This multi-center, double-blind, vehicle-controlled, randomized crossover design study will evaluate the safety and efficacy of topically applied naloxone lotion, 0.5%, for the treatment of pruritus in patients with the mycosis fungoides (MF) or Sézary syndrome (SS) Forms of Cutaneous T-cell Lymphoma (CTCL). This study will also determine if there is systemic absorption of the drug in a subset of subjects and if so, describe the range and mean plasma levels reached after two weeks of three time daily (TID) dosing. Funding Source - FDA OOPD
There will be 160 subjects enrolled in the study. The study consists of a Screening Period of up to 7 days during which inclusion / exclusion criteria will be reviewed. Subjects meeting inclusion / exclusion criteria including the diagnostic criteria for MF or SS and a score of at least 5 on the 11-Point Numeric Rating Scale (NRS) for Pruritus will complete the one week Screening Period. Subjects will complete a daily diary for NRS for Pruritus scores and Sleep scores. At the end of the Screening Period, subjects who have a NRS for Pruritus score of at least 5 recorded in the diary on at least 4 of the 7 days preceding Day 0 will be eligible to continue. Baseline assessments will be recorded for vital signs, pruritic body surface area, skin integrity, PQOL, and laboratory results. The Baseline period will be followed by a 2 week Treatment Period 1 in which subjects will be randomized to Naloxone Lotion 0.5% or Placebo Lotion to be applied TID for 14 days. During the 2 week Treatment Period subjects will complete daily diaries of NRS for Pruritis scores and Sleep scores. On Day 14 subjects will return to the clinic to review diaries, adverse events (AEs), concomitant medications, and to record body surface area for pruritus, skin integrity, PQOL, and laboratory results. Subjects will then enter a Washout Period for up to 56 days until the subject again scores at least 5 on the NRS for Pruritus on 4 consecutive or 4 of the past 7 days or 56 days pass. Subjects will then enter a 2 week Treatment Period 2 during which the same procedures as Treatment Period 1 will be performed except subjects will receive the alternate treatment to that assigned in Treatment Period 1. Subjects will then have the option to enter a 26 Week Open Label Treatment Period 3 during which the same procedures as Treatment Period 1 and 2 will be performed except subjects will return only at Week 13 and Week 26 and all subjects will be treated with Naloxone Lotion 0.5%.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
59
Topical TID for 2 weeks
Topical TID for 2 weeks
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States
City of Hope
Duarte, California, United States
Stanford University
Palo Alto, California, United States
USSF Health Morsani Center for Advanced Healthcare
Tampa, Florida, United States
Cleveland Clinic Indian River Hospital
Vero Beach, Florida, United States
Robert H. Lurie Comprehensive Cancer Center
Chicago, Illinois, United States
Rush University Medical Center
Chicago, Illinois, United States
Dawes Fretzin Clinical Research Group, LLC
Indianapolis, Indiana, United States
University of Minnesota
Minneapolis, Minnesota, United States
St. Louis University Dermatology
St Louis, Missouri, United States
...and 6 more locations
Numeric Rating Scale (NRS) for Pruritus
Change from Baseline to Day 14 in average NRS for Pruritus for each Treatment Period
Time frame: Baseline and 2 Weeks
Responder Analysis - The difference in the proportion of subjects with a meaningful clinically significant improvement at the end of the two periods.
The difference in the proportion of subjects with a meaningful clinically significant improvement at the end of the two periods. A clinically significant improvement is defined as an improvement of at least one category on the 4-point (none, mild, moderate, severe) Likert Scale verbal rating scale (VRS) and at least two points on the 11-point NRS for Pruritus. The NRS for Pruritus scores will be converted to VRS scores as follows for the analysis: 0=none, 1-3=mild, 4-6=moderate, and 7-10=severe.
Time frame: Baseline and 2 Weeks
Numeric Rating Scale for Sleep
The change from Baseline at each week of the NRS for Sleep average score for each Treatment Period.
Time frame: Baseline and 1 and 2 weeks
Numeric Rating Scale for Pruritus
The change from Baseline at Week 1 of the NRS for Pruritus average score for each Treatment Period.
Time frame: Baseline and 1 week
Categorical Rating Scale (CRS) for Skin Integrity
The change from Baseline at Week 2 of the CRS for Skin Integrity for each Treatment Period.
Time frame: Baseline and 2 weeks
Pruritus Quality of Life Score (PQOL)
The change from Baseline in the final categorization of the PQOL at Day 14 of each Treatment Period
Time frame: Baseline and Day 14 of each Treatment period
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