Trial Outcomes & Findings for Safety and Effectiveness Study of Imiquimod Creams for Treatment of Actinic Keratoses (AKs) (NCT NCT00605176)

NCT ID: NCT00605176

Last Updated: 2010-06-29

Results Overview

Subject status with respect to complete clearance of AK lesions at End of Study (EOS), ie, the Week 14 visit. Complete clearance was defined as the absence of clinically visible or palpable AK lesions in the treatment area. All lesions within the identified treatment area were included in the count, even if the lesion was a new lesion or 'subclinical' lesion that had not been identified at Baseline.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

479 participants

Primary outcome timeframe

End of Study the Week 14 visit

Results posted on

2010-06-29

Participant Flow

Recruitment started on January 15, 2008 all subjects were randomized by March 17, 2008. The studies were performed at 26 investigational centers in the United States.

Subjects were screened and had to meet eligibility requirements for randomization. The most frequent reason for screen failure (104 of screen failures) was that the subject did not have between 5 and 20 visible or palpable Actinic Keratosis (AK) lesions on either the face or the balding scalp.

Participant milestones

Participant milestones
Measure
3.75% Imiquimod Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Overall Study
STARTED
160
160
159
Overall Study
COMPLETED
149
154
150
Overall Study
NOT COMPLETED
11
6
9

Reasons for withdrawal

Reasons for withdrawal
Measure
3.75% Imiquimod Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Overall Study
Adverse Event
2
1
3
Overall Study
Withdrawal by Subject
4
2
4
Overall Study
Lost to Follow-up
2
2
1
Overall Study
Non-complicance with study procedures
1
0
0
Overall Study
Use of concomitant therapy
1
0
1
Overall Study
Other (not due to AE)
1
1
0

Baseline Characteristics

Safety and Effectiveness Study of Imiquimod Creams for Treatment of Actinic Keratoses (AKs)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
3.75% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Total
n=479 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
82 Participants
n=5 Participants
88 Participants
n=7 Participants
90 Participants
n=5 Participants
260 Participants
n=4 Participants
Age, Categorical
>=65 years
78 Participants
n=5 Participants
72 Participants
n=7 Participants
69 Participants
n=5 Participants
219 Participants
n=4 Participants
Age Continuous
64.5 years
STANDARD_DEVIATION 10.6 • n=5 Participants
64.3 years
STANDARD_DEVIATION 10.5 • n=7 Participants
64.3 years
STANDARD_DEVIATION 8.9 • n=5 Participants
64.4 years
STANDARD_DEVIATION 10.0 • n=4 Participants
Sex: Female, Male
Female
28 Participants
n=5 Participants
33 Participants
n=7 Participants
29 Participants
n=5 Participants
90 Participants
n=4 Participants
Sex: Female, Male
Male
132 Participants
n=5 Participants
127 Participants
n=7 Participants
130 Participants
n=5 Participants
389 Participants
n=4 Participants
Region of Enrollment
United States
160 participants
n=5 Participants
160 participants
n=7 Participants
159 participants
n=5 Participants
479 participants
n=4 Participants

PRIMARY outcome

Timeframe: End of Study the Week 14 visit

Population: Efficacy analyses were conducted on the intent-to-treat (ITT) population. For the primary efficacy variable, imputations were made for missing data points using last observation carried forward (LOCF, primary analysis), taking all missed observations as failure (sensitivity analysis), and using observed cases only (supportive analysis).

Subject status with respect to complete clearance of AK lesions at End of Study (EOS), ie, the Week 14 visit. Complete clearance was defined as the absence of clinically visible or palpable AK lesions in the treatment area. All lesions within the identified treatment area were included in the count, even if the lesion was a new lesion or 'subclinical' lesion that had not been identified at Baseline.

Outcome measures

Outcome measures
Measure
3.75% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Number of Participants With Complete Clearance of AK Lesions
57 participants
49 participants
10 participants

SECONDARY outcome

Timeframe: End of Study the Week 14 visit

Population: Efficacy analyses were conducted on the intent-to-treat (ITT) population. Imputations were made for missing data points using last observation carried forward (LOCF).

Subject status with respect to partial clearance of AK lesions at end of study (EOS), defined as at least a 75% reduction in the number of AK lesions in the treatment area compared with Baseline.

