Fluphenazine Hydrochloride for Psoriasis (FP-CL2)
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Purpose
The objective of this study is to assess the safety and biologic activity of intralesional injection of fluphenazine in adult subjects with psoriasis.
| Condition | Intervention | Phase |
|---|---|---|
|
Psoriasis |
Drug: Fluphenazine Drug: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Ascending-Dose, Double-Blind, Placebo-Controlled, Study of Intralesional Fluphenazine Hydrochloride for Psoriasis |
- The following primary biologic activity outcome measure will be evaluated at 4 weeks: Improvement in target lesion scoring. [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
- The following secondary biologic activity outcome measure will be evaluated at 4 weeks: Improvement from baseline in the target lesion Visual Analog Scale (VAS) score for pruritus. [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
- Safety Outcome Measures: All adverse events will be recorded and monitored. [ Time Frame: 8 weeks ] [ Designated as safety issue: Yes ]
- Fluphenazine serum levels to be measured at baseline, after 2 hours & after 1 week. [ Time Frame: 1 week ] [ Designated as safety issue: Yes ]
| Enrollment: | 15 |
| Study Start Date: | November 2008 |
| Study Completion Date: | January 2011 |
| Primary Completion Date: | November 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Placebo
The sterile placebo: Bacteriostatic Sodium Chloride for Injection.
|
Drug: Placebo
Intralesional injection of placebo
|
|
Active Comparator: Fluphenazine
This will be an ascending dose study with the first cohort of 5 subjects dosed at 100 µg/mL, followed by cohorts at 500 and 2500 µg/mL. Dosing will be on Days 0, 7 and 14 and will consist of 5, or 10, 100 µL injections into the psoriatic lesion. The number of injections will depend on the lesion size. As this is a vehicle controlled study, subjects will receive intralesional injections of both drug and placebo, each into a separate target plaque, in a randomized fashion.
|
Drug: Fluphenazine
Intralesional injection of Fluphenazine
Other Name: FP-CL2
|
Detailed Description:
This is a double-blind, placebo-controlled, bilateral, ascending dose study.
In vitro, fluphenazine has been shown to suppress growth of proliferating T-lymphocytes. Fluphenazine would be expected to also suppress growth of proliferating T-lymphocytes in psoriatic plaques.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adults 18 to 65 years of age with psoriasis, in general good health as determined by the Principal Investigator based upon the results of medical history, laboratory profile, and physical examination
- Must have symmetric target lesions 2-4 cm in diameter on each side of the body (e.g., thighs) with baseline Target Lesion Score (TLS) of 6 or higher (scale of 0-12) for each target
Women are eligible to participate in the study if they meet one of the following criteria:
- Women who are postmenopausal (for at least one year), sterile, or hysterectomized
Women of childbearing potential must undergo monthly pregnancy testing during the study and agree to use two of the following methods of contraception throughout the study and for 60 days after the last dose of study drug:
- Oral contraceptives
- Transdermal contraceptives
- Injectable or implantable methods
- Intrauterine devices
- Barrier methods (diaphragm with spermicide, condom with spermicide)
(Abstinence and Tubal Ligation are also considered a form of Birth control.)
Exclusion Criteria:
- Patient is not asymptomatic and has major ailments on screening exam.
- Infliximab (Remicade®) or alefacept (Amevive®) within the past 6 months (24 weeks)
- Etanercept (Enbrel®), efalizumab (Raptiva™), adalimumab (Humira®) or other TNF-alpha inhibitor within the past 3 months (12 weeks)
- Other systemic psoriasis therapies (e.g., methotrexate, cyclosporine, acitretin) or PUVA within the past 4 weeks
- UVB or topical therapy (other than OTC moisturizers and shampoos) within the past 2 weeks (including topical corticosteroids, vitamin A and D analogues) with the exception of betamethasone valerate lotion (0.01%) for treatment of scalp lesions, and triamcinolone cream (0.1%) for lesions at least 3 inches away from the target lesions
- Receipt of an investigation agent within the past 4 weeks
- Systemic corticosteroid therapy
- Inability to understand consent or comply with protocol (patients will be asked if they understand or have any questions)
- Pregnancy, lactation, or unwillingness to use adequate birth control during the study
- Impaired hepatic function
- Known HIV/AIDS, hepatitis B/C
- Blood dyscrasia
- Epilepsy
- Tardive dyskinesia
- Excessive alcohol consumption (drinking more than two drinks per day on average for men or more than one drink per day on average for women)
- Use of phenothiazine antipsychotics or anticholinergics
- Current use of SSRI, tricyclic, or norepinephrine reuptake inhibitor antidepressants or use within 6 weeks of beginning the study
- Concurrent use of anti-seizure drugs, with the exception of gabapentin for treatment of neuropathy
- Known allergy to fluphenazine or other phenothiazines, sesame oil or sesame seeds
- Known allergy to parabens, PABA or benzyl alcohol
- Clinically significant and uncontrolled cardiovascular disease
- QTc > 450 msec, or evidence of a clinically significant dysrhythmia on ECG
- Operator of heavy machinery
- Pheochromocytoma
- Clinically significant mitral valve disease
- History of breast cancer
- History of seizure disorder
- Occupational exposure to organophosphate insecticides
- Parkinson's disease and other related movement disorders
Screening Lab abnormalities including:
- Serum Asparate transaminase (AST) or Alanine transaminase (ALT) > 2.5 upper limits of normal
- Creatinine ≥ 1.6 mg/dL
- Bilirubin ≥ 1.5 mg/dL
- White blood cell (WBC) count < 3 x 10^9 /L
- Platelets < 100 x 10^9/L
- Hemoglobin < 10 g/dL in females or < 12g/dL in males
- Glucose ≥ 200 mg/dL
- Fasting blood sugar ≥ 126 mg/dL
- Concurrent use of drugs listed in Appendix E of protocol
Contacts and Locations| United States, Massachusetts | |
| Tufts Medical Center, Department of Dermatology | |
| Boston, Massachusetts, United States, 02111 | |
| United States, New Jersey | |
| Robert Wood Johnson Medical School, Psoriasis Center of Excellence | |
| New Brunswick, New Jersey, United States, 08903 | |
| Principal Investigator: | Alice B. Gottlieb, M.D., PhD. | Tufts Medical Center, Department of Dermatology |
More Information
Additional Information:
Publications:
| Responsible Party: | Alice Gottlieb, Principal Investigator, Tufts Medical Center |
| ClinicalTrials.gov Identifier: | NCT00929578 History of Changes |
| Other Study ID Numbers: | FP-CL2 |
| Study First Received: | June 25, 2009 |
| Last Updated: | July 20, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Tufts Medical Center:
|
Psoriasis T-lymphocytes Fluphenazine |
Additional relevant MeSH terms:
|
Psoriasis Skin Diseases, Papulosquamous Skin Diseases Fluphenazine Fluphenazine depot Fluphenazine enanthate Antipsychotic Agents Tranquilizing Agents Central Nervous System Depressants |
Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Psychotropic Drugs Dopamine Antagonists Dopamine Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013