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Acne VulgarisPhase 1NCT03709654

A Study of the Safety, Engraftment, and Action of Multi-Dosed NB01 in Adults With Moderate Acne

A Phase 1 study testing NB01 in people with Acne Vulgaris, run by Naked Biome, Inc. at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Acne vulgaris is a disease caused my multiple factors including overgrowth of bacteria, clogged pores, excessive sebum production and hormonal changes. Recent literature from the Human Microbiome Project has shown there are bacterial strains specific to healthy and acne disease states (Fitz-Gibbon et al, 2013, Johnson… Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Acne Vulgaris
What is being tested?
NB01
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
36 participants
Where
3 sitesUnited States
Study dates
1 Nov 2018to 30 Sep 2019
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Subject has provided written informed consent.
  • Subject is male or non-pregnant female, 18-40 years of age, inclusive at Screening.
  • Subject has moderate facial acne vulgaris
  • Female subject with non-cyclical acne.
  • Women of childbearing potential (WOCBP) willing to use adequate contraception during study participation
  • Male subjects willing to use an acceptable method of contraception during study participation.
  • Subject has the ability to personally apply benzoyl peroxide (BPO) and study drug, as per protocol.

Who cannot join

  • Subject has active bacterial, viral, or fungal skin infections.
  • Subject has active nodulocystic acne or acne conglobate, acne fulminans, or other forms of acne (e.g., acne mechanica).
  • Subject is currently participating in an investigational drug, device, or biologic study or has used an investigational drug, biologic or device treatment within 30 days prior to first application of the study drug.
  • Subjects with prosthetic heart valves, pacemakers, intravascular catheters, or other foreign or prosthetic devices/implantable devices/hardware.
  • Subject has a history of chronic human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV) infections.
  • Subject has a history of malignancy (with the exception of non-melanoma skin cancer).
Show all 11Show fewer
  • Subject is immunosuppressed (such as resulting from transplantation, immunosuppressive therapy, active HIV infection/acquired immune deficiency syndrome [AIDS], neutropenia).
  • Subject had a major surgical procedure, open biopsy, or significant traumatic injury within 14 days of initiating study drug (unless the wound has healed), or anticipation of the need for major surgery during the study.
  • Subjects with close contacts (e.g., spouses, children, or members in the same household) that have severe skin barrier defects or are immunocompromised.
  • Female subject is pregnant or lactating or is planning to become pregnant and/or breast feed within the duration of study participation.
  • Other entry criteria not listed above will be reviewed of each prospective subject by the study staff to confirm eligibility

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • 01

    Arlington, Texas, 76011

  • 02

    Austin, Texas, 78759

  • 03

    San Diego, California, 92123

Other trials in United States

About this study

Official title: A Multicenter, Randomized, Double-Blind, Vehicle-Controlled Phase 1B Study of the Safety, Short-Term Engraftment and Action of NB01 in Adults With Moderate Acne

Acne vulgaris is a disease caused my multiple factors including overgrowth of bacteria, clogged pores, excessive sebum production and hormonal changes. Recent literature from the Human Microbiome Project has shown there are bacterial strains specific to healthy and acne disease states (Fitz-Gibbon et al, 2013, Johnson et al, 2016, McDowell et al, 2012, Tomida et al, 2013)

From this data, the investigators hypothesize that by eliminating disease-associated bacterial strains and replacing them with health-associated strains, recurrences or flares of acne may be improved, mitigated, and prevented. Instead of current approaches which focus on eliminating all bacteria from the skin, the investigators aim to deliver healthy bacteria to restore the skin to a healthy state via this replacement therapy.

The investigators aim to test this in a Phase Ib multiple application study evaluating the safety, tolerability, and clinical impact that a multiple applications of NB01 have on adult subjects with moderate acne.

Read the detailed description

A Multicenter, Randomized, Double-Blind, Vehicle-Controlled Phase 1B Study of the Safety, Short-Term Engraftment and Action of NB01 in Adults With Moderate Acne

Acne vulgaris is a multifactorial disease caused by overgrowth of Propionibacterium acnes (P. acnes), impaction of hair follicles, excessive sebum production and hormonal dysregulation. Recent literature from the Human Microbiome Project has shown there are unique microbial signatures specific to healthy and acne disease states.

From this data, the investigators hypothesize that by eliminating resident disease-associated bacterial strains and replacing them with health-associated strains, recurrences/fares of acne may be improved, mitigated, and prevented. Instead of current approaches which focus on eliminating all bacteria from the skin, the investigators aim to deliver healthy bacteria (NB01) to restore the skin to a healthy state via this replacement therapy.

