A Short-contact Plaque Test Study With Daivobet® Gel in Psoriasis Vulgaris

A Phase IIa Exploratory Study Evaluating the Anti-psoriatic Effect of Daivobet® Gel Applied Then Removed After 10 Minutes, Daivobet® Gel Applied Then Removed After 20 Minutes, Daivobet® Gel Applied for 24 Hours and Daivobet® Gel Vehicle Applied for 24 Hours

Status

Completed

Phases

Phase 2

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01607853

Enrollment

Registered

2012-05-30

Start date

2012-06-30

Completion date

2012-10-31

Last updated

2025-03-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Psoriasis Vulgaris

Brief summary

The purpose of this study is to evaluate the anti-psoriatic effect of Daivobet® gel applied then removed after 10 minutes (+/- 2 minutes), Daivobet® gel applied then removed after 20 minutes (+/- 2 minutes) compared with Daivobet® gel and Daivobet® gel vehicle applied for 24 hours (+/- 2 hours), using the psoriasis plaque test modified from the method developed by KJ Dumas and JR Scholtz.

Interventions

DRUGDaivobet® gel applied then removed after 10 minutes (+/- 2 minutes)

Once daily application, 3 weeks

DRUGDaivobet® gel applied then removed after 20 minutes (+/- 2 minutes)

Once daily application, 3 weeks

DRUGDaivobet® gel applied for 24 hours (+/- 2 hours)

Once daily application, 3 weeks

DRUGDaivobet® gel vehicle applied for 24 hours (+/- 2 hours)

Once daily application, 3 weeks

Study design

Allocation

RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

OTHER

Masking

SINGLE (Investigator)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Following verbal and written information about the trial, the subject has to provide signed and dated informed consent before any study related activities are carried out. 2. Age 18 years or above. 3. Either sex. 4. All skin types. 5. Subjects with a diagnosis of psoriasis vulgaris with lesions located on arms, legs and/or trunk. The lesions must have a total size suitable for application of 4 different products. 6. Subjects with, in the opinion of the investigator, stable psoriasis based on Total Plaque Score evaluated at screening visit and at visit 2 (baseline). 7. Subjects with psoriasis lesions (plaques) assessed by a Total Clinical Score (sum of scores of erythema, scaling and infiltration) of 4 to 9 inclusive, but each individual item ≥ 1. 8. Subjects willing and able to follow all the study procedures and complete the whole study. 9. Subjects affiliated to a social security system. 10. Female subjects of childbearing potential using a reliable method of contraception for at least 1 month before the study start and during the course of the study (e.g., oral contraceptive pill, intrauterine device, contraceptive patches, implantable contraception, condoms) or females of non-childbearing potential (i.e. postmenopausal (absence of menstrual bleeding for 2 years), hysterectomy, bilateral ovariectomy or tubal section/ligation). 11. Female with a negative urine pregnancy test (at screening visit).

Exclusion criteria

1. Females who are pregnant, of child-bearing potential and who wish to become pregnant during the study, or who are breast feeding. 2. Systemic treatment with biological therapies (marketed or not marketed) with a possible effect on psoriasis vulgaris within 4 weeks (etanercept), 2 months (adalimumab, alefacept, infliximab), 4 months (ustekinumab) or 4 weeks/5 half-lives (which-ever is longer) for experimental biological products prior to randomisation and during the study. 3. Systemic treatments with all other therapies than biologicals, with a potential effect on psoriasis vulgaris (e.g., corticosteroids, retinoids, immunosuppressants) within the 4- week period prior to randomisation and during the study. 4. Use of phototherapy within the following time periods prior to randomisation and during the study: * PUVA or Grenz ray therapy (4 weeks), * UVB (2 weeks). 5. Subjects using one of the following topical drugs within 4 weeks prior to randomisation and during the study: \- Potent or very potent (WHO group III-IV) corticosteroids. 6. Subjects using one of the following topical drugs for the treatment of psoriasis within 2 weeks prior to randomisation and during the study: * WHO group I-II corticosteroids (except if used for treatment of scalp and/or facial psoriasis), * Topical retinoids, * Vitamin D analogues, * Topical immunomodulators (e.g. calcineurin inhibitors), * Anthracen derivatives, * Tar, * Salicylic acid. 7. Subjects using emollients on the target plaques within one week before randomisation and during the study. 8. Initiation of, or expected changes in concomitant medication that may affect psoriasis vulgaris (e.g., beta blockers, anti-malaria drugs, lithium and ACE inhibitors) within 2 weeks prior to randomisation and during the study. 9. Subjects with current diagnosis of guttate, erythrodermic, exfoliative or pustular psoriasis. 10. Subjects with known/suspected disorders of calcium metabolism associated with hypercalcemia within the last 10 years, based on medical history. 11. Subjects with any of the following conditions present on the test area: viral (e.g. herpes or varicella) lesions of the skin, fungal and bacterial skin infections, parasitic infections and atrophic skin. 12. Subjects with skin manifestations in relation to syphilis or tuberculosis, rosacea, perioral dermatitis, acne vulgaris, atrophic skin, striae atrophicae, fragility of skin veins, icthyosis, acne rosacea, ulcers and wounds within the plaque test areas. 13. History of any severe disease or serious current condition (based on subject interview and/or results of screening physical examination) which, in the opinion of the investigator, would put the subject at risk by participating in the study or would interfere significantly with the evaluation of study results or the study course (e.g. cancer, severe cardiopathy, severe renal insufficiency, severe hepatic insufficiency). 14. Subjects who have received treatment with any non-marketed drug substance (i.e., an agent which has not yet been made available for clinical use following registration) within the 4 week period prior to randomisation or longer, if the class of the substance requires a longer washout as defined above (e.g., biological treatments). 15. Subjects with current participation in any other interventional clinical trial, based on interview of the subject. 16. Subjects with known or suspected hypersensitivity to component(s) of the investigational products. 17. Subjects with any concomitant medical or dermatological disorder(s) which might preclude accurate evaluation of the psoriasis. 18. Subjects foreseeing an intensive solar exposure during the study (UV radiation, etc.) or having been exposed within two weeks preceding the screening visit. 19. Subjects impossible to contact in case of emergency. 20. Subjects who are known or, in the opinion of the investigator, are unlikely to comply with the Clinical Study Protocol (e.g. alcoholism, drug dependency or psychotic state). 21. Subjects who are in an exclusion period in the National Biomedical Research Register of the French Ministry of Health at randomisation. 22. Subjects under guardianship, hospitalized in a public or private institution, for a reason other than the research or subject deprived of freedom. 23. Subjects previously randomised in this trial.

