Trial Outcomes & Findings for Study of Alwextin® Cream in Treating Epidermolysis Bullosa (NCT NCT00825565)

NCT ID: NCT00825565

Last Updated: 2018-02-28

Results Overview

A common measure of the degree of involvement in skin disease is the Body Surface Area Index (BSAI). This measure is also commonly used in psoriasis studies. It is a global measure of disease "spread" with weighting factors.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

8 participants

Primary outcome timeframe

baseline and then every 4 weeks for a total of 12 weeks

Results posted on

2018-02-28

Participant Flow

Subjects were identified at regularly scheduled clinic visits with the Principal Investigator at Children's Memorial Hospital.

Subjects were instructed to discontinue use of allantoin 1.5% cream (Alwyn) for at least 30 days prior to initiating the study medication, allantoin 3% cream (Alwextin).

Participant milestones

Participant milestones
Measure
Allantoin 3% Cream
This is an open-label study in which all enrolled subjects were assigned to receive the study medication, allantoin 3% cream. Subjects were required to have a diagnosis of Epidermolysis Bullosa (EB). The diagnosis of EB was based on diagnostic immunomapping, electron microscopy, or the principal investigator's judgment based on clear clinical characteristics. Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Overall Study
STARTED
8
Overall Study
COMPLETED
8
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Study of Alwextin® Cream in Treating Epidermolysis Bullosa

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Allantoin 3% Cream
n=8 Participants
This is an open-label study in which all enrolled subjects were assigned to receive the study medication, allantoin 3% cream. Subjects were required to have a diagnosis of Epidermolysis Bullosa (EB). The diagnosis of EB was based on diagnostic immunomapping, electron microscopy, or the principal investigator's judgment based on clear clinical characteristics. Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Age, Categorical
<=18 years
8 Participants
n=93 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=93 Participants
Age, Categorical
>=65 years
0 Participants
n=93 Participants
Age, Continuous
3.3 years
STANDARD_DEVIATION 2.7 • n=93 Participants
Sex: Female, Male
Female
5 Participants
n=93 Participants
Sex: Female, Male
Male
3 Participants
n=93 Participants
Region of Enrollment
United States
8 participants
n=93 Participants

PRIMARY outcome

Timeframe: baseline and then every 4 weeks for a total of 12 weeks

Population: Subjects who used allantoin 3% cream for an entire month prior to the BSA monthly assessment were included in the analysis.

A common measure of the degree of involvement in skin disease is the Body Surface Area Index (BSAI). This measure is also commonly used in psoriasis studies. It is a global measure of disease "spread" with weighting factors.

Outcome measures

Outcome measures
Measure
Allantoin 3% Cream
n=8 Participants
Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Upper Limbs
Trunk
Lower Limbs
Blister/Erosion Reduction Based on Change in Body Surface Area (BSA) Coverage
Baseline assessment
57.25 percentage of BSA involvement
Standard Deviation 19.1
Blister/Erosion Reduction Based on Change in Body Surface Area (BSA) Coverage
Week 4 assessment
39.40 percentage of BSA involvement
Standard Deviation 24.1
Blister/Erosion Reduction Based on Change in Body Surface Area (BSA) Coverage
Week 8 assessment
27.25 percentage of BSA involvement
Standard Deviation 17.9
Blister/Erosion Reduction Based on Change in Body Surface Area (BSA) Coverage
Week 12 assessment
25.45 percentage of BSA involvement
Standard Deviation 21.1

PRIMARY outcome

Timeframe: baseline and then every 4 weeks for a total of 12 weeks

Population: Subjects who used allantoin 3% cream on the target wound daily up to full closure of that wound were included in the analysis.

EB patients may have chronic wounds which are resistant to healing. Wound size may be very large and the probability of total wound closure with currently available treatments is unlikely. Reduction in the size of wounds may be clinically important to the rate of infection and pain. If a patient has a reduction in the size of wounds which are refractory to healing, this may be seen as a positive outcome. Wound size reduction is one of the primary assessments used to determine the efficacy of the study cream. Wounds which had been present for at least several weeks prior to study entry were measured by using VISITRAK Digital, a Smith and Nephew wound tracing and measurement system that will calculate the length and width of the lesion (class 1 medical device; FDA listing designation E142354FDA). Only one target lesion per patient was used for the study assessment. At each subsequent study until the final visit, the target lesion was evaluated using VISITRAK Digital.

Outcome measures

Outcome measures
Measure
Allantoin 3% Cream
n=8 Participants
Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Upper Limbs
Trunk
Lower Limbs
Target Wound Size Reduction or Closure
Baseline assessment
8 number of unhealed target wounds
Target Wound Size Reduction or Closure
Week 12 assessment
1 number of unhealed target wounds

PRIMARY outcome

Timeframe: baseline and then every 4 weeks for a total of 12 weeks

Population: One subject discontinued after week 3. One subject discontinued at Month 2. Only data presented for subjects who used cream on entire body for the entire month was used in the analysis.

The FDA has suggested that a global measure of severity might be the best way to assess EB from visit to visit. Assessment score may be influenced by other clinical observations in addition to the percentage of body affected by blistering and erosions. The assessment was intended to be a "global impression." This scale produced a score with the following correlations: 0 = clear (no blistering/erosions) 1-2 = almost clear (infrequent blistering and erosions) 3-4 = mild disease (up to 15% of body affected) 5-6 = moderate disease (between 16-25% of body affected) 7-8 = severe disease (between 26-50% of body affected) 9-10 = very severe disease (greater than 50% of body affected)

Outcome measures

Outcome measures
Measure
Allantoin 3% Cream
n=8 Participants
Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Upper Limbs
Trunk
Lower Limbs
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 6
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 1
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 1
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 2
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 3
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 4
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 5
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 6
0 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 7
1 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 8
2 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 9
3 Participants
Physician Global Assessment of Severity (PGAS)
Baseline · PGAS score of 10
2 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 1
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 2
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 3
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 4
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 5
2 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 7
2 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 8
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 9
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 1 · PGAS score of 10
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 2
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 3
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 4
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 5
2 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 6
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 7
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 8
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 9
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 2 · PGAS score of 10
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 1
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 2
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 3
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 4
2 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 5
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 6
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 7
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 8
0 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 9
1 Participants
Physician Global Assessment of Severity (PGAS)
Month 3 · PGAS score of 10
0 Participants

PRIMARY outcome

Timeframe: baseline and at 12 weeks

Population: Subjects who used cream on entire body for the entire month was used in the analysis.

In addition to skin blistering and erosions, people with EB experience other symptoms, such as erythema on unblistered skin, wound oozing, weeping, and crusting. These symptoms may vary with area of the body evaluated. This scale evaluates the following signs: Blistering and erosions, oozing/weeping/crusting, pruritis, erythema on unblistered surrounding skin, pain, milia Each of these signs will be scored in 4 body areas: head/neck, upper limbs, trunk, lower limbs The following scale is used:0 = clear 1 = almost clear 2 = mild 3 = moderate 4 = severe

