This is a multicenter, parallel group, randomized, double-blind pilot Phase III clinical study of JDP-205 (cetirizine) injection, versus diphenhydramine injection, 50 mg/mL (Benadryl or generic equivalent), in approximately 36 patients with acute urticaria requiring treatment in Hospital Emergency Departments, Urgent Care Centers and Allergy Clinics.
Multicenter, parallel group, randomized, double-blind pilot Phase III clinical study of JDP-205 (cetirizine) injection, versus diphenhydramine injection, 50 mg/mL (Benadryl or generic equivalent), in approximately 36 patients with acute urticaria requiring treatment in Hospital Emergency Departments, Urgent Care Centers and Allergy Clinics. This study will be conducted in 33 patient who either present themselves to the hospital emergency department, allergy clinic or urgent care centers with acute urticaria or developed acute urticaria following a allergen challenge at an allergy clinic. Following informed consent, eligibility will be established, capturing baseline data including vitals, age, medical history, and medications taken prior to coming to the clinical study site. Following data collection, study subjects will be randomized in a 1:1 ratio to receive study drug of either cetirizine 10 mg IV or diphenhydramine, 50 mg IV. Baseline data including vital signs, the extent of urticaria and erythema, the severity of pruritus, and the level of sedation will be recorded prior to and at 1 hour and 2 hours post study drug administration, and at the time of "Readiness for Discharge". The actual time at which the investigator determines that the subject is ready for discharge (physically and mentally fit) from the study site will also be recorded. At these same time intervals, subjects will be asked to self-rate (recorded by study staff) severity of their pruritus and level of sedation (recorded by study staff). Twenty-four hours following discharge from the study site, study staff will call the subject to ask them a few short questions to follow-up on the treatment of their acute urticaria. All adverse and serious adverse events experienced by the subjects following informed consent, and all data captured will be recorded in the source documents and/or case report forms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
36
Cetirizine, 10mg/mL; a single 1.0 mL injection via intravenous (IV) push over a period of \~2 minutes
Diphenhydramine Injection, 50 mg/mL; a single 1.0 mL injection via intravenous (IV) push over a period of \~2 minutes
University of Cincinnati, Department of Emergency Medicine
Cincinnati, Ohio, United States
OSU Hospitals, Department of Emergency Medicine
Columbus, Ohio, United States
Glengarry Memorial Hospital, Independent Practice
Alexandria, Ontario, Canada
Ottawa Hospital, Civic Campus
Ottawa, Ontario, Canada
Extent of Urticaria/Erythema Score (Physician Assessment)
Extent of Urticaria/Erythema Score (Physician Assessment), capturing extent of urticaria/erythema, using the Body Chart (adopted from Burn Chart). Extent of Urticaria/Erythema Score is the average of the 2 scores: 1. Percentage of body area using the body chart (adopted from burn Chart) 0 = none, 1= mild (,25% body coverage), 2 = moderate (25-50% body coverage, 3 = Severe/intense .50% body coverage 2. Intensity of redness (adopted from PASI) 0 = none, 1 = mile (light pink) 2= moderate (pink), 3 =severe/intense (red)
Time frame: Baseline, 1 hour, 2 hour, Discharge (up to 4 hours)
Physician Pruritus Severity Score
Physician Pruritus Severity Score based on patient expression of severity of itchiness. 0= none 1 = Mild (patient expresses itchiness but tolerable, and does not scratch 2= moderate definite awareness, bothersome, intermittently scratch affected area 3= severe difficult to tolerate scratch vigorously
Time frame: Baseline, 1 hour, 2 hour, discharge or up to 4 hours post intervention, whichever came first
Patient Pruritis Severity Score
Patient Pruritis Severity Score based on severity of itching at time of assessment. How severly are your hives itching at the moment? 0 = none 1= mild minimal awareness easily tolerated 2 = moderate definite awareness quite bothersome 3= severe difficult to tolerate
Time frame: Baseline, 1 hour, 2 hour, discharge or up to 4 hours post intervention, whichever came first
Composite Acute Urticaria Score Change From Baseline
A composite acute urticaria score, the sum of Extent of urticaria/erythema score (Physician), Physician pruritis score and Patient pruritis severity score. A composite acute urticaria score which the sum of the above three parameters (i.e. 0-9) was calculated post hoc for each patient at each time point and then their score change from the baseline were compared between the two treatment groups. Higher values indicate a worse outcome.
Time frame: Baseline, 1 hour, 2 hour, Discharge (an average of 1 day)
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St. Michael's Hospital
Toronto, Ontario, Canada
Del Carpio Independent Practice
Montreal, Quebec, Canada
Sedation Scores and Time to Readiness for Discharge
Time from study drug injection to time to readiness for discharge based on composite sedation score at readiness for discharge consist of Physician Sedation Score and Patient Sedation Score Physician Sedation Score Score ranged from 0 to 4 (0=min, 4=max) 0 = None (Patient is completely alert. Does not look tired at all), 1 = Mild (Patient sitting/lying comfortably, and looks tired), 2 = Moderate (Drowsy, with occasional eyes closing), 3 = Severe (Asleep, with eyes closed but responds to minor motor stimulation), 4 = Extremely Severe (Asleep; does not respond to minor motor stimulation) Patient Sedation Score Score ranged from 0 to 4 (0=min, 4=max) 0 = None (Not drowsy at all), 1 = Mild (Slightly drowsy), 2 = Moderate (Quite drowsy), 3 = Severe (Extremely drowsy), 4 = Extremely Severe (Asleep, cannot self-rate) Higher the sedation score = worse outcome A composite sedation score which is the sum of the two parameters.
Time frame: Assessed at discharge or up to 4 hours post intervention, whichever came first data at discharge reported.
Percentage of Patients Requiring Additional Medication
Percentage of Patients Requiring Additional Medication (Rescue Medication)
Time frame: Baseline, 1 hour, 2 hour, Discharge (an average of 1 day)
Sedation Scores and Time to Readiness for Discharge HH:MM
Time from study drug injection to time to readiness for discharge based on Physician and Patient Sedation Scores Physician Sedation Score: 0 = None 1 = Mild 2 = Moderate 3= Severe 4 = Extremely Severe Patient Sedation Score 0= None 1- Mild 2 = Moderate 3= Severe 4 = Extremely Severe Higher scores = worse outcome
Time frame: Assessed at discharge or up to 4 hours post intervention, whichever came first data at discharge reported.