Design outcomes

Primary

Measure	Time frame	Description
Change in Total Clinical Score From Baseline to Day 22	baseline to day 22	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clincal Score

Secondary

Measure	Time frame	Description
Change in Total Clinical Score at Day 8 Compared to Baseline	Baseline to day 8	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clinical Score.
Change in Total Clinical Score at Day 11 Compared to Baseline	Baseline to day 11	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clinical Score.
Change in Total Clinical Score at Day 15 Compared to Baseline	Baseline to day 15	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clinial Score.
Change in Total Clinical Score at Day 18 Compared to Baseline	Baseline to day 18	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clinical Score.
Change From Baseline in Erythema at Day 4.	Baseline to day 4	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Erythema at Day 8.	Baseline to day 8	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Erythema at Day 11	Baseline to day 11	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Erythema at Day 15	Baseline to day 15	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Erythema at Day 18	Baseline to day 18	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Erythema at Day 22	Baseline to day 22	Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Infiltration at Day 4	Baseline to day 4	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Infiltration at Day 8	Baseline to day 8	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change in Total Clinical Score at Day 4 Compared to Baseline	Baseline to day 4	Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clinical Score.
Change From Baseline in Infiltration at Day 15	Baseline to day 15	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Infiltration at Day 18	Baseline to day 18	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Infiltration at Day 22	Baseline to day 22	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 4	Baseline to day 4	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 8	Baseline to day 8	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 11	Baseline to day 11	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 15	Baseline to day 15	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 18	Baseline to day 18	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change From Baseline in Scaling at Day 22	Baseline to day 22	Investigator's rating of the clinical appearance of scaling. Maximum score is 3 (most severe); minimum score is 0 (absent).
Change in Lesion Thickness Measured by Ultrasound From Baseline to Day 22.	Baseline to day 22	—
Change in Skin Thickness - Echo-poor Band - Measured by Ultrasound From Baseline to Day 22	Baseline to day 22	—
Change From Baseline in Infiltration at Day 11	Baseline to day 11	Investigator's rating of the clinical appearance of infiltration. Maximum score is 3 (most severe); minimum score is 0 (absent).

Countries

France

Participant flow

Recruitment details

Start date: 28-Jun-2012 Completion date: 15-Oct-2012

Pre-assignment details

Prior to randomisation, the subjects entered a washout phase (if required) where antipsoriatic treatment and other relevant treatments had to be discontinued as defined by the exclusion criteria. Depending on prior use of disallowed treatments, the washout phase could last for up to 21 days.

