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Completed

NCT Number: NCT04875026

Frequency and Intensity of Local Reactions in Patients Treated With 4% 5-FU vs 4% 5-FU Associated With an Emollient Cream: a Randomised, Controlled Clinical Trial

Transient local skin reactions with topical Actinic Keratosis treatments such as 5-FluoroUracil (5-FU) often lead to non-adhesion from patients and thus to treatment failure. In regards to 5-FU treatment, these local reactions are related to the pharmacological action of the molecule. The current therapeutic challenge is to reduce the local reactions induced by 5-FU without interfering with its efficacy, in particular by the use of an emollient cream.

The aim of the present study is to investigate how the use of an emollient, namely Dexeryl, could improve the local skin reactions occurring during 4 weeks of a 4% 5-FU treatment.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Private practice Maire, Arras, France

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Participants are eligible only if all of the following criteria apply:

Age

  • Participant must be more than 18 years old inclusive, at the time of signing the informed consent.

Type of Participant and Disease Characteristics

  • Individuals with a clinical diagnosis of actinic keratosis (AK).
  • Individuals harboring 5 or more clinically recognizable (palpable and/or visible to unaided eye) AK lesions of the face, and/or ears and/or scalp. The AK lesions must be clinically typical non hypertrophic and/or nonhyperkeratotic.
  • Subject in good general condition and free of any disease state or condition which, in the investigator's opinion, could impair evaluation of actinic keratosis or could expose the subject to an unacceptable risk by study participation.

Sex

  • Male or female. A Female participant is eligible to participate if she is not a woman of childbearing potential (WOCBP), defined as postmenopausal (cessation of menses >12 months) or surgically sterile (history of bilateral tubal ligation, bilateral oophorectomy, total hysterectomy).

Informed Consent

  • Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Ethical/Legal considerations

  • Affiliated to a social security system, or is a beneficiary (if applicable in the national regulation).

Exclusion criteria

Participants are excluded from the study if any of the following criteria apply:

Medical Conditions

  • With AK lesions within treatment areas which are hyperkeratotic or which are clinically suspected to be squamous cell carcinoma (SCC).
  • With pre-existing local skin reactions with a total score ≥ 3.
  • History of hypersensitivity to the ingredients of Tolak® or Dexeryl®.
  • With a known allergy to peanut or soya.
  • Non postmenopausal or non surgically sterile woman considered as WOCBP, pregnant or breastfeeding women.

Prior/Concomitant Therapy

  • Under systemic 5-fluorouracil or any systemic cancer treatment within eight weeks prior to the study.
  • Under any other topical AK treatments or therapies (e.g., Cryotherapy or Photodynamic therapy) in the treatment area(s) within eight weeks prior to starting the study.
  • Treated with systemic steroids, immunosuppressants or immunomodulators within four weeks prior to the study.
  • Under prescription retinoids or topical steroids in the treatment area(s) within four weeks prior to the study.
  • With known dihydropyrimidinedehydrogénase (DPD) deficiency or under treatment with brivudine, sorivudine or analogues within 4 weeks prior to starting the study.
  • Treated with glycolic acid products and alpha-hydroxy products in the treatment area(s) within four weeks prior to starting the study.
  • Treated with chemical peeling products in the treatment area(s) within eight weeks prior to starting the study.

Prior/Concurrent Clinical Study Experience

  • Is participating in another clinical trial
  • Has participated in another clinical trial within the last 30 days, has received treatment with known remnant effects or undergone investigation liable to interfere with the present clinical trial Other Exclusions
  • Is a family member of the Investigator or any associate, colleague, and employee assisting in the conduct of the study (secretary, nurse, technician,…)
  • Is in a position likely to represent a conflict of interest
  • Has forfeited his / her freedom by administrative or legal award or is under guardianship

Treatment and study plan

5-fluorouracil 4% (Tolak)

Drug

Application of Tolak once daily in the evening for 4 weeks

Dexeryl

Device

Application of Dexeryl once daily in the morning for 8 weeks

Primary outcomes

  1. Local Skin Reaction (LSR) total score

    Time frame: at 4 weeks or Last Observation Carried Forward (LOCF)

    Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).

