Impetigo, Secondarily Infected Traumatic Lesions (SITL)
Conditions
Brief summary
A national, prospective single arm phase II study investigating the pharmacokinetics and safety of the 2% TD1414 cream when applied 3 times daily for 7 days to adult patients with impetigo or Secondarily Infected Traumatic Lesions (SITL). A total of 20 patients will be enrolled.
Interventions
Application 3 times daily for 7 days
Sponsors
Study design
Eligibility
Inclusion criteria
* Ability and willingness to comply with all the study requirements/procedures * Age ≥ 18 and ≤65 years * Primary bullous/non-bullous impetigo or SITL * Patients suffering from primary bullous/non-bullous impetigo must have: * Not more than 10 discrete lesions, and * A total lesional area ≥ 1 cm2 and ≤ 100 cm2, and * Any surrounding erythema must not extend beyond 2 cm from the edge of the lesion, and * Total SIRS score equal to or ≥ 8 * Patients suffering from SITL must have: * A total infected area of the traumatic lesion ≥ 1 cm2 and ≤ 100 cm2, and * Any surrounding erythema must not extend beyond 2 cm from the edge of the lesion, and * Total SIRS score ≥ 8, and * SITL not caused by burns or animal/human bite * Amenable for treatment with topical antibiotic alone * Body Mass Index ≥18 and ≤ 35 kg/m2.
Exclusion criteria
* Immunosuppressed state or other serious systemic disease * Signs and/or symptoms of systemic infection, such as malaise and fever or local adenopathy and fever * Unwillingness to abstain from use of any other topical products including emollients on the lesional area during the study * Systemic treatment with antibacterials or immunosuppressive agents (e.g. corticosteroids) within 2 days before day 1 (inhaled/intranasal steroids may be used) * Topical treatment with antibacterials, immunosuppressive agents (e.g. corticosteroids) or antiseptics (e.g. alcohol, chlorhexidine, hydrogen peroxide, iodine) on the lesional area within 2 days before day 1 * Indication for surgical or systemic treatment of the SITL/impetigo * Known or suspected hypersensitivity to any of the components of the study medication * Participation in any other interventional clinical trial or use of an investigational drug within 30 days or 5 half-lives (whichever is longer) prior to day 1 * Previously enrolled in this study * A blood alcohol content ≥ 0.08% as determined by a Breathalyzer test * Known or suspected history of alcohol abuse/alcoholism or drug abuse * Known or suspected impairment of liver function * Heart rhythm disturbances or clinically significant quantitative or qualitative abnormality in the pretreatment ECG * Blood donation in excess of 500mL within 56 days before day 1 or donation during the study or within 3 days of leaving the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to Reach Peak Serum Concentration (Tmax ) by Amount of TD1414 Cream Used | From 0 hours to 240 hours | Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| TD1414 Serum Concentration by Timepoint | From 0 hours to 240 hours | On Days 1 and 2(and possibly Day 3 depending on the time of first application on Day 1) a sample was taken for pharmacokinetic(PK) analysis at any time before first application on Day 1, and at 12±1, 18±1, 24±1 and 36±4 hours after first application. If the 36±4 hours sampling time fell on Day 3, then a second sample was also required on Day 3, but was to be obtained at 6pm or afterwards. On Days 3 to 6(and also Day 7 if the very last application fell on Day 8), one sample was taken on each day at any time during the day. On Days 7 and 8(or Days 8 and 9 if very last application was on Day 8), a sample was taken immediately before the very last application and at 6±1, 12±1 and 24±2 hours after the very last application. On Days 9 and 10, one sample was taken on each day at any time during the day. If the participant had already had a sample(s) taken on Day 9 because the timing of some of the post-last application samples fell on this day, then further samples were not required on Day 9 |
| Peak TD1414 Serum Concentration (Cmax ) | From 0 hours to 240 hours | The Cmax was summarised by lesion size at baseline, by SIRS scores at baseline and by amount of TD1414 cream used. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. For description of lesion size, SIRS score and amount of TD1414 cream used please see outcome measure 3, 4 and 5 respectively. |
