Efficacy and Safety of CIP-Isotretinoin in Patients With Severe Recalcitrant Nodular Acne

Status: Active, not recruiting
Study State Date: September 2009
Primary Completion Date: Anticipated April 2011
Study Type: Interventional
Study Design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Phase: Phase 3

Sponsor(s):
Cipher Pharmaceuticals Inc.
 
Information By: Cipher Pharmaceuticals Inc.
Trial Identifier: NCT00975143
Official Title: A Double-Blind, Randomized, Phase III, Parallel Group Study Evaluating the Efficacy and Safety of CIP-Isotretinoin in Patients With Severe Recalcitrant Nodular Acne

Description:  The purpose of this study is to compare the efficacy and safety of CIP-Isotretinoin and a marketed (generic) formulation of isotretinoin when both are administered twice daily with meals.

Accepts Healthy Volunteers?: No
Enrollment: 1100 Anticipated
Minimum Age: 12 Years
Maximum Age: 54 Years
Gender(s): Both
Additional Criteria:  Inclusion Criteria: - Severe recalcitrant nodular acne, which in the opinion of the investigator is compatible with isotretinoin treatment. - Ten (10) or more nodular lesions (facial and/or truncal). - Treatment-naïve patients without any prior exposure to systemic isotretinoin or other retinoids. - Age between 12 and 54 years. - Weight between 40 and 110 kg. - Negative serum human chorionic gonadotropin (hCG) pregnancy test consistent with a non-pregnant state (females only). - No significant disease or clinically significant finding in a physical examination. - No clinically significant abnormal laboratory value. - No clinically significant abnormal vital sign measurement. - Patients presenting with stable and controlled diabetes mellitus (Types I and II) may be included in the study. However, patients should not have had a hospitalization for any diabetes related complications in the last 12 months, and must be on stable medication for the preceding 6 months. To be included in the study, the patients should have Hemoglobin-A1c values ≤ 6.5% at screening and in the test done 3 - 4 months previously. - Patients with previously diagnosed Polycystic Ovarian Syndrome (PCOS) may be included in the study if in the opinion of the investigator they do not have any other clinically significant abnormality (e.g. metabolic syndrome or elevated lipids). Exclusion Criteria: - Female patients will be excluded from the study if they: - Are pregnant; - Are at high risk for becoming pregnant or likely to become pregnant during treatment; - Will be breast-feeding or considering breast feeding during the course of the study. - Known history or presence of any clinically significant unstable medical condition(s) which in the opinion of the investigator could pose a risk for the safety of the patient including any previous history of gastrointestinal disease. - Patients with any skin disease or other condition that might interfere with the evaluation of recalcitrant nodular acne. - Patients will be interviewed using the SCID-CT current and lifetime modules for Major Depression, Mania, and Psychosis. Patients with a lifetime history of psychosis will be excluded. Patients with a history of major depressive, manic, hypomanic or mixed episodes will not be excluded unless they have had an episode during the preceding year. - Patients with any past or current psychotic symptoms. - Patients reporting any suicidal behaviour (including attempts, interrupted attempts, aborted attempts, or other preparatory behaviours), within the past year, or serious suicidal ideation in the past year, will be excluded from study participation. - A lifetime history of wishing to be dead, non-specific active suicidal thoughts or active suicidal ideation without intent to act will not result in exclusion. - Known history or suspected carcinoma. - Known history of liver or kidney disorders (hepatic and renal insufficiency). - Known history or current pseudotumor cerebri (benign intracranial hypertension). - Patients with HLA-B27 related disease, rheumatoid arthritis, rickets or other vitamin D depletion disease or phosphate metabolic disease, severe scoliosis > 15 Cobb angle, history of back surgery/injuries, ongoing use of anticonvulsants known to affect bone metabolism and other genetic or acquired rheumatologic and joint diseases. - All pediatric patients with serum 25-hydroxyvitamin D levels < 20 ng/mL. - Patients with hearing disorders who in the opinion of the investigator would not be able to participate in audiometric testing for the study. - Hypersensitivity or idiosyncratic reaction to isotretinoin, Vitamin A and/or any other drug substances with similar activity. - Allergy to soy beans, soy bean oil or any other ingredients in the study medications. - On a special diet within four weeks prior to drug administration (e.g., liquid, protein, raw food diet). - Difficulty consuming two (2) meals a day to sustain weight and health.

Conditions:
Severe Nodular Acne
Interventions:
Drug: CIP-Isotretinoin and Isotretinoin
 
Primary Outcome Measures:
Co-primary outcomes: a) Total nodular lesion count (facial and truncal); and b) Proportion of patients who achieve at least a 90% reduction in total number of nodular lesions (facial and truncal).
Time Frame: 20 weeks
Safety Issue: No

 
Secondary Outcome Measures:
Proportion of patients who are rated as clear/almost clear on the six-point Physicians' Global Assessment Scale.
Time Frame: 20 weeks
Safety Issue: No

 
Patient Groups:
Assigned Interventions:

CIP-Isotretinoin: Experimental
Drug: CIP-Isotretinoin and Isotretinoin
0.5 mg/kg/day for 4 weeks, and 1 mg/kg/day for 16 weeks, taken orally, twice daily.

