Impact of CCH Treatment of Buttock and Thigh Cellulite in Adult Women

Study Overview
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Brief Summary
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This is a single center, open-label, Phase 2a study to assess the photonumeric scale, morphological, and histopathological changes associated with Collagenase Clostridium Histolyticum (CCH) in adult women with moderate or severe Edematous Fibrosclerotic Panniculopathy (EFP).

Official Title
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A Phase 2a, Open Label Study to Assess the Impact of CCH Treatment of Buttock and Thigh Cellulite in Adult Females Using Photonumeric Scales, Magnetic Resonance Imaging and Histopathology

Conditions
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Cellulite, Edematous Fibrosclerotic Panniculopathy (EFP)

Intervention / Treatment
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* Drug: EN3835


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have both buttocks or both posterolateral thighs with: A score of 3 or 4 (moderate or severe) as reported by the investigator using the Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS). A Hexsel Cellulite Severity Scale (CSS) Subsection A Number of Evident Depressions score of >0, and Subsection B Depth of Depressions score of 2 )medium depth depression) or 3 (deep depressions).. Have a minimum of 2 well defined and isolated cellulite dimples. Be willing to apply sunscreen to the treatment area before each exposure to the sun for the duration of the study (from the Screening Visit through the Day 251/Early Termination Visit). Be judged to be in good health. Have a negative pregnancy test. Be willing and able to cooperate with the requirements of the study. Exclusion Criteria: Is from a vulnerable population, as defined by the United States (US) Code of Federal Regulations (CFR) Title 45, Part 46, Section 46.111(b) and other local and national regulations, including but not limited to, employees (temporary, part-time, full time, etc) or a family member of the research staff conducting the study, or of the sponsor, or of the contract research organization, or of the Institutional Review Board (IRB)/Independent Ethics Committee (IEC). Has a history of sensitivity or allergy to collagenase or any other excipient of CCH. Has systemic conditions (coagulation disorders, malignancy, keloidal scar, abnormal wound healing) that restricts study participation. Has local (in areas to be treated) conditions (thrombosis, vascular disorder, active infection/inflammation, active cutaneous alteration, tattoo/mole) that restricts study participation. Has skin laxity or linear undulations on the treatment region (both buttocks or both thighs) that can be effaced by lifting skin. Requires anticoagulant or antiplatelet medication during the study. Has used or intends to use any of the local applications/therapies/injections/procedures that restricts study participation. Has used any form of artificial tanning (sprays, lotions, tanning booth, etc) within the 30 days prior to the first dose of study treatment or plans to use any form of artificial tanning during the study (through the Day 251/Early Termination Visit). Has a positive HIV test and/or a positive Hepatitis B surface antigen (HBsAg) or Hepatitis B core antibody (HBcAb) test at screening. Has had any surgery, invasive procedure (eg, liposuction), injectable treatment (eg, KYBELLA®) or any similar treatment. Has a history of keloids, hypertrophied scars, and/or other complications following biopsy. Has any contraindications for MRI(implant containing metal, internal metallic object, permanent cosmetics/make-up, claustrophobia, syncope, low blood pressure, epilepsy, asthma, sickle cell disease) that restricts study participation. Has received any collagenase treatments at any time prior to treatment in this study and/or has received EN3835 or CCH in a previous investigational study for cellulite. Has previously received treatment with CCH in this clinical study. Has received treatment with an investigational product within 30 days (or 5 half-lives, whichever is longer) of the Screening Visit. Is pregnant and/or is providing breast milk or plans to become pregnant and/or to provide breast milk during the course of the study. Has any other condition(s) that, in the investigator's opinion, might indicate the subject to be unsuitable for the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Buttock & Posterolateral Thigh<br>EN3835 up to 1.68 mg (Collagenase Clostridium Histolyticum) | Drug: EN3835<br>* Collagenase Clostridium Histolyticum (CCH)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Change From Baseline (Screening) in PR-PCSS | Patient-Reported Photonumeric Cellulite Severity Scale (PR-PCSS) is a 5-point photonumeric scale rating cellulite severity from 0 (None) to 4 (Severe) from a patient's perspective | Day 71 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Change From Baseline (Screening) in CR-PCSS | Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS) is a 5-point photonumeric scale rating cellulite severity from 0 (None) to 4 (Severe) from a clinician's perspective | Day 22, Day 43 and Day 71 | 
| The Change From Baseline (Screening) in Hexsel Cellulite Severity Scale (CSS) | Hexsel CSS is a photonumeric scale that looks at 5 key morphologic features of cellulite, each feature is evaluated on a 4-point scale from 0 (Low) to 3 (High) | Day 22, Day 43 and Day 71 | 
| MRI Before and After CCH Treatment | Magnetic Resonance Imaging (MRI) of cellulite before and after CCH treatment | Day 71 | 
| Histopathology Before and After CCH Treatment | Histopathology of biopsies defined by the observation of the biopsied specimen by a trained Pathologist | Day 71 |