Cantharidin Application in Molluscum Patients (CAMP-2)

• ClinicalTrials.gov Identifier: NCT03377803
• Recruitment Status: Completed
• First Posted: December 19, 2017
• Results First Posted: December 14, 2021
• Last Update Posted: December 14, 2021
• Sponsor: Verrica Pharmaceuticals Inc.
• Collaborators: Instat Consulting, Inc.; Paidion Research, Inc.; Database Integrations, Inc.
• Information provided by (Responsible Party): Verrica Pharmaceuticals Inc.

Study Description

Brief Summary:

This study is a Phase 3, randomized, double-blind, placebo-controlled, pivotal study to evaluate the safety and efficacy of VP-102 topical film-forming solution in subjects with Molluscum Contagiosum. VP-102 will be applied once every 21 days for up to 4 applications, to treatable molluscum contagiosum (molluscum) lesions on subjects 2 years and older. Efficacy will be assessed as the proportion of subjects achieving complete clearance of all treatable molluscum lesions (baseline and new) on the Day 84 visit.

Condition or disease	Intervention/treatment	Phase
Molluscum Contagiosum	Combination Product: VP-102 - Cantharidin, Topical Film Forming Solution; Combination Product: Placebo -Topical Film Forming Solution without VP-102	Phase 3

Detailed Description:

This is a Phase 3, multi-center, randomized, double-blind, placebo (vehicle)-controlled, pivotal study that will be conducted in the United States to determine the efficacy and safety of VP-102 following treatment of molluscum lesions for up to 4 treatments, every 21 days, with VP-102/placebo in 250 subjects. Subjects will receive active VP-102 or placebo in a 3:2 ratio. Study drug (VP-102 or placebo) will be supplied in single-use applicators.

The film-forming Study drug solution will be applied and left on the lesions for 24 hours before the subject and/or parents/guardian washes the lesions. Study drug may be removed prior to the 24-hour time point in the event treatment-emergent AEs are experienced.

Molluscum lesions will be treated without occlusion in all anatomic areas including the face, trunk, back, arms, legs, hands, feet, anogenital region and buttocks.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 262 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Pivotal Study to Evaluate the Safety and Efficacy of VP-102 Topical Film-Forming Solution [0.7% (w/v) Cantharidin] in Subjects (2 Years and Older) With Molluscum Contagiosum
• Actual Study Start Date: February 14, 2018
• Actual Primary Completion Date: September 26, 2018
• Actual Study Completion Date: September 26, 2018

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: VP-102; VP-102 is contained within a single-use applicator. The VP-102 applicator consists of a plastic tube containing a sealed glass ampule and an applicator tip. One ampule contains 450 μL of VP-102 (0.7% [w/v] cantharidin) solution.	Combination Product: VP-102 - Cantharidin, Topical Film Forming Solution; VP-102, a single-use drug device combination product containing (cantharidin) topical solution, 0.7% (w/v). Up to 4 applications of VP-102 will be administered to Molluscum lesions at 21-day intervals.
Placebo Comparator: Placebo; Placebo is contained within a single-use applicator. The placebo applicator consists of a plastic tube containing a sealed glass ampule and an applicator tip. One ampule contains 450μl of placebo solution with the same color and consistency as VP-102.	Combination Product: Placebo -Topical Film Forming Solution without VP-102; Placebo a single-use drug device combination product containing only the vehicle. Up to 4 applications of Placebo will be administered to Molluscum lesions at 21-day intervals.

Outcome Measures

Primary Outcome Measures :

1. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 84 Visit (EOS) [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 84 visit (EOS).

Secondary Outcome Measures :

1. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 63 Visit [ Time Frame: Day 1 (Baseline) compared to Day 63 ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 63 visit.
2. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 42 Visit [ Time Frame: Day 1 (Baseline) compared to Day 42 ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 42 visit.
3. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 21 Visit [ Time Frame: Day 1 (Baseline) compared to Day 21 ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 21 visit.

Other Outcome Measures:

1. Change From Baseline of the Composite Score From the Children's Dermatology Life Quality Index (CDLQI) Assessment at the EOS Visit to Measure the Quality of Life and Impact of Skin Disease in the Subset of Subjects 4 -16 Years of Age [ Time Frame: Day 1 (Baseline), 21, 42, 63 and Day 84 (EOS) ]

   Change from Baseline to EOS Day 84 of the Composite Score From the Children's Dermatology Life Quality Index (CDLQI) Assessment at the EOS Visit to Measure the Quality of Life and Impact of Skin Disease in the Subset of Subjects 4 -16 Years of Age.