 
Isotretinoin: Active Comparator
Drug: CIP-Isotretinoin and Isotretinoin
0.5 mg/kg/day for 4 weeks, and 1 mg/kg/day for 16 weeks, taken orally, twice daily.

 


Investigators:
Study Chair: Guy Webster, MD, Jefferson Medical College of Thomas Jefferson University
Study Chair: James J. Leyden, MD, University of Pennsylvania
Study Director: Jason A. Gross, PharmD, Cipher Pharmaceuticals Inc.

Responsible Party:
Cipher Pharmaceuticals Inc. (Arshi Kizilbash, M.D., Medical Director)

Study Locations:
+ Show All 49 Study Locations


United States, Alabama
Total Skin & Beauty Dermatology Center 
Birmingham, Alabama, United States



United States, Arkansas
Burke Pharmaceutical Research 
Hot Springs, Arkansas, United States



United States, California
Center for Dermatology Clinical Research 
Fremont, California, United States

Dermatology Research Associates 
Los Angeles, California, United States

Dermatology Specialists 
Oceanside, California, United States

Skin Surgery Medical Group, Inc. 
San Diego, California, United States



United States, Colorado
Horizons Clinical Research Center 
Denver, Colorado, United States



United States, Florida
Ameriderm Research 
Jacksonville, Florida, United States

North Florida Dermatology Associates, PA 
Jacksonville, Florida, United States

Park Avenue Dermatology 
Orange Park, Florida, United States

Ameriderm Research 
Ormond Beach, Florida, United States



United States, Georgia
Peachtree Dermatology Associates, PC 
Atlanta, Georgia, United States

MedaPhase Inc. 
Newnan, Georgia, United States



United States, Idaho
Northwest Clinical Trials 
Boise, Idaho, United States

Northwest Clinical Trials 
Nampa, Idaho, United States



United States, Indiana
Dawes Fretzin Clinical Research 
Indianapolis, Indiana, United States

The Indiana Clinical Trials Center, PC 
Plainfield, Indiana, United States

The South Bend Clinic, LLP 
South Bend, Indiana, United States



United States, Kentucky
Dermatology and Skin Cancer Specialists / Pediaresearch, LLC 
Owensboro, Kentucky, United States



United States, Massachusetts
ActivMed Practices & Research 
Haverhill, Massachusetts, United States



United States, Michigan
Great Lakes Research Group 
Bay City, Michigan, United States

Hamzavi Dermatology 
Fort Gratiot, Michigan, United States



United States, Minnesota
Minnesota Clinical Study Center 
Fridley, Minnesota, United States



United States, Nebraska
Skin Specialists, PC 
Omaha, Nebraska, United States



United States, New Jersey
Comprehensive Clinical Research 
Berlin, New Jersey, United States



United States, Ohio
Haber Dermatology, Clinical Research Center 
South Euclid, Ohio, United States



United States, Oregon
Oregon Dermatology and Research Center 
Portland, Oregon, United States



United States, Pennsylvania
Paddington Testing Company Inc. 
Philadelphia, Pennsylvania, United States



United States, South Carolina
Radiant Research, Inc. 
Greer, South Carolina, United States



United States, Tennessee
Dermatology Associates of Knoxville 
Knoxville, Tennessee, United States

Tennessee Clinical Research Center 
Nashville, Tennessee, United States



United States, Texas
Arlington Center for Dermatology 
Arlington, Texas, United States

Suzanne Bruce and Associates - The Center for Skin Research 
Houston, Texas, United States

Stephen Miller, MD, PA Dermatology 
San Antonio, Texas, United States

Progressive Clinical Research 
San Antonio, Texas, United States



United States, Utah
Dermatology Research Center 
Salt Lake City, Utah, United States



United States, Washington
Premier Clinical Research 
Spokane, Washington, United States



Canada
Derm Research @ 888 Inc. 
Vancouver, Canada

Dermadvances Research 
Winnipeg, Canada

Durondel C.P. Inc 
Moncton, Canada

Newlab Clinical Research Inc. 
St. John's, Canada

UltraNova Skincare 
Barrie, Canada

Dermatrials Research 
Hamilton, Canada

The Guenther Dermatology Research Centre 
London, Canada

Lynderm Research Inc. 
Markham, Canada

North Bay Dermatology Centre 
North Bay, Canada

Institute of Cosmetic and Laser Surgery 
Oakville, Canada

K. Papp Clinical Research 
Waterloo, Canada

Windsor Clinical Research 
Windsor, Canada

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