The investigators aim to test this in a Phase 1B multiple application study evaluating the safety, tolerability, and clinical impact that a multiple, daily, applications of NB01 has on adult subjects with moderate acne. Investigators will be profiling the change in microbiome over the course of therapy to determine if exogenously delivered bacteria can populate the skin (engraftment) and cause a shift in the microbiome safely and subsequently impact acne biomarkers that may correlate with clinical disease.

The investigators intend for this therapy to eventually be used in acne subjects with ages ranging from 13-40, and all disease severities as either monotherapy for mild to mild/moderate acne and as an adjuvant therapy for moderate to severe acne at all body sites, with special attention to facial involvement.

This approach is standard to acne therapy whereby mild disease will be treated with a monotherapy (i.e., topical Benzoyl peroxide [BPO]) and moderate/severe disease will be treated with various combinatory regimens (topical antibiotics, BPO, topical retinoids, oral antibiotics).

Primary Objectives:

  1. To determine the safety and tolerability of a multiple application of topical P. acnes microbiome transplant ("NB01").

Exploratory Objectives:

  1. To define engraftment duration of NB01.
  2. To evaluate preliminary clinical efficacy using Acne Lesion Counts (total, inflammatory, and non-inflammatory), Investigator Global Assessment (IGA), and subjective improvement of acne based on subject reported outcomes (Acne QoL Questionnaire).
  3. To evaluate treatment effects, based on sebum production in a subpopulation from sites 02 and 03.

Approximately 36 total male and female adult subjects combined with moderate, non-cyclical acne will be enrolled into the trial. Approximately twenty four (24) subjects will be randomly assigned treatment and twelve (12) subjects will be randomly assigned to vehicle control.

This is a multiple topical application study of live bacteria for the study of acne in adult subjects. Following a 5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial, 11 weeks of daily topical application of NB01 will be evaluated.

Subject participation in the trial will approximately 12 weeks.

Conditions
Acne Vulgaris
Being tested
NB01, Vehicle Control
Keywords
acne, pimple, black head, white head, zit, probiotic
Medical subject headings
Acne Vulgaris

What participants receive

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

  • NB01Biological

    5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of NB01

  • Vehicle ControlOther

    5-7 day pretreatment of gold standard benzoyl peroxide therapy to kill resident facial bacterial followed by 11 weeks of daily topical application of vehicle control

Study groups in NCT03709654
Study groupRoleWhat they receive
Treatment ArmExperimentalSubjects will undergo 1 week lead-in with BPO followed by 11 weeks of NB01 probiotic applied topically.
Receives: Biological: NB01
Vehicle ControlPlacebo comparatorSubjects will undergo 1 week lead-in with BPO followed by 11 weeks of vehicle applied topically.
Receives: Other: Vehicle Control

What is being measured

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

  1. Number of Participants With Changes in Local Skin Reactions

    Local Skin Reactions (LSRs) including Erythema, edema, erosion/ulceration, scaling/dryness, and scabbing/crusting scored at Baseline (day of first application) and Week 12 (end of treatment) and reported for each visit as: Absent, Mild, Moderate, or Severe.

    The number of participants (and %) with no change or improvement from Baseline to week 12 visit are reported.

    The number of participants (and %) whose score worsened from Baseline to week 12 visit are reported.

    Measured: Day 0 through day 80

  2. Number of Participants With Successful Follicular Engraftment of NB01

    Follicular engraftment sampling used Biore® Strips at Screening and day 80 (several days after end of treatment).

    The number of subjects with "success" at EOT where "success" is defined as a Follicular Biore® sample with "yes" outcome based on recovery of live NB01at day 80.

    Measured: 12 weeks

  3. Absolute Change in Genotype Markers: Skin Surface Engraftment "Success"

    Skin surface engraftment "success" endpoint is defined by a change in genotype (TaqMan) markers compared to Screening; value is percentage of bacterial population containing health-associated genotype. Result is absolute change from screening value.

    Measured: Day 0 through day 80

  4. Absolute Change From Screening in Acne Lesion Counts

    Reporting absolute change in counts.

    Measured: Day 0 through day 80

  5. Percent Change From Screening in Acne Lesion Counts

    Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment)

    Measured: Day 0 through day 80

  6. Number of Participants Achieving "Success" on Investigator Global Assessment (IGA)

    The investigator assessed the participant's inflammatory lesions on the face using the Investigator Global Assessment (IGA) 5-point scale.

