Clinical trial NCT01407679: Efficacy and Safety of Oral Alitretinoin (Toctino®) in the Treatment of Patients With Cutaneous Lupus Erythematosus
Official title: Efficacy and Safety of Oral Alitretinoin (Toctino®) in the Treatment of Patients With Cutaneous Lupus Erythematosus: A Multicentre, Open-Label, Prospective Pilot Study
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Lupus Erythematosus, Cutaneous
Keywords: cutaneous lupus erythematosus
discoid lupus erythematosus
subacute cutaneous lupus erythematosus
lupus erythematosus tumidus
Lead sponsor: University Hospital Muenster
Sponsor class: OTHER
Collaborators: name: Basilea Pharmaceutica International Ltd
First posted: 2011-08-02
Enrollment: 7
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: To evaluate the therapeutic effect of oral alitretinoin (Toctino®) in the treatment of CLE with respect to proportion of responders based on the Revised Cutaneous Lupus Disease Area and Severity Index (RCLASI) activity score for skin lesions at baseline and after 24 weeks of treatment or at the latest assessment for patients who withdrew prematurely. Response is defined as a reduction of 50% in the total RCLASI compared to the baseline value ("RCLASI 50").


Eligibility criteria: Inclusion Criteria:

* A clinical and histological diagnosis of CLE (DLE, SCLE, LET) who failed to respond to topical corticosteroids;
* Total RCLASI activity score of skin lesions \>6 (at least 3 points in at least 2 locations);
* At least one primary but preferably 2 methods of contraception;

Exclusion Criteria:

* Systemic Lupus Erythematosus (SLE) with major systemic organ involvement, e.g. clinical significant renal involvement, requiring systemic medical treatment for the disease;
* Clinically significant illness that may influence the outcome of the study in the four weeks before and during the study;
* Active severe infection diseases, including chronic or localized;
* Patients with hepatic insufficiency (AST, ALT \> 2.5 x ULN), severe renal failure (creatinine clearance \< 60ml/min), or hypercholesterolemia characterized by:

  1. Fasting triglyceridemia \> 1.5 x upper limit of normal (ULN)
  2. Fasting total cholesterol \> 1.5 x ULN
  3. Fasting low-density lipoprotein (LDL) cholesterol \> 1.5x ULN
* Patients with known hypersensitivity to other retinoids or vitamin A derivatives, or to any study medication component, especially soybean oil and partly hydrogenated soybean oil;
* Patients with cardiovascular risk factors that would exclude a starting dose of 30 mg of alitretinoin;
* Topical corticosteroids within 14 days prior to dosing;
* Patients treated with any systemic or topical retinoids within 4 weeks before start of study treatment;
* Drugs with a potential for drug-drug interaction, such as systemic tetracyclines, ketoconazole, or St. John"s Wort within 1 week, or receiving systemic itraconazole within 2 weeks, before start of study treatment;
* Initiation or change in the dose of any current systemic medication for the treatment of CLE/SLE prior to the study (time depending on drug class and half-life);
* Treatment with immunosuppressive drugs for other reasons, 4 weeks prior and within the study;
* Concomitant medication with drugs with a known photosensitizing potential, e.g. tetracyclines, griseofulvin, thiazides, furosemide, sulfonamides or tolbutamide;
* Drugs associated to CLE-induction: terbinafine, hydrochlorothiazide, diltiazem, verapamil, nifedipine, nitrendipine, fluorouracil, penicillamine, infliximab, adalimumab, etanercept, pantoprazole;

Other protocol-defined inclusion/exclusion criteria may apply

Primary outcomes:
measure: Primary efficacy outcome is the response rate at week 24 or at the latest assessment for patients who withdrew prematurely.
timeFrame: Week 24 or at the latest assessment for patients who withdrew prematurely.
Secondary outcomes:
measure: Proportion of patients with RCLASI 50 at week 12 of treatment.
timeFrame: Week 12 of treatment
measure: Proportion of patients with at least partial response at end of therapy (with regard to RCLASI activity score for skin lesions).
timeFrame: End of therapy (up to 24 weeks)
measure: Patient's global assessment and VAS for itch and pain 12 weeks after the beginning of treatment.
timeFrame: 12 weeks after the beginning of treatment
measure: Number of Participants with Adverse Events (AEs) and their severity.
timeFrame: 24 weeks of treatment + 5 weeks of follow up
measure: Patient's global assessment and VAS for itch and pain at the end of therapy.
timeFrame: End of therapy (up to 24 weeks)
Other outcomes:
Locations:
city: Mannheim
country: Germany
facility: Department of Dematology, University Hospital
state: Baden-Wuerttemberg
city: Muenchen
country: Germany
facility: Department of Dermatology, Ludwig-Maximilians University
state: Bayern
city: Muenster
country: Germany
facility: Department of Dermatology, University Hospital
state: Westfalen
Study officials:
affiliation: Department of Dermatology, University Hospital Muenster, Muenster, Germany
name: Annegret Kuhn, Prof. Dr.
role: PRINCIPAL_INVESTIGATOR
References: