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Completed

NCT Number: NCT02669888

Indigo Naturalis in Treating Atopic Dermatitis Topically

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that most commonly occurs in children. The aims of this project are:

1. To evaluate the efficacy of indigo naturalis ointment in treating AD topically; 2. To evaluate the safety of indigo naturalis ointment in treating AD topically; 3. To investigate whether indigo naturalis ointment treatment is associated with a change in total IgE, cytokines, eosinophils, and CRP in patients with AD; 4. To evaluate whether indigo naturalis ointment treatment improves the quality of life in patients with AD.

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Key information

Age range

6 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Chang Gung Memorial Hospital at Keelung, Kelung, Taiwan

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About this study

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that most commonly occurs in children. AD is characterized by itchy and dry skin that affects approximately 5 to 20% of children in the world. Currently, corticosteroids are the most widely prescribed medication in treating AD; however, there are concerns regarding the side effects such as skin atrophy, telangiectasia, striae, folliculitis and adrenocortical suppression that inhibits growth in children. Many patients and families seek complementary and alternative medications such as traditional Chinese medicine (TCM). In TCM, indigo naturalis has been used to treat various infectious and inflammatory skin diseases for hundreds of years. Ancient TCM literature has recorded that indigo naturalis is also effective in treating facial eczema (AD) in infants.

The aims of this project are: (1) To evaluate the efficacy of indigo naturalis ointment in treating AD topically; (2) To evaluate the safety of indigo naturalis ointment in treating AD topically; (3) To investigate whether indigo naturalis ointment treatment is associated with a change in total IgE, cytokines, eosinophils, and CRP in patients with AD; (4) To evaluate whether indigo naturalis ointment treatment improves the quality of life in patients with AD.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Between 6 and 65 years old, female or male.
  • Atopic dermatitis fulfilling the diagnostic criteria of Williams et al.
  • Atopic dermatitis involving <40% of BSA. (Base on the BSA result of Screening)
  • An Investigator's Global Assessment (IGA) score of 2, 3 or 4 which corresponds to mild, moderate or severe disease. (Base on the IGA result of Screening)
  • Female patients of child-bearing age with negative pregnancy test at screening.
  • Female patients of child-bearing age that agree to continue using birth control measures approved by the investigator and agree not to lactate for the duration of the study.
  • Agree to only receive stable doses of an additive-free, basic bland emollient for at least 7 days before baseline (day0)
  • Willing to comply with study protocol and agree to sign an informed consent form.

Exclusion criteria

  • Having a history of topical or systematical hypersensitivity to indigo naturalis or its excipient (e.g. beeswax) in ointment
  • Undergoing phototherapy (e.g. UVB, PUVA) or systemic therapy (e.g. Immunosuppressive agents) within 30 days.
  • Having used topical therapy (e.g. topical corticosteroids) for dermatitis within 7 days before the first application of the study medication.
  • Having a significant concurrent disease, such as: significant abnormalities in hematology, severe uncontrolled metabolic syndrome (e.g., hypertension, diabetes mellitus, metabolic arthritis, hyperthyroidism), psychiatric disease, cancer or AIDS.
  • Having abnormal liver or renal function (AST/ALT >3 x ULN, creatinine >2.0 mg/dl).
  • Women who are lactating, pregnant or preparing to be pregnant.

Treatment and study plan

Indigo naturalis ointment

Drug

Every 10 x 10 cm area of lesion requires 0.5 g of ointment, applied twice daily (morning and evening, separated by approximately 12±2 hours) for 6 weeks.

Other names: Lindioil ointment

Placebo

Drug

Every 10 x 10 cm area of lesion requires 0.5 g of ointment, applied twice daily (morning and evening, separated by approximately 12±2 hours) for 6 weeks.

Primary outcomes

  1. Percentage change in Eczema Area Severity Index (EASI) scores from baseline to week 6

    Time frame: 6 weeks

    The Eczema Area and Severity Index (EASI) is used to measure the disease severity of erythema, infiltration/papulation, excoriation, and lichenification each on a scale of 0 to 3 (none to severe) as well as the percentage of disease area on a scale of 0 to 6 for the head ⁄ neck, upper limb, trunk and lower limb body regions. Each body region score is calculated by multiplying the disease severity score by the disease area score and by the multiplier. The scores are summed to give the total EASI score, ranging from 0 to a maximum 72.

    The mean percentage change in EASI = (EASI baseline-EASI post-treat) / EASI baseline x 100%

Secondary outcomes

  1. Proportion of subjects who have achieved EASI-50, EASI-75, and EASI-90 after 6 weeks of treatment

    Time frame: 6 weeks

    It is defined as at least 50%, 75%, and 90% reduction in EASI score relative to the baseline.

  2. Proportion of subjects with a change in Investigator's Global Assessment (IGA, range 0-5) from baseline to week 6.

    Time frame: 6 weeks

    • Proportion of subjects with an IGA score of 0 (clear) or 1 (almost clear) at week 6.
    • Proportion of subjects with ≥ 2 point improvement in IGA at week 6.
  3. The mean percentage change in Total Body Surface Area involved with AD (BSA, range 0%-100%) from baseline to week 6.

    Time frame: 6 weeks

    BSA is total Body Surface Area involved, ranging from 0% (none) to 100% (total body surface involved)

  4. The mean change in pruritus score (10-cm visual analogue scale) from baseline to week 6.

    Time frame: 6 weeks

    Visual Analogue Scale (VAS) for pruritus severity rates from 0 (no itching) to 10 (very severe itching)

  5. Clinical-immunological correlation between the treatment outcome and the changes in the level of immunoglobin E (IgE), cytokines, eosinophil count, and C-reactive protein (CRP) in the peripheral blood from baseline to week 6.

    Time frame: 6 weeks

    Measuring the correlations of treatment by EASI score and BSA, with the changes in IgE, eosinophils, cytokines (IL-1β, IL-6, TNF-α…) from baseline to week 6.

  6. The mean change in Dermatology Life Quality Index (DLQI)from baseline to week 6

    Time frame: 6 weeks

    The DLQI is a self-administered 10-item questionnaire, ranges from 0 (best) to 30 (worst); the higher the score, the more quality of life is impaired.

    For subjects from age 6 to age 16, children's DLQI (CDLQI) will used.

  7. Physician's Global Assessment (PGA ) at week 6.

    Time frame: 6 weeks

    0 = Symptoms cleared or excellent improvement of 90-100%; 1 = Marked improvement of 75-89%; 2 = Moderate improvement of 50-74%; 3 = Slight improvement of 3049%; 4 = No appreciable improvement of 029%; 5 = Worsening of the condition

  8. Subject's Global Assessment (SGA) at week 6.

    Time frame: 6 weeks

    0 = Symptoms cleared or excellent improvement of 90-100%; 1 = Marked improvement of 75-89%; 2 = Moderate improvement of 50-74%; 3 = Slight improvement of 3049%; 4 = No appreciable improvement of 029%; 5 = Worsening of the condition

Sponsors and collaborators

Lead sponsor

Chang Gung Memorial Hospital

Other

Collaborators

  • Ministry of Science and Technology, Taiwan

Registry information

Official study title

Efficacy and Safety of Topical Indigo Naturalis in Treating Atopic Dermatitis: A Randomized, Double-Blind, Placebo-Controlled Trial

Important dates

Study start
2015
Primary completion
2017
Study completion
2017
First posted
Feb 1, 2016
Registry last updated
Feb 14, 2017

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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