    The scale ranges from 0 (best): clear, no evidence of papules or pustules to 4 (worst): severe, inflammatory lesions are more apparent, many papules/pustules.

    The outcome is the number of subjects in each treatment group achieving "success" at Week 12; "success" defined as an IGA score of "clear (score=0)" or "almost clear (score=1)" and at least a two-point reduction in IGA compared to Baseline.

    Measured: Day 0 through day 80

  7. Change in Acne QoL Questionnaire Score

    At each visit, subjects were asked to complete the Acne Quality of Life [QoL] Questionnaire to assess subjective improvement of acne with 7 response choices ranging from extremely to not at all. The total score ranges from 19 to 114; higher scores reflect improved QoL.

    Outcome measure is absolute change in Acne QoL (Total Score) from Baseline to Day 80.

    Measured: Day 0 through day 80

  8. Absolute Change From Screening in Acne Lesion Counts: Outlier Censored

    After reviewing the data, one Treatment Arm subject was found to be an extreme outlier and was censored from this ad-hoc analysis.

    Reporting absolute change in counts.

    Measured: Day 0 through day 80

  9. Percent Change From Screening in Acne Lesion Counts: Outlier Censored

    Efficacy endpoint: Percent change from Screening lesion counts at Day 80 (end of treatment)

    Measured: Day 0 through day 80

  10. Follicular Engraftment

    Follicular communities were genotyped for health-associated loci at both Screening and 12-week visits. The percent increase of Cas5 in multiple communities from each subject is reported.

    Measured: 12 weeks

Secondary outcomes (1)
  1. Absolute Change in Sebum Production.

    Exploratory Endpoint: Absolute change from Baseline to week 12 in sebum production measured at the mid-glabellar region of the forehead using a Sebumeter.

    Measured: Day 0 through day 80

Timeline

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

  1. First posted17 Oct 2018
  2. Study start1 Nov 2018
  3. Primary completion30 Sep 2019
  4. Study completion30 Sep 2019

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized Double Blind Vehicle Controlled Trial, dual arm with 2:1 treatment to vehicle assignment
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03709654
Sponsor's protocol ID
NB01-P1BMA
Status last verified
Jul 2020
First submitted
9 Oct 2018
Last updated
3 Aug 2020
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Initially there is no plan to share IPD. This may change later as the clinical plan develops.

Publications

  • Fitz-Gibbon S, Tomida S, Chiu BH, Nguyen L, Du C, Liu M, Elashoff D, Erfe MC, Loncaric A, Kim J, Modlin RL, Miller JF, Sodergren E, Craft N, Weinstock GM, Li H. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013 Sep;133(9):2152-60. doi: 10.1038/jid.2013.21. Epub 2013 Jan 21.

    PubMed 23337890
  • Johnson T, Kang D, Barnard E, Li H. Strain-Level Differences in Porphyrin Production and Regulation in Propionibacterium acnes Elucidate Disease Associations. mSphere. 2016 Feb 10;1(1):e00023-15. doi: 10.1128/mSphere.00023-15. eCollection 2016 Jan-Feb.

    PubMed 27303708
  • McDowell A, Barnard E, Nagy I, Gao A, Tomida S, Li H, Eady A, Cove J, Nord CE, Patrick S. An expanded multilocus sequence typing scheme for propionibacterium acnes: investigation of 'pathogenic', 'commensal' and antibiotic resistant strains. PLoS One. 2012;7(7):e41480. doi: 10.1371/journal.pone.0041480. Epub 2012 Jul 30.

    PubMed 22859988
  • Tomida S, Nguyen L, Chiu BH, Liu J, Sodergren E, Weinstock GM, Li H. Pan-genome and comparative genome analyses of propionibacterium acnes reveal its genomic diversity in the healthy and diseased human skin microbiome. mBio. 2013 Apr 30;4(3):e00003-13. doi: 10.1128/mBio.00003-13.

    PubMed 23631911

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing NB01 in people with Acne Vulgaris, run by Naked Biome, Inc. at 3 sites in United States.

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 7 inclusion and 11 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: finished, as of the sponsor's last update on 3 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. 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. Some participants in this study may receive a placebo. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Aug 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Participants With Changes in Local Skin Reactions (time frame: Day 0 through day 80). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03709654, which also lists 4 linked publications.

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 3 Aug 2020.

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