| Peak Serum Concentration by Baseline Lesion Size | From 0 hours to 240 hours | On Day 1 (before the first application), the (sub)investigator recorded the size of the lesion(s). For each participant the size of the lesion was allocated to one of two categories: ≤15cm² or \>15cm². The Cmax is presented by baseline lesion size category (≤15 cm² and \>15 cm²). Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Peak Serum Concentration by SIRS Score | From 0 hours to 240 hours | On Day 1 (before the first application), the (sub)investigator recorded the severity of the lesion(s). The severity was to be recorded using the Severity of Infection Rating Scale (SIRS). For the SIRS, the following seven clinical signs/symptoms of infection were assessed: Exudates/pus Crusting Erythema Oedema Tissue warmth Itching Pain Each of the seven signs/symptoms was scored using the following scale: 0 = absent 2 = mild 4 = moderate 6 = severe The scores for each sign/symptom were summed to give the total SIRS score. The total SIRS score could range from 0 to 42. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Peak Serum Concentration by Amount of TD1414 Cream Used | From 0 hours to 240 hours | The weight of TD1414 cream used was calculated by subtracting the weight of the used dispensed tube from the mean weight of a full tube. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Time to Reach Peak Serum Concentration (Tmax ) | From 0 hours to 240 hours | Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Time to Reach Peak Serum Concentration (Tmax ) by Baseline Lesion Size | From 0 hours to 240 hours | Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Time to Reach Peak Serum Concentration (Tmax ) by SIRS Score | From 0 hours to 240 hours | Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Area Under the Curve (AUC(0-t)) | From 0 hours to 240 hours | Area under the concentration-time curve (AUC(0-t)) from time 0 to time of last non-zero observation after dosing, calculated by linear/log trapezoidal method. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Area Under the Curve by Baseline Lesion Size | From 0 hours to 240 hours | On Day 1 (before the first application), the (sub)investigator recorded the size of the lesion(s). For each participant the size of the lesion was allocated to one of two categories: ≤15cm² or \>15cm². Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Area Under the Curve by SIRS Score | From 0 hours to 240 hours | On Day 1 (before the first application), the (sub)investigator recorded the severity of the lesion(s). The severity was to be recorded using the Severity of Infection Rating Scale (SIRS). For the SIRS, the following seven clinical signs/symptoms of infection were assessed: Exudates/pus, Crusting, Erythema, Oedema, Tissue warmth, Itching and Pain. Each of the seven signs/symptoms was scored using the following scale: 0 = absent 2 = mild 4 = moderate 6 = severe The scores for each sign/symptom were summed to give the total SIRS score. The total SIRS score could range from 0 to 42. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
| Area Under the Curve (AUC(0-t)) by Amount of TD1414 Cream Used | From 0 hours to 240 hours | The weight of TD1414 cream used was calculated by subtracting the weight of the used dispensed tube from the mean weight of a full tube. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| TD1414 2% TD1414 Cream: Application 3 times daily for 7 days | 20 |
| Total | 20 |
Baseline characteristics
| Characteristic | TD1414 |
|---|---|
| Age, Continuous | 32.1 years STANDARD_DEVIATION 11.8 |
| Region of Enrollment United States | 20 participants |
| Sex: Female, Male Female | 8 Participants |
| Sex: Female, Male Male | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 20 |
| serious Total, serious adverse events | 0 / 20 |
Outcome results
Area Under the Curve (AUC(0-t))
Area under the concentration-time curve (AUC(0-t)) from time 0 to time of last non-zero observation after dosing, calculated by linear/log trapezoidal method. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: AUC(0-t) could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| TD1414 | Area Under the Curve (AUC(0-t)) | 32138 h*pg/mL | Standard Deviation 123032 |
Area Under the Curve (AUC(0-t)) by Amount of TD1414 Cream Used
