A double blind, within patient, placebo controlled trial to assess the efficacy of Juvista (avotermin) in conjunction with scar revision surgery for the improvement of disfiguring scars. - Juvista in scar revision surgery of disfiguring scars

• Conditions: Improvement of scar appearance; MedDRA version: 9.1Level: LLTClassification code 10039589Term: Scarring

• Registration Number: EUCTR2008-002124-28-DE
• Lead Sponsor: Renovo Ltd

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2009-01-29
• Last Update Posted: 1 April 2013

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 350

Inclusion Criteria

General Inclusion Criteria
The following general inclusion criteria are required to ensure that the patients included in the trial are suitable for entry in terms of their general health and the provision of informed consent.

-Male and female patients aged 18-85 years with disfiguring linear scars that are suitable for revision by excision and direct closure, who have provided written informed consent.
-A body mass index between 15 and 35 kg/m2 (calculated using Quetelet’s index [weight (kg)/height m2]

-Patients with, in the opinion of the Investigator, clinically acceptable results for the laboratory tests specified in the trial protocol (see Section 6.4.2). All laboratory tests must be performed within 28 days of the first trial dose administration.
-Patients with, in the opinion of the Investigator, acceptable ECG results at study screening.
-If females of child bearing potential, patients must be using a highly effective method(s) of contraception and agree to do so from at least the screening visit until one month after administration of the final study dose. For the purposes of the protocol, highly effective method(s) of contraception will be defined as consistently and correctly used implants, injectables, combined oral contraceptives, sexual abstinence or a vasectomised partner.

Scar Specific Inclusion Criteria
The following scar specific inclusion criteria are required to ensure that patients included in the trial have disfiguring scars which are suitable for surgical revision. The criteria also ensure that the scar area to be revised is suitable to assess the efficacy of the active study treatment against the placebo (i.e. symmetrical around the midline). The scar areas must be of the correct length and in a suitable area for accurate, representative photographs to be taken. Patients may have an entire scar revised or partial revision of an existing scar where a suitable area of a scar fits the required criteria.

-The scar area to be revised is disfiguring. To be considered disfiguring for this trial scars must have at least one of the following characteristics.
oScar area 13 or more cm in length.
oScar area at least 0.6 cm wide at widest part.
Surface contour of scar area elevated or depressed on palpation.
oScar area adherent to underlying tissue.
oSkin hypo-or hyper-pigmented in an area exceeding 39 cm2.
oSkin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding 39 cm2.

-The scar to be revised is at least 12 months old.

-The investigator considers that the appearance of the scar area to be revised can be improved with surgery alone.
-The scar area is linear and suitable for revision by excision and direct closure.
-The scar area to be revised is symmetrical in appearance around the mid-line.
-The scar area to be revised is between 7cm and 20cm in length.
-The scar area to be revised runs along a flat surface which is in the same focal plane and suitable for accurate medical photography.
-The scar is approved for entry into the trial by the Independent Expert Screening Panel

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

General Exclusion Criteria
The general exclusion criteria are required to exclude patients whose medical history, ongoing conditions or lifestyle could affect the assessment of efficacy or safety during the trial.

The following criteria exclude patients who have compromised healing rates which may impact on scarring and subsequent treatment assessment:

-Patients who on direct questioning and / or physical examination, have evidence of any past or present clinically significant medical condition that would impair wound healing including :
oSignificant rheumatoid arthritis as diagnosed by the American Rheumatologic Association criteria for rheumatoid arthritis (see Appendix 5).

oOther clinically significant autoimmune disease.
oSignificant hepatic impairment (LFTs >3 times upper limit of normal).
oInadequately or uncontrolled congestive heart failure (New York Heart Association classes I and II can be included, classes III and IV should be excluded, see Appendix 5).
oCurrently active malignancy or history of any malignancy.
oImmunosuppression or chemotherapy in the twelve months prior to the screening visit.
oA history of radiotherapy to the study scar area.
oDiabetes mellitus (unless controlled by diet and exercise alone).
oA bleeding disorder or current use of anti-thrombotic therapy (aspirin, ticlopidine and clopidogrel are permitted).

-Patients who are known to have chronic viral infection (including HIV, hepatitis B and hepatitis C).

-Patients with a creatinine clearance (CLcr) of 80ml/min or less. Creatinine clearance will be determined from the serum creatinine level at pre-study screening using the following formula :
oCLcr = (140-age (years)) x weight(kg)/ 72 x serum creatinine (mg/dL) { x 0.85 for females }

-Patients with a skin disorder that is chronic or currently active and affects the area to be revised.

The following criteria exclude patients who may not complete the trial assessments or who have conditions which may interfere with the assessment of drug safety:

-Patients who, in the opinion of the Investigator, have significant ongoing psychiatric disorders, which may interfere with the trial assessments / visits.

-Patients with a history of clinically significant hypersensitivity to any of the drugs or surgical dressings to be used in this trial.
-Patients who are taking, or have taken, any investigational drugs within 3 months prior to the screening visit.
-Patients undergoing investigations or changes in management for an existing medical condition (excluding the scar for revision).
-Patients who have received an immunization or vaccination therapy in the 4 weeks prior to dosing or who are due to receive such treatments in the 4 weeks after final dose of IMP.
-Patients who have undergone any surgery in the 4 weeks prior to dosing.
-Patients with current, uncontrolled arterial hypertension.
-Patients who have had UV exposure (natural or artificial) to the scar area in the 4 weeks prior to dosing.
-Patients who are or who become pregnant up to and including Day 0 or who are lactating.
-In the opinion of the Investigator, a patient who is not likely to complete the trial for whatever reason.

Scar Specific Exclusion Criteria
The following scar specific exclusion criteria are required to ensure that patients included in the trial do not have a history of keloid scarring as the efficacy of Juvista has not been determined in the revision of keloid scars and will be evaluated as part of a separate development plan

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified