This is a phase 1, multi-center, randomized, vehicle-controlled, double-blinded, parallel-group study. Approximately 6 sites will conduct the study at Germany. Approximately 61 patients (male and female) planned to be screened. 51 patient planned to be randomized. Patients will be randomized to 1 of 3 treatment arms (KM-001 0.3%, KM-001 1%, or vehicle cream) iina a ration of 1:1:1 Patient's duration of participation will be up to 7 weeks, * a screening period with 1 visit (Visit 1) within up to 14 days (Days -14 to -1), * a 4-week treatment period with 3 visits (Visit 2 on Day 0, Visit 3 on Day 7, Visit 4 at Day 28 and 2 phone calls on Days 14 and 21, and * a 1-week follow-up period with 1 visit (Visit 5 on Day 35), as well as unscheduled visits as needed Since KM-001 is tested in humans for the first time, the safety of KM-001 will be evaluated in a subgroup of 6 patients (sentinel group) at selected sites prior to screening of the remaining sites. Efficacy assessments will include subjective assessments of itch and investigator assessment of the treatment effect on LSC target lesion using scoring systems. Safety parameter (including physical examination, vital signs, ECG, standard laboratory test, and PK analysis) will be monitored from the signing of the informed consent form (ICF) until the last follow-up visit. Recording of AEs and serious AEs (SAEs) will be done throughout the study with special attention to local AEs in the treatment area (LSC target lesion, dermal safety).
This phase I study will be performed in patients with LSC instead of healthy subjects as in these patients, the significant histological changes (acanthosis and parakeratosis) result in heavily altered physiology and anatomy of the skin and any data including tolerability generated by administering the IMP on healthy skin can hardly be extrapolated to patients with LSC. The setting can be compared with early studies in Psoriasis patients where it is established to include patients from the beginning. Based on preclinical experiments, no pharmacological relevant systemic absorption is expected. PK sampling will be done for confirmation. Parallel group comparison is a common method and provides optimal conditions for examining efficacy. Comparisons to a vehicle is a common procedure. Randomization provides the most reliable and impartial method of determining differences between treatments as in this case active versus vehicle. Double-blind conditions minimize any possible observer bias regarding treatment effects. A vehicle control is included to evaluate the efficacy, safety, and tolerability of the cream without the active ingredient and to differentiate whether the drug substance or the drug product might cause any effects. A duration of a 4-week treatment period is assumed to be appropriate to assess efficacy, safety, and tolerability based on preclinical data
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
55
KM-001 will be supplied in glass jars (30 ml) and will be provided to patients with spatulas and polyethylene gloves on all the clinical visits. the patient will use IMP twice a day for 28 days.
patients will provide a blood sample for a chemistry blood test on days -14 (screening visit), Day 7(visit 3), day 28 (end of treatment) or at ET visit.
patients will provide a blood sample for a hematology blood test on days -14 (screening visit), Day 7(visit 3), day 28 (end of treatment) or at ET visit.
Patients will provide a blood sample for a urine test on days -14 (screening visit), Day 7(visit 3), day 28 (end of treatment) or at ET visit.
Patients will provide a blood sample for serelogy test at day -14 (screening visit)
patients will undergo an ECG examination on days -14 (screening visit), and day 28 (end of treatment visit).
Women of child-bearing potential only will provide at all the on-site visits b-hCG concentration will be tested
PK test will be performed on day 1, 7, 28, 35 and on ET visit
patients will undergo a physical examination on all the clinical visits
patient's vital signs will be measured on all the clinical visits
patient's disease evaluations will be evaluated on all the clinical visits
patient's disease evaluations will be evaluated on all the clinical visits
The patient will record IMP adminidsration and AE events in a diary every day throughout the all study period
Fachklinik Bad Bentheim - Dermatologische Studienambulanz
Bensheim, Germany
Rothhaar Studien GmbH
Berlin, Germany
Safety endpoint - Will be assessed through collection and analysis of adverse events
Incidence of treatment-emergent adverse events (AEs) and serious adverse events (SAEs)
Time frame: up to 7 weeks
Safety endpoint-Hematology blood test
RBC, WBC and platelets count, absolute neutrophils, lymphocytes, monocytes, eosinophil and basophil counts, reticulocyte count, hemoglobin, hematocrit, MCV and MCH will be tested and assess. The assessment will be compared thr baseline results. Exceptional values above the normal or below the normal will indicate an aggravation of the participant's condition
Time frame: up to 7 weeks
Safety endpoint- Serology blood test - HBV
HBsAb,HBsAg, HBcAb will be prformed at screening visit. laboratory measurements will be assessed and listed.
Time frame: up to 14 days
Safety endpoint- Serology blood test- Hepatits C
Hepatits C virus antibody will be prformed at screening visit. laboratory measurements will be assessed and listed.
Time frame: up to 14 days
Safety endpoint- Serology blood test- HIV
HIV will be prformed at screening visit. laboratory measurements will be assessed and listed.
Time frame: up to 14 days
Safety endpoint-Chemistry
Chemistry measurements will be presented descriptively by visit including changes from baseline for quantitative outcomes. Shift tables showing changes with respect to the normal range between baseline and each post-baseline visit will be shown. Incidence of any laboratory outcome of clinical significance will be shown for scheduled and unscheduled measures, including a presentation for each laboratory parameter.
Time frame: up to 7 weeks
Safety endpoin-Urine tests
Specific gravity, pH, glucose, protein, blood and ketones by will perform by dipstick. assessment will be compared to the normal range. Change from baseline (Day -14 to -1 \[screening/Visit 1\]) in safety laboratory parameters at Day 7 (Visit 3 or ETV) and Day 28 (Visit 4 or ETV)
Time frame: up to 7 weeks
Safety endpoin-Pregnancy test
In women of child-bearing potential only. At all the on-site visits serum beta-human chorionic gonadotropin (b-hCG) concentration will be tested.
Time frame: up to 7 weeks
Safety endpoin-Vital signs- Pulse
units: BPM (beats per minute) Data management team will assess and review the vital signs. The category of the assessments will be compared to the normal ranges. Exceptional values above the norm or below the norm indicate an aggravation of the participant's condition
Time frame: up to 7 weeks
Safety endpoin-Vital signs- Blood pressure
units: blood pressure \[mm Hg\]. Data management team will assess and review the vital signs. The category of the assessments will be compared to the normal ranges. Exceptional values above the norm or below the norm indicate an aggravation of the participant's condition
Time frame: up to 7 weeks
Safety endpoin-Vital signs- Body temperature
body temperature will be assesed and the changes from the baseline. units:Celsius degrees. Data management team will assess and review the vital signs. The category of the assessments will be compared to the normal ranges.
Time frame: up to 7 weeks
Safety endpoin-Electrocardiogram
A 12-lead, resting, digital ECG will be taken for each participant at Screening and on Day 28 or at ETV. the following ECG parameters will be recorded: heart rate (HR), PR, QT and QRS intervals and QTC. Resting ECG parameter and changes from baseline will be assesed
Time frame: up to 7 weeks
Safety endpoin-Physical examination
A complete examination will be performed at screening and baseline: As a minimum, the following body systems will be examined and listed: basic status of the main organ systems (ear nose throat, heart, lungs, abdomen, neurological status) as well as physical examination of the skin. An abbreviated examination including a comprehensive skin examination will be performed at other indicated visits. Height and weight measurement will be performed at screening only.
Time frame: up to 4 weeks
KM-001 plasma levels (PK) - Cmax
CMAX measurement (mg/ml)
Time frame: Up to 5 weeks
KM-001 plasma levels (PK) - Tmax
Tmax measurement (h)
Time frame: Up to 5 weeks
KM-001 plasma levels (PK) - AUC 0-t
AUC measurement (mg\*h/L)
Time frame: Up to 5 weeks
Efficacy endpoint will be assessed through collection and analysis of lesion Assessment-IGA
Effect of the treatment on LSC-target lesion, as assessed by location shift in IGA score Effect of the treatment will be assessed using the Investigator's Global Assessment (IGA) scale, which is a 5-point scale (from 0 ="no disease" to 4="severe disease").
Time frame: up to 7 weeks
Efficacy endpoint will be assessed through collection and analysis of lesion Assessment- (PP-NRS)
Change and percent change from baseline in the PP-NRS. The measument will perform via using the peak pruritus-numerical rating scale (PP-NRS) , an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). The PP-NRS was designed to measure peak pruritus, or 'worst' itch, over the previous 24 hours
Time frame: up to 7 weeks
Efficacy endpoint will be assessed through collection and analysis of lesion Assessment- (PP-NRS)- responders
Percent responders in PP-NRS. The measument will perform via using the peak pruritus-numerical rating scale (PP-NRS) , an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). A responder is defined to have an improvement of at least 4 points on the 11-point PP-NRS scale
Time frame: up to 7 weeks
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