Cutaneous Sarcoidosis, Sarcoidosis
Conditions
Brief summary
ACTHAR gel has efficacy in the treatment of cutaneous sarcoidosis
Detailed description
Sarcoidosis is a multisystem granulomatous disease of unknown cause. Although sarcoidosis most commonly affects the lung3, it may affect any organ. Although corticosteroids are recognized as the drug of choice for sarcoidosis, ACTH is the only drug that is FDA-approved for this disorder. However, there is limited data on the efficacy of ACTH for this condition. Presently, corticosteroids as considered the drug of choice for the treatment of cutaneous sarcoidosis. However, ACTHER GEL not only has obvious anti-inflammatory effects by resulting in corticosteroid production, but it may also activate melanocortin receptors. The melanocortin system has powerful anti-inflammatory properties that may be beneficial in the treatment of cutaneous sarcoidosis.
Interventions
DRUGACTHAR Gel 40 units twice weekly
ACTHAR Gel (adrenocorticotropic hormone) 40 units twice weekly between Baseline and week 12.
DRUGACTHAR Gel 80 units twice weekly.
ACTHAR Gel (adrenocorticotropic hormone) 80 units twice weekly between Baseline and week 12.
Sponsors
Albany Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients must have biopsy-proven sarcoidosis. 2. a) Patients with active cutaneous sarcoidosis and two active lesions on stable therapy or no therapy for at least two months AND/OR b) Patients with active cutaneous sarcoidosis and lupus pernio lesions on stable therapy or no therapy for at least two months. A maximum of 5 patients may be enrolled fulfilling criterion b) above. 3. Both lesions must have a SASI induration score of \> 1 and a SASI induration + erythema score of \> 2. 4. If two lesions are present, one must be \> 1cm in diameter and the subject must be willing to have it biopsied. The second lesion must be at least 0.5 cm in diameter. 5. If a subject has only lupus pernio facial lesions, one needs to be at least 0.5 cm in diameter.
Exclusion criteria
1. Previous toxic or allergic reaction to ACTHAR gel 2. The presence of another skin condition in addition to sarcoidosis that would interfere with the assessment of the sarcoidosis skin lesions. 3. Uncontrolled hypertension. 4. Uncontrolled diabetes. 5. Active infection. 6. A medical condition that, in the opinion of the investigator would place the subject at significant risk by administering ACTHAR gel.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The change in SASI induration & erythema score. | Between week 0 and week 12. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Photographic change | Between week 0 and week 12. | Photographic change (improved, worse, no change as determined by investigators blinded to the time of the photographs) |
| SAT skin module | Between week 0 and week 12. | — |
| DLQI | Between week 0 and week 12. | — |
| Extent of granulomatous inflammation in the biopsy lesion | Between week 0 and week 12. | Extent of granulomatous inflammation in the biopsy lesion (as judged by pathologists blinded to the time of the biopsy). |
Countries
United States
Contacts
Primary ContactHaroon Chaudhry, MBBS
Backup ContactMarc A. Judson, MD
Outcome results
None listed