythema, discharge)), dysgeusia, or discoloration of oral cavity/teeth/tongue) as assessed by number of patients that terminate NORM treatment. | 21 days |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the effectiveness of NORM to resolve oral fungal infection | Assess the number of participants who experience clearing of the infection by negative smear/culture | 21 days |
| To assess the effectiveness of NORM to resolve clinical symptoms of candidiasis |
| Measure | Description | Time Frame |
|---|---|---|
| To categorize the major reasons impacting the tolerance of NORM during oral administration | Tolerance as assessed by number of patient reported outcomes (PRO) of irritation and dysgeusia of the rinse, dental sensitivity while willing to continue to use the rinse | 21 days |
| Determine incidence and severity of adverse reactions |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Keith Moore, PHARMMD | SaNOtize R&D Corp | Study Director |
| Joel Epstein | Atlantis Dental Cambie | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atlantis Dental Cambie | Vancouver | British Columbia | V5Z 4T1 | Canada |
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| Label | URL |
|---|---|
| Related Info | View source |
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| ID | Term |
|---|---|
| D002180 | Candidiasis, Oral |
| ID | Term |
|---|---|
| D002177 | Candidiasis |
| D009181 | Mycoses |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D009569 | Nitric Oxide |
| ID | Term |
|---|---|
| D026361 | Reactive Nitrogen Species |
| D005609 | Free Radicals |
| D007287 | Inorganic Chemicals |
| D009589 | Nitrogen Oxides |
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Open label
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|
|
Mean time to achieve clearing of clinical infection (no symptoms [0] or mild [1]) from Baseline until Day 21 |
| 21 days |
| To assess the effectiveness of NORM to reduce the need for an oral antifungal agent | Proportion of participants that require nystatin intervention | 21 days |
Safety as assessed by number and severity of adverse events |
| 21 days |
| To assess reoccurrence of candidiasis | Proportion of participants with reemergence of candidiasis infection | 28 days |
| To assess of exacerbation of candidiasis | Proportion of participants with an increased Candida sp. associated with their lesions (determined as an increase of 2 or more semi-quantitative steps (e.g., scant to moderate or light to heavy)) | 28 days |
| D009059 |
| Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D017672 |
| Nitrogen Compounds |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
| D009930 | Organic Chemicals |