Vitiligo
Conditions
Keywords
Vitiligo, PDE-4 inhibitor, Phototherapy, Repigmentation
Brief summary
This is a phase 2A clinical trial designed to test the pro-melanogenic and anti-inflammatory role of phosphodiesterase-4 inhibitors (PDE4i), alone and in combination with active narrow band UVB (NBUVB), in vitiligo lesions. This is a double-blind, randomized controlled trial (RCT) with six study arms. The goal is for 64 participants to be recruited and complete the study.
Interventions
DRUGCrisaborole 2 % Topical Ointment
Twice daily crisaborole 2% topical ointment
DRUGPF-07038124 0.01% topical ointment
Twice daily PF-07038124 0.01% topical ointment
DEVICENBUVB phototherapy
Home narrow band UVB phototherapy exposure sessions 3 times per week
DEVICESham phototherapy
Non-NBUVB visible light radiation exposure sessions 3 times per week
DRUGVehicle
Twice daily vehicle ointment
Sponsors
Pfizer
University of Colorado, Denver
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Double-blind
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Active or stable non-segmental vitiligo at Screening and Baseline visits: * A clinical diagnosis of non-segmental vitiligo (vitiligo vulgaris or acrofacial vitiligo) for at least 3 months, AND * Body Surface Area affected (BSA) involvement 3%-90%, excluding involvement of scalp, palms of the hands, soles of the feet, AND * BSA \>= 0.25% involvement of the facial area, AND * Minimum Facial Vitiligo Area Scoring Index (F-VASI) \>=0.25% and Total VASI \>=3% * Must agree that the treatment area will involve 3%-25% BSA * If receiving concomitant medication for any reason other than vitiligo, must be on a stable regimen (no new drug or dosage changes within 7 days of baseline visit) and willing to remain on stable regimen for duration of the study * Must agree to stop all other treatments for vitiligo from screening through 1 week after discontinuation of study drug treatment * Must be capable of giving signed informed consent and comply with the requirements and restrictions as listed in the informed consent document and protocol * Must agree to avoid exposure to the sun as much as possible and not to use tanning booths, sun lamps, or other ultraviolet light sources other than requested by the study team during the study
Exclusion criteria
* Pregnant or breastfeeding females * Females of childbearing potential who are unwilling or unable to use contraception for the duration of the study and for at least 28 days after the last dose of study intervention * Other types of vitiligo that do not meet criteria for active or stable or non-segmental vitiligo, including segmental, mucosal, focal, and mixed vitiligo, and those with vitiligo universalis * Active forms of other hypo- or depigmentation, as detailed in the protocol * Active forms of inflammatory skin disease(s) associated with hypo- or depigmentation at the time of screening or baseline that, in the opinion of the investigator, would interfere with evaluation of vitiligo or response to treatment * Leukotrichia in more than 33% of the facial area affected with vitiligo lesions OR leukotrichia in more than 33% of the total BSA affected with vitiligo lesions * History of transplantation procedure for vitiligo at any point * History of any skin bleaching treatment for vitiligo or other dermatoses at any point * Active acute or chronic skin infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 4 weeks prior to first drug application (baseline), OR superficial skin infections within 2 weeks prior to first drug application (NOTE: MAY BE RESCREENED AFTER INFECTION RESOLUTION) * Known history of severe allergic or anaphylactoid reaction to any PDE4 inhibitors or lidocaine * Documented lack of response to prior PDE4 inhibitor therapy * Presence of other severe, progressive, or uncontrolled diseases, including but not limited to renal, hepatic, cardiac, pulmonary, endocrine, immunological/rheumatological, hematological, gastrointestinal, metabolic, neurologic, psychiatric, immunodeficiency (including HIV positive serology), OR significant laboratory abnormalities that would increase risk associated with study participation or interfere with interpretation of study results, or in the opinion of the investigator, the participant is inappropriate for entry into the study, or unwilling/unable to comply with protocol-specified assessments and lifestyle considerations * Any malignancies or history of skin malignancies, excluding adequately treated or excised non-metastatic basal cell or squamous cell skin cancer, or cervical carcinoma in situ * Significant trauma or major surgery 1 month prior to screening or considered in imminent need of surgery during the study * Alcohol or substance abuse within 6 months of screening that in the opinion of the investigator would preclude participation or adherence in the study * Previous administration of an investigational drug or vaccine occurring within 30 days preceding the first application of study drug used in this study * Any biologic or immune-modulating agent (including oral JAK inhibitors, PDE4i, other immunosuppressive agents such as oral corticosteroids, calcineurin inhibitors, azathioprine, mycophenolate mofetil) requires a washout period of 8 weeks before screening and through the final safety follow-up visit * Any topical treatment (such as topical steroids, calcineurin inhibitors, vitamin D analogs, JAK inhibitors, PDE4i) requires a washout period of 2 weeks before screening visit and through the final safety follow-up visit * Ultraviolet light exposure, including UVB/UVA/PUVA delivered by booth/excimer laser, or tanning bed exposure, requires a washout period of 8 weeks before screening and through the final safety follow-up visit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of participants achieving at 50% or greater improvement from baseline in facial Vitiligo Area Scoring Index (F)-VASI | 6 months (week 24) | Assessment of facial repigmentation via changes in depigmented areas |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of participants achieving 50% or greater improvement from baseline in total (T)-VASI | 6 months (week 24) |
| Proportion of participants achieving 90% or greater improvement from baseline in F-VASI | 6 months (week 24) |
| Proportion of participants achieving a Vitiligo Noticeability Scale (VNS) rating of a lot less noticeable or no longer noticeable | 6 months (week 24) |
| Percentage change from baseline in facial segment of Body Surface Area affected (F-BSA) | 6 months (24 weeks) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Assessment of percent change from baseline in serum key inflammatory chemokines | Baseline (pre-treatment) and at 3 months (12 weeks) and 6 months (24 weeks) | Molecular outcome: using samples for serum measurements of IFN-gamma, IL-15, CXCL-9, CXCL-10, which have been implicated in vitiligo pathogenesis |
| Assessment of melanocyte population expansion via immunohistochemistry (IHC) studies | Baseline (day 0, pre-treatment) and 3 months (12 weeks) | Molecular outcome: using skin biopsies treated with PDE4i with/without active NBUVB |
| Quantification of pigment via Fontana-Masson staining | Baseline (day 0, pre-treatment) and 3 months (12 weeks) | Molecular outcome: using skin biopsies treated with PDE4i with/without active NBUVB |
Countries
United States
Outcome results
None listed