This study is designed to assess skin tolerability, skin irritation, and adhesion of the 350 mg Donepezil Transdermal Patch (DTP-system), following 3, 7-day applications to 3 specific areas of the body (upper back, upper middle arm, side of torso) of elderly Alzheimer's patients. The total application time for the DTP-system is 21 days.
This is a randomized, placebo-controlled study designed to evaluate skin irritation, skin tolerability, and adhesion of the 350 mg DTP-system following 3 consecutive 7-day applications to 3 specific areas of the body (upper back, upper arm, side of torso) of elderly Alzheimer's patients. The total exposure time for the DTP-system is 21 days. All patients receive 1 Donepezil Transdermal Patch (DTP-system) and 1 placebo patch, each applied to opposite sides of the body (e.g., placebo patch to the left side of the upper back, and DTP-system to the right side of the upper back). Patients are randomized to receive the active patch to either the left or the right side of the body according to 1 of 6 treatment sequences listed below. The treatment sequence is repeated for the opposite side of the body for a total of 12 treatment sequences (4 patients in each treatment sequence). The patches are applied to one of 3 body locations for 7 days, for a total exposure period of 21 days, according to one of the following sequences: 1. Upper Back, Upper Arm, Side of Torso (Right) 2. Upper Arm, Side of Torso, Upper Back (Right) 3. Side of Torso, Upper Back, Upper Arm (Right) 4. Upper Back, Side of Torso, Upper Arm (Right) 5. Upper Arm, Upper Back, Side of Torso (Right) 6. Side of Torso, Upper Arm, Upper Back (Right) 7. Upper Back, Upper Arm, Side of Torso (Left) 8. Upper Arm, Side of Torso, Upper Back (Left) 9. Side of Torso, Upper Back, Upper Arm (Left) 10. Upper Back, Side of Torso, Upper Arm (Left) 11. Upper Arm, Upper Back, Side of Torso (Left) 12. Side of Torso, Upper Arm, Upper Back (Left) Patches are applied on Days 1, 8, and 15 according to the randomization schedule. Oral Aricept is taken daily through Day -1, and is re-started on Day 22 or at the time of early termination if before Day 22. Patients are seen in the clinic at Screening and on Days 1, 8, 15, 22, and at the End of Study Visit; for all other daily visits, the patients may be seen either at the clinic or in their residence, provided the assessments are completed as described in the protocol. Skin irritation is assessed immediately upon patch removal and at 1, 24, and 48 hours after removal.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
49
Active and placebo patches will be applied to opposite sides for 7 days.
Active and placebo patches will be applied to opposite sides for 7 days.
Xenoscience, Inc
Phoenix, Arizona, United States
Margolin Brain Institute
Fresno, California, United States
Collaborative Neuroscience Network, Inc
Garden Grove, California, United States
Synergy Clinical Research Center
National City, California, United States
Skin Irritation (Erythema and Edema)
Erythema and edema were used to determine skin irritation using a modified Draize scale. Score 0 = no erythema/edema; Score 1 = very slight erythema/edema; Score 2 = well-defined erythema/slight edema; Score 3 = moderate to severe erythema/edema; Score 4 = severe erythema/edema.
Time frame: Immediately after patch removal
Skin Irritation (Erythema)
Erythema was used to determine skin irritation using a modified Draize scale. Score 0 = no erythema; Score 1 = very slight erythema; Score 2 = well-defined erythema; Score 3 = moderate to severe erythema; Score 4 = severe erythema.
Time frame: 1, 24, and 48 hours after patch removal (Days 8-10; Days 15-17; Days 22-24)
Skin Irritation (Edema)
Edema was used to determine skin irritation using a modified Draize scale. Score 0 = no edema; Score 1 = very slight edema; Score 2 = slight edema; Score 3 = moderate to severe edema; Score 4 = severe edema.
Time frame: 1, 24, and 48 hours after patch removal (Days 8-10; Days 15-17; Days 22-24)
Skin Irritation (Papules and Vesicles)
Papules and vesicles were assessed according to the following scoring criteria: Score 0 = no evidence of papules or vesicles; Score 1 = few papules or vesicles (\< 10) observed on the skin site; Score 2 = more papules or vesicles (≥ 10) observed on \< 50 % of skin site, diffuse or few clusters; Score 3 = many papules or vesicles observed on ≥ 50% of skin site, diffuse or few clusters; Score 4 = many papules or vesicles observed on \> 50% of skin site, with multiple (\> 3) clusters.
Time frame: Immediately after patch removal
Skin Irritation (Papules and Vesicles)
Papules and vesicles were assessed according to the following scoring criteria: Score 0 = no evidence of papules or vesicles; Score 1 = few papules or vesicles (\< 10) observed on the skin site; Score 2 = more papules or vesicles (≥ 10) observed on \< 50 % of skin site, diffuse or few clusters; Score 3 = many papules or vesicles observed on ≥ 50% of skin site, diffuse or few clusters; Score 4 = many papules or vesicles observed on \> 50% of skin site, with multiple (\> 3) clusters.
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Apex Research Institute
Santa Ana, California, United States
Meridien Research
Brooksville, Florida, United States
Miami Jewish Home and Hospital for the Aged
Miami, Florida, United States
Time frame: 1, 24, and 48 hours after patch removal (Days 8-10; Days 15-17; Days 22-24)
Skin Irritation (Other Skin Effects)
Other skin effects were assessed according to the following scoring criteria: Score 0 = no other effects observed; Score 1 = slight glazed appearance; Score 2 = marked glazing; Score 3 = glazing with peeling and cracking; Score 4 = glazing with fissures; Score 5 = film of dried serous exudate covering all or part of the patch site; Score 6 = small petechial erosions and/or scabs.
Time frame: Immediately after patch removal
Skin Irritation (Other Skin Effects)
Other skin effects were assessed according to the following scoring criteria: Score 0 = no other effects observed; Score 1 = slight glazed appearance; Score 2 = marked glazing; Score 3 = glazing with peeling and cracking; Score 4 = glazing with fissures; Score 5 = film of dried serous exudate covering all or part of the patch site; Score 6 = small petechial erosions and/or scabs.
Time frame: 1, 24, and 48 hours after patch removal (Days 8-10; Days 15-17; Days 22-24)
Safety, Tolerability, and Adhesion
See Adverse Event section for Safety assessment. Adhesion was assessed according to the following scoring criteria: Score 0 = approximately \> 90% adhered (essentially no lift off the skin); Score 1 = approximately 75% to \< 90% adhered (some edges only lifting off the skin); Score 2 = approximately 50% to \< 75% adhered (less than half of the system lifting off the skin); Score of 3 = approximately \< 50% adhered but not detached (more than half of the system lifting off the skin without falling off); Score of 4 = Patch-system detached (patch /overlay completely off the skin).
Time frame: Safety was assessed throughout the study. Adhesion was assessed daily and immediately prior to patch removal on Days 8, 15, and 22.