Clinical trial NCT04996485: Scientific Substantiation and Assessment of the Effectiveness of Pathogenetic Methods of Therapy for Congenital Ichthyosis in Children
Official title: Scientific Substantiation and Assessment of the Effectiveness of Pathogenetic Methods of Therapy for Congenital Ichthyosis in Children
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE4
Conditions: Congenital Ichthyosis
Keywords: Congenital ichthyosis
Netherton syndrome
Autosomal recessive congenital ichthyosis
Biologic therapy
Lead sponsor: National Medical Research Center for Children's Health, Russian Federation
Sponsor class: OTHER_GOV
First posted: 2021-08-09
Enrollment: 50
Sex: ALL
Minimum age (years): 6
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This is an experimental non-randomized clinical study aimed at expanding the indications for the use of biological drugs with the aim of using them for the pathogenetic therapy of children with congenital ichthyosis.

Detailed description: This is an experimental non-randomized clinical study aimed at expanding the indications for the use of biological drugs with the aim of using them for the pathogenetic therapy of children with congenital ichthyosis.

The study will include 50 children aged 6 months to 18 years with a clinically and genetically confirmed diagnosis of congenital ichthyosis. Patients will be divided into 4 groups who will receive symptomatic therapy (using active external agents, emollients and / or systemic retinoids) or biologics targeting the cytokines IL-12 / IL-23, IL-4 / IL-13 and IL -17A. Immunophenotyping of all patients will be performed, the cytokine profile and spectrum of sensitization and the degree of NF-kB activation in lymphocytes will be determined. In experimental group №3, 10 patients with Netherton syndrome will receive dupilumab, in experimental group №2, 10 patients will receive ustekinumab, and in experimental group №1 10 patients will receive secukinumab. Efficiency will be assessed using the Ichthyosis Area Severity Index (IASI), determination of the level of TEWL, and the change in quality of life will also be assessed using the Children's Dermatological Life Quality Index (CDLQI) in comparison from baseline, than at 16 and 52 weeks. Throughout the study, the safety profile (registration of the development of infectious diseases) will be assessed.

Eligibility criteria: Inclusion Criteria:

* The subject has signed an informed consent; parental or legal representative consent for patients under 18 years of age, as well as additional consent for patients aged ≥ 15 and \<18.

  * At the time of participation in the study, the age of the subject is not less than 6 months and not more than 18 years.
  * At the time of participation in the study, a clinical diagnosis was established: Congenital ichthyosis with various clinical forms, with the exception of vulgar and X - linked congenital ichthyosis (genetic research is not a prerequisite for participation in the study).
* Subjects should have at least moderate IASI erythema associated with his / her ichthyosis, and a decrease in the quality of life according to CDLQI ≥ 10
* Absence of signs of severe infectious diseases (pneumonia, tuberculosis, etc.)
* No previous history of the use of the following genetically engineered biological drugs: ustekinumab, secukinumab, dupilumab

Exclusion Criteria:

* Subjects who have an allergic reaction to ustekinumab, secukinumab or other components of the drugs.
* Subjects who have bacterial and/or fungal diseases.
* Subjects who have problems in dynamic observation.
* Subjects who will have a worsening of clinical symptoms

Primary outcomes:
measure: Change in Ichthyosis Area Severity Index (IASI)
timeFrame: From Baseline up to 16 weeks
measure: Change in Ichthyosis Area Severity Index (IASI)
timeFrame: 52 weeks
Secondary outcomes:
measure: Transepidermal water loss (TEWL) level change
timeFrame: From Baseline up to 16 weeks
measure: Transepidermal water loss (TEWL) level change
timeFrame: 52 weeks
measure: Change in the Children's Dermatology Life Quality Index (CDLQI)
timeFrame: From Baseline up to 16 weeks
measure: Change in the Children's Dermatology Life Quality Index (CDLQI)
timeFrame: 52 weeks
Other outcomes:
Locations:
city: Moscow
country: Russian Federation
facility: National Medical Research Center for Children's Health
Study officials:
References: