Psoriasis Vulgaris
Conditions
Brief summary
This is a phase 2, open-label, single-group, multicentre trial in which the investigational product, MC2-01 cream, is investigated in adolescent subjects (age 12 to 16 years, 11 months) with clinically diagnosed extensive psoriasis vulgaris.
Detailed description
The MC2-01 cream is designed for optimal patient satisfaction - it quickly absorbs into the skin leaving it nicely moisturized allowing patients to move on with daily routines. In this trial, subjects who fulfil all inclusion and exclusion criteria are enrolled in the trial and will apply one dose of trial medication topically once daily for 8 weeks. The purpose of the trial, is to determine the and pharmacokinetic parameters of MC2-01 cream in adolescent subjects under maximum use conditions.
Interventions
DRUGMC2-01 cream
MC2-01 cream (Calcipotriene/betamethasone dipropionate, w/w 0.005%/ 0.064%)
Sponsors
MC2 Therapeutics
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
* The parent(s), or legal guardian(s) (according to national law) have provided written informed consent following their receipt of verbal and written information about the trial * The subject (according to national law) has provided written assent to the trial following their receipt of verbal and written information about the trial * Generally healthy males or non-pregnant females, of any race or ethnicity, who are between 12 to 16 years, 11-month-old at Screening Visit 1 (SV1) * At Visit 1/Day 0, have a clinical diagnosis of plaque psoriasis (psoriasis vulgaris) of at least 6 months duration involving body (trunk and/or limbs), with or without scalp * Have a treatment area between 10% and 30% of the Body Surface Area (BSA) on the body (trunk and/or limbs) and scalp, excluding psoriatic lesions on the face, genitals, and intertriginous areas, at Visit 1/Day 0 * Have a Physician's Global Assessment (PGA) of at least moderate severity on the treatment area * A normal HPA axis function including a serum cortisol concentration above 4,5 mcg/dl before ACTH-challenge and equal or above 18 mcg/dl 30 minutes after ACTH challenge, at Screening Visit 2 (SV2) * A serum albumin-corrected calcium below the upper reference limit at SV2
Exclusion criteria
* Have a current diagnosis of unstable forms of psoriasis, including erythrodermic or pustular psoriasis * Other inflammatory skin disease in the treatment area that may confound the evaluation of the psoriasis vulgaris * Presence of infections in the treatment area or skin manifestations or atrophic skin, atrophic striae, skin vein fragility, ichthyosis, acne vulgaris, acne rosacea, rosacea, ulcers and wounds in the treatment area * Presence of pigmentation, extensive scarring, pigmented lesions or sunburn in the treatment areas, which could interfere with the rating of efficacy parameters * Planned excessive or prolonged exposure to either natural or artificial sunlight * Use of phototherapy (psoralen + ultraviolet A radiation and ultraviolet B radiation within 4 weeks prior to SV2 and during the trial * Current or past history of disorders of calcium metabolism associated with hypercalcemia, vitamin D toxicity, severe renal insufficiency, or severe hepatic disorders * Oral calcium supplements, vitamin D supplements, bisphosphonates or calcitonin within 4 weeks prior to SV2 * Planned initiation of, or changes to concomitant medication that could affect calcium metabolism during the trial; * Planned initiation of, or changes to, concomitant estrogen therapy during the trial * Strong systemic cytochrome P450 3A4 (CYP 3A4) inhibitors or inducers within 4 weeks prior to SV2 and during the trial * Use of topical treatments, except for emollients and non-medicated shampoos, with a possible effect on psoriasis within 2 weeks prior to SV2 and during the trial * Systemic treatment with biological therapies, with a possible effect on psoriasis vulgaris within the following time period prior to SV2 and during the trial * Initiation of, or expected changes to, concomitant medication that may affect psoriasis during the trial * Any of the following conditions, whether known or suspected; Clinically diagnosed depression where the subject is in current treatment with medication approved for treatment of depression; Endocrine disorders known to affect cortisol levels or HPA axis integrity; Non-nocturnal sleep patterns * Use of systemic medication that suppresses the immune system and other systemic chemotherapeutic antineoplastic therapy within 4 weeks prior to the SV2 and during the trial * Use