Acne Vulgaris
Conditions
Keywords
acne, pimple, black head, white head, zit, probiotic
Brief summary
Acne vulgaris is a disease caused my multiple factors including overgrowth of bacteria, clogged pores, excessive sebum production and hormonal changes. Recent literature from the Human Microbiome Project has shown there are bacterial strains specific to healthy and acne disease states (Fitz-Gibbon et al, 2013, Johnson et al, 2016, McDowell et al, 2012, Tomida et al, 2013) From this data, the investigators hypothesize that by eliminating disease-associated bacterial strains and replacing them with health-associated strains, recurrences or flares of acne may be improved, mitigated, and prevented. Instead of current approaches which focus on eliminating all bacteria from the skin, the investigators aim to deliver healthy bacteria to restore the skin to a healthy state via this replacement therapy. The investigators aim to test this in a Phase Ib multiple application study evaluating the safety, tolerability, and clinical impact that a multiple applications of NB01 have on adult subjects with moderate acne.
Detailed description
A Multicenter, Randomized, Double-Blind, Vehicle-Controlled Phase 1B Study of the Safety, Short-Term Engraftment and Action of NB01 in Adults With Moderate Acne Acne vulgaris is a multifactorial disease caused by overgrowth of Propionibacterium acnes (P. acnes), impaction of hair follicles, excessive sebum production and hormonal dysregulation. Recent literature from the Human Microbiome Project has shown there are unique microbial signatures specific to healthy and acne disease states. From this data, the investigators hypothesize that by eliminating resident disease-associated bacterial strains and replacing them with health-associated strains, recurrences/fares of acne may be improved, mitigated, and prevented. Instead of current approaches which focus on eliminating all bacteria from the skin, the investigators aim to deliver healthy bacteria (NB01) to restore the skin to a healthy state via this replacement therapy. The investigators aim to test this in a Phase 1B multiple application study evaluating the safety, tolerability, and clinical impact that a multiple, daily, applications of NB01 has on adult subjects with moderate acne. Investigators will be profiling the change in microbiome over the course of therapy to determine if exogenously delivered bacteria can populate the skin (engraftment) and cause a shift in the microbiome safely and subsequently impact acne biomarkers that may correlate with clinical disease. The investigators intend for this therapy to eventually be used in acne subjects with ages ranging from 13-40, and all disease severities as either monotherapy for mild to mild/moderate acne and as an adjuvant therapy for moderate to severe acne at all body sites, with special attention to facial involvement. This approach is standard to acne therapy whereby mild disease will be treated with a monotherapy (i.e., topical Benzoyl peroxide \[BPO\]) and moderate/severe disease will be treated with various combinatory regimens (topical antibiotics, BPO, topical retinoids, oral antibiotics). Primary Objectives: 1\. To determine the safety and tolerability of a multiple application of topical P. acnes microbiome transplant (NB01). Exploratory Objectives: 1. To define engraftment duration of NB01. 2. To evaluate preliminary clinical efficacy using Acne Lesion Counts (total, inflammatory, and non-inflammatory), Investigator Global Assessment (IGA), and subjective improvement of acne based on subject reported outcomes (Acne QoL Questionnaire). 3. To evaluate treatment effects, based on sebum production in a subpopulation from sites 02 and 03. Approximately 36 total male and female adult subjects combined with moderate, non-cyclical acne will be enrolled into the trial. Approximately twenty four (24) subjects will be randomly assigned treatment and twelve (12) subjects will be randomly assigned to vehicle control. This is a multiple topical application study of live bacteria for the study of acne in adult subjects. Following a 5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial, 11 weeks of daily topical application of NB01 will be evaluated. Subject participation in the trial will approximately 12 weeks.
Interventions
5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of NB01
5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of vehicle control
Sponsors
Study design
Masking description
Double blind
Intervention model description
Randomized Double Blind Vehicle Controlled Trial, dual arm with 2:1 treatment to vehicle assignment
Eligibility
Inclusion criteria
1. Subject has provided written informed consent. 2. Subject is male or non-pregnant female, 18-40 years of age, inclusive at Screening. 3. Subject has moderate facial acne vulgaris 4. Female subject with non-cyclical acne. 5. Women of childbearing potential (WOCBP) willing to use adequate contraception during study participation 6. Male subjects willing to use an acceptable method of contraception during study participation. 7. Subject has the ability to personally apply benzoyl peroxide (BPO) and study drug, as per protocol.
Exclusion criteria
1. Subject has active bacterial, viral, or fungal skin infections. 2. Subject has active nodulocystic acne or acne conglobate, acne fulminans, or other forms of acne (e.g., acne mechanica). 3. Subject is currently participating in an investigational drug, device, or biologic study or has used an investigational drug, biologic or device treatment within 30 days prior to first application of the study drug. 4. Subjects with prosthetic heart valves, pacemakers, intravascular catheters, or other foreign or prosthetic devices/implantable devices/hardware. 5. Subject has a history of chronic human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV) infections. 6. Subject has a history of malignancy (with the exception of non-melanoma skin cancer). 7. Subject is immunosuppressed (such as resulting from transplantation, immunosuppressive therapy, active HIV infection/acquired immune deficiency syndrome \[AIDS\], neutropenia). 8. Subject had a major surgical procedure, open biopsy, or significant traumatic injury within 14 days of initiating study drug (unless the wound has healed), or anticipation of the need for major surgery during the study. 9. Subjects with close contacts (e.g., spouses, children, or members in the same household) that have severe skin barrier defects or are immunocompromised. 10. Female subject is pregnant or lactating or is planning to become pregnant and/or breast feed within the duration of study participation. Other entry criteria not listed above will be reviewed of each prospective subject by the study staff to confirm eligibility
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Follicular Engraftment | 12 weeks | Follicular communities were genotyped for health-associated loci at both Screening and 12-week visits. The percent increase of Cas5 in multiple communities from each subject is reported. |
| Number of Participants With Changes in Local Skin Reactions | Day 0 through day 80 | Local Skin Reactions (LSRs) including Erythema, edema, erosion/ulceration, scaling/dryness, and scabbing/crusting scored at Baseline (day of first application) and Week 12 (end of treatment) and reported for each visit as: Absent, Mild, Moderate, or Severe. The number of participants (and %) with no change or improvement from Baseline to week 12 visit are reported. The number of participants (and %) whose score worsened from Baseline to week 12 visit are reported. |
| Number of Participants With Successful Follicular Engraftment of NB01 | 12 weeks | Follicular engraftment sampling used Biore® Strips at Screening and day 80 (several days after end of treatment). The number of subjects with success at EOT where success is defined as a Follicular Biore® sample with yes outcome based on recovery of live NB01at day 80. |
| Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Day 0 through day 80 | Skin surface engraftment success endpoint is defined by a change in genotype (TaqMan) markers compared to Screening; value is percentage of bacterial population containing health-associated genotype. Result is absolute change from screening value. |
| Absolute Change From Screening in Acne Lesion Counts | Day 0 through day 80 | Reporting absolute change in counts. |
| Percent Change From Screening in Acne Lesion Counts | Day 0 through day 80 | Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment) |
| Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Day 0 through day 80 | The investigator assessed the participant's inflammatory lesions on the face using the Investigator Global Assessment (IGA) 5-point scale. The scale ranges from 0 (best): clear, no evidence of papules or pustules to 4 (worst): severe, inflammatory lesions are more apparent, many papules/pustules. The outcome is the number of subjects in each treatment group achieving success at Week 12; success defined as an IGA score of clear (score=0) or almost clear (score=1) and at least a two-point reduction in IGA compared to Baseline. |
| Change in Acne QoL Questionnaire Score | Day 0 through day 80 | At each visit, subjects were asked to complete the Acne Quality of Life \[QoL\] Questionnaire to assess subjective improvement of acne with 7 response choices ranging from extremely to not at all. The total score ranges from 19 to 114; higher scores reflect improved QoL. Outcome measure is absolute change in Acne QoL (Total Score) from Baseline to Day 80. |
| Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Day 0 through day 80 | After reviewing the data, one Treatment Arm subject was found to be an extreme outlier and was censored from this ad-hoc analysis. Reporting absolute change in counts. |
| Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Day 0 through day 80 | Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Absolute Change in Sebum Production. | Day 0 through day 80 | Exploratory Endpoint: Absolute change from Baseline to week 12 in sebum production measured at the mid-glabellar region of the forehead using a Sebumeter. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Treatment Arm Subjects will undergo 1 week lead-in with BPO followed by 11 weeks of NB01 probiotic applied topically.
