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Evaluation of Adrenal Suppression Potential and Pharmacokinetics of Halobetasol Lotion 0.05%

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.
 
ClinicalTrials.gov Identifier: NCT03212963
Recruitment Status : Completed
First Posted : July 11, 2017
Last Update Posted : November 19, 2019
Sponsor:
Information provided by (Responsible Party):
Sun Pharmaceutical Industries Limited

Brief Summary:
The objective of this open-label multicentric study is to determine the adrenal suppression potential and the pharmacokinetic (PK) properties of halobetasol lotion (HBP) applied twice daily for up to two weeks in subjects aged 12 to 16 years 11 months with stable plaque psoriasis. Subject enrollment will continue until at least 20 subjects with both screening and end of study (EOS) serum cortisol data (pre- and pos-tcosyntropin stimulation) have completed the study without any significant protocol violations (evaluable subjects). This may require the enrollment of approximately 25 subjects.

Condition or disease Intervention/treatment Phase
Plaque Psoriasis Drug: Halobetasol Topical Lotion Phase 4

Detailed Description:

This is an open label, multicenter study of an investigational formulation of HBP Lotion, 0.05% in male and female subjects aged 12 to 16 years 11 months with stable plaque psoriasis. Approximately 25 subjects with stable plaque psoriasis on at least 10% of their BSA (excluding the face, scalp, groin, axillae and other intertriginous areas), who fulfill the inclusion/exclusion criteria will be enrolled at multiple study sites. All subjects will have a screening CST to assess their HPA axis response at Visit 1 (Screening Visit).

Enrollment into the treatment phase of the study should be timed such that the screening CST will be performed a minimum of 20 days before Baseline Visit. At Visit 2 (Baseline), eligible subjects with normal adrenal function will be eligible to participate in the study.

Subjects will apply HBP Lotion, 0.05% to all psoriasis plaques identified at Visit 2 twice daily (approximately every 12 hours) for the assigned treatment period or until the investigator verifies the subject's psoriasis has cleared. The study is designed to determine the adrenal suppression potential and pharmacokinetic properties of the test article after the subject applies a maximum of approximately 50 grams per week for up to a two week treatment period. All subjects will have a CST to reassess their HPA axis response at EOS (or earlier if the investigator verifies the subject's psoriasis has cleared). In this study, an abnormal Hypothalamujs Pituitary Adrenal axis response to 0.25 milligram dose of cosyntropin is defined as a post-CST serum total cortisol level of less than equal to18 μg/dL.

Eligible subjects will have blood drawn at Screening for baseline drug concentration in plasma. On Day 8, all subjects, regardless of lesion clearance, will have blood drawn for assessment of trough drug concentration in plasma. At the Day 15 visit, subjects who have continued to treat lesions will have a final PK blood sample collected approximately 12 hours after their Day 14 evening application and just prior to the initiation of the CST.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 16 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: Open label study to evaluate adrenal suppression potential and pharmacokinetics of halobetasol lotion 0.05%
Masking: None (Open Label)
Primary Purpose: Other
Official Title: An Open Label Evaluation of the Adrenal Suppression Potential and Pharmacokinetic Properties of Twice Daily Halobetasol Propionate Lotion, 0.05% in Subjects 12 to 16 Years 11 Months of Age With Plaque Psoriasis Receiving Two Weeks of Treatment
Actual Study Start Date : March 21, 2017
Actual Primary Completion Date : August 12, 2019
Actual Study Completion Date : August 12, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Psoriasis

Arm Intervention/treatment
Experimental: Halobetasol lotion treatment arm
All subjects will receive Halobetasol Topical Lotion, 0.05%.
Drug: Halobetasol Topical Lotion
Halobetasol Lotion 0.05%, applied twice daily in subjects aged 12 to 16 years 11 months with stable plaque psoriasis.
Other Name: Halobetasol topical lotion 0.05%




Primary Outcome Measures :
  1. Hypothalamus pituitary adrenal axis suppression [ Time Frame: 2 weeks ]
    HPA axis responses to stimulation by cosyntropin will be dichotomized to "normal" and "abnormal". An abnormal HPA axis response is defined as a 30-minute post-stimulation serum cortisol level that is ≤18 μg/dL at the end of study.


Other Outcome Measures:
  1. Safety endpoint assessed by Adverse events [ Time Frame: 2 weeks ]
    Adverse events

  2. Plasma Levels of halobetasol lotion [ Time Frame: Day 8 and Day 15 ]
    Trough HBP concentrations in plasma will be assessed at Screening, Day 8 and Day 15/EOS approximately 12 hour posttreatment.

