TolaSure is a topical gel for the promotion of accelerated wound healing. This Phase I study will assess the safety, tolerability, and clinical effects of TolaSure when applied to wounded skin areas of patients diagnosed with severe epidermolysis bullosa simplex (i.e., EBS-Dowling Meara). A total of 10, severe EBS patients, males and females ages 18 years and older, will be enrolled. Patients will apply TolaSure and Vehicle Gel once-daily for a maximum of 10 weeks.
This is a closed-label, randomized, double-blind, Phase I clinical study to assess the safety and tolerability of the investigational product (IP), TolaSure Gel, 5% w/w, in patients diagnosed with severe epidermolysis bullosa simplex (EBS, previously known as EBS-Dowling Meara). Each patient (5 to complete) will apply TolaSure Gel, 5% w/w and TolaSure Vehicle Gel once-daily to defined Treatment Areas and Suction Blister Areas. End of Study (EOS) will occur at the Principal Investigator's (PI's) discretion according to the resolution or lack of improvement of the Treatment Areas. The maximum time a patient could be in the study is 10 weeks. The average time frame for each patient to complete the study is expected to be 6-8 weeks. The primary safety endpoint will be the incidence of treatment-emergent adverse events (TEAEs). Safety monitoring will include physical exams, vital sign measurements, clinical laboratory testing (blood and urinalysis), and urine pregnancy testing (as appropriate). Secondary efficacy endpoints will (1) assess wound severity within the Treatment Areas using an Investigator Global Assessment (IGA) scoring system, (2) examine under a microscope keratinocyte morphology and the incidence of keratin aggregates in Treatment Area skin biopsies, (3) determine the time required to induce a suction blister within the designated Suction Blister Areas, and (4) evaluate patient self-assessment of overall impression, pain, and itch within the Treatment Areas. The information obtained from these assessments will be used to examine the efficacy of TolaSure treatment in improving EBS symptoms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TolaSure Topical Gel is applied once-daily for up to 10 weeks to designated Treatment Area and Suction Blister Area.
TolaSure Vehicle Gel is applied once-daily for up to 10 weeks to designated Treatment Area and Suction Blister Area.
Stanford University School of Medicine, Dermatology Department
Redwood City, California, United States
Incidence of Treatment-Emergent Adverse Events (TEAEs)
Safety monitoring will include clinical chemistry tests, physical examinations (including assessment of Treatment and Suction Blister Areas), and vital sign measurements. These assessments along with AE reviews will identify potential TEAEs.
Time frame: Day 1, Day 2, then Weekly until End of Study (maximum 10 weeks)
Investigator Global Assessment (IGA)
The Principal Investigator will use the IGA scale to score the average overall severity of the EBS wounds within the Treatment Areas, considered together. Changes from baseline in IGA scores for the TolaSure-treated and Vehicle-treated Treatment Areas will be analyzed.
Time frame: Day 1, Day 2, then Weekly until End of Study (maximum 10 weeks)
Keratin Aggregate Counts and Cell Morphology Assessment
Biopsies from perilesional skin in each of the Treatment Areas are examined to determine a change from baseline in the number of keratin aggregate positive basal and suprabasal keratinocytes using transmission electron microscopy (TEM) and/or light microscopy.
Time frame: Day 1, During Study (optional, estimated Week 3-Week 6), End of Study (maximum 10 weeks)
Suction Blister Time
A suction blister is raised within the Suction Blister Areas and the time to blister formation is recorded in seconds. Changes from baseline suction blister times in the TolaSure-treated and Vehicle-treated Suction Blister Areas will be analyzed.
Time frame: Day 1 and End of Study (maximum 10 weeks)
Patient's-reported Overall Impression Score of Treatment Areas
Change from baseline in the patient-reported overall impression score of both the TolaSure-treated and Vehicle-treated Treatment Areas will be calculated.
Time frame: Day 1, then Weekly until End of Study (maximum 10 weeks)
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DOUBLE
Enrollment
6
Patient's-reported Pain Score of Treatment Areas
Change from baseline in the patient-reported pain numerical rating scale (NRS) of both the TolaSure-treated and Vehicle-treated Treatment Areas will be calculated.
Time frame: Day 1, then Weekly until End of Study (maximum 10 weeks)
Patient's-reported Itch Score of Treatment Areas
Change from baseline in the patient-reported itch numerical rating scale (NRS) of both the TolaSure-treated and Vehicle-treated Treatment Areas will be calculated.
Time frame: Day 1, then Weekly until End of Study (maximum 10 weeks)