This is a phase 2 randomized, multi-center, double-blind, vehicle controlled, 90 day, safety, efficacy, and systemic exposure study followed by a 90 day open-label extension of trifarotene cream in adults and adolescents with autosomal recessive ichthyosis with lamellar scale.
This is a 2-cohort, multicenter study in subjects with moderate to severe LI. Adults (Cohort A) and adults and adolescents (Cohort B) will be randomized in a double-blind fashion to 1 of 2 doses of active or vehicle and treated twice weekly for 90 days. Subjects who complete the randomized, double-blind portion of the study will be eligible to enter a 90 day, open-label extension study. Approximately 15 adults (≥18 years old) will be randomized into the first cohort of subjects (Cohort A) in a 1:1:1 ratio and treated twice weekly for up to 90 days. If no safety issues are identified, both adults and adolescents (ages 12-17 years, inclusive) will be allowed to enroll in Cohort B. Subjects in Cohort B will be randomized 1:1:1 and treated twice weekly for up to 90 days in the same manner as subjects in Cohort A. All subjects who complete 90 days of double-blind study treatment will be eligible to enroll in a 90 open-label extension. Subjects in the open-label extension will receive active twice weekly for up to 90 days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
65
A fixed dose (determined at Visit 1) of 200 µg/g applied topically twice weekly to up to 90% BSA
A fixed dose (determined at Visit 1) of 100 µg/g applied topically twice weekly to up to 90% BSA
A fixed dose (determined at Visit 1) applied topically twice weekly, up to 36 g per dose up to 90% BSA
The Percentage of Subjects in Each Treatment Group Who Experienced Successful Resolution of LI.
The percentage of subjects in each treatment group who experienced successful resolution of LI where "success" is defined as clear/almost clear on treated areas and at least a 2-grade change from Baseline at Day 90/end-of-treatment (EOT) in the Double-blind Period on the 5-point IGA full body scale.
Time frame: 90 Days
Total 16-point Visual Index for Ichthyosis Severity (VIIS)
5-point Visual Index for Ichthyosis Severity (VIIS) for scaling (overall 16 points) for scaling, i.e. 0-4 points for 4 body areas: chest/abdomen, back, arms and legs) where minimum is 0 and maximum is 16 (e.g. 4 points for each of the four body parts). 0 (Clear) No scaling 1. (Almost Clear) Very fine, non-coalescent scales 2. (Mild) Small and thin, non-coalescent scales 3. (Moderate) Large and rather thick scales starting to coalesce 4. (Severe) Very large, adherent, coalescent and very thick scales
Time frame: 90 Days
The Difference in Mean Scores Using Individual Score for Roughness
The amount of roughness of the skin will be measured on a 5-point scale. 0 (Clear) Smooth skin 1. (Almost Clear) Hardly palpably roughness 2. (Mild) Mild roughness (fine sand paper-like) 3. (Moderate) Moderate, coarse roughness (coarse sand paper-like) 4. (Severe) Very coarse skin (broken cornflakes-like)
Time frame: 90 Days
The Difference in Mean Scores Using Palm Sole Assessment
Thickening of the skin on the palms and soles will be measured on a 5-point scale: 0 (Clear) No thickening, no roughness, no fissure 1. (Almost Clear) Only slight thickening, minimal to no roughness, no fissures 2. (Mild) Some thickening, mild roughness on palpation, few fissures may be present 3. (Moderate) Substantial and diffuse thickening, coarse roughness on palpation may be present, fissures may be present 4. (Severe) Very thickened and rough skin, numerous fissures
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TCR Medical Corporation
San Diego, California, United States
Children's Hospital Colorado
Aurora, Colorado, United States
Yale University
New Haven, Connecticut, United States
NorthShore University HealthSystem
Skokie, Illinois, United States
Dawes Fretzin Clinical Research Group, LLC
Indianapolis, Indiana, United States
DermAssociates, PC
Rockville, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Medical University of South Carolina
Charleston, South Carolina, United States
Texas Dermatology and Laser Specialists
San Antonio, Texas, United States
...and 26 more locations
Time frame: 90 Days
The Difference in Proportion of Subjects With Presence of Fissures on Palms Between the Active and Vehicle Groups
Fissuring will be assessed by recording the presence or absence of fissures, the number of fissures present, and the pain associated with each fissure. The subject will assess pain associated with fissures as ranging from 0-3 (none, mild, moderate, severe) at day 90 between the active trifarotene cream HE1 and vehicle groups
Time frame: 90 Days
Quality of Life Measurement Per Dermatology Life Quality Index (DLQI)
The DLQI, or the Dermatology Quality of Life Index, is a dermatology-specific Quality of Life instrument. It is a simple 10-question validated questionnaire with 6 domains (symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment); higher scores indicate poorer quality of life. Responses collected are on a scale of 0-3 depending on the question relevance to the subject. Response (Score) Very much (scored 3) A lot (scored 2) A little (scored 1) Not at all (scored 0) Not relevant (scored 0) A minimum score of 0 and maximum score of 30 is obtained by summing the score of each question. The higher the score, the more quality of life is impaired. 0-1 = no effect at all on patient's life 2-5 = small effect on patient's life 6-10 = moderate effect on patient's life 11-20 = very large effect on patient's life 21-30 = extremely large effect on patient's life
Time frame: 90 Days
The Difference in Proportion of Subjects With Presence of Fissures on Soles Between the Active and Vehicle Groups
Fissuring will be assessed by recording the presence or absence of fissures, the number of fissures present, and the pain associated with each fissure. The subject will assess pain associated with fissures as ranging from 0-3 (none, mild, moderate, severe) at day 90 between the active trifarotene cream HE1 and vehicle groups
Time frame: 90 Days