NB01: 5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of NB01 | 23 |
| Vehicle Control Subjects will undergo 1 week lead-in with BPO followed by 11 weeks of vehicle applied topically.
Vehicle Control: 5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of vehicle control | 13 |
| Total | 36 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 |
| Overall Study | Lost to Follow-up | 1 | 1 |
| Overall Study | Withdrawal by Subject | 1 | 1 |
Baseline characteristics
| Characteristic | Total | Vehicle Control | Treatment Arm |
|---|---|---|---|
| Age, Continuous | 24.4 years STANDARD_DEVIATION 5.63 | 24.6 years STANDARD_DEVIATION 4.7 | 24.3 years STANDARD_DEVIATION 6.19 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 17 Participants | 7 Participants | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 19 Participants | 6 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Investigator's Global Assessment (IGA) Score - Face IGA at Baseline | 3 Score on scale STANDARD_DEVIATION 0 | 3 Score on scale STANDARD_DEVIATION 0 | 3 Score on scale STANDARD_DEVIATION 0 |
| Investigator's Global Assessment (IGA) Score - Face IGA at Screening | 3 Score on scale STANDARD_DEVIATION 0 | 3 Score on scale STANDARD_DEVIATION 0 | 3 Score on scale STANDARD_DEVIATION 0 |
| Lesion Count Inflammatory lesions | 29.6 number of lesions STANDARD_DEVIATION 6.7 | 30.5 number of lesions STANDARD_DEVIATION 5.6 | 29.1 number of lesions STANDARD_DEVIATION 7.3 |
| Lesion Count Non-Inflammatory lesions | 36.4 number of lesions STANDARD_DEVIATION 13.2 | 37.4 number of lesions STANDARD_DEVIATION 12.8 | 35.9 number of lesions STANDARD_DEVIATION 13.5 |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants | 0 Participants | 2 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 29 Participants | 12 Participants | 17 Participants |
| Region of Enrollment United States | 36 participants | 13 participants | 23 participants |
| Sex: Female, Male Female | 24 Participants | 8 Participants | 16 Participants |
| Sex: Female, Male Male | 12 Participants | 5 Participants | 7 Participants |
| Skin bacterial genotype Cas5/Panbac | 7.5 percentage of genotype STANDARD_DEVIATION 12.9 | 7.8 percentage of genotype STANDARD_DEVIATION 13 | 7.3 percentage of genotype STANDARD_DEVIATION 12.8 |
| Skin bacterial genotype deoR/Panbac | 23.3 percentage of genotype STANDARD_DEVIATION 25.4 | 26.0 percentage of genotype STANDARD_DEVIATION 27.4 | 21.8 percentage of genotype STANDARD_DEVIATION 24.2 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 23 | 0 / 13 |
| other Total, other adverse events | 4 / 23 | 1 / 13 |
| serious Total, serious adverse events | 0 / 23 | 0 / 13 |
Outcome results
Absolute Change From Screening in Acne Lesion Counts
Reporting absolute change in counts.