  3. Safety Endpoint assessed by Local Skin Reactions [ Time Frame: 2 weeks ]
    Local Skin Reactions

  4. Extent of exposure to halobetasol lotion 0.05% [ Time Frame: 2 weeks ]
    The total amount of test article applied (grams) will be calculated from the weights of the returned test articles. Mean, median, standard deviation, minimum and maximum will be determined for the total amount of test article used by each subject.



Information from the National Library of Medicine

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Ages Eligible for Study:   12 Years to 16 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subject is male or non-pregnant female and is 12 to 16 years 11 months of age.
  2. Subject has provided written informed assent and was accompanied by the parent or legal guardian at the time of assent/consent signing. The parent or legal guardian has provided informed consent for the subject. 3. Subject has a clinical diagnosis of stable plaque psoriasis involving a minimum of 10% body surface area (BSA) within the Treatment Area. The "Treatment Area" is defined as the entire body exclusive of the face, scalp, groin, axillae, and other intertriginous areas.

4. Subject has an Investigator's Global Assessment (IGA) score of at least three (3 = moderate) at the Baseline Visit.

5. Subject is willing and able to apply the test article as directed, comply with study instructions and commit to all follow-up visits for the duration of the study.

6. Females must have a negative urine pregnancy test (UPT) at the Screening and Baseline Visits and agree to use an effective form of birth control for the duration of the study.

Exclusion Criteria:

  1. Subject has spontaneously improving or rapidly deteriorating plaque psoriasis.
  2. Subject has guttate, pustular, erythrodermic or other non-plaque forms of psoriasis.
  3. Subject has a physical condition which, in the investigator's opinion, might impair evaluation of plaque psoriasis, adrenal axis function (e.g., Addison's Disease, Cushing's Syndrome) or which exposes the subject to an unacceptable risk by study participation.
  4. Subject has used any phototherapy (including laser), photochemotherapy or systemic psoriasis therapy including methotrexate, retinoids, cyclosporine or biologics within 30 days prior to the initiation of treatment with the test article.
  5. Subject has used systemic corticosteroids (including oral or intramuscular) or topical, inhaled or intranasal corticosteroids within 30 or 14 days, respectively, prior to Part B of the Screening Visit and/or the subject has used systemic or topical corticosteroids between Part B of the Screening Visit and the initiation of treatment.
  6. Subject has had prolonged exposure to natural or artificial sources of ultraviolet radiation within 30 days prior to the initiation of treatment or is intending to have such exposure during the study that is thought by the investigator to likely modify the subject's disease.
  7. Subject has used topical psoriatic therapy including tar, anthralin, retinoids, vitamin D analogs (e.g., Dovonex®) within 14 days prior to the initiation of treatment with the test article.
  8. Subject has used emollients/moisturizers on areas to be treated within one day prior to the initiation of treatment with the test article.
  9. Subject is currently using lithium or Plaquenil (hydroxychloroquine).
  10. Subject is currently using a beta-blocking medication (e.g., propranolol) or angiotensin converting enzyme (ACE) inhibitors (e.g., lisinopril) at a dose that has not been stabilized, in the opinion of the investigator.
  11. Subject has a history of sensitivity to any of the ingredients in the test article.
  12. Subject is pregnant, lactating, or is planning to become pregnant during the study.
  13. Subject is currently enrolled in an investigational drug or device study.
  14. Subject has used an investigational drug or investigational device treatment within 30 days prior to Visit 1 (Screening).
  15. Subject has been previously enrolled in this study and treated with the test article.
  16. Subject has an irregular sleep schedule or works night shifts (cortisol levels exhibit physiological diurnal variation).
  17. Subject has a screening Cosyntropin Stimulation Test (CST) with a post 30-minute stimulation cortisol level of less than equal to 18 μg/dL.
  18. Subject is known to be noncompliant or is unlikely to comply with the requirements of the study protocol (e.g., due to alcoholism, drug dependency, mental incapacity) in the opinion

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 ClinicalTrials.gov identifier (NCT number): NCT03212963


Locations
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United States, California
First OC Dermatology
Fountain Valley, California, United States, 92708
United States, Florida
Power MD Clinical Research Institute
Hialeah, Florida, United States, 33012
United States, Missouri
MediSearch Clinical Trials
Saint Joseph, Missouri, United States, 64506
Sponsors and Collaborators
Sun Pharmaceutical Industries Limited
Investigators
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Study Chair: Stephanie Magajna, MS Therapeutics, Inc.

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Responsible Party: Sun Pharmaceutical Industries Limited
ClinicalTrials.gov Identifier: NCT03212963    
Other Study ID Numbers: 177-0551-201
First Posted: July 11, 2017    Key Record Dates
Last Update Posted: November 19, 2019
Last Verified: November 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Psoriasis
Halobetasol
Skin Diseases, Papulosquamous
Skin Diseases
Clobetasol
Vasoconstrictor Agents
Anti-Inflammatory Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs