Metformin for the Treatment of Hidradenitis Suppurativa (HS)

Phase 3

Completed

• Conditions: Hidradenitis Suppurativa
• Interventions: Combination Product: Metformin

• Registration Number: NCT04649502
• Lead Sponsor: K.R. van Straalen

Brief Summary

A randomized controlled trial investigating the metformin is the treatment for hidradenitis suppurativa. Metformin combined with doxycycline will be compared to the standard treatment of doxycycline monotherapy for HS severity and the effect on the pre-diabetic condition.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-11-16
• Study First Submitted QC: 2020-11-24
• Study First Posted: 2020-12-02
• Study Start: 2021-01-25
• Primary Completion: 2023-01-29
• Study Completion: 2023-08-23
• Status Verified: 2023-10
• Last Update Submitted: 2023-10-09
• Last Update Posted: 2023-10-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 62

Inclusion Criteria

• Age ≥18 years at baseline
• A diagnosis of HS for at least 1 year prior to baseline
• mild to moderately active disease defined by a HS Physician Global Assessment (HS-PGA) score of 2-3 and the Refined Hurley classification of mild to moderate at baseline
• Indication for systemic therapy; i.e. uncontrolled disease under conventional topical therapy.
• Able and willing to give written informed consent and to comply with the study requirements

Exclusion Criteria

• Pregnant and lactating women
• Concomitant diabetes mellitus
• Use of antibiotics within 14 days prior to baseline
• Use of immunosuppressing/modulating therapies within 28 days prior to baseline
• A known allergy to metformin or doxycycline or any of the ingredients metformin or doxycycline

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Metformin combined with doxycycline	Metformin	-
Doxycyline combined with placebo	Metformin	-

Primary Outcome Measures

Name	Time	Method
IHS4	24 weeks	International Hidradenitis Suppurativa Severity Score System (IHS4)

Secondary Outcome Measures

Name	Time	Method
Metabolic syndrome	12 and 24 weeks	Change in parameters of metabolic syndrome (waist circumference, blood pressure, HDL cholesterol, and triglycerides) from baseline and differences between the groups at week 12 and 24.
Lesion Count	12 and 24 weeks	• Change in lesion count from baseline and differences between the groups at 12 and 24 week. Difference in lesion count will be assessed between the groups at week 12 and 24.
HiSCR	12 and 24 weeks	The percentage of HiSCR achievers (a ≥ 50% reduction in inflammatory lesion count (abscesses + inflammatory nodules), and no increase in abscesses or draining fistulas when compared with baseline) and the difference between the groups at week 12 and 24.
Insulin resistance	12 and 24 weeks	• Change in insulin resistance from baseline using the HOMA-IR (based on fasting glucose and insulin levels) and differences between the groups at week 12 and 24.
NRS-Pain	12 and 24 weeks	Change in skin related pain from baseline, on a numerical rating scale, and differences between the groups at week 12 (V2) and 24 (V4)
Safety and Tolerability	up to 24 weeks	• Incidence and severity of all adverse events (according to medDRA) will be analysed throughout the study, and renal function and lactate will be assessed at every visit.
Pre-diabetic disorder	12 and 24 weeks	Change in HbA1c from baseline and differences between the groups at week 12 and week 24.
Flares	12 and 24 weeks	Change in self-reported frequency of flares from baseline and differences between the groups at week 12 and 24.
DLQI	12 and 24 weeks	Change in quality of life from baseline and differences between the groups, measured with the Dermatologic Life Quality Index and the EQ-5D, at week 12 and 24.
Treatment satisfaction	up to 24 weeks	Difference in treatment satisfaction and recommendation on a 5- and 3-point Likert scale respectively at week 12 and 24 between the groups.
Cost-effectiveness	24 weeks	• For cost-effectiveness the direct medical costs will be will be assessed using the iMTA Medical Consumption Questionnaire (iMCQ), The measurement will be at baseline, at 12 weeks and at 24 weeks. Productivity losses will be collected using the iMTA Productivity Cost Questionnaire (iPCQ) includes three modules measuring productivity losses of paid work due to 1) absenteeism and 2) presenteeism and productivity losses related to 3) unpaid work. The friction cost method for valuing the production losses will be applied in accordance to the Dutch manual for costing studies. Hence, the productivity loss will be valued per worker by age and gender and, for long term absences, taking into account that productivity costs to society is confined to the period needed to replace a worker (the friction period). Cost effectiveness will be estimated using Dutch manual for costing studies in economic evaluations (publication of the Health Care Institute (ZIN).
Bio-markers	24 weeks	* The correlation between baseline calprotectin levels and disease severity for both groups.; * The correlation between calprotectin levels and treatment response in each group at week 12 and 24.
HS-PGA	12 and 24 weeks	The change in HS-PGA from baseline and the difference between the groups at week 12 and 24.

Trial Locations

Locations (1)

Erasmus MC; 🇳🇱 Rotterdam, Netherlands