The proposed Phase 2/3 trial with double-blind and open-label extension phases is an international, multicenter study designed to assess the efficacy and safety of diacerein 1% ointment in patients with generalized EBS.
Epidermolysis bullosa simplex (EBS) is a genetic skin disorder characterized by skin fragility and recurrent blister formation, primarily caused by mutations in keratins 5 and 14. EBS has 3 common subtypes based on clinical severity and manifestations: localized EBS, intermediate EBS and severe EBS. Severe EBS and intermediate EBS collectively are also known as generalized EBS due to widespread blistering. Disruption of the keratin 5/14 filament network in basal keratinocytes is a key factor in EBS pathogenesis, compromising skin integrity. The severity of EBS is linked to the extent of keratin mutations disrupting this network, particularly resulting in keratin aggregates in severe cases. Recent studies suggest that mutated keratin proteins can trigger inflammation, exacerbating EBS. Elevated proinflammatory cytokines, like IL-1β and IL-6, are observed in EBS patients, and IFN-γ may mediate inflammation, promoting keratin aggregations. As a result, targeting inflammation is considered a potential therapeutic approach in EBS. AC-203 (diacerein 1% ointment) is a topical formulation of diacerein, well-known for its ability to inhibit IL-1β and other proinflammatory cytokines. Moreover, diacerein and its active metabolite, rhein, have demonstrated ability in reducing keratin aggregates in keratinocytes derived from severe EBS. Taken together, with its anti-inflammatory property and ability to diminish keratin aggregation, AC-203 shows promise in reducing the clinical severity of EBS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
80
Mission dermatology Center
Rancho Santa Margarita, California, United States
RECRUITINGStanford University
Stanford, California, United States
RECRUITINGChildren's Hospital Colorado
Aurora, Colorado, United States
RECRUITINGPediatric Skin Research, LLC
Miami, Florida, United States
Proportion of patients achieving treatment success on the IGA of the Treatment Area, in which treatment success is defined as a score of 0 or 1 with at least a 2-point reduction
The static IGA is the investigator's visual clinical assessment of the average overall intensity of lesions in the designated Treatment Area at a particular time point. EBS-IGA is a 5-point scale is a 5-point scale (clear=0; almost clear=1; mild=2; moderate=3; severe=4)
Time frame: from Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT)
Change in % BSA of EBS lesions in the Treatment Area
The Body Surface Area (BSA) of the Assessment Area will be collected for all lesions included within the Treatment Area using the palmar method
Time frame: from Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT)
Change in pain intensity score
Wong-Baker FACES® Pain Rating Scale will be used for patients 3 years and older.
Time frame: Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT)
Change in pruritus intensity score
ItchyQuant will be used for patients aged 6 years and older, including adult patients
Time frame: from Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT)
Change in EBDASI score (skin activity)
The EBDASI is a valid and reliable EB-specific outcome measurement tool to assess the overall extent of disease activity and damage in patients with various subtypes of EB, including EBS. Section I (skin), the severity of disease, including erosion/blisters/crusting etc., will be measured at 12 different skin sites.
Time frame: from Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT).
Change in the QOLEB score
The Life Epidermolysis Bullosa (QOLEB) questionnaire is a valid and reliable, EB-specific QOL measurement tool, for the quantification of QOL in patients with various subtypes of EB, including EBS. It consists of 17 questions with four response choices from "not at all" to "constant"
Time frame: from Baseline A (Visit 2/Day 1) to Week 8 (Visit 5/EOT)
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Northwestern University - Lurie Childrens's Hospital
Chicago, Illinois, United States
RECRUITINGStony Brook Dermatology
Stony Brook, New York, United States
RECRUITINGCincinnati Childrens Hospital
Cincinnati, Ohio, United States
RECRUITINGMedical University of South Carolina
Charleston, South Carolina, United States
RECRUITINGTexas Dermatology and Laser Specialists
San Antonio, Texas, United States
RECRUITINGRoyal Melbourne Hospital
Melbourne, Victoria, Australia
NOT_YET_RECRUITING...and 26 more locations