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A Study to Compare Sitavig (Acyclovir) Buccal Tablet With a Placebo in the Treatment of Herpes Labialis in Participants Whose Immune System Works Normally

A Randomized, Multi-Center, Double Blinded, Self-Initiated, Single Treatment Study Comparing Sitavig® (Acyclovir) 50 mg Muco-adhesive Buccal Tablet to Placebo in the Treatment of Herpes Labialis in Immunocompetent Adults

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05098938
Enrollment
2020
Registered
2021-10-28
Start date
2021-11-23
Completion date
2024-07-02
Last updated
2025-09-02

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

Conditions

Recurrent Herpes Labialis

Brief summary

Researchers are looking for a better way to treat people who have recurrent herpes labialis, also known as cold sores. This is a type of viral infection that causes redness and blisters on the mouth and lip and that recurs. Herpes labialis is caused by a virus called the herpes simplex virus (HSV). The infection is spread when a person comes into direct contact with someone else who has the infection. Once a person becomes infected with HSV, the virus multiplies and spreads, which can cause redness and blistering on the mouth and lip. The blisters crust over and heal. Once healed, the virus is said to go into an inactive phase. This means the virus does not cause any symptoms, but still remains in the body. HSV can then become active again. This means causing cold sore lesions to reappear. HSV can become active in different ways. Some of these include when a person has a fever, comes into contact with strong sunlight or has a condition that lowers one's immune system It can also happen during a woman's menstrual cycle, also called a period. In this study, the researchers want to gather additional data on acyclovir 50 mg tablet, an available treatment for herpes labialis. It is a buccal tablet that sticks to the gum inside the mouth and directly treats the infected area to help stop the HSV from multiplying and spreading. In this study, the researchers want to compare the efficacy of acyclovir 50 mg buccal tablets versus placebo in the treatment of herpes labialis. A placebo is a treatment that looks like the study medicine but does not have any medicine in it. Study participants will include those who have had at least 4 episodes of herpes labialis within the past 12 months prior to joining the study. To compare the study treatments, the researchers will measure the duration of episode (DOE) for each participant. DOE is amount of time it takes for symptoms to disappear and for herpes labialis lesions to heal after taking the study treatment. A doctor will look at the participants' symptom scores and facial images to determine the DOE. Assessments will be done over a period of 14 days. The participants in this study will apply either acyclovir 50mg buccal tablet or the placebo as a tablet to the upper gum 1 time. There will be a 2 week treatment phase and a 12 month follow up phase. The participants in this study will not be required to visit the study site. Instead, the participants will have virtual meetings with the study doctors from their homes using the internet. During the treatment phase, there will be 2 meetings. Throughout the follow up phase, the doctors will call the participants 4 times. Each participant will be in the study for about 20 months. During the treatment phase of the study, the participants will: * take their blood pressure and pulse * check their mouth health through a questionnaire * take pictures of their face and herpes labialis symptoms During the whole study the participants will answer questions about how they are feeling, what medications they are taking, and what adverse events they are having. The doctors will keep track of any adverse events. An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments.

Detailed description

Participants will be randomly assigned one of two treatment groups - acyclovir 50 mg buccal tablet or a placebo buccal tablet. Face images as well as symptom scores will be recorded at baseline, treatment initiation and over the next 14 days. Participants will automatically transition to the Follow-up Phase. Participants will be in contact with the sites using weekly virtual check-ins with the e-diary/App with the purpose reporting any adverse events, concomitant medications , or new outbreaks of herpes labialis.

Interventions

DRUGAcyclovir 50mg buccal/topical tablet, BAYM008894/UI1614773

Oral (upper gum area), 50mg, 1 tablet.

DRUGPlacebo

Oral (upper gum area), 1 table.

Sponsors

Bayer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Males or females, 18 years of age or older inclusive; * History of recurrent HL lesions where: * Recurrence is defined as at least 4 episodes in the preceding 12 months; * At least half of the episodes should be vesicular in nature; * At least half of the episodes should be preceded by prodromal symptoms; * Herpes labialis lesions are characterized by their localization on the cutaneous and/or mucosal surfaces of the lips; * Willing to avoid, during the treatment phase, the use of anti-inflammatory (not including low-dose (81 mg) aspirin), anti-herpetic, antibiotic and antiviral agents as well as steroids or other natural products that would interfere with the immune system response; * Female participants of childbearing potential must be using a medically acceptable form of birth control during screening \[e.g., hormonal contraceptives (oral, patch, injectable or vaginal ring), implantable device (implantable rod or intrauterine device), or a double barrier\], abstinence or in same sex relationship and have a negative pregnancy test at Screening and prior to study drug administration. Female participants of non-childbearing potential must be amenorrheic for at least two years or have undergone surgical sterilization (i.e. tubal ligation/occlusion, hysterectomy and/or bilateral oophorectomy); * Agreement to abstain from any mechanical disruption of the prodromal area or lesion (i.e. scrubbing, lancing, shaving the area, rubbing with alcohol, application of heat emitting devices used for cold sore treatment, etc.); * Capable of giving signed informed consent as described in protocol which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol; * Ability to understand and follow study-related instructions; * Be willing and able to participate in all scheduled visits, treatment plan, and trial procedures according to the clinical protocol.

Exclusion criteria

* Participants who did not develop herpes prodromal symptoms within 6 months after randomization in the study; * More than 50% of recurrences that aborted spontaneously (without intervention) in the past 12 months; * Primary herpes lesion outside the lips (e.g., nose, chin, etc.); * Abnormal peri-oral skin condition that might affect the normal course of cold sores (e.g., eczema, psoriasis, etc.); * Oral diseases whose prodromal symptoms may mimic those of herpes labialis, including recurrent oral aphthous disease; * Allergy to any acyclovir or its containing agents; * Milk allergy or known history of hypersensitivity to one of the components of Sitavig; * Self-reported immunocompromised condition, including self-reported Human Immunodeficiency Virus (HIV) positive and previous bone marrow or organ transplant; * Known medical history of renal disease, that in the judgment of the investigator is severe; * Females who are planning to become pregnant, are pregnant or lactating.

Design outcomes

Primary

MeasureTime frameDescription
Duration of Episode (DOE) Was Measured in Hours (Using the Science 37 Platform), of a Single Treated Herpes Labialis (HL) LesionUp to 14 daysDuration of episode (DOE) is defined as the time from the initiation of treatment (study intervention) to the healing of primary lesions (loss of crust) for participants who experience a vesicular lesion. For participants whose primary lesions are not vesicular in nature, duration of episode is the time from study intervention initiation to the return to normal skin as determined by the independent blinded reader of the participant's face images using a 6-point Likert scale or to the cessation of symptoms, whichever comes last.

Secondary

MeasureTime frameDescription
Incidence of Aborted LesionsUp to 14 daysIncidence of aborted lesions, defined as treated HL lesions that do not progress to the vesicular or crust stage. A lesion that returns to normal skin without forming a vesicle or crust will be counted as an aborted lesion.
Incidence of Recurrence of HL Lesions During the 12-months Follow-up PeriodUp to 12 months
Time to Recurrence of HL Lesions, Measured in Days From Resolution of the Cold Sore Treated in the Treatment Phase Until Onset of Prodromal SymptomsUp to 12 months
Incidence of Treatment-Emergent Adverse Events (TEAE)sUp to 12 months
Percentage of Participants Who Have at Least One RecurrenceUp to 12 months

Countries

United States

Participant flow

Recruitment details

The study was conducted in the United States of America (USA) as a decentralized study between 23 Nov 2021 (First participant first visit) and 2 July 2024 (Last participant last visit).

Pre-assignment details

2020 participants were randomized into the study, 1009 in the Sitavig arm and 1011 in the Placebo arm. 1019 participants were run-in failure, 505 in the Sitavig arm and 514 in the Placebo arm, so that 504 participants were included in the Sitavig arm and 497 in the Placebo arm.

Participants by arm

ArmCount
Sitavig
Sitavig (acyclovir) 50 mg muco-adhesive buccal tablet (one tablet application on Day 1)
493
Placebo
Placebo muco-adhesive buccal tablet (one tablet application on Day 1)
483
Total976

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall Study6 months visit was missed20
Overall StudyAdverse Event43
Overall Studychange in medication10
Overall Studyexclusionary medication use12
Overall Studyfit for use was not completed within window30
Overall StudyIMP delivery missed15
Overall Studyinclusion/exclusion criteria change115
Overall Studylack of compliance2619
Overall StudyLost in treatment period1713
Overall StudyLost to Follow-up3740
Overall StudyMet an exclusion criterion03
Overall Studyno prodromal symptoms after 6 months10
Overall StudyPhysician Decision2532
Overall StudyRun-in Failure in early study505514
Overall StudyRun in failure in treatment phase11
Overall Studytreatment failure21
Overall StudyV2 visit was not completed within window01
Overall StudyWithdrawal by Subject03

Baseline characteristics

CharacteristicSitavigPlaceboTotal
Age, Continuous42.7 Years
STANDARD_DEVIATION 12.38
43.0 Years
STANDARD_DEVIATION 12.19
42.9 Years
STANDARD_DEVIATION 12.28
Ethnicity (NIH/OMB)
Hispanic or Latino
43 Participants37 Participants80 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
450 Participants445 Participants895 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants1 Participants1 Participants
Sex: Female, Male
Female
402 Participants399 Participants801 Participants
Sex: Female, Male
Male
91 Participants84 Participants175 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 5040 / 497
other
Total, other adverse events
143 / 504146 / 497
serious
Total, serious adverse events
5 / 5047 / 497

Outcome results

Primary

Duration of Episode (DOE) Was Measured in Hours (Using the Science 37 Platform), of a Single Treated Herpes Labialis (HL) Lesion

Duration of episode (DOE) is defined as the time from the initiation of treatment (study intervention) to the healing of primary lesions (loss of crust) for participants who experience a vesicular lesion. For participants whose primary lesions are not vesicular in nature, duration of episode is the time from study intervention initiation to the return to normal skin as determined by the independent blinded reader of the participant's face images using a 6-point Likert scale or to the cessation of symptoms, whichever comes last.

Time frame: Up to 14 days

Population: PP population: The Per Protocol (PP) population included all subjects who completed 14-days of evaluations and did not have any major protocol violations.

ArmMeasureValue (MEDIAN)
SitavigDuration of Episode (DOE) Was Measured in Hours (Using the Science 37 Platform), of a Single Treated Herpes Labialis (HL) Lesion66.5 Hours
PlaceboDuration of Episode (DOE) Was Measured in Hours (Using the Science 37 Platform), of a Single Treated Herpes Labialis (HL) Lesion73.6 Hours
p-value: 0.716Log Rank
Secondary

Incidence of Aborted Lesions

Incidence of aborted lesions, defined as treated HL lesions that do not progress to the vesicular or crust stage. A lesion that returns to normal skin without forming a vesicle or crust will be counted as an aborted lesion.

Time frame: Up to 14 days

Population: PP population: The Per Protocol (PP) population included all subjects in ITT who completed 14-days of evaluations and did not have any major protocol violations.

ArmMeasureValue (NUMBER)
SitavigIncidence of Aborted Lesions40 lesions
PlaceboIncidence of Aborted Lesions58 lesions
p-value: 0.102Chi-squared
Secondary

Incidence of Recurrence of HL Lesions During the 12-months Follow-up Period

Time frame: Up to 12 months

Population: Follow-up population: The follow-up population included all participants, who continued into the 12-months Follow-up period and was defined as participants whose lesions were all treated at the end of the treament period (of 14 days) of the study.

ArmMeasureValue (NUMBER)
SitavigIncidence of Recurrence of HL Lesions During the 12-months Follow-up Period117 lesions
PlaceboIncidence of Recurrence of HL Lesions During the 12-months Follow-up Period94 lesions
p-value: 0.712Chi-squared
Secondary

Incidence of Treatment-Emergent Adverse Events (TEAE)s

Time frame: Up to 12 months

Population: Safety analysis set

ArmMeasureGroupValue (NUMBER)
SitavigIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with serious TEAEs4 participants
SitavigIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with treatment related serious TEAEs0 participants
SitavigIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with treatment related TEAEs16 participants
SitavigIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with TEAEs leading to study discontinuation0 participants
SitavigIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with TEAEs146 participants
PlaceboIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with TEAEs leading to study discontinuation0 participants
PlaceboIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with TEAEs149 participants
PlaceboIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with serious TEAEs6 participants
PlaceboIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with treatment related TEAEs10 participants
PlaceboIncidence of Treatment-Emergent Adverse Events (TEAE)sParticipants with treatment related serious TEAEs0 participants
Secondary

Percentage of Participants Who Have at Least One Recurrence

Time frame: Up to 12 months

ArmMeasureValue (NUMBER)
SitavigPercentage of Participants Who Have at Least One Recurrence31.0 percentage of participants
PlaceboPercentage of Participants Who Have at Least One Recurrence23.5 percentage of participants
Secondary

Time to Recurrence of HL Lesions, Measured in Days From Resolution of the Cold Sore Treated in the Treatment Phase Until Onset of Prodromal Symptoms

Time frame: Up to 12 months

Population: Follow-up population: The follow-up population included all participants, who continued into the 12-months Follow-up period and was defined as participants whose lesions were all treated at the end of the treament period (of 14 days) of the study.

ArmMeasureValue (MEDIAN)
SitavigTime to Recurrence of HL Lesions, Measured in Days From Resolution of the Cold Sore Treated in the Treatment Phase Until Onset of Prodromal Symptoms88.0 days
PlaceboTime to Recurrence of HL Lesions, Measured in Days From Resolution of the Cold Sore Treated in the Treatment Phase Until Onset of Prodromal Symptoms88.0 days
p-value: 0.575Log Rank

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026