Trial Outcomes & Findings for Efficacy and Safety of Ingenol Mebutate Gel 0.06% When Applied Once Daily for 2, 3 or 4 Consecutive Days to a Treatment Area of Approximately 250 cm2 on Trunk and Extremities in Subjects With Actinic Keratosis (NCT NCT01998984)

NCT ID: NCT01998984

Last Updated: 2025-03-10

Results Overview

Complete clearance of AKs at Week 8 was defined as a 100% reduction from baseline in number of AKs. The table presents the mean across 1000 multiple imputations. Missing values for AK count were imputed sequentially from a negative binomial regression model with treatment group, AK counts at the previous visit, and analysis site as covariates and log baseline AK count as offset.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

266 participants

Primary outcome timeframe

At Week 8

Results posted on

2025-03-10

Participant Flow

Participants were followed for 8 weeks following the first application of investigational medicinal product (IMP) at Day 1 (4-day treatment period including an 8-week follow-up period).

266 participants were enrolled of which 224 participants were randomized to treatment

Participant milestones

Participant milestones
Measure
Ingenol 2 Days
Ingenol mebutate gel 0.06% and vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg). Vehicle gel was applied for 2 days and ingenol mebutate gel 0.06% was applied for 2 days for a total 4 consecutive days.
Ingenol 3 Days
Ingenol mebutate gel 0.06% and vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg). Vehicle gel was applied for 1 day and ingenol mebutate gel 0.06% was applied for 3 days for a total 4 consecutive days.
Ingenol 4 Days
Ingenol mebutate gel 0.06% applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg) for 4 consecutive days.
Vehicle
Vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg) for 4 consecutive days.
Overall Study
STARTED
55
59
49
61
Overall Study
COMPLETED
55
58
48
58
Overall Study
NOT COMPLETED
0
1
1
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Ingenol 2 Days
Ingenol mebutate gel 0.06% and vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg). Vehicle gel was applied for 2 days and ingenol mebutate gel 0.06% was applied for 2 days for a total 4 consecutive days.
Ingenol 3 Days
Ingenol mebutate gel 0.06% and vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg). Vehicle gel was applied for 1 day and ingenol mebutate gel 0.06% was applied for 3 days for a total 4 consecutive days.
Ingenol 4 Days
Ingenol mebutate gel 0.06% applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg) for 4 consecutive days.
Vehicle
Vehicle gel applied topically once daily to a contiguous area of approximately 250 cm2 sun-damaged skin on trunk (except chest), or extremities (arm with or without back of hand, or leg) for 4 consecutive days.
Overall Study
Adverse Event
0
0
0
1
Overall Study
Lost to Follow-up
0
1
0
1
Overall Study
Withdrawal by Subject
0
0
1
0
Overall Study
Other
0
0
0
1

Baseline Characteristics

Efficacy and Safety of Ingenol Mebutate Gel 0.06% When Applied Once Daily for 2, 3 or 4 Consecutive Days to a Treatment Area of Approximately 250 cm2 on Trunk and Extremities in Subjects With Actinic Keratosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ingenol 2 Days
n=55 Participants
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 Participants
3 days treatment with ingenol mebutate 0.06% gel and 1 day treatment with vehicle gel
Ingenol 4 Days
n=49 Participants
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 Participants
4 days treatment with vehicle gel
Total
n=224 Participants
Total of all reporting groups
Age, Continuous
67.7 years
n=5 Participants
68.1 years
n=7 Participants
68.8 years
n=5 Participants
68.6 years
n=4 Participants
68.3 years
n=21 Participants
Sex: Female, Male
Female
20 Participants
n=5 Participants
27 Participants
n=7 Participants
13 Participants
n=5 Participants
20 Participants
n=4 Participants
80 Participants
n=21 Participants
Sex: Female, Male
Male
35 Participants
n=5 Participants
32 Participants
n=7 Participants
36 Participants
n=5 Participants
41 Participants
n=4 Participants
144 Participants
n=21 Participants
Region of Enrollment
United States
24 Participants
n=5 Participants
26 Participants
n=7 Participants
17 Participants
n=5 Participants
25 Participants
n=4 Participants
92 Participants
n=21 Participants
Region of Enrollment
Australia
31 Participants
n=5 Participants
33 Participants
n=7 Participants
32 Participants
n=5 Participants
36 Participants
n=4 Participants
132 Participants
n=21 Participants

PRIMARY outcome

Timeframe: At Week 8

Population: The analysis was based on the Full Analysis Set, which was defined as all randomized participants.

