Acne Vulgaris
Conditions
Brief summary
This study will assess the safety and efficacy of dapsone gel versus vehicle control in patients with acne vulgaris.
Detailed description
This is a multicenter, double-blind, randomized, parallel-group, vehicle-controlled study to assess the safety and efficacy of dapsone 7.5% gel versus vehicle administered topically once daily for 12 weeks in patients with acne vulgaris.
Interventions
Dapsone gel applied topically to the face and to affected areas of the trunk once daily for 12 weeks.
Dapsone gel vehicle applied topically to the face and to affected areas of the trunk once daily for 12 weeks.
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of acne vulgaris * Willing to avoid excessive or prolonged exposure to ultraviolet light (eg, sunlight, tanning beds) throughout the study
Exclusion criteria
* Severe cystic acne, acne conglobata, acne fulminans, or secondary acne * Use of phototherapy devices (eg, ClearLight™), energy-based devices, adhesive cleansing strips (eg, Pond's®, Biore®), or cosmetic procedures (eg, facials, peeling, comedo extraction) in the past week * Use of anti-inflammatory medications, salicylic acid; corticosteroids, antibiotics, antibacterials (including benzoyl peroxide-containing products \[eg, benzamycin\]), retinoids; other topical acne treatments (eg, photodynamic therapy, medicated soaps such as those containing benzoyl peroxide, salicylic acid, sulfur, or sodium sulfacetamide) in the past 2 weeks * Use of birth control pills strictly for acne control
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Patients With a Score of 0 (None) or 1 (Minimal) on the 5-point Global Acne Assessment Score (GAAS) | Week 12 | The Investigator evaluated the patient's acne severity using the 5-point GAAS scale with 0 being none and 4 being severe. The complete scale is as follow: Grade 0 (none) = No evidence of facila acne vulgaris; Grade 1 (minimal) = Few noninflammatory lesions (comedones) are present, a few inflammatory lesions (papules/pustules) may be present, no nodulo-cyctic lesions are allowed; Grade 2 (mild) = Several to many noninflammatory lesions (comedones) are present, a few inflammatory lesions (papules/pustules) are present, no nodulo-cystic lesions are allowed; Grade 3 (moderate) = Many noninflammatory (comedones) and inflammatory lesions (papules/pustules) are present, no nodulo-cystic lesions are allowed; Grade 4 (severe) = Significant degree of inflammatory disease, papules/pustules are a predominant feature, a few nodulo-cystic lesions may be present, comedones may be present. |
| Change From Baseline in Inflammatory Facial Lesion Counts | Baseline, Week 12 | The Investigator evaluated the patient's inflammatory lesions (papule, pustule and nodule/cyst). A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening). |
| Change From Baseline in Noninflammatory Facial Lesion Counts | Baseline, Week 12 | The Investigator evaluated the patient's noninflammatory lesions (papule, pustule and nodule/cyst). A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in the 9-Item ASIS Sign Domain Score | Baseline, Week 12 | The patient assessed signs of acne vulgaris using the ASIS. The sign domain is a composite of 9 items of the 17 items on the overall scale. Each of the items is assessed on a 5-point scale: 0 (best) to 4 (worst). The sign domain score is calculated as the average of the 9 items for a total possible score of 0 to 4. A negative number change from baseline indicates an improvement and a positive number change from baseline indicates a worsening. |
| Change From Baseline in Total Lesion Counts | Baseline, Week 12 | The Investigator evaluated the patient's inflammatory (papule, pustule and nodule/cyst) and non-inflammatory (blackhead and whitehead) lesions. A papule is a small, red, solid elevation less than 1.0 cm in diameter, a pustule is a small, circumscribed elevation of the skin that contains yellow-white exudate and a nodule/cyst is a circumscribed, elevated, solid lesion generally more than 0.5 cm in diameter with palpable depth. The total lesion count was the sum of the inflammatory and non-inflammatory lesion counts. A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening). |
| Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Redness on a the 5-Point ASIS Scale | Baseline, Week 12 | The patient assessed their facial redness using item 8 on the 5-point ASIS. Item 8 scores ranged from 0 (Not at all red) to 4 (Very red). The percentage of patients who reported at least a 1-grade improvement from baseline in their facial redness are reported. |
| Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Oiliness on a the 5-Point ASIS Scale | Baseline, Week 12 | The patient assessed their facial oiliness using item 1 on the 5-point ASIS. Item 1 scores ranged from 0 (Not at all oily) to 4 (Very oily). The percentage of patients who reported at least a 1-grade improvement from baseline in their facial oiliness are reported. |
| Percentage Change From Baseline in Total Lesion Counts | Baseline, Week 12 | The Investigator evaluated the patient's Inflammatory (papule, pustule and nodule/cyst) and Non-inflammatory (blackhead and whitehead) lesions. A papule is a small, red, solid elevation less than 1.0 cm in diameter, a pustule is a small, circumscribed elevation of the skin that contains yellow-white exudate and a nodule/cyst is a circumscribed, elevated, solid lesion generally more than 0.5 cm in diameter with palpable depth. The total lesion count was the sum of the inflammatory and non-inflammatory lesion counts. A negative percent change from baseline indicates a reduction in lesion counts (improvement) and a positive percent change from baseline indicates an increase in lesion counts (worsening). |
| Percentage of Patients Reporting Very Good or Excellent on Item 10 of the 5-Point Acne Symptom Impact Scale (ASIS) | Week 12 | The patient assessed the impact of their acne vulgaris on the look of their face using item 10 on the 5-point ASIS. Item 10 scores range from 1 (Excellent) to 5 (Bad). The percentage of patients who had an ASIS score of 4 (Fair) or 5 (Bad) at baseline and who reported Very good or Excellent at Week 12 are reported. |
Countries
Canada, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Dapsone Gel Dapsone gel applied topically to the face and to affected areas of the trunk once daily for 12 weeks. | 1,118 |
| Dapsone Gel Vehicle Dapsone gel vehicle applied topically to the face and to affected areas of the trunk once daily for 12 weeks. | 1,120 |
| Total | 2,238 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 2 | 2 |
| Overall Study | Lack of Efficacy | 1 | 1 |
| Overall Study | Lost to Follow-up | 45 | 40 |
| Overall Study | Other Reasons | 25 | 28 |
| Overall Study | Personal Reasons | 15 | 19 |
| Overall Study | Pregnancy | 2 | 1 |
| Overall Study | Protocol Violation | 2 | 2 |
Baseline characteristics
| Characteristic | Dapsone Gel | Dapsone Gel Vehicle | Total |
|---|---|---|---|
| Age, Continuous | 20.5 Years STANDARD_DEVIATION 8.15 | 20.4 Years STANDARD_DEVIATION 7.38 | 20.4 Years STANDARD_DEVIATION 7.77 |
| Sex: Female, Male Female | 618 Participants | 631 Participants | 1249 Participants |
| Sex: Female, Male Male | 500 Participants | 489 Participants | 989 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 1,117 | 0 / 1,118 |
| serious Total, serious adverse events | 4 / 1,117 | 4 / 1,118 |
Outcome results
Change From Baseline in Inflammatory Facial Lesion Counts
The Investigator evaluated the patient's inflammatory lesions (papule, pustule and nodule/cyst). A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening).
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Dapsone Gel | Change From Baseline in Inflammatory Facial Lesion Counts | Baseline | 29.6 Number of Inflammatory Lesions | Standard Error 0.23 |
| Dapsone Gel | Change From Baseline in Inflammatory Facial Lesion Counts | Change from Baseline at Week 12 | -15.6 Number of Inflammatory Lesions | Standard Error 0.35 |
| Dapsone Gel Vehicle | Change From Baseline in Inflammatory Facial Lesion Counts | Baseline | 30.0 Number of Inflammatory Lesions | Standard Error 0.23 |
| Dapsone Gel Vehicle | Change From Baseline in Inflammatory Facial Lesion Counts | Change from Baseline at Week 12 | -14.0 Number of Inflammatory Lesions | Standard Error 0.35 |
Change From Baseline in Noninflammatory Facial Lesion Counts
The Investigator evaluated the patient's noninflammatory lesions (papule, pustule and nodule/cyst). A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening).