Time frame: Day 0 through day 80
Population: modified intent-to-treat (mITT) population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 2 | -4.3 lesion count | Standard Deviation 4.77 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 7 | -8.4 lesion count | Standard Deviation 6.64 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 12 | -15.5 lesion count | Standard Deviation 7.84 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 2 | -1.9 lesion count | Standard Deviation 8.89 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 7 | -8.6 lesion count | Standard Deviation 8.58 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 12 | -15 lesion count | Standard Deviation 16.93 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 7 | -9.2 lesion count | Standard Deviation 8.52 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 2 | -4.7 lesion count | Standard Deviation 6.8 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 2 | -3.0 lesion count | Standard Deviation 6.3 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 7 | -6.7 lesion count | Standard Deviation 7.32 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 12 | -17.6 lesion count | Standard Deviation 10.66 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 12 | -14.5 lesion count | Standard Deviation 9.56 |
Absolute Change From Screening in Acne Lesion Counts: Outlier Censored
After reviewing the data, one Treatment Arm subject was found to be an extreme outlier and was censored from this ad-hoc analysis. Reporting absolute change in counts.
Time frame: Day 0 through day 80
Population: Ad Hoc Subject 02-005 (outlier) Censored mITT Population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 2 | -3.6 lesion count | Standard Deviation 2.77 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 12 | -15.1 lesion count | Standard Deviation 7.79 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 7 | -9.7 lesion count | Standard Deviation 7.35 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 7 | -8.5 lesion count | Standard Deviation 6.81 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 12 | -18 lesion count | Standard Deviation 10.31 |
| Treatment Arm | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 2 | -4.2 lesion count | Standard Deviation 4.82 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 12 | -17.6 lesion count | Standard Deviation 10.66 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 12 | -14.5 lesion count | Standard Deviation 9.56 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 2 | -3.0 lesion count | Standard Deviation 6.3 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 2 | -4.7 lesion count | Standard Deviation 6.8 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 7 | -6.7 lesion count | Standard Deviation 7.32 |
| Vehicle Control | Absolute Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 7 | -9.2 lesion count | Standard Deviation 8.52 |
Absolute Change in Genotype Markers: Skin Surface Engraftment Success
Skin surface engraftment success endpoint is defined by a change in genotype (TaqMan) markers compared to Screening; value is percentage of bacterial population containing health-associated genotype. Result is absolute change from screening value.
Time frame: Day 0 through day 80
Population: modified intent-to-treat (mITT)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 2 weeks | 6.9 percentage of bacterial population | Standard Deviation 20.32 |
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 7 weeks | 5.5 percentage of bacterial population | Standard Deviation 17.63 |
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 12 weeks | 3.9 percentage of bacterial population | Standard Deviation 25.27 |
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 2 weeks | 3.7 percentage of bacterial population | Standard Deviation 8.16 |
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 7 weeks | 6.6 percentage of bacterial population | Standard Deviation 17.84 |
| Treatment Arm | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 12 weeks | 4.0 percentage of bacterial population | Standard Deviation 10.32 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 7 weeks | 3.9 percentage of bacterial population | Standard Deviation 10.42 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 2 weeks | 2.5 percentage of bacterial population | Standard Deviation 14.17 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 2 weeks | 4.8 percentage of bacterial population | Standard Deviation 12.56 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 7 weeks | 2.9 percentage of bacterial population | Standard Deviation 16.96 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 2 (Cas 5), 12 weeks | 19.6 percentage of bacterial population | Standard Deviation 38.69 |
| Vehicle Control | Absolute Change in Genotype Markers: Skin Surface Engraftment Success | Genotype 1 (deoR), 12 weeks | 14.9 percentage of bacterial population | Standard Deviation 36.76 |
Change in Acne QoL Questionnaire Score
At each visit, subjects were asked to complete the Acne Quality of Life \[QoL\] Questionnaire to assess subjective improvement of acne with 7 response choices ranging from extremely to not at all. The total score ranges from 19 to 114; higher scores reflect improved QoL. Outcome measure is absolute change in Acne QoL (Total Score) from Baseline to Day 80.