The weight of TD1414 cream used was calculated by subtracting the weight of the used dispensed tube from the mean weight of a full tube. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: AUC(0-t) could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Area Under the Curve (AUC(0-t)) by Amount of TD1414 Cream Used | <=2 g | 13642 h*pg/mL | Standard Deviation 23828 |
| TD1414 | Area Under the Curve (AUC(0-t)) by Amount of TD1414 Cream Used | >2 g | 59932 h*pg/mL | Standard Deviation 150278 |
Area Under the Curve by Baseline Lesion Size
On Day 1 (before the first application), the (sub)investigator recorded the size of the lesion(s). For each participant the size of the lesion was allocated to one of two categories: ≤15cm² or \>15cm². Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: AUC(0-t) could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Area Under the Curve by Baseline Lesion Size | <=15 cm^2 | 21240 h*pg/mL | Standard Deviation 61954 |
| TD1414 | Area Under the Curve by Baseline Lesion Size | >15 cm^2 | 78836 h*pg/mL | Standard Deviation 192236 |
Area Under the Curve by SIRS Score
On Day 1 (before the first application), the (sub)investigator recorded the severity of the lesion(s). The severity was to be recorded using the Severity of Infection Rating Scale (SIRS). For the SIRS, the following seven clinical signs/symptoms of infection were assessed: Exudates/pus, Crusting, Erythema, Oedema, Tissue warmth, Itching and Pain. Each of the seven signs/symptoms was scored using the following scale: 0 = absent 2 = mild 4 = moderate 6 = severe The scores for each sign/symptom were summed to give the total SIRS score. The total SIRS score could range from 0 to 42. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: AUC(0-t) could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Area Under the Curve by SIRS Score | SIRS score <=13 | 17923 h*pg/mL | Standard Deviation 69972 |
| TD1414 | Area Under the Curve by SIRS Score | SIRS score >13 | 61488 h*pg/mL | Standard Deviation 160681 |
Peak Serum Concentration by Amount of TD1414 Cream Used
The weight of TD1414 cream used was calculated by subtracting the weight of the used dispensed tube from the mean weight of a full tube. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Cmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Peak Serum Concentration by Amount of TD1414 Cream Used | <=2 g | 323.5 pg/mL | Standard Deviation 858.2 |
| TD1414 | Peak Serum Concentration by Amount of TD1414 Cream Used | >2 g | 1081.0 pg/mL | Standard Deviation 2976.6 |
Peak Serum Concentration by Baseline Lesion Size
On Day 1 (before the first application), the (sub)investigator recorded the size of the lesion(s). For each participant the size of the lesion was allocated to one of two categories: ≤15cm² or \>15cm². The Cmax is presented by baseline lesion size category (≤15 cm² and \>15 cm²). Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Cmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Peak Serum Concentration by Baseline Lesion Size | <=15 cm^2 | 484.1 pg/mL | Standard Deviation 1755.1 |
| TD1414 | Peak Serum Concentration by Baseline Lesion Size | >15 cm^2 | 1233.3 pg/mL | Standard Deviation 3545 |
Peak Serum Concentration by SIRS Score
On Day 1 (before the first application), the (sub)investigator recorded the severity of the lesion(s). The severity was to be recorded using the Severity of Infection Rating Scale (SIRS). For the SIRS, the following seven clinical signs/symptoms of infection were assessed: Exudates/pus Crusting Erythema Oedema Tissue warmth Itching Pain Each of the seven signs/symptoms was scored using the following scale: 0 = absent 2 = mild 4 = moderate 6 = severe The scores for each sign/symptom were summed to give the total SIRS score. The total SIRS score could range from 0 to 42. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Cmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Peak Serum Concentration by SIRS Score | SIRS score <=13 | 416.2 pg/mL | Standard Deviation 1937.5 |
| TD1414 | Peak Serum Concentration by SIRS Score | SIRS score >13 | 1068.3 pg/mL | Standard Deviation 2931.6 |
Peak TD1414 Serum Concentration (Cmax )
The Cmax was summarised by lesion size at baseline, by SIRS scores at baseline and by amount of TD1414 cream used. Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses. For description of lesion size, SIRS score and amount of TD1414 cream used please see outcome measure 3, 4 and 5 respectively.