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Dapsone Gel | Change From Baseline in Noninflammatory Facial Lesion Counts | Baseline | 46.7 Number of Noninflammatory Lesions | Standard Error 0.46 |
| Dapsone Gel | Change From Baseline in Noninflammatory Facial Lesion Counts | Change from Baseline at Week 12 | -20.8 Number of Noninflammatory Lesions | Standard Error 0.55 |
| Dapsone Gel Vehicle | Change From Baseline in Noninflammatory Facial Lesion Counts | Baseline | 46.7 Number of Noninflammatory Lesions | Standard Error 0.46 |
| Dapsone Gel Vehicle | Change From Baseline in Noninflammatory Facial Lesion Counts | Change from Baseline at Week 12 | -18.7 Number of Noninflammatory Lesions | Standard Error 0.55 |
Percentage of Patients With a Score of 0 (None) or 1 (Minimal) on the 5-point Global Acne Assessment Score (GAAS)
The Investigator evaluated the patient's acne severity using the 5-point GAAS scale with 0 being none and 4 being severe. The complete scale is as follow: Grade 0 (none) = No evidence of facila acne vulgaris; Grade 1 (minimal) = Few noninflammatory lesions (comedones) are present, a few inflammatory lesions (papules/pustules) may be present, no nodulo-cyctic lesions are allowed; Grade 2 (mild) = Several to many noninflammatory lesions (comedones) are present, a few inflammatory lesions (papules/pustules) are present, no nodulo-cystic lesions are allowed; Grade 3 (moderate) = Many noninflammatory (comedones) and inflammatory lesions (papules/pustules) are present, no nodulo-cystic lesions are allowed; Grade 4 (severe) = Significant degree of inflammatory disease, papules/pustules are a predominant feature, a few nodulo-cystic lesions may be present, comedones may be present.
Time frame: Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dapsone Gel | Percentage of Patients With a Score of 0 (None) or 1 (Minimal) on the 5-point Global Acne Assessment Score (GAAS) | 29.8 Percentage of Patients |
| Dapsone Gel Vehicle | Percentage of Patients With a Score of 0 (None) or 1 (Minimal) on the 5-point Global Acne Assessment Score (GAAS) | 20.9 Percentage of Patients |
Change From Baseline in the 9-Item ASIS Sign Domain Score
The patient assessed signs of acne vulgaris using the ASIS. The sign domain is a composite of 9 items of the 17 items on the overall scale. Each of the items is assessed on a 5-point scale: 0 (best) to 4 (worst). The sign domain score is calculated as the average of the 9 items for a total possible score of 0 to 4. A negative number change from baseline indicates an improvement and a positive number change from baseline indicates a worsening.
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Dapsone Gel | Change From Baseline in the 9-Item ASIS Sign Domain Score | Baseline | 2.04 Scores on a Scale | Standard Deviation 0.627 |
| Dapsone Gel | Change From Baseline in the 9-Item ASIS Sign Domain Score | Change from Baseline at Week 12 | -0.74 Scores on a Scale | Standard Deviation 0.7 |
| Dapsone Gel Vehicle | Change From Baseline in the 9-Item ASIS Sign Domain Score | Baseline | 2.07 Scores on a Scale | Standard Deviation 0.612 |
| Dapsone Gel Vehicle | Change From Baseline in the 9-Item ASIS Sign Domain Score | Change from Baseline at Week 12 | -0.68 Scores on a Scale | Standard Deviation 0.675 |
Change From Baseline in Total Lesion Counts
The Investigator evaluated the patient's inflammatory (papule, pustule and nodule/cyst) and non-inflammatory (blackhead and whitehead) lesions. A papule is a small, red, solid elevation less than 1.0 cm in diameter, a pustule is a small, circumscribed elevation of the skin that contains yellow-white exudate and a nodule/cyst is a circumscribed, elevated, solid lesion generally more than 0.5 cm in diameter with palpable depth. The total lesion count was the sum of the inflammatory and non-inflammatory lesion counts. A negative change from baseline indicates a reduction in lesion counts (improvement) and a positive change from baseline indicates an increase in lesion counts (worsening).