Secondary outcomes

  1. Local Skin Reaction (LSR) total score

    Time frame: at 2 weeks (first follow-up)

    Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).

  2. Local Skin Reaction (LSR) total score

    Time frame: at 8 weeks (last follow up)

    Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).

  3. Local Skin Reaction (LSR) items alone

    Time frame: at 2 weeks (first follow-up)

    Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst

  4. Local Skin Reaction (LSR) items alone

    Time frame: at 4 weeks (second follow up)

    Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst

  5. Local Skin Reaction (LSR) items alone

    Time frame: at 8 weeks (last follow up)

    Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst

  6. Subjective signs at each visit

    Time frame: at 2 weeks (first follow-up)

    Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.

  7. Subjective signs at each visit

    Time frame: at 4 weeks (second follow up)

    Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.

  8. Subjective signs at each visit

    Time frame: at 8 weeks (last follow up)

    Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.

  9. Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4

    Time frame: at 2 weeks (first follow-up)

    Intensity grading of adverse events

  10. Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4

    Time frame: at 4 weeks (second follow up)

    Intensity grading of adverse events

  11. Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4

    Time frame: at 8 weeks (last follow up)

    Intensity grading of adverse events

  12. Adverse Events reported by patients or noticed by investigator

    Time frame: at 2, 4 and 8 weeks (first follow-up)

  13. Drop outs due to Adverse Events (AE) related to local skin reaction

    Time frame: at 2, 4 and 8 weeks (first follow-up)

    discontinuation rate

  14. Use of rescue treatment

    Time frame: at 2 weeks (first follow-up)

  15. Use of rescue treatment

    Time frame: at 4 weeks (second follow up)

  16. Use of rescue treatment

    Time frame: at 8 weeks (last follow up)

  17. Treatment satisfaction (acceptability): measured by Treatment Satisfaction Questionnaire for Medication version 9 (TSQM-9)

    Time frame: at 4 weeks (end of treatment) or at Patient Withdrawal

    The TSQM-9 questionnaire includes nine questions that assess patients' satisfaction by providing score on three scales: effectiveness (questions 1 to 3), convenience (questions 4 to 6) and global satisfaction (questions 7 to 9). The scores of each scale range from 0 to 100, where a higher score indicates a greater satisfaction

  18. Treatment adherence

    Time frame: at 4 weeks

    assessed by the participant using a self questionnaire

  19. Treatment adherence

    Time frame: at optional visit (when applicable), up to 8 weeks

    assessed by the participant using a self questionnaire

  20. Health-related quality of life measured by actinic keratosis quality of life questionnaire (AKQoL)

    Time frame: at 8 weeks (last follow up)

    actinic keratosis quality of life patient questionnaire, for Spain and Germany only. 0 is the best outcome, 27 is the worst outcome

  21. Rates of patients with complete and partial clearance rates

    Time frame: at 8 weeks (last follow up)

  22. Rates of patients with partial clearance rates

    Time frame: at 8 weeks (last follow up)

  23. Percentage change in number of AK lesions

    Time frame: at baseline

  24. Percentage change in number of AK lesions

    Time frame: at 2 weeks (first follow-up)

  25. Change in number of AK lesions

    Time frame: at 2 weeks (first follow-up)

  26. Percentage change in number of AK lesions

    Time frame: at 4 weeks (second follow up)

  27. Change in number of AK lesions

    Time frame: at 4 weeks (second follow up)

  28. Percentage change in number of AK lesions

    Time frame: at 8 weeks (last follow up)

  29. Change in number of AK lesions

    Time frame: at 8 weeks (last follow up)

Sponsors and collaborators

Lead sponsor

Pierre Fabre Medicament

Industry

Collaborators

  • Clinact

Registry information

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
May 6, 2021
Registry last updated
Sep 19, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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