The purpose of this trial is to evaluate the safety and efficacy of long-term treatment with NPC-12G gel (0.2% sirolimus gel) to angiofibroma and other skin lesions in patients with tuberous sclerosis complex in the open-label trial.
Tuberous Sclerosis Complex (TSC) is an autosomal dominant hereditary disease that causes benign tumors on the almost whole body (including skin, brain, kidney, lung and heart), behavior disorder as autism, mental retardation and neurologic symptom as epilepsy. Angiofibroma is a TSC-specific facial skin lesion, and hamartoma caused by increase of the component of skin connective tissues and blood vessels. Other skin lesions due to TSC are white macule (hypomelanotic macule), plaque, shagreen patch and ungual fibromas. Current therapeutic methods for angiofibroma are laser and surgical treatments, but there are problems as many relapses, deficiency of evidence, change of pigment, scar and risk of infection. This is a multicenter and open-label trial. The trial consists of two phase. In the first trial phase for 52 weeks, the efficacy as well as the safety is evaluated. For the second trial phase the trial will be continued until the date of approval of NDA for NPC-12G. The safety is evaluated during the second trial phase, but not the efficacy. Patients who meet all entry criteria for the trial apply 0.2% NPC-12G gel twice a day. Patients will visit at 4 to 5-week intervals for the first 6 months of the first trial phase, and then 3 months intervals thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
94
NPC-12G gel is administered topically twice a day for 52 weeks or longer
Graduate School of Medicine, Osaka University
Suita, Osaka, Japan
The discontinuation rate due to adverse events
The first discontinuation in each patient due to adverse events is assessed.Completion of week 26 and 52 are cut-off points for interim-analyses by Kaplan-Meier method
Time frame: 52 weeks and longer
Adverse events and adverse events related to the test drug
The number of discontinuation/ resume due to adverse events are evaluated. Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: 52 weeks and longer
Adverse events related to the test drug leading to the discontinuation permanently
The incidence of adverse events are evaluated. Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: 52 weeks and longer
Serious adverse events and serious adverse events related to the test drug
The incidence of serious adverse events are evaluated. Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: 52 weeks and longer
Adverse events and adverse events related to the test drug leading to modification of dosage and administration
The incidence of adverse events are evaluated. Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: 52 weeks and longer
Significant adverse events and significant adverse events related to the test drug
The incidence of significant adverse events such as local irritation are evaluated. Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: 52 weeks and longer
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Laboratory tests, vital signs
Completion of week 26 and 52 are cut-off points for interim-analyses
Time frame: Baseline and every 3 months for laboratory tests, every scheduled visit for vital sign]
Blood level of sirolimus
Whole blood level of sirolimus are measured any day time at baseline and every 3 months visit
Time frame: Baseline and every 3 months only for the first trial phase
Improvements in angiofibroma
Improvements comparing with baseline is assessed using photograph by the investigator and the central photo-judgement committee. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
Improvements in sizes of angiofibroma
Improvements comparing with baseline is assessed using photograph by the investigator and the central photo-judgement committee. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
Improvements in redness of angiofibroma
Improvements comparing with baseline is assessed using photograph by the investigator and the central photo-judgement committee. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
Improvements in white macule and plaque upper neck
Improvements comparing with baseline is assessed using photograph by the investigator and the central photo-judgement committee. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
The rate of patients evaluated ''improvement'' or more (improvement rate) in above the efficacy measures.
Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
Change in total score of DLQI and CDLQI from baseline
DLQI for subjects 16 years old and greater, or CDLQI for children of less than 16 years old is assessed by patients. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 4, 8, 12, 26, 39 and 52
Degree of patient's satisfaction
Patient's satisfaction is assessed by patient. Completion of week 26 is a cut-off point for interim-analysis.
Time frame: Week 12, 26, 39 and 52