Participants by arm

Arm	Count
Daivobet® Gel Each of the 24 subjects participating in this exploratory trial received: * Daivobet® gel applied then removed after 10 minutes (+/- 2 minutes) : Once daily application, 3 weeks * Daivobet® gel vehicle applied for 24 hours (+/- 2 hours) : Once daily application, 3 weeks * Daivobet® gel applied then removed after 20 minutes (+/- 2 minutes) : Once daily application, 3 weeks * Daivobet® gel applied for 24 hours (+/- 2 hours) : Once daily application, 3 weeks The products were applied on 4 test sites of 2 cm according to random assignment to specific sites on one psoriasis plaque.	24
Total	24

Arm

Count

Daivobet® Gel

Each of the 24 subjects participating in this exploratory trial received: * Daivobet® gel applied then removed after 10 minutes (+/- 2 minutes) : Once daily application, 3 weeks * Daivobet® gel vehicle applied for 24 hours (+/- 2 hours) : Once daily application, 3 weeks * Daivobet® gel applied then removed after 20 minutes (+/- 2 minutes) : Once daily application, 3 weeks * Daivobet® gel applied for 24 hours (+/- 2 hours) : Once daily application, 3 weeks The products were applied on 4 test sites of 2 cm according to random assignment to specific sites on one psoriasis plaque.

Total

Baseline characteristics

Characteristic	Daivobet® Gel
Age, Categorical <=18 years	0 Participants
Age, Categorical >=65 years	4 Participants
Age, Categorical Between 18 and 65 years	20 Participants
Age, Continuous	46.7 years STANDARD_DEVIATION 14.7
Region of Enrollment France	24 participants
Sex: Female, Male Female	7 Participants
Sex: Female, Male Male	17 Participants

Adverse events

Event type	EG000 affected / at risk
deaths Total, all-cause mortality	— / —
other Total, other adverse events	4 / 24
serious Total, serious adverse events	0 / 24

Outcome results

Primary

Change in Total Clinical Score From Baseline to Day 22

Investigator's rating of the clinical appearance of a psoriatic lesion. Maximum score is 9 (most severe); minimum score is 0 (least severe). The single items erythema, scaling, and infiltration (maximum score 3 each) are summed to obtain the Total Clincal Score

Time frame: baseline to day 22

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change in Total Clinical Score From Baseline to Day 22	-3.6 units on a scale	Standard Deviation 1.6
Daivobet® Gel Applied Then Removed After 20 Minutes	Change in Total Clinical Score From Baseline to Day 22	-3.7 units on a scale	Standard Deviation 2
Daivobet® Gel Applied for 24 Hours	Change in Total Clinical Score From Baseline to Day 22	-4.9 units on a scale	Standard Deviation 1.5
Daivobet® Gel Vehicle Applied for 24 Hours	Change in Total Clinical Score From Baseline to Day 22	-1.3 units on a scale	Standard Deviation 0.9

Secondary

Change From Baseline in Erythema at Day 11

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 11

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 11	-0.79 units on a scale	Standard Deviation 0.57
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 11	-0.85 units on a scale	Standard Deviation 0.52
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 11	-1.06 units on a scale	Standard Deviation 0.58
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 11	-0.27 units on a scale	Standard Deviation 0.36

Secondary

Change From Baseline in Erythema at Day 15

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 15

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 15	-1.00 units on a scale	Standard Deviation 0.49
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 15	-1.04 units on a scale	Standard Deviation 0.62
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 15	-1.29 units on a scale	Standard Deviation 0.57
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 15	-0.31 units on a scale	Standard Deviation 0.48

Secondary

Change From Baseline in Erythema at Day 18

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 18

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 18	-1.04 units on a scale	Standard Deviation 0.53
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 18	-1.19 units on a scale	Standard Deviation 0.53
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 18	-1.42 units on a scale	Standard Deviation 0.5
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 18	-0.46 units on a scale	Standard Deviation 0.41

Secondary

Change From Baseline in Erythema at Day 22

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 22

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 22	-1.17 units on a scale	Standard Deviation 0.6
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 22	-1.31 units on a scale	Standard Deviation 0.66
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 22	-1.56 units on a scale	Standard Deviation 0.61
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 22	-0.42 units on a scale	Standard Deviation 0.41

Secondary

Change From Baseline in Erythema at Day 4.

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 4

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 4.	-0.17 units on a scale	Standard Deviation 0.32
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 4.	-0.23 units on a scale	Standard Deviation 0.36
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 4.	-0.23 units on a scale	Standard Deviation 0.36
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 4.	-0.06 units on a scale	Standard Deviation 0.22

Secondary

Change From Baseline in Erythema at Day 8.

Investigator's rating of the clinical appearance of erythema. Maximum score is 3 (most severe); minimum score is 0 (absent).

Time frame: Baseline to day 8

Arm	Measure	Value (MEAN)	Dispersion
Daivobet® Gel Applied Then Removed After 10 Minutes	Change From Baseline in Erythema at Day 8.	-0.54 units on a scale	Standard Deviation 0.51
Daivobet® Gel Applied Then Removed After 20 Minutes	Change From Baseline in Erythema at Day 8.	-0.56 units on a scale	Standard Deviation 0.5
Daivobet® Gel Applied for 24 Hours	Change From Baseline in Erythema at Day 8.	-0.67 units on a scale	Standard Deviation 0.55
Daivobet® Gel Vehicle Applied for 24 Hours	Change From Baseline in Erythema at Day 8.	-0.15 units on a scale	Standard Deviation 0.35

Secondary