   From responses to that questionnaire, a composite score was calculated. The calculated composite score was the sum of the individual 10 items of the CDLQI and could range from 0-30. For each item on the

   CDLQI, a score of 0-3 was assigned using the following scores per response:

   • 3: Very much (or Prevented School, Question 7 only)
   • 2: Quite a lot
   • 1: Only a little
   • 0: Not at all Larger composite CDLQI scores indicate skin condition is having more effect on subjects' lives (worse outcome).
2. Percent Change of All Treatable Molluscum Lesions (Baseline and New) From Baseline at the EOS Visit [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percent change of all treatable molluscum lesions (baseline and new) from baseline at the EOS visit.
3. Change From Baseline in the Number of Treatable Molluscum Lesions (Baseline and New) at the EOS Visit [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Change from baseline in the number of treatable molluscum lesions (baseline and new) at the EOS visit.
4. Percentage of Subjects Exhibiting a 75% or Greater Reduction of All Treatable Molluscum Lesions (Baseline and New) at the EOS Visit [ Time Frame: Day 1 (Baseline) compared to Day 84(EOS) ]
   Percentage of subjects exhibiting a 75% or greater reduction of all treatable molluscum lesions (baseline and new) at the EOS visit.
5. Percentage of Subjects Exhibiting a 90% or Greater Reduction of All Treatable Molluscum Lesions (Baseline and New) at the EOS Visit [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percentage of subjects exhibiting a 90% or greater reduction of all treatable molluscum lesions (baseline and new) at the EOS visit.
6. Subject Reported Spread to Household Members as Measured by Any New Occurrence of Molluscum in Household Members of Subject [ Time Frame: Days 1, 21, 42, 63 and 84 (EOS). ]
   Subject reported spread to household members as measured by any new occurrence of molluscum in household members of subject.

Eligibility Criteria

• Ages Eligible for Study: 2 Years and older (Child, Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

To qualify for inclusion in this study, subjects must:

1. Be healthy subjects, at least 2 years of age or older.
2. Consent to having all molluscum lesions treated and the physician must be willing to treat all molluscum lesions initially present. Lesions within 10mm of the eyelid margins or the margin of any mucosal membrane should be evaluated carefully to ensure that they can be safely treated. Non-mucosal genital area lesions and inflamed lesions are considered treatable.
3. Be otherwise medically healthy with no clinically significant medical history as determined by the investigator. Subjects exhibiting active Atopic Dermatitis may be enrolled.
4. On day of treatment refrain from application of all topical agents including alcohol-based sanitary products and sunscreens for a minimum of 4 hours before Study drug application. Topical agents including alcohol-based sanitary products and sunscreens may be used after application of the study drug so long as they are not applied within 5cm of treated skin lesions.
5. Refrain from swimming, bathing or prolonged immersion in water or any liquids until the Study drug is removed.
6. Have the ability or have a guardian with the ability to follow study instructions and be likely to complete all study requirements.
7. Provide written informed consent or assent in a manner approved by the institutional review board (IRB) and/or have a parent/guardian provide written informed consent as evidenced by the signature on an IRB approved assent/consent form.
8. Provide written authorization for use and disclosure of protected health information.
9. Agree to allow photographs to be taken, (selected sites only) of selected lesions at every visit that will be used for training, publication and future marketing brochures.

Exclusion Criteria:

Subjects will be excluded from the study if they:

1. Are unable to cooperate with the requirements or visits of the study, as determined by the investigator.
2. Are systemically immunosuppressed or are receiving treatments such as chemotherapy or other non-topical immunosuppressive agents.
3. Have any lesions present at baseline in anatomic locations that the subject/parent/guardian or the physician is unwilling to treat.
4. Have had any previous treatment of molluscum including the use of cantharidin, antivirals, retinoids, curettage or freezing of lesions in the past 14 days. Additional treatments should not be implemented during the course of the study.
5. Have a history of illness or any dermatologic disorder which, in the opinion of the investigator, will interfere with accurate counting of lesions or increase the risk of adverse events.
6. History or presence of clinically significant medical, psychiatric, or emotional condition or abnormality that, in the opinion of the investigator, would compromise the safety of the subject or the quality of the data.
7. Have a history or presence of hypersensitivity or an idiosyncratic reaction to the Study drug or related compounds, or drug product excipients (acetone, ethyl alcohol, nitrocellulose, hydroxypropyl cellulose, castor oil, camphor, gentian violet, and denatonium benzoate).
8. Have a condition or situation that may interfere significantly with the subject's participation in the study (e.g., subjects who required hospitalization in the 2 months prior to screening for an acute or chronic condition including alcohol or drug abuse), at the discretion of the investigator.
9. Have received another investigational product within 14 days prior to the first application of the Study drug.
10. Have been treated within 14 days with a product that contains cantharidin (topical or homeopathic preparations) for any reason prior to screening.
11. Are sexually active or may become sexually active and are unwilling to practice responsible birth control methods. (e.g., combination of condoms and foam, birth control pills, intrauterine device, patch, shot and vaginal ring, etc.). Withdrawal is not an acceptable method of birth control. Females that have reached menarche must have a negative urine pregnancy test at each visit prior to treatment with Study drug.
12. Are pregnant or breastfeeding.

