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Bullous PemphigoidPhase 2NCT01571895

Pilot Efficacy and Safety Study of Oral DF2156A in Patients With Active Bullous Pemphigoid

A Phase 2 study testing DF2156A in people with Bullous Pemphigoid, run by Dompé Farmaceutici S.p.A at 4 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The objective of this clinical trial was to evaluate whether DF2156A has a potential in improving the clinical outcome in patients with active blistering bullous pemphigoid (BP) to warrant its further development. The safety of DF2156A in the specific clinical setting was also evaluated. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bullous Pemphigoid
What is being tested?
DF2156A
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4 participants
Where
4 sitesin 2 countries
Study dates
20 Feb 2012to 5 Jul 2012
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female patients aged >50 years.
  • Patients with newly diagnosed or relapsing bullous pemphigoid based on clinical diagnosis to be confirmed by direct immunofluorescence and indirect immunofluorescence on salt-spit skin (or BP180 and/or BP230 ELISA). Confirmation by laboratory tests will be obtained ideally before or anyway within one week after enrolment.
  • For the purpose of this study, clinical relapses are defined as re-appearance of clinical symptoms after the patient had attained remission lasting for more than 3 months without immunosuppressive treatment. In patients with relapsing BP, clinical diagnosis will be confirmed by indirect immunofluorescence or BP180 and/or BP230 ELISA only.
  • Patients with mild to moderate active blistering disease (total number of blisters between 1 and 30) whether associated or not with urticarial/eczematous lesions.
  • Patients with modified ABSIS score ≤50
  • Patients free from any systemic treatments that may affect the course of the disease with the following off-period prior to enrolment:
Show all 12Show fewer
  • 3 weeks: steroids, dapsone, tetracyclines, nicotinamide,
  • 3 months: azathioprine, mycofenolate mofetil, cyclophosphamide, methotrexate, intravenous immunoglobulins, immunoadsorption, TNF antagonists
  • 12 months: rituximab, leflunomide
  • Patients free from any topical treatments other than topical antibiotics and antiseptics in the 4 days prior to enrolment.
  • Patients able to comply with the protocol procedures for the duration of the study, including scheduled follow-up visits and examinations.
  • Patients able to provide informed consent.

Who cannot join

  • Patients with a Karnofsky rating score <40%.
  • Patients with mucosal involvement.
  • Patients with moderate to severe renal impairment as per calculated creatinine clearance (CLcr) < 50 mL/min according to the Cockcroft-Gault formula (Cockcroft-Gault , 1976).
  • Patients with hepatic dysfunction defined by increased ALT/AST > 3 x upper limit of normal (ULN) and increased total bilirubin > 3 mg/dL [>51.3 μmol/L].
  • Patients with hypoalbuminemia defined as serum albumin < 3 g/dL.
  • Patients with a baseline (day 0/1, pre-dose) QTcF > 470 msec.
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  • Patients who had a myocardial infarction in the 6 months prior to enrolment.
  • Patients on treatment with phenytoin, warfarin, sulphonylurea hypoglycemics (e.g. tolbutamide, glipizide, glibenclamide/glyburide, glimepiride, nateglinide) and high dose of amitriptyline (> 50 mg/day).
  • Patients with known hypersensitivity to non-steroidal antiinflammatory drugs.
  • Patients using any investigational agent within 12 months prior to enrolment.
  • Pregnant or breast feeding women. Unwillingness to use effective contraceptive measures up to 2 months after the end of study drug administration (females and males).
  • Additional Exclusion Criteria for Germany only:
  • Patients with hypokalemia defined as serum potassium < 3.5 mmol/L.
  • Patients with clinically relevant bradycardia (heart rate < 50 beats/min)
  • Patients with a complete left bundle branch block.
  • Patients with a history of uncontrolled or labile hypertension
  • Patients with a history of congestive heart failure.
  • Patients with a history of cardiomyopathy.
  • Patients with unstable angina pectoris.
  • Patients with a personal or family history of congenital or documented acquired QT interval prolongation.
  • Patients with a significant atrial or ventricular arrhythmia or symptomatic arrhythmia in the past.