Complete clearance of AKs at Week 8 was defined as a 100% reduction from baseline in number of AKs. The table presents the mean across 1000 multiple imputations. Missing values for AK count were imputed sequentially from a negative binomial regression model with treatment group, AK counts at the previous visit, and analysis site as covariates and log baseline AK count as offset.

Outcome measures

Outcome measures
Measure
Ingenol 2 Days
n=55 Participants
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 Participants
1 day treatment with vehicle gel and 3 days treatment with ingenol mebutate 0.06% gel
Ingenol 4 Days
n=49 Participants
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 Participants
4 days treatment with vehicle gel
Percentage of Participants With Complete Clearance of Actinic Keratosis Lesions (AKs)
12.7 percentage of participants
5.1 percentage of participants
26.8 percentage of participants
0.0 percentage of participants

SECONDARY outcome

Timeframe: At Week 8

Population: The analysis was based on the Full Analysis Set, which was defined as all randomized participants.

The number of clinically visible AK lesions identified in the treatment area was to be recorded at Visit 1(≤14 days prior to Day 1). The analysis was based on 1000 imputations of actinic keratosis lesion count at Week 8 using a negative binomial regression model with factors treatment and analysis site and with log of baseline actinic keratosis lesion count as offset. The table shows the adjusted percentage reduction from baseline. Values for the Ingenol 4 days arm were calculated separately based on observed cases. On the basis of the data monitoring committee's recommendation the 4-day active treatment group was closed, and this arm was excluded from statistical models and comparisons in the secondary efficacy analyses.

Outcome measures

Outcome measures
Measure
Ingenol 2 Days
n=55 Participants
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 Participants
1 day treatment with vehicle gel and 3 days treatment with ingenol mebutate 0.06% gel
Ingenol 4 Days
n=48 Participants
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 Participants
4 days treatment with vehicle gel
Percentage of Reduction in Actinic Keratosis (AK) Lesion Count From Baseline (Day 1) (Multiple Imputation)
64.5 percentage of reduction
Interval 57.8 to 70.2
68.3 percentage of reduction
Interval 62.4 to 73.4
73.6 percentage of reduction
Interval 65.8 to 81.5
11.9 percentage of reduction
Interval -2.2 to 24.1

SECONDARY outcome

Timeframe: At Week 8

Population: The analysis was based on the Full Analysis Set, which was defined as all randomized participants.

Partial clearance of AKs at Week 8, defined as at least 75% reduction from baseline in number of AKs, was analysed in the same way as the primary response criterion. The percent reduction at Week 8 from baseline was analyzed using a negative binomial regression for the AK count at Week 8 with treatment group and pooled sites as factors and baseline count as offset variable (using multiple imputations to account for missing values). The table presents the mean across 1000 multiple imputations. Missing values for AK count were imputed sequentially from a negative binomial regression model with treatment group, AK counts at the previous visit, and analysis site as covariates and log baseline AK count as offset.

Outcome measures

Outcome measures
Measure
Ingenol 2 Days
n=55 Participants
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 Participants
1 day treatment with vehicle gel and 3 days treatment with ingenol mebutate 0.06% gel
Ingenol 4 Days
n=49 Participants
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 Participants
4 days treatment with vehicle gel
Percentage of Participants With Partial Clearance of AKs
47.3 percentage of participants
56.2 percentage of participants
60.4 percentage of participants
2.0 percentage of participants