of live vaccines 4 weeks before SV2 and during the trial * Have clinical signs of skin infection with bacteria, viruses, or fungi * Known human immunodeficiency virus (HIV) infection, active hepatitis B or hepatitis C * Known or suspected of hypersensitivity to any component of the test product * Known allergic asthma, serious allergies or allergies where recurrent acute or chronic treatment is necessary * Have any chronic or acute medical condition that, in the opinion of the investigator, may pose a risk to the safety of the subject, or may interfere with the assessment of safety or efficacy in this trial * Require the use of any concomitant medication that, in the investigator's opinion, has the potential to cause an adverse effect when given with the Investigational Product (IP) or will interfere with the interpretation of the trial results * Subject with known abnormal reduction in muscle mass, as judged by the investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in U-Calcium Metabolism at Week 8 | Week 8 | Change from Baseline to Week 8 in Urinary Calcium/Creatinine ratio (mol/mol) |
| Change in S-Calcium Metabolism at Week 8 | Week 8 | Change from Baseline to Week 8 in albumin-corrected S-calcium |
| Change in U-Calcium Metabolism at Week 4 | Week 4 | Change from Baseline to Week 4 in Urinary Calcium/Creatinine ratio (mol/mol) |
| Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 4 | Week 4 | Adrenal function will be assessed in a challenge test with an intravenous dose of cosyntropin. Measurement of serum cortisol levels pre- and post- stimulation is an accepted standard method used to evaluate adrenal suppression. The test consists of an initial blood sampling. Following the blood sample, an intravenous bolus injection of 0.25 mg cosyntropin is given. The serum cortisol concentration 30 min. after will reflect stimulation of the adrenal glands induced by cosyntropin. HPA axis suppression is define as serum cortisol below 18 µg/dL |
| Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 8 | Week 8 | Adrenal function will be assessed in a challenge test with an intravenous dose of cosyntropin. Measurement of serum cortisol levels pre- and post- stimulation is an accepted standard method used to evaluate adrenal suppression. The test consists of an initial blood sampling. Following the blood sample, an intravenous bolus injection of 0.25 mg cosyntropin is given. The serum cortisol concentration 30 min. after will reflect stimulation of the adrenal glands induced by cosyntropin. HPA axis suppression is define as serum cortisol below 18 µg/dL |
| Change in S-Calcium Metabolism at Week 4 | Week 4 | Change from Baseline to Week 4 in albumin-corrected S-calcium |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Maximum Plasma Drug Concentration [Tmax] of Betamethasone 17-propionate at Week 4 | Week 4 | Time to maximum plasma drug concentration \[Tmax\] of the metabolite of BDP, betamethasone 17-propionate measured at Week 4. |
| The Maximum Plasma Concentration [Cmax] of Betamethasone 17-propionate at Week 4 | Week 4 | The Maximum Plasma Concentration \[Cmax\] of the metabolite of BDP, betamethasone 17-propionate measured at Week 4. |
Countries
Czechia, Germany
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| MC2-01 Cream MC2-01 (calcipotriene/betamethasone dipropionate, w/w 0.005%/0.064%) cream. One application daily for 8 weeks
MC2-01 cream: MC2-01 cream (Calcipotriene/betamethasone dipropionate, w/w 0.005%/ 0.064%) | 7 |
| Total | 7 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Protocol Violation | 1 |
Baseline characteristics
| Characteristic | MC2-01 Cream |
|---|---|
| Age, Continuous | 14.7 years STANDARD_DEVIATION 1.4 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 7 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 7 Participants |
| Region of Enrollment Czechia | 5 participants |
| Region of Enrollment Germany | 2 participants |
| Sex: Female, Male Female | 3 Participants |
| Sex: Female, Male Male | 4 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 7 |
| other Total, other adverse events | 3 / 7 |
| serious Total, serious adverse events | 0 / 7 |
Outcome results
Primary
Change in S-Calcium Metabolism at Week 4
Change from Baseline to Week 4 in albumin-corrected S-calcium
Time frame: Week 4
Population: 7 subjects were included in the safety population at baseline and Week 4. At Week 8 1 subjects was withdrawn.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MC2-01 Cream | Change in S-Calcium Metabolism at Week 4 | -0.037 mmol/L | Standard Deviation 0.084 |
Primary
Change in S-Calcium Metabolism at Week 8
Change from Baseline to Week 8 in albumin-corrected S-calcium
Time frame: Week 8
Population: 7 subjects were included in the safety population at baseline and Week 4. At Week 8 1 subjects was withdrawn.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MC2-01 Cream | Change in S-Calcium Metabolism at Week 8 | -0.027 mmol/L | Standard Deviation 0.06 |
Primary
Change in U-Calcium Metabolism at Week 4
Change from Baseline to Week 4 in Urinary Calcium/Creatinine ratio (mol/mol)
Time frame: Week 4
Population: 7 subjects were included in the safety population at baseline and Week 4. At Week 8 1 subjects was withdrawn.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MC2-01 Cream | Change in U-Calcium Metabolism at Week 4 | 0.115 mol/mol | Standard Deviation 0.426 |
Primary
Change in U-Calcium Metabolism at Week 8
Change from Baseline to Week 8 in Urinary Calcium/Creatinine ratio (mol/mol)
Time frame: Week 8
Population: 7 subjects were included in the safety population at baseline and Week 4. At Week 8 1 subjects was withdrawn.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| MC2-01 Cream | Change in U-Calcium Metabolism at Week 8 | 0.058 mol/mol |
Primary
Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 4
Adrenal function will be assessed in a challenge test with an intravenous dose of cosyntropin. Measurement of serum cortisol levels pre- and post- stimulation is an accepted standard method used to evaluate adrenal suppression. The test consists of an initial blood sampling. Following the blood sample, an intravenous bolus injection of 0.25 mg cosyntropin is given. The serum cortisol concentration 30 min. after will reflect stimulation of the adrenal glands induced by cosyntropin. HPA axis suppression is define as serum cortisol below 18 µg/dL
Time frame: Week 4
Population: The HPA population was defined as all subjects in the safety population that showed a normal HPA function at the screening visit.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| MC2-01 Cream | Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 4 | 0 Participants |
Primary
Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 8
Adrenal function will be assessed in a challenge test with an intravenous dose of cosyntropin. Measurement of serum cortisol levels pre- and post- stimulation is an accepted standard method used to evaluate adrenal suppression. The test consists of an initial blood sampling. Following the blood sample, an intravenous bolus injection of 0.25 mg cosyntropin is given. The serum cortisol concentration 30 min. after will reflect stimulation of the adrenal glands induced by cosyntropin. HPA axis suppression is define as serum cortisol below 18 µg/dL
Time frame: Week 8
Population: The HPA population was defined as all subjects in the safety population that showed a normal HPA function at the screening visit.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| MC2-01 Cream | Number of Participants With HPA (Hypothalamic-pituitary-adrenal) Axis Suppression at Week 8 | 0 Participants |
Secondary
The Maximum Plasma Concentration [Cmax] of Betamethasone 17-propionate at Week 4
The Maximum Plasma Concentration \[Cmax\] of the metabolite of BDP, betamethasone 17-propionate measured at Week 4.
Time frame: Week 4
Population: The Maximum Plasma Concentration \[Cmax\] of the metabolite of BDP, betamethasone 17-propionate, was quantifiable in 3 out of 6 (50 %) participants only, thus the data only reflects result from 3 participants. The 3 remaining participants had values below Lower Limit of Quantification (LLOQ).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MC2-01 Cream | The Maximum Plasma Concentration [Cmax] of Betamethasone 17-propionate at Week 4 | 37.53 pg/mL | Standard Deviation 22.82 |
Secondary
Time to Maximum Plasma Drug Concentration [Tmax] of Betamethasone 17-propionate at Week 4
Time to maximum plasma drug concentration \[Tmax\] of the metabolite of BDP, betamethasone 17-propionate measured at Week 4.
Time frame: Week 4
Population: The Maximum Plasma Concentration \[Cmax\] of the metabolite of BDP, betamethasone 17-propionate, was quantifiable in 3 out of 6 (50 %) participants only, thus the data only reflects result from 3 participants. The 3 remaining participants had values below Lower Limit of Quantification (LLOQ).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MC2-01 Cream | Time to Maximum Plasma Drug Concentration [Tmax] of Betamethasone 17-propionate at Week 4 | 2.333 Hours | Standard Deviation 1.155 |