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

Germany3 sites
  • Department of Dermatology - Universitäts-Hautklinik; Hauptstraße 7

    Freiburg im Breisgau, 79104

  • Klinik für Dermatologie, Allergologie und Venerologie - Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Ratzeburger Allee 160

    Lübeck, 23538

  • Klinik für Dermatologie und Allergologie - Philips Universität; 35037

    Marburg, 35037

Other trials in Germany

Italy1 site
  • I Divisione di Dermatologia, Istituto Dermopatico dell'Immacolata, IRCCS;

    Roma, 00167

Other trials in Italy

About this study

Official title: A Phase 2, Multicentre, Single Arm, Pilot Study to Assess the Efficacy and the Safety of 150 mg Twice a Day Oral DF2156A in Patients With Active Bullous Pemphigoid.

The objective of this clinical trial was to evaluate whether DF2156A has a potential in improving the clinical outcome in patients with active blistering bullous pemphigoid (BP) to warrant its further development. The safety of DF2156A in the specific clinical setting was also evaluated.

Read the detailed description

The study was a phase 2, multicentre, single arm, pilot study. It has been designed to determine if DF2156A has sufficient activity to warrant its further development.

A total of twelve (12) BP patients were planned to be involved. They were planned to receive DF2156A orally at the dose of 150 mg twice a day for a maximum of 14 days.

Recruitment was intended to be competitive among the study sites, until the planned number of patients is enrolled. Competitive recruitment has been chosen to increase the speed of recruitment and to account for any unexpected occurrence at a site that negatively impact enrolment rate.

The single arm design has been chosen as an appropriate tool for this pilot phase 2 study, considering that BP is a rare disease where a placebo control is not acceptable. Moreover, as there is no spontaneous acute recovery from the active blistering condition, any improvement in patient outcome can be attributed to a positive effect of the Investigational Product.

Each patient was intended to be involved in the study for a screening period, for 14 days of treatment, for all required measurements up to hospital discharge (planned on day 8+1 of treatment) and for one assessment occasion on day 15+1, either during hospital stay or after hospital discharge (out-patient visit). An optional post-treatment visit might be scheduled at day 30+3.

Due to the lack of efficacy observed at 1/3 of the enrollment at the investigated dosage, the patients' enrollment was interrupted and trial, hence, was early terminated. More precisely, only 1 of the 4 enrolled patients completed the study's 14-day treatment period. The remaining 3 patients were discontinued from the study early (1 patient due to treatment failure and 2 patients who were discontinued and admitted to rescue therapy).

While DF2156A appeared to be safe and was generally well-tolerated with only mild AEs reported in 3 patients (and no deaths, SAEs, or discontinuations from the study due to AEs), the limited sample size of the safety population prevents any overall conclusions of safety regarding the investigational product. For this reason no results other than listings are available.

See the MEX0111 synopsis on the EU Clinical Trial Register: https://www.clinicaltrialsregister.eu/ctr-search/rest/download/result/attachment/2011-000756-42/1/27931

Being tested
DF2156A
Keywords
Autoimmune inflammatory blistering disorder
Medical subject headings
Pemphigoid, Bullous

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DF2156ADrug

    DF2156A is a novel small molecule that inhibits the biological activity of the CXC ligand 8 [CXCL8; formerly interleukin (IL)-8] through inhibition of the activation of CXCL8 receptors: CXCR1 and CXCR2. This specific inhibitor stems from a program of drug design of molecules intended to modulate chemokine action.

Study groups in NCT01571895
Study groupRoleWhat they receive
DF2156A 150 mgExperimental150 mg capsule twice a day (every 12 h) for a maximum of 14 days
Receives: Drug: DF2156A

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total number of blisters from baseline

    Total number of blisters from baseline

    Measured: day 0/1 (pre-dose), 8 and 15

  2. Modified ABSIS score change from baseline

    ABSIS score will be measured according to the pemphigus scoring sheet [Rosenbach, 2009] adjusted to the clinical manifestation in BP patients, as per specifications in protocol.

    Measured: day 0/1 (pre-dose), 8 and 15

  3. Physician Global Assessment (PGA) score measured on a 0-10 scale [Rosenbach, 2009]. Percent change from baseline

    PGA score will be measured according to the following scale:

    0

    1 2 3 4 5 6 7 8 9 10 Perfect Worst health skin condition imaginable

    The following guidelines will help standardize PGA:

    0: no lesions 2: almost cleared, no functional impairment 4: few lesions / low functional impairment 6: moderate 8: severe / extensive 10: life-threatening

    Measured: day 0/1 (pre-dose), 8 and 15

  4. Pruritus measured on a 10 cm visual analogue scale. Absolute value change from baseline

    Pruritus will be measured according to the following scale:

    0 10 No pruritus Worst pruritus I can imagine

    Measured: day 0/1 (pre-dose), 8 and 15

  5. Eosinophil blood count. Percent change from baseline

    Eosinophil blood count. Percent change from baseline

    Measured: screening and day 15

  6. Percentage of patients with treatment failure (drug discontinuation due to disease worsening)

    treatment failure (drug discontinuation due to disease worsening)

    Measured: day 8

  7. Percentage of patients completely free from blisters

    Percentage of patients completely free from blisters

    Measured: day 15

  8. Number of patients who are still free from blisters without requiring any systemic or topical rescue treatment - Optional

    Number of patients who are still free from blisters without requiring any systemic or topical rescue treatment - Optional

    Measured: Day 30

  9. QTcF. Change from baseline

    QTcF. Change from baseline

    Measured: Italy: day 0/1 (pre-dose), day 1, 5, 8 and 15___Ger:day 0/1 (pre-dose), day 1, 3, 5, 8 and 15

  10. Incidence of Adverse Events and Serious Adverse Events

    Incidence of Adverse Events and Serious Adverse Events

    Measured: throughout the study up to day 15 or 30

  11. Blisters percent change from baseline

    Blisters percent change from baseline

    Measured: day 0/1 (pre-dose), 8 and 15

  12. Modified ABSIS score percent change from baseline

    ABSIS score will be measured according to the pemphigus scoring sheet [Rosenbach, 2009] adjusted to the clinical manifestation in BP patients, as per specifications in protocol.

    Measured: day 0/1 (pre-dose), 8 and 15

  13. Physician Global Assessment (PGA) score measured on a 0-10 scale [Rosenbach, 2009]. Absolute value change from baseline

    PGA score will be measured according to the following scale:

    0

    1 2 3 4 5 6 7 8 9 10 Perfect Worst health skin condition imaginable

    The following guidelines will help standardize PGA:

    0: no lesions 2: almost cleared, no functional impairment 4: few lesions / low functional impairment 6: moderate 8: severe / extensive 10: life-threatening

    Measured: day 0/1 (pre-dose), 8 and 15

  14. Pruritus measured on a 10 cm visual analogue scale. Percent change from baseline

    Pruritus will be measured according to the following scale:

    0 10 No pruritus Worst pruritus I can imagine

    Measured: day 0/1 (pre-dose), 8 and 15

  15. Eosinophil blood count. Absolute number change from baseline

    Eosinophil blood count. Absolute number change from baseline

    Measured: screening and day 15

  16. Number of patients with treatment failure (drug discontinuation due to disease worsening)

    Number of patients with treatment failure (drug discontinuation due to diseas

    Measured: day 8

  17. Number of patients completely free from blisters

    Number of patients completely free from blisters

    Measured: day 15

  18. QTcF. Absolute value

    QTcF. Absolute value

    Measured: Italy: day 0/1 (pre-dose), day 1, 5, 8 and 15___Ger:day 0/1 (pre-dose), day 1, 3, 5, 8 and 15

Secondary outcomes (1)
  1. Plasma levels of DF2156A and its major metabolites (DF2227 and DF2108) at steady state conditions

    Plasma levels of DF2156A and its major metabolites (DF2227 and DF2108) at steady state conditions

    Measured: day 5 and 8

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Apr 2012 (estimated)
  2. Study start20 Feb 2012
  3. Primary completion5 Jul 2012
  4. Study completion5 Jul 2012

Why it stopped: Lack of efficacy observed at 1/3 of the enrollment at investigated dosage. No results available.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
4 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01571895
Sponsor's protocol ID
MEX0111
Other IDs
2011-000756-42
Status last verified
Dec 2023
First submitted
4 Apr 2012
Last updated
22 Dec 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing DF2156A in people with Bullous Pemphigoid, run by Dompé Farmaceutici S.p.A at 4 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 22 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Germany, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Lack of efficacy observed at 1/3 of the enrollment at investigated dosage. No results available.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total number of blisters from baseline (time frame: day 0/1 (pre-dose), 8 and 15). The study lists 18 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Dec 2023.

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