Time frame: From 0 hours to 240 hours
Population: Cmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| TD1414 | Peak TD1414 Serum Concentration (Cmax ) | 650.4 pg/mL | Standard Deviation 2433.6 |
TD1414 Serum Concentration by Timepoint
On Days 1 and 2(and possibly Day 3 depending on the time of first application on Day 1) a sample was taken for pharmacokinetic(PK) analysis at any time before first application on Day 1, and at 12±1, 18±1, 24±1 and 36±4 hours after first application. If the 36±4 hours sampling time fell on Day 3, then a second sample was also required on Day 3, but was to be obtained at 6pm or afterwards. On Days 3 to 6(and also Day 7 if the very last application fell on Day 8), one sample was taken on each day at any time during the day. On Days 7 and 8(or Days 8 and 9 if very last application was on Day 8), a sample was taken immediately before the very last application and at 6±1, 12±1 and 24±2 hours after the very last application. On Days 9 and 10, one sample was taken on each day at any time during the day. If the participant had already had a sample(s) taken on Day 9 because the timing of some of the post-last application samples fell on this day, then further samples were not required on Day 9
Time frame: From 0 hours to 240 hours
Population: One participant withdrew at day 3 due to the participant being out of range of the inclusion criterion.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | TD1414 Serum Concentration by Timepoint | 24 hours Post First Application | 1195.7 pg/mL | Standard Deviation 2448.1 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 3 | 659.1 pg/mL | Standard Deviation 1461.8 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 18 hours Post First Application | 864.1 pg/mL | Standard Deviation 1635.7 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 36 hours Post First Application | 888.4 pg/mL | Standard Deviation 1878.6 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 4 | 309.0 pg/mL | Standard Deviation 578.5 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 12 hours Post First Application | 624.3 pg/mL | Standard Deviation 1255.3 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 5 | 344.4 pg/mL | Standard Deviation 673 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 6 | 178.8 pg/mL | Standard Deviation 199.1 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Prior last application | 177.4 pg/mL | Standard Deviation 220.5 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 6 hours Post Last Application | 189.9 pg/mL | Standard Deviation 231.1 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 12 hours Post Last Application | 190.6 pg/mL | Standard Deviation 214 |
| TD1414 | TD1414 Serum Concentration by Timepoint | 24 hours Post Last Application | 108.6 pg/mL | Standard Deviation 135 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 9 | 99.2 pg/mL | Standard Deviation 125.4 |
| TD1414 | TD1414 Serum Concentration by Timepoint | Day 10 | 47.2 pg/mL | Standard Deviation 60.1 |
Time to Reach Peak Serum Concentration (Tmax )
Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Tmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Value (MEDIAN) | Dispersion |
|---|---|---|---|
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) | 32.08 hours | Standard Deviation 59.82 |
Time to Reach Peak Serum Concentration (Tmax ) by Amount of TD1414 Cream Used
Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Tmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (MEDIAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by Amount of TD1414 Cream Used | <=2 g | 28.15 hours | Standard Deviation 63.9 |
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by Amount of TD1414 Cream Used | >2 g | 33.65 hours | Standard Deviation 62.68 |
Time to Reach Peak Serum Concentration (Tmax ) by Baseline Lesion Size
Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: Tmax could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (MEDIAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by Baseline Lesion Size | <=15 cm^2 | 47.42 hours | Standard Deviation 56.91 |
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by Baseline Lesion Size | >15 cm^2 | 23.73 hours | Standard Deviation 69.77 |
Time to Reach Peak Serum Concentration (Tmax ) by SIRS Score
Please see 1. Primary Outcome for details on collection of blood samples for the Pharmacokinetic analyses.
Time frame: From 0 hours to 240 hours
Population: AUC(0-t) could not be calculated for one participant as all values below lower limit of quantification (TD1414 concentration = 50pg/mL).
| Arm | Measure | Group | Value (MEDIAN) | Dispersion |
|---|---|---|---|---|
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by SIRS Score | <=13 cm^2 | 42.21 hours | Standard Deviation 62.79 |
| TD1414 | Time to Reach Peak Serum Concentration (Tmax ) by SIRS Score | >13 cm^2 | 24.22 hours | Standard Deviation 58.03 |