Safety, Tolerability, Pharmacokinetics and Efficacy of Twice Daily Application of Topical BioLexa in Adult Healthy Subjects and Patients With Mild to Moderate Atopic Dermatitis

• ClinicalTrials.gov Identifier: NCT04544943
• Recruitment Status: Completed
• First Posted: September 10, 2020
• Last Update Posted: November 17, 2022
• Sponsor: Hoth Therapeutics, Inc.
• Collaborator: Novotech (Australia) Pty Limited
• Information provided by (Responsible Party): Hoth Therapeutics, Inc.

Study Description

Brief Summary:

This is a Phase 1, randomised, double-blind, vehicle controlled study to determine the safety, tolerability, PK and efficacy of twice daily application of topical BioLexa™ lotion, administered for 28 days in adult healthy subjects, in adult patients with mild to moderate AD and in adolescent patients with mild to moderate AD.

Condition or disease	Intervention/treatment	Phase
Atopic Dermatitis	Drug: BioLexa- Cohort 1; Drug: BioLexa- Cohort 2; Drug: Placebo; Drug: Gentamicin	Phase 1

Detailed Description:

This study will consist of 3 parts. Part A: Part A will consist of Cohort 1 constituting of heathy subjects. The total body surface area (BSA) dosed will be either 9% or 27% BSA for Cohort 1 subjects. Part A will include both an active-control (lotion base + 0.1% gentamicin) and a placebo control, applied at 9% or 27% BSA.

Part B: Part B will consist of Cohort 2 made up of adult mild to moderate AD patients. The minimum %BSA dosed will be 3% BSA and the maximum will be 27% BSA for patients in Cohort 2. Part B will include both an active-control (lotion base + 0.1% gentamicin) and a placebo control.

Open-Label Cohort: After closure of Part B, open-label enrolment of patients with mild to moderate atopic dermatitis affecting 3-27% BSA for treatment with BioLexa for 14 days (unblinded).

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 31 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: A Randomised, Double-Blind, Vehicle Controlled, Sequential Group Study to Determine the Safety, Tolerability, Pharmacokinetics and Efficacy of Twice Daily Application of Topical BioLexa in Adult Healthy Subjects and Patients With Mild to Moderate Atopic Dermatitis
• Actual Study Start Date: May 17, 2021
• Actual Primary Completion Date: September 21, 2022
• Actual Study Completion Date: September 21, 2022

Arms and Interventions

Arm	Intervention/treatment
Experimental: Cohort 1; Route of Administration: Topical; Dosage Form: Topical lotion. Product Name: BioLexa. The total body surface area (BSA) dosed will be either 9% or 27% BSA. Part A will include both an active-control (lotion base + 0.1% gentamicin) and a placebo control, applied at 9% or 27% BSA.	Drug: BioLexa- Cohort 1; Twice daily application of topical BioLexa™ lotion, administered for 14 days in adult healthy subjects; Drug: Placebo; Twice daily (BID) application of placebo for 14 days; Drug: Gentamicin; Twice daily (BID) application of Gentamicin for 14 days
Placebo Comparator: Cohort 2; Route of Administration: Topical; Dosage Form: Topical lotion. Product Name: BioLexa. The minimum % BSA dosed will be 3% BSA and the maximum will be 27% BSA for patients in Cohort 2. Part B will include both an active-control (lotion base + 0.1% gentamicin) and a placebo control.	Drug: BioLexa- Cohort 2; Twice daily application of topical BioLexa™ lotion, administered for 14 days in adult mild to moderate AD patients; Drug: Placebo; Twice daily (BID) application of placebo for 14 days; Drug: Gentamicin; Twice daily (BID) application of Gentamicin for 14 days
Experimental: Open-Label; Route of Administration: Topical; Dosage Form: Topical lotion. Product Name: BioLexa. The minimum % BSA dosed will be 3% BSA and the maximum will be 27% BSA for patients	Drug: BioLexa- Cohort 1; Twice daily application of topical BioLexa™ lotion, administered for 14 days in adult healthy subjects

Outcome Measures

Primary Outcome Measures :

1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]) of BioLexa™ and active control (gentamicin only) [ Time Frame: Measurements at Baseline till Follow-up/EOS visit (14 days) or early termination ]
   Measured by Incidence of Treatment-Emergent Adverse Events

Secondary Outcome Measures :

1. To evaluate the preliminary efficacy of BioLexa™ and active control (gentamicin only) in patients with mild to moderate AD (Part B only)- by Eczema Area and Severity Index (EASI) score [ Time Frame: Measured on Day 7, 14, 21 and 28 ]
   Measured by the change from Baseline in the Eczema Area and Severity Index (EASI) score
2. To evaluate the preliminary efficacy of BioLexa™ in patients with mild to moderate AD (Part B only)- by Scoring Atopic Dermatitis [ Time Frame: Measured on on Day 7, 14, 21 and 28 ]
   Measured by the change from Baseline in Scoring Atopic Dermatitis (SCORAD) index
3. To characterize pharmacokinetic (PK) profile of BioLexa and active control (gentamicin only) (Part A and B)- AUC [ Time Frame: Measurements at Baseline till the end of the study (14 days) ]
   Measured through Area under the curve (AUC)
4. To characterize pharmacokinetic (PK) profile of BioLexa and active control (gentamicin only) (Part A and B)- Cmax [ Time Frame: Measurements at Baseline till the end of the study (14 days) ]
   Measured through maximum (or peak) serum concentration (Cmax)
5. To characterize pharmacokinetic (PK) profile of BioLexa and active control (gentamicin only) (Part A and B)- Tmax [ Time Frame: Measurements at Baseline till the end of the study (14 days) ]
   Measured through time of peak concentration (Tmax)