Outcome measures

Outcome measures
Measure
Allantoin 3% Cream
n=8 Participants
Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Upper Limbs
n=8 Participants
Trunk
n=8 Participants
Lower Limbs
n=8 Participants
Physician Assessment of Individual Signs
Milia- Month 3 · Severe
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Erythema- Month 3 · Severe
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia-Baseline · Clear
7 Participants
8 Participants
8 Participants
8 Participants
Physician Assessment of Individual Signs
Milia-Baseline · Almost Clear
1 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia-Baseline · Mild
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia-Baseline · Moderate
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia-Baseline · Severe
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia- Month 3 · Clear
3 Participants
3 Participants
3 Participants
4 Participants
Physician Assessment of Individual Signs
Milia- Month 3 · Almost Clear
1 Participants
0 Participants
1 Participants
0 Participants
Physician Assessment of Individual Signs
Milia- Month 3 · Mild
0 Participants
1 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Milia- Month 3 · Moderate
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pain-Month 3 · Clear
2 Participants
2 Participants
2 Participants
2 Participants
Physician Assessment of Individual Signs
Pruritis-Baseline · Severe
0 Participants
3 Participants
3 Participants
1 Participants
Physician Assessment of Individual Signs
Pruritus-Month 3 · Moderate
1 Participants
1 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Pruritus-Month 3 · Severe
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting-Baseline · Clear
1 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Erythema- Month 3 · Moderate
0 Participants
0 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting- Month 3 · Severe
0 Participants
0 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Pruritis-Baseline · Almost Clear
5 Participants
5 Participants
3 Participants
3 Participants
Physician Assessment of Individual Signs
Pruritis-Baseline · Mild
1 Participants
0 Participants
0 Participants
2 Participants
Physician Assessment of Individual Signs
Erythema-Baseline · Clear
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pain-Baseline · Clear
1 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pain-Baseline · Almost Clear
4 Participants
4 Participants
3 Participants
1 Participants
Physician Assessment of Individual Signs
Pain-Baseline · Mild
2 Participants
1 Participants
0 Participants
1 Participants
Physician Assessment of Individual Signs
Pain-Baseline · Moderate
0 Participants
1 Participants
3 Participants
2 Participants
Physician Assessment of Individual Signs
Pain-Baseline · Severe
1 Participants
2 Participants
2 Participants
4 Participants
Physician Assessment of Individual Signs
Pain-Month 3 · Almost Clear
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pain-Month 3 · Mild
2 Participants
1 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Pain-Month 3 · Moderate
0 Participants
1 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pain-Month 3 · Severe
0 Participants
0 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Pruritis-Baseline · Clear
2 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Pruritis-Baseline · Moderate
0 Participants
0 Participants
2 Participants
2 Participants
Physician Assessment of Individual Signs
Pruritus-Month 3 · Clear
3 Participants
2 Participants
2 Participants
2 Participants
Physician Assessment of Individual Signs
Pruritus-Month 3 · Almost Clear
0 Participants
1 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Pruritus-Month 3 · Mild
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Blisters/Erosions-Baseline · Clear
1 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Blisters/Erosions-Baseline · Almost Clear
1 Participants
1 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Blisters/Erosions-Baseline · Mild
4 Participants
1 Participants
2 Participants
0 Participants
Physician Assessment of Individual Signs
Blisters/Erosions-Baseline · Moderate
2 Participants
4 Participants
3 Participants
3 Participants
Physician Assessment of Individual Signs
Blisters/Erosions-Baseline · Severe
0 Participants
2 Participants
3 Participants
5 Participants
Physician Assessment of Individual Signs
Blisters/Erosions- Month 3 · Clear
0 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Blisters/Erosions- Month 3 · Almost Clear
2 Participants
0 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Blisters/Erosions- Month 3 · Mild
2 Participants
2 Participants
2 Participants
1 Participants
Physician Assessment of Individual Signs
Blisters/Erosions- Month 3 · Moderate
0 Participants
2 Participants
0 Participants
1 Participants
Physician Assessment of Individual Signs
Blisters/Erosions- Month 3 · Severe
0 Participants
0 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting-Baseline · Almost Clear
3 Participants
2 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting-Baseline · Mild
1 Participants
0 Participants
1 Participants
0 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting-Baseline · Moderate
3 Participants
5 Participants
3 Participants
3 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting-Baseline · Severe
0 Participants
1 Participants
3 Participants
4 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting- Month 3 · Clear
1 Participants
0 Participants
0 Participants
0 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting- Month 3 · Almost Clear
1 Participants
1 Participants
2 Participants
1 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting- Month 3 · Mild
0 Participants
1 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Oozing/Weeping/Crusting- Month 3 · Moderate
2 Participants
2 Participants
0 Participants
1 Participants
Physician Assessment of Individual Signs
Erythema-Baseline · Almost Clear
3 Participants
2 Participants
1 Participants
0 Participants
Physician Assessment of Individual Signs
Erythema-Baseline · Mild
4 Participants
1 Participants
1 Participants
3 Participants
Physician Assessment of Individual Signs
Erythema-Baseline · Moderate
0 Participants
3 Participants
2 Participants
2 Participants
Physician Assessment of Individual Signs
Erythema-Baseline · Severe
1 Participants
2 Participants
4 Participants
3 Participants
Physician Assessment of Individual Signs
Erythema- Month 3 · Clear
1 Participants
1 Participants
1 Participants
1 Participants
Physician Assessment of Individual Signs
Erythema- Month 3 · Almost Clear
2 Participants
2 Participants
2 Participants
2 Participants
Physician Assessment of Individual Signs
Erythema- Month 3 · Mild
1 Participants
1 Participants
0 Participants
0 Participants

Adverse Events

Allantoin 3% Cream

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Allantoin 3% Cream
n=8 participants at risk
This is an open-label study in which all enrolled subjects were assigned to receive the study medication, allantoin 3% cream. Subjects were required to have a diagnosis of Epidermolysis Bullosa (EB). The diagnosis of EB was based on diagnostic immunomapping, electron microscopy, or the principal investigator's judgment based on clear clinical characteristics. Subjects were instructed to apply allantoin 3% cream once daily to the entire body.
Skin and subcutaneous tissue disorders
red, itchy skin
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
Respiratory, thoracic and mediastinal disorders
cough
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
General disorders
fever
25.0%
2/8 • Number of events 2 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
Skin and subcutaneous tissue disorders
red spots on right foot
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
Skin and subcutaneous tissue disorders
red spots on left foot
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
Gastrointestinal disorders
diarrhea
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.
Gastrointestinal disorders
hematemesis
12.5%
1/8 • Number of events 1 • For 12 week duration of study. Adverse events (AE) and serious adverse events (SAE_that were unresolved by study completion date were followed for an additional 1 month post-study completion.
AE is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medical treatment or procedure. SAE meets any of these criteria: causes death, hospitalization, disability, or birth defect, is life-threatening, is an important medical event that may require intervention to prevent these outcomes.

Additional Information

Stephanie Rangel

Northwestern University

Phone: 312-503-5942

Results disclosure agreements

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