Adverse Events

Ingenol 2 Days

Serious events: 3 serious events
Other events: 48 other events
Deaths: 0 deaths

Ingenol 3 Days

Serious events: 5 serious events
Other events: 55 other events
Deaths: 0 deaths

Ingenol 4 Days

Serious events: 4 serious events
Other events: 47 other events
Deaths: 0 deaths

Vehicle

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

Serious adverse events

Serious adverse events
Measure
Ingenol 2 Days
n=55 participants at risk
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 participants at risk
1 day treatment with vehicle gel and 3 days treatment with ingenol mebutate 0.06% gel
Ingenol 4 Days
n=49 participants at risk
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 participants at risk
4 days treatment with vehicle gel
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Squamous cell carcinoma of skin
5.5%
3/55 • From Day 1 to Week 8 (Day 56)
6.8%
4/59 • From Day 1 to Week 8 (Day 56)
6.1%
3/49 • From Day 1 to Week 8 (Day 56)
0.00%
0/61 • From Day 1 to Week 8 (Day 56)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Keratoacanthoma
0.00%
0/55 • From Day 1 to Week 8 (Day 56)
0.00%
0/59 • From Day 1 to Week 8 (Day 56)
2.0%
1/49 • From Day 1 to Week 8 (Day 56)
0.00%
0/61 • From Day 1 to Week 8 (Day 56)
Cardiac disorders
Angina pectoris
0.00%
0/55 • From Day 1 to Week 8 (Day 56)
1.7%
1/59 • From Day 1 to Week 8 (Day 56)
0.00%
0/49 • From Day 1 to Week 8 (Day 56)
0.00%
0/61 • From Day 1 to Week 8 (Day 56)

Other adverse events

Other adverse events
Measure
Ingenol 2 Days
n=55 participants at risk
2 days treatment with ingenol mebutate 0.06% gel and 2 days treatment with vehicle gel
Ingenol 3 Days
n=59 participants at risk
1 day treatment with vehicle gel and 3 days treatment with ingenol mebutate 0.06% gel
Ingenol 4 Days
n=49 participants at risk
4 days treatment with ingenol mebutate 0.06% gel
Vehicle
n=61 participants at risk
4 days treatment with vehicle gel
General disorders
Application site pain
81.8%
45/55 • From Day 1 to Week 8 (Day 56)
84.7%
50/59 • From Day 1 to Week 8 (Day 56)
87.8%
43/49 • From Day 1 to Week 8 (Day 56)
4.9%
3/61 • From Day 1 to Week 8 (Day 56)
General disorders
Application site pruritus
34.5%
19/55 • From Day 1 to Week 8 (Day 56)
45.8%
27/59 • From Day 1 to Week 8 (Day 56)
28.6%
14/49 • From Day 1 to Week 8 (Day 56)
3.3%
2/61 • From Day 1 to Week 8 (Day 56)
General disorders
Application site discomfort
3.6%
2/55 • From Day 1 to Week 8 (Day 56)
5.1%
3/59 • From Day 1 to Week 8 (Day 56)
4.1%
2/49 • From Day 1 to Week 8 (Day 56)
1.6%
1/61 • From Day 1 to Week 8 (Day 56)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Bowen's disease
1.8%
1/55 • From Day 1 to Week 8 (Day 56)
0.00%
0/59 • From Day 1 to Week 8 (Day 56)
6.1%
3/49 • From Day 1 to Week 8 (Day 56)
1.6%
1/61 • From Day 1 to Week 8 (Day 56)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Seborrhoeic keratosis
1.8%
1/55 • From Day 1 to Week 8 (Day 56)
0.00%
0/59 • From Day 1 to Week 8 (Day 56)
6.1%
3/49 • From Day 1 to Week 8 (Day 56)
0.00%
0/61 • From Day 1 to Week 8 (Day 56)
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/55 • From Day 1 to Week 8 (Day 56)
5.1%
3/59 • From Day 1 to Week 8 (Day 56)
2.0%
1/49 • From Day 1 to Week 8 (Day 56)
0.00%
0/61 • From Day 1 to Week 8 (Day 56)

Additional Information

Clinical Trial Disclosure Manager

LEO Pharma A/S

Phone: +45 4494 5888

Results disclosure agreements

  • Principal investigator is a sponsor employee Prior to submitting or presenting a manuscript relating to the clinical trial to a publisher, reviewer or other outside person, the investigator shall provide to LEO Pharma A/S a copy of all such manuscripts, and LEO Pharma A/S shall have rights to review and comment. Upon the request of LEO Pharma A/S the investigator shall remove any confidential information (other than results generated by the investigator) prior to submitting or presenting the manuscripts.
  • Publication restrictions are in place

Restriction type: OTHER