Outcome measures

Outcome measures
Measure
3.75% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Number of Participants With Partial Clearance of AK Lesions
95 participants
77 participants
36 participants

SECONDARY outcome

Timeframe: From baseline to End of Study the Week 14 visit

Population: Intent to treat (ITT) Last Observation Carried Forward (LOCF)

Percent change from Baseline to end of study (EOS) in investigator counts of AK lesions.

Outcome measures

Outcome measures
Measure
3.75% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Percent Change From Baseline in AK Lesion Count
-81.8 percent change
Interval -100.0 to 188.9
-71.8 percent change
Interval -100.0 to 90.0
-25.0 percent change
Interval -100.0 to 300.0

SECONDARY outcome

Timeframe: At all visits - from Baseline to End of study (Week 14)

Population: All participants were evaluated for local skin reactions (LSR) at every visit. Summary of LSR - area under the curve (AUC) of sum of LSR Scores (days). ITT population. The time period for the AUC extends to 8 weeks after the end of treatment (Week 14). Only subjects who received treatment in both treatment cycles are included in this analysis.

Six local skin reaction (LSR) signs were predefined and were assessed for presence and intensity at each study visit. These included: Erythema, Edema, Weeping/Exudate, Flaking/Scaling/Dryness, Scabbing/Crusting and Erosion/Ulceration. The LSRs were scored as 0=none, 1=mild, 2=moderate, 3=severe. Mean scores were summated over time (14 weeks) to yield a mean LSR AUC (area under the curve)

Outcome measures

Outcome measures
Measure
3.75% Imiquimod Cream
n=148 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=158 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=153 Participants
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Local Skin Reactions
272.0 units on a scale * days
Standard Deviation 123.0
242.5 units on a scale * days
Standard Deviation 126.2
139.8 units on a scale * days
Standard Deviation 104.1

Adverse Events

3.75% Imiquimod Cream

Serious events: 5 serious events
Other events: 14 other events
Deaths: 0 deaths

2.5% Imiquimod Cream

Serious events: 5 serious events
Other events: 7 other events
Deaths: 0 deaths

Placebo Cream

Serious events: 2 serious events
Other events: 13 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
3.75% Imiquimod Cream
n=160 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Nervous system disorders
Cerebrovascular accident
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Cardiac disorders
Atrial fibrillation
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Gastrointestinal disorders
Small intestine obstruction
0.62%
1/160 • Number of events 2 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Psychiatric disorders
Anxiety
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Cardiac disorders
Chest pain
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Gastrointestinal disorders
Diarrhea
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Infections and infestations
Pneumonia bacterial
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Cardiac disorders
Acute myocardial infarction
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
General disorders
Non-cardiac chest pain
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Infections and infestations
Pneumonia
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Cardiac disorders
Angina pectoris
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.62%
1/160 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/159 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Gastrointestinal disorders
Intestinal obstruction
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.63%
1/159 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Reproductive system and breast disorders
Prostatitis
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.00%
0/160 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
0.63%
1/159 • Number of events 1 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.

Other adverse events

Other adverse events
Measure
3.75% Imiquimod Cream
n=160 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
2.5% Imiquimod Cream
n=160 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Placebo Cream
n=159 participants at risk
250 mg/packet, up to 2 packets applied daily for 2 treatment cycles. The first treatment cycle consisted of 2 weeks of daily treatment followed by 2 weeks of no treatment, and the second treatment cycle consisted of an additional 2 weeks of daily treatment followed by 8 weeks of no treatment.
Nervous system disorders
Headache
6.2%
10/160 • Number of events 10 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
1.9%
3/160 • Number of events 3 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
3.1%
5/159 • Number of events 5 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
Infections and infestations
Nasopharyngitis
2.5%
4/160 • Number of events 4 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
2.5%
4/160 • Number of events 4 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.
5.0%
8/159 • Number of events 8 • From study screening through the last study visit. Day 1 (first study visit) through the end of study (Week 14 visit)
Subjects were queried indirectly regarding AEs during each study visit.

Additional Information

Sharon F. Levy, MD

Graceway Pharmaceuticals LLC

Phone: 267-948-0400

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place