Efficacy and Tolerability Study of Topical Ciclosporin in a Psoriasis Plaque Test

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00578370
Recruitment Status : Completed
First Posted : December 21, 2007
Last Update Posted : November 5, 2008
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Brief Summary:

Ciclosporin is a cyclic nonribosomal polypeptide of 11 amino acids produced by the fungi Tolypocladium inflatum and Cylindrocarpon lucidum. Ciclosporin is a highly efficient immunosuppressant drug widely used in post-allergenic organ transplant to reduce the activity of the subject's immune system and so the risk of organ rejection. Apart from transplant medicine, ciclosporin is also used in the treatment of autoimmune diseases like psoriasis and infrequently in rheumatoid arthritis and related diseases, although it is only used in severe cases.

Ciclosporin blocks the lymphocytes, especially the T-lymphocytes, in the G0- or G1-phase of the cell cycle. Moreover it inhibits the production and release of lymphokines including interleukin 2 or the T-cell growth factor.

Generally ciclosporin is taken orally (capsule or solution)or by injection in doses of 1.5 to 5.5 mg/kg/day. In the topical cutaneous emulsion presented here, ciclosporin is available at a concentration of 0.5 and 1.5%.

The purpose of this study is the demonstration of antipsoriatic efficacy and tolerability of topical cutaneous ciclosporin in subjects with psoriasis vulgaris.

Condition or disease Intervention/treatment Phase
Psoriasis Drug: Ciclosporin 0.5% (Formulation 01B) Drug: Ciclosporin 1.5% (Formulation 02B) Drug: 0.1% betamethasone Drug: 0.005% calcipotriol Drug: Formulation 00B Phase 1 Phase 2

Detailed Description:

Psoriasis is a common dermatological disorder, consisting of both an inflammatory and a hyperproliferative component. Scaly, erythematous infiltrated skin lesions are indicative of psoriasis vulgaris. The disease is characterized micromorphologically by epidermal hyperplasia with incomplete differentiation, intraepidermal accumulation of polymorphonuclear neutrophils, elongated papillae containing dilated, tortuous capillaries and lymphohistiocytic infiltrate.

Since the underlying cause of the disease remains unknown, causal therapy is not possible. The complex clinical picture necessitates a polypragmatic therapeutic approach. Typical therapies include phototherapy and photochemotherapy, topical treatment with corticosteroids, vitamin D3 analogs, coal-tar preparations and dithranol, and systemic treatment with retinoids, methotrexate and ciclosporin (oral or injection).

In the present study the topical cutaneous ciclosporin formulation for topical treatment of psoriasis will be tested in low-dose for efficacy and tolerability. Two concentrations of the ciclosporin formulation (0.5% and 1.5%), the corresponding vehicle, a marketed corticoid preparation and a marketed topical Vitamin-D-analog will be tested simultaneously in the same patient. Five test fields located at the torso and at the extremities will be examined per subject, and will be treated non-occlusively on 22 study days over a period study of 26 days.

Experimental measurements (sonography) and clinical assessments will be performed at baseline and on some study days.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 25 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase I, Single-Center, Randomized, Vehicle-Controlled Study, Double-Blind for the Study Preparations and Observer-Blind for the Comparators to Determine the Antipsoriatic Efficacy and Tolerability of Topical Formulations With Ciclosporin in a Psoriasis Plaque Test
Study Start Date : November 2007
Actual Primary Completion Date : April 2008
Actual Study Completion Date : April 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Psoriasis
U.S. FDA Resources

Arm Intervention/treatment
Experimental: 1 Drug: Ciclosporin 0.5% (Formulation 01B)
Cutaneous emulsion 200µl once a day (26 days)
Experimental: 2 Drug: Ciclosporin 1.5% (Formulation 02B)
Cutaneous emulsion 200µl once a day (26 days)
Active Comparator: 3 Drug: 0.1% betamethasone
Solution 200µl once a day (26 days)
Other Name: Betnesol V crinale 0.1%
Active Comparator: 4 Drug: 0.005% calcipotriol
Solution 200µl once a day (26 days)
Other Name: Daivonex solution 0.005%
Placebo Comparator: 5 Drug: Formulation 00B
Cutaneous emulsion (Vehicle to Formulation 01B and Formulation 02B) 200µl once a day (26 days)

Primary Outcome Measures :
  1. Psoriatic infiltrate measured by sonography [ Time Frame: 26 days ]

Secondary Outcome Measures :
  1. Skin condition measured by scoring [ Time Frame: 26 days ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Subjects with chronic plaque type psoriasis
  • Sexually active females of childbearing potential should either be surgically sterile (hysterectomy or tubal ligation), or should use a highly effective medically accepted contraceptive regimen

Exclusion Criteria:

  • Local treatment with antipsoriatics (except for salicylic acid in vaseline) in the 4 weeks preceding and during the study (corticosteroids 8 weeks)
  • Systemic treatment with antipsoriatics or therapy with PUVA, selected ultraviolet photo therapy in the three months preceding and during the study
  • Treatment with systemic or locally acting medications which might counter or influence the study aim
  • Previous therapy with methotrexate over many years
  • Therapy with nephrotoxic medication
  • Therapy with digoxin, colchicin and statins
  • Medications which might influence the potassium metabolism
  • Subjects with known dysfunction of the calcium metabolism
  • Subjects with increased uric acid or potassium serum levels
  • Erythrodermic psoriasis, psoriasis punctata and pustular psoriasis or extended chronic stationary forms of psoriasis
  • Subjects with acute virus infection
  • Subjects with acne, anogenital pruritus, rosacea, perioral dermatitis, specific skin problems (skin tuberculosis, luetic skin diseases), vaccination reactions, skin infections caused by bacteria or viruses
  • Symptoms of a clinically significant illness that may influence the outcome of the study in the four weeks before and during the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00578370

Hamburg, Germany, 20095
Sponsors and Collaborators
Principal Investigator: Johannes Gassmueller, MD Bioskin GmbH

Wendt H, Frosch PJ. Psoriasis-Plaque Test. 31 - 35 in: Clinico-pharmacological models for the assay of topical corticoids. Wendt H, Frosch PJ (eds.) 1982, Karger Verlag, Basel

Responsible Party: ISDIN Identifier: NCT00578370     History of Changes
Other Study ID Numbers: ISD001-CI-07
First Posted: December 21, 2007    Key Record Dates
Last Update Posted: November 5, 2008
Last Verified: November 2008

Keywords provided by ISDIN:
Plaque type psoriasis
Psoriasis plaque test

Additional relevant MeSH terms:
Skin Diseases, Papulosquamous
Skin Diseases
Pharmaceutical Solutions
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antifungal Agents
Anti-Infective Agents
Dermatologic Agents
Antirheumatic Agents
Calcineurin Inhibitors
Anti-Inflammatory Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Anti-Asthmatic Agents
Respiratory System Agents