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 65 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

1. Healthy male or female volunteers, aged 18 to 65 years
2. Participants must be in good general health, with no significant medical history, have no clinically significant abnormalities on physical examination at Screening and/or before administration of the initial dose of study drug; (Part A)
3. Participants must have a BMI between ≥ 18.0 and ≤ 35.0 kg/m2 at Screening; (Part A and B)
4. Participants must have clinical laboratory values within normal range as specified by the testing laboratory, unless deemed not clinically significant by the Investigator or delegate; (Part A and B)
5. Participants must be a non-smoker or a smoker who smokes no more than 2 cigarettes or equivalent per week in order to be included in the study; (Part A and B)
6. Participants must have no relevant dietary restrictions, and be willing to consume standard meals provided; (Part A and B)
7. Females must be non-pregnant and non-lactating, and must use an acceptable, highly effective double contraception from screening until study completion, including the follow-up period.
8. Males must not donate sperm for at least 90 days after the last dose of study drug (Part A and B);
9. Participants must have the ability and willingness to attend the necessary visits to the CRU (Part A and B);

10. Participants must be willing and able to provide written informed consent after the nature of the study has been explained and prior to the commencement of any study procedures (Part A and B).

    In addition to the above-mentioned criteria, participants in Part B should also fulfill the following inclusion criteria:

11. Male and Female, 18 to 65 years (Cohort 2 - adult patients)
12. Physician documented history or confirmed diagnosis of mild to moderate AD for at least 6 months prior to screening. AD should be diagnosed by EASI score of Mild or Moderate on Day 1;
13. Mild to moderate AD with a minimum of 3% to a maximum of 27% BSA involvement on Day 1 (excluding the scalp, designated venous access areas, palms and soles);
14. Participant has a minimum of 2 AD lesions;
15. Informed consent of parent(s) or legal guardian, and, if age appropriate, assent by the patient, as required by local laws;

Exclusion Criteria:

1. Pregnant or lactating at Screening or planning to become pregnant (self or partner) at any time during the study, including the follow-up period; (Part A and B)
2. Prior or ongoing medical conditions, medical history, physical findings, or laboratory abnormality that, in the Investigator's (or delegate's) opinion, could adversely affect the safety of the participant; (Part A and B)
3. Presence of any underlying physical or psychological medical condition that, in the opinion of the Investigator, would make it unlikely that the participant will comply with the protocol or complete the study per protocol; (Part A and B)
4. Blood donation or significant blood loss within 60 days prior to the first study drug administration; (Part A and B)
5. Plasma donation within 7 days prior to the first study drug administration; (Part A and B)
6. Fever (body temperature >38°C) or symptomatic viral or bacterial infection within 2 weeks prior to Screening; (Part A and B)
7. History of severe allergic or anaphylactic reactions; (Part A and B)
8. Known contact sensitivity to aminoglycosides; (Part A and B)
9. Contact sensitivity to BioLexa or any formulation ingredients; (Part A and B)
10. History of malignancy, except for non-melanoma skin cancer, excised more than 2 years ago and cervical intraepithelial neoplasia that has been successfully cured more than 5 years prior to Screening; (Part A and B)
11. Abnormal ECG findings at Screening that are considered by the Investigator to be clinically significant; (Part A and B)
12. History or presence of a condition associated with significant immunosuppression; (Part A and B)
13. History of life-threatening infection (e.g. meningitis); (Part A and B)

14. Infections requiring parenteral antibiotics within the 6 months prior to Screening; (Part A and B)

    In addition to the above-mentioned criteria, participants in Part B who also fulfill the following exclusion criteria must be excluded from the study:

15. Have used antiseptic treatments (e.g. bleach baths, potassium permanganate etc.) within 1 month before Baseline visit. (Patients who have recently used antiseptic treatment may be rescreened at a later date if they wish to participate in the study and agree to stop antiseptic treatment)
16. Treatment with the following topical agents within 2 weeks before the Baseline visit: corticosteroids, phosphodiesterase inhibitors, tacrolimus or pimecrolimus.
17. Systemic treatment for AD or for condition, with steroids or other immunosuppressive/immunomodulating substances, e.g., cyclosporine, mycophenolate-mofetil, azathioprine or methotrexate within 4 weeks before the Baseline visit or 5 half-lives whichever is longer. Use of steroid inhalers and nasal corticosteroids is allowed
18. Treatment with any cell depleting agents, e.g., rituximab, within 6 months of the Baseline visit or treatment with other biologics within 3 months of the Baseline visit
19. Prior treatment with dupilumab or any antibody against IL-4Rα or IL-13 within 1 month before Baseline visit.

Contacts and Locations

Locations

Australia, New South Wales

Novatrials

Kotara, New South Wales, Australia, 2289

Sponsors and Collaborators

Hoth Therapeutics, Inc.

Novotech (Australia) Pty Limited

Investigators

• Principal Investigator: Oscar Cumming, Dr; Novatrials

More Information

• Responsible Party: Hoth Therapeutics, Inc.
• ClinicalTrials.gov Identifier: NCT04544943
• Other Study ID Numbers: AD-001
• First Posted: September 10, 2020
• Last Update Posted: November 17, 2022
• Last Verified: November 2022

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Dermatitis, Atopic; Dermatitis; Eczema; Skin Diseases; Skin Diseases, Genetic; Genetic Diseases, Inborn; Skin Diseases, Eczematous; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Gentamicins; Anti-Bacterial Agents; Anti-Infective Agents; Protein Synthesis Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action