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Dapsone Gel | Change From Baseline in Total Lesion Counts | Baseline | 76.4 Total Lesion Counts | Standard Error 0.56 |
| Dapsone Gel | Change From Baseline in Total Lesion Counts | Change from Baseline at Week 12 | -36.2 Total Lesion Counts | Standard Error 0.76 |
| Dapsone Gel Vehicle | Change From Baseline in Total Lesion Counts | Baseline | 76.9 Total Lesion Counts | Standard Error 0.56 |
| Dapsone Gel Vehicle | Change From Baseline in Total Lesion Counts | Change from Baseline at Week 12 | -32.3 Total Lesion Counts | Standard Error 0.75 |
Percentage Change From Baseline in Total Lesion Counts
The Investigator evaluated the patient's Inflammatory (papule, pustule and nodule/cyst) and Non-inflammatory (blackhead and whitehead) lesions. A papule is a small, red, solid elevation less than 1.0 cm in diameter, a pustule is a small, circumscribed elevation of the skin that contains yellow-white exudate and a nodule/cyst is a circumscribed, elevated, solid lesion generally more than 0.5 cm in diameter with palpable depth. The total lesion count was the sum of the inflammatory and non-inflammatory lesion counts. A negative percent change from baseline indicates a reduction in lesion counts (improvement) and a positive percent change from baseline indicates an increase in lesion counts (worsening).
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Dapsone Gel | Percentage Change From Baseline in Total Lesion Counts | -48.9 Percent Change in Lesion Count | Standard Error 0.97 |
| Dapsone Gel Vehicle | Percentage Change From Baseline in Total Lesion Counts | -43.2 Percent Change in Lesion Count | Standard Error 0.97 |
Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Oiliness on a the 5-Point ASIS Scale
The patient assessed their facial oiliness using item 1 on the 5-point ASIS. Item 1 scores ranged from 0 (Not at all oily) to 4 (Very oily). The percentage of patients who reported at least a 1-grade improvement from baseline in their facial oiliness are reported.
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dapsone Gel | Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Oiliness on a the 5-Point ASIS Scale | 48.5 Percentage of Patients |
| Dapsone Gel Vehicle | Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Oiliness on a the 5-Point ASIS Scale | 49.3 Percentage of Patients |
Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Redness on a the 5-Point ASIS Scale
The patient assessed their facial redness using item 8 on the 5-point ASIS. Item 8 scores ranged from 0 (Not at all red) to 4 (Very red). The percentage of patients who reported at least a 1-grade improvement from baseline in their facial redness are reported.
Time frame: Baseline, Week 12
Population: Intent-to-Treat: all randomized patients
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dapsone Gel | Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Redness on a the 5-Point ASIS Scale | 53.8 Percentage of Patients |
| Dapsone Gel Vehicle | Percentage of Patients Reporting at Least a 1-Grade Improvement From Baseline in Facial Redness on a the 5-Point ASIS Scale | 52.9 Percentage of Patients |
Percentage of Patients Reporting Very Good or Excellent on Item 10 of the 5-Point Acne Symptom Impact Scale (ASIS)
The patient assessed the impact of their acne vulgaris on the look of their face using item 10 on the 5-point ASIS. Item 10 scores range from 1 (Excellent) to 5 (Bad). The percentage of patients who had an ASIS score of 4 (Fair) or 5 (Bad) at baseline and who reported Very good or Excellent at Week 12 are reported.
Time frame: Week 12
Population: Intent-to-Treat: all randomized patients with data at this time point
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dapsone Gel | Percentage of Patients Reporting Very Good or Excellent on Item 10 of the 5-Point Acne Symptom Impact Scale (ASIS) | 24.2 Percentage of Patients |
| Dapsone Gel Vehicle | Percentage of Patients Reporting Very Good or Excellent on Item 10 of the 5-Point Acne Symptom Impact Scale (ASIS) | 22.0 Percentage of Patients |