Contacts and Locations

Locations

United States, California

Bakersfield Dermatology

Bakersfield, California, United States, 93309

Rady Children's Hospital

San Diego, California, United States, 92123

Redwood Family Dermatology

Santa Rosa, California, United States, 95403

United States, Florida

Solution Through Advanced Research

Jacksonville, Florida, United States, 32256

Lenus Research and Medical Group

Sweetwater, Florida, United States, 33172

United States, Illinois

Northwestern Memorial Hospital

Chicago, Illinois, United States, 60611

United States, Indiana

Dermatology Center of Northwestern Indiana

Crown Point, Indiana, United States, 46307

Pedia Research

Evansville, Indiana, United States, 47715

United States, Kentucky

Pedia Research

Owensboro, Kentucky, United States, 42301

United States, Michigan

Hamzavi Dermatology

Fort Gratiot, Michigan, United States, 48059

United States, Nebraska

Midwest Children's Health-Northwoods

Lincoln, Nebraska, United States, 68505

Midwest Children's Health

Lincoln, Nebraska, United States, 68505

United States, Texas

Tekton Research

Austin, Texas, United States, 78745

DCOL Center for Clinical Research

Longview, Texas, United States, 75605

United States, Virginia

The Education and Research Foundation

Lynchburg, Virginia, United States, 24501

Sponsors and Collaborators

Verrica Pharmaceuticals Inc.

Instat Consulting, Inc.

Paidion Research, Inc.

Database Integrations, Inc.

Investigators

• Principal Investigator: Lawrence Eichenfield, MD; Rady Children's Hospital; San Diego, California

  Study Documents (Full-Text)

Documents provided by Verrica Pharmaceuticals Inc.:

Study Protocol  [PDF] February 1, 2018

Statistical Analysis Plan  [PDF] October 17, 2018

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Eichenfield LF, Kwong P, Gonzalez ME, Yan A, D'Arnaud P, Burnett P, Olivadoti M. Safety and Efficacy of VP-102 (Cantharidin, 0.7% w/v) in Molluscum Contagiosum by Body Region: Post hoc Pooled Analyses from Two Phase III Randomized Trials. J Clin Aesthet Dermatol. 2021 Oct;14(10):42-47.

Eichenfield LF, Siegfried E, Kwong P, McBride M, Rieger J, Glover D, Willson C, Davidson M, Burnett P, Olivadoti M. Pooled Results of Two Randomized Phase III Trials Evaluating VP-102, a Drug-Device Combination Product Containing Cantharidin 0.7% (w/v) for the Treatment of Molluscum Contagiosum. Am J Clin Dermatol. 2021 Mar;22(2):257-265. doi: 10.1007/s40257-020-00570-8. Epub 2021 Feb 18.

Eichenfield LF, McFalda W, Brabec B, Siegfried E, Kwong P, McBride M, Rieger J, Willson C, Davidson M, Burnett P. Safety and Efficacy of VP-102, a Proprietary, Drug-Device Combination Product Containing Cantharidin, 0.7% (w/v), in Children and Adults With Molluscum Contagiosum: Two Phase 3 Randomized Clinical Trials. JAMA Dermatol. 2020 Dec 1;156(12):1315-1323. doi: 10.1001/jamadermatol.2020.3238.

• Responsible Party: Verrica Pharmaceuticals Inc.
• ClinicalTrials.gov Identifier: NCT03377803
• Other Study ID Numbers: VP-102-102
• First Posted: December 19, 2017
• Results First Posted: December 14, 2021
• Last Update Posted: December 14, 2021
• Last Verified: November 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: Yes
• Device Product Not Approved or Cleared by U.S. FDA: Yes

Keywords provided by Verrica Pharmaceuticals Inc.:

Molluscum; Skin Diseases; Poxviridae Infections; Skin Diseases; Infectious; Skin Diseases; Viral; DNA Poxvirus

Additional relevant MeSH terms:

Molluscum Contagiosum; Poxviridae Infections; DNA Virus Infections; Virus Diseases; Infections; Skin Diseases, Viral; Skin Diseases, Infectious; Skin Diseases; Pharmaceutical Solutions; Cantharidin; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action