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Safety and Effectiveness Study of Actinic Keratosis Treatment Following Cryosurgery

Phase 3
Completed
Conditions
Actinic Keratosis
Interventions
Drug: placebo cream
Registration Number
NCT00894647
Lead Sponsor
Graceway Pharmaceuticals, LLC
Brief Summary

The objective of this study is to evaluate the efficacy and safety of imiquimod cream versus placebo cream when used after cryosurgery in the treatment of actinic keratoses (AKs).

Detailed Description

In this multicenter, randomized, double-blind, placebo-controlled study, the efficacy and safety of imiquimod 3.75% cream following cryosurgery to treat clinically typical visible or palpable AK lesions on the face was compared with that of placebo cream. Based on a 1:1 randomization, approximately 120 subjects applied imiquimod 3.75% cream daily (up to 500 mg cream daily \[18.75 mg imiquimod\]) and approximately 120 subjects applied placebo cream daily during two 2-week periods (Cycle 1 and Cycle 2) separated by 2 weeks of no treatment. Subjects visited the clinic 9 times-1 screening/cryosurgery visit (additional visits might be needed during the screening period to assess healing from the cryosurgery), 4 treatment visits(treatment initiation at Weeks 0 and 4 and treatment follow-up at the end of Weeks 2 and 6), and 4 posttreatment visits (4, 8, 14, and 20 weeks after the last administration of study treatment at the end of Week 6). The total study duration for a subject, including a 2-week screening period, was up to 28 weeks.

Prior to cryosurgery, subjects had to have ≥10 clinically typical visible or palpable AK lesions in an area that exceeded 25 cm\^2 on the face to be eligible for participation in the study. At screening, a minimum of 5 visible lesions were not treated with cryosurgery, and 5 to 14 visible lesions were treated with cryosurgery. Subjects had to have at least 5 AK lesions after the skin healed sufficiently from the cryosurgery to be eligible for randomization to either imiquimod 3.75% or placebo cream. Subjects applied up to 2 packets of study cream (500 mg total) as a thin layer to the entire face, avoiding the periocular areas, lips, and nares; ears were excluded from both assessment and treatment. Study cream was applied prior to normal sleeping hours and removed approximately 8 hours later with mild soap and water. Rest periods from daily treatment could be approved by the investigator as needed, with treatment resumption at the investigator's discretion.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
247
Inclusion Criteria
  • In good general health
  • Negative urine pregnancy test (for women of child-bearing potential) and agree to use an approved method of birth control while enrolled in the study.
  • Prior to cryosurgery, have ≥ 10 clinically typical (visible or palpable) AKs in an area that exceeds 25 cm2 on the face.
  • Must have had cryosurgery on 5 to 14 AKs on the face after giving informed consent and prior to receiving study medication. Lesions previously treated with cryosurgery must be healed sufficiently prior to randomization to study cream.
  • Following cryosurgery, have ≥ 5 clinically typical (visible or palpable) AKs in an area that exceeds 25 cm2 on the face that are suitable for treatment with the study cream.
Exclusion Criteria
  • Women who are pregnant, lactating, or planning to become pregnant during the study
  • Had a medical event within 90 days of the visit (e.g., stroke, heart attack, etc.).
  • Have any skin condition in the treatment area that may be made worse by treatment with imiquimod (e.g., rosacea, psoriasis, atopic dermatitis, eczema).
  • Have received specific treatments/medications in the treatment area within the designated time period prior to study treatment initiation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2placebo creamplacebo cream in 250mg/packet, up to 2 packets applied daily
imiquimod creamimiquimod creamImiquimod 3.75% cream, 250 mg single-use packets, up to 2 packets applied daily
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Percentage of Lesion CountWeek 26

The primary efficacy endpoint was a comparison between the active and placebo treatment groups of percent change from baseline in the total AK lesion count at Week 26. All AK lesions on the face were included in the analysis-treated and untreated AK lesions at baseline (defined as the AK lesion count just prior to cryosurgery) and new lesions that appeared post-baseline.

Secondary Outcome Measures
NameTimeMethod
Percent of Subjects With Complete ClearanceWeek 26

Proportion of subjects who achieved complete clearance of all AK lesions, cryosurgery-treated AK lesions, and non cryosurgery-treated AK lesions from baseline to Week 26/EOS in the ITT population.

Number of Participants With Any Post-baseline Local Skin Reactions (LSRs)Weeks 2, 4, 6, 10, 14, 20, and 26

LSRs were assessed independently from AEs. The frequency and percentage of subjects, as well as the mean (SD) and median score for severity (none=0, mild=1, moderate=2, and severe=3), were summarized by treatment group and by visit for the following LSRs: erythema, edema, weeping/exudates, flaking/ scaling/dryness, and scabbing/crusting. Erosion and ulceration were also evaluated (none=0, erosion=1, and ulceration=2). A score of greater than 0 for the specified LSR was considered a "treatment site reaction".

Trial Locations

Locations (18)

Dermatology Research Associates

🇺🇸

Los Angeles, California, United States

Evanston Northwestern Healthcare

🇺🇸

Skokie, Illinois, United States

Progressive Clinical Research

🇺🇸

San Antonio, Texas, United States

MedaPhase, Inc.

🇺🇸

Newman, Georgia, United States

Skin Specialists PC

🇺🇸

Omaha, Nebraska, United States

Spencer Dermatology & Skin Surgery Center

🇺🇸

St. Petersberg, Florida, United States

Therapeutics Clinical Research

🇺🇸

San Diego, California, United States

DermResearch Inc.

🇺🇸

Austin, Texas, United States

Academic Dermatology Association

🇺🇸

Albuquerque, New Mexico, United States

Oregon Medical Research Center

🇺🇸

Portland, Oregon, United States

Wake Forest Univ School of Medicine

🇺🇸

Winston-Salem, North Carolina, United States

DermResearchCenter of New York

🇺🇸

Stony Brook, New York, United States

Ultranova Skincare

🇨🇦

Barrie, Ontario, Canada

Clinique de Dermatologie

🇨🇦

Moncton, New Brunswick, Canada

Guildford Dermatology Specialists

🇨🇦

Surrey, British Columbia, Canada

Probity Medical Research

🇨🇦

Waterloo, Ontario, Canada

Palm Beach Dermatology

🇺🇸

West Palm Beach, Florida, United States

Dermatology Treatment and Research Center

🇺🇸

Dallas, Texas, United States

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