Time frame: Day 0 through day 80
Population: modified intent-to-treat (mITT) population
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Arm | Change in Acne QoL Questionnaire Score | 9.7 score on a scale | Standard Deviation 16.2 |
| Vehicle Control | Change in Acne QoL Questionnaire Score | 33.2 score on a scale | Standard Deviation 23.65 |
Follicular Engraftment
Follicular communities were genotyped for health-associated loci at both Screening and 12-week visits. The percent increase of Cas5 in multiple communities from each subject is reported.
Time frame: 12 weeks
Population: modified intent-to-treat (mITT) population
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Arm | Follicular Engraftment | 6518.9 Percent increase Cas5 | Standard Deviation 6711.94 |
| Vehicle Control | Follicular Engraftment | 492 Percent increase Cas5 | Standard Deviation 939.2 |
Number of Participants Achieving Success on Investigator Global Assessment (IGA)
The investigator assessed the participant's inflammatory lesions on the face using the Investigator Global Assessment (IGA) 5-point scale. The scale ranges from 0 (best): clear, no evidence of papules or pustules to 4 (worst): severe, inflammatory lesions are more apparent, many papules/pustules. The outcome is the number of subjects in each treatment group achieving success at Week 12; success defined as an IGA score of clear (score=0) or almost clear (score=1) and at least a two-point reduction in IGA compared to Baseline.
Time frame: Day 0 through day 80
Population: modified intent-to-treat (mITT) population
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Treatment Arm | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 2 weeks | 0 Participants |
| Treatment Arm | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 7 weeks | 1 Participants |
| Treatment Arm | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 12 weeks | 6 Participants |
| Vehicle Control | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 2 weeks | 0 Participants |
| Vehicle Control | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 7 weeks | 0 Participants |
| Vehicle Control | Number of Participants Achieving Success on Investigator Global Assessment (IGA) | Success at 12 weeks | 1 Participants |
Number of Participants With Changes in Local Skin Reactions
Local Skin Reactions (LSRs) including Erythema, edema, erosion/ulceration, scaling/dryness, and scabbing/crusting scored at Baseline (day of first application) and Week 12 (end of treatment) and reported for each visit as: Absent, Mild, Moderate, or Severe. The number of participants (and %) with no change or improvement from Baseline to week 12 visit are reported. The number of participants (and %) whose score worsened from Baseline to week 12 visit are reported.
Time frame: Day 0 through day 80
Population: The Safety population included all randomized subjects who received and applied study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Erythema: No Change / Improved | 19 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Edema: Worsened | 2 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Scaling/Dryness: No Change / Improved | 16 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Scaling/Dryness: Worsened | 5 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Scabbing/Crusting: No Change / Improved | 19 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Scabbing/Crusting: Worsened | 2 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Itching: No Change / Improved | 15 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Itching: Worsened | 6 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Pain: No Change / Improved | 20 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Pain: Worsened | 1 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Erythema: Worsened | 2 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Edema: No Change / Improved | 19 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Erosion/Ulceration: No Change / Improved | 20 Participants |
| Treatment Arm | Number of Participants With Changes in Local Skin Reactions | Erosion/Ulceration: Worsened | 1 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Pain: No Change / Improved | 12 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Edema: No Change / Improved | 9 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Itching: Worsened | 1 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Erosion/Ulceration: Worsened | 0 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Erythema: Worsened | 1 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Scaling/Dryness: No Change / Improved | 11 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Erosion/Ulceration: No Change / Improved | 12 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Scaling/Dryness: Worsened | 1 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Pain: Worsened | 0 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Scabbing/Crusting: No Change / Improved | 12 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Edema: Worsened | 3 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Scabbing/Crusting: Worsened | 0 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Erythema: No Change / Improved | 11 Participants |
| Vehicle Control | Number of Participants With Changes in Local Skin Reactions | Itching: No Change / Improved | 11 Participants |
Number of Participants With Successful Follicular Engraftment of NB01
Follicular engraftment sampling used Biore® Strips at Screening and day 80 (several days after end of treatment). The number of subjects with success at EOT where success is defined as a Follicular Biore® sample with yes outcome based on recovery of live NB01at day 80.
Time frame: 12 weeks
Population: The modified intent-to-treat (mITT) population included all randomized subjects who were dispensed the study drug and had at least 1 post-baseline assessment. Subjects were included in the treatment group to which they were randomized, regardless of the treatment received.~All randomized subjects (N=36) were included in the mITT population.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Treatment Arm | Number of Participants With Successful Follicular Engraftment of NB01 | 1 Participants |
| Vehicle Control | Number of Participants With Successful Follicular Engraftment of NB01 | 0 Participants |
Percent Change From Screening in Acne Lesion Counts
Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment)
Time frame: Day 0 through day 80
Population: modified intent-to-treat (mITT) population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 12 | -54.8 percent change from Baseline | Standard Deviation 26.29 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 2 | -5.8 percent change from Baseline | Standard Deviation 23.99 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 7 | -25.0 percent change from Baseline | Standard Deviation 23.55 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 12 | -43.5 percent change from Baseline | Standard Deviation 44.96 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 2 | -15.8 percent change from Baseline | Standard Deviation 18.72 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 7 | -28.9 percent change from Baseline | Standard Deviation 20.72 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 2 | -14.8 percent change from Baseline | Standard Deviation 20.1 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 12 | -49.2 percent change from Baseline | Standard Deviation 27.19 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 12 | -49 percent change from Baseline | Standard Deviation 23.84 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 2 | -6.2 percent change from Baseline | Standard Deviation 16.09 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Inflammatory Lesion Count: week 7 | -20.0 percent change from Baseline | Standard Deviation 22.41 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts | Non-Inflammatory Lesion Count: week 7 | -21.5 percent change from Baseline | Standard Deviation 17.93 |
Percent Change From Screening in Acne Lesion Counts: Outlier Censored
Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment)
Time frame: Day 0 through day 80
Population: Ad Hoc Subject 02-005 Censored mITT Population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 12 | -53.0 percent change from Baseline | Standard Deviation 25.72 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 12 | -51.8 percent change from Baseline | Standard Deviation 26.42 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 2 | -10.5 percent change from Baseline | Standard Deviation 8.55 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 7 | -29.0 percent change from Baseline | Standard Deviation 21.25 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 7 | -27.8 percent change from Baseline | Standard Deviation 20.18 |
| Treatment Arm | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 2 | -15.2 percent change from Baseline | Standard Deviation 18.91 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 12 | -49.0 percent change from Baseline | Standard Deviation 23.84 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 2 | -14.8 percent change from Baseline | Standard Deviation 20.1 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 7 | -20.0 percent change from Baseline | Standard Deviation 22.41 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Inflammatory Lesion Count: week 12 | -49.2 percent change from Baseline | Standard Deviation 27.19 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 2 | -6.2 percent change from Baseline | Standard Deviation 16.09 |
| Vehicle Control | Percent Change From Screening in Acne Lesion Counts: Outlier Censored | Non-Inflammatory Lesion Count: week 7 | -21.5 percent change from Baseline | Standard Deviation 17.93 |
Absolute Change in Sebum Production.
Exploratory Endpoint: Absolute change from Baseline to week 12 in sebum production measured at the mid-glabellar region of the forehead using a Sebumeter.
Time frame: Day 0 through day 80
Population: modified intent-to-treat subpopulation visiting a subset of sites with a Sebumeter.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Arm | Absolute Change in Sebum Production. | 26.2 μg/cm^2 | Standard Deviation 52.48 |
| Vehicle Control | Absolute Change in Sebum Production. | -22.9 μg/cm^2 | Standard Deviation 34.47 |