This study would assess the clinical efficacy of add-on topical timolol 0.5% gel to betamethasone valerate 0.1% for the treatment of EGFR-TKI induced paronychia. Eligible patients, who develop paronychia (affecting fingernails, toenails or both), will be included in this study. They will be randomized in 1:1 ratio using computer-generated randomization list to receive either combination of topical timolol 0.5% gel and betamethasone valerate 0.1% lotion application twice daily or betamethasone valerate 0.1% lotion application twice daily. Patients in timolol combination treatment group will receive topical timolol 0.5% gel twice daily with occlusion (i.e. covered with adhesive badge) and betamethasone valerate 0.1% lotion twice daily with occlsuion for 1 month. Patients in routine arm would receive the management according to routine clinical practice, including prescription of betamethasone valerate 0.1% lotion twice daily for 1 month with occlusion. For patients who do not have paronychia completely resolved after 4 weeks, the treatment assigned will be continued for another 4 to 8 weeks , up to 12 weeks to see the effect.
The aim of this study ist o assess the clinical efficacy of add-on topical timolol 0.5% gel to betamethasone valerate 0.1% for the treatment of EGFR-TKI induced paronychia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Topical timolol 0.5% eye drops (liquid form) twice daily with occlusion (i.e. covered with adhesive badge) and betamethasone valerate 0.1% cream twice daily with occlsuion for 1 month.
Betamethasone valerate 0.1% cream application twice daily
Queen Mary Hospital
Hong Kong, Hong Kong
RECRUITINGThe difference in the proportion of patients achieved complete response (disappearance of the lesion, absent pain, and/or bleeding)
The primary outcome of this study is the proportion of patients achieved complete response (disappearance of the lesion, absent pain, and/or bleeding) on topical timolol 0.5% eye drops as compared to betamethasone valerate 0.1% cream.
Time frame: From baseline to month 3
The proportion of patients achieved complete or partial response
Proportion of patients achieved complete or partial response (improvement in at least 1 of these 3 items)
Time frame: From baseline to month 3
Lack of response as well as proportion of patients with reduced severity of paronychia
Proportion of patients lack of response (improvement in less than 1 item)
Time frame: From baseline to month 3
Change in chronic paronychia severity index scale with treatment
Involvement of 1 nail fold = 1; involvement of 2 nail folds \[proximal or/and lateral\] = 2; bilateral lateral nail fold involvement and proximal nail fold involvement = 3), edema (absent = 0; mild = 1; moderate = 2; severe = 3), erythema (absent = 0; mild = 1; moderate = 2; severe = 3), nail plate changes (absent = 0; mild = 1; moderate = 2; severe = 3), and cuticle involvement (normal = 0; damaged = 1; absent = 2), producing a combined total score (between 0 \[min.\] and 14 \[max.\]
Time frame: From baseline to month 3
The improvement of paronychia by 4 point scale
1: 0 to \<30% , 2: 30 to \<50% ,3: 50 to 75% ,4: 75 to 100 % improvement)
Time frame: From baseline to month 3
Change in severity of pain by Visual Analog Scale
VAS scores ≤3.4cm corresponded to mild pain-related interference with functioning, scores of 3.5-6.4 to moderate interference, and scores ≥6.5 to severe interference.
Time frame: From baseline to month 3
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