Official Title

Efficacy and Safety of Ingenol Mebutate Gel 0.06% When Applied Once Daily for 2, 3 or 4 Consecutive Days to a Treatment Area of Approximately 250 cm2 on Trunk and Extremities in Subjects With Actinic Keratosis
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    266
This is a randomised, double-blind, parallel groups, vehicle controlled, 8-week phase 2 trial. The objective is to evaluate efficacy of ingenol mebutate gel 0.06 % after once daily treatment for 2, 3 or 4 consecutive days compared to vehicle gel
Study Started
Jan 31
2014
Primary Completion
Jul 31
2014
Study Completion
Jul 31
2014
Results Posted
Dec 07
2018
Last Update
Dec 07
2018

Drug ingenol mebutate

Other Placebo

2 days placebo and 2 days drug Experimental

Placebo and drug

1 day placebo and 3 days drug Experimental

Placebo and drug

4 days placebo Placebo Comparator

Placebo

4 days drug Experimental

Drug

Criteria

Inclusion Criteria:

Subjects with 5 to 20 clinically typical, visible and discrete AKs within a contiguous area of approximately 250 cm² sun-damaged skin on either trunk (except chest), or extremities

Exclusion Criteria:

Location of the treatment area (trunk (except chest) or extremities)

within 5 cm of an incompletely healed wound,
within 5 cm of a suspected basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)
Prior treatment with ingenol mebutate within the selected treatment area

Lesions in the treatment area that have:

atypical clinical appearance (e.g., hypertrophic,hyperkeratotic or cutaneous horns) and/or,
recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions)

Summary

Ingenol 2 Days

Ingenol 3 Days

Ingenol 4 Days

Vehicle

All Events

Event Type Organ System Event Term Ingenol 2 Days Ingenol 3 Days Ingenol 4 Days Vehicle

Percentage of Participants With Complete Clearance of Actinic Keratosis Lesions (AKs)

Complete clearance of AKs at Week 8 was defined as a 100% reduction from baseline in number of AKs. The table presents the mean across 1000 multiple imputations. Missing values for AK count were imputed sequentially from a negative binomial regression model with treatment group, AK counts at the previous visit, and analysis site as covariates and log baseline AK count as offset.

Ingenol 2 Days

12.7
percentage of participants

Ingenol 3 Days

5.1
percentage of participants

Ingenol 4 Days

26.8
percentage of participants

Vehicle

Percentage of Reduction in Actinic Keratosis (AK) Lesion Count From Baseline (Day 1) (Multiple Imputation)

The number of clinically visible AK lesions identified in the treatment area was to be recorded at Visit 1(≤14 days prior to Day 1). The analysis was based on 1000 imputations of actinic keratosis lesion count at Week 8 using a negative binomial regression model with factors treatment and analysis site and with log of baseline actinic keratosis lesion count as offset. The table shows the adjusted percentage reduction from baseline. Values for the Ingenol 4 days arm were calculated separately based on observed cases. On the basis of the data monitoring committee's recommendation the 4-day active treatment group was closed, and this arm was excluded from statistical models and comparisons in the secondary efficacy analyses.

Ingenol 2 Days

64.5
percentage of reduction (Mean)
95% Confidence Interval: 57.8 to 70.2

Ingenol 3 Days

68.3
percentage of reduction (Mean)
95% Confidence Interval: 62.4 to 73.4

Ingenol 4 Days

73.6
percentage of reduction (Mean)
95% Confidence Interval: 65.8 to 81.5

Vehicle

11.9
percentage of reduction (Mean)
95% Confidence Interval: -2.2 to 24.1

Percentage of Participants With Partial Clearance of AKs

Partial clearance of AKs at Week 8, defined as at least 75% reduction from baseline in number of AKs, was analysed in the same way as the primary response criterion. The percent reduction at Week 8 from baseline was analyzed using a negative binomial regression for the AK count at Week 8 with treatment group and pooled sites as factors and baseline count as offset variable (using multiple imputations to account for missing values). The table presents the mean across 1000 multiple imputations. Missing values for AK count were imputed sequentially from a negative binomial regression model with treatment group, AK counts at the previous visit, and analysis site as covariates and log baseline AK count as offset.

Ingenol 2 Days

47.3
percentage of participants

Ingenol 3 Days

56.2
percentage of participants

Ingenol 4 Days

60.4
percentage of participants

Vehicle

2.0
percentage of participants

Total

224
Participants

Age, Continuous

68.3
years (Mean)
Full Range: 39.0 to 91.0

Region of Enrollment

Sex: Female, Male

Overall Study

Ingenol 2 Days

Ingenol 3 Days

Ingenol 4 Days

Vehicle

Drop/Withdrawal Reasons

Ingenol 3 Days

Ingenol 4 Days

Vehicle