NCT02670655

Brief Summary

Iontophoresis is a transdermal drug-delivery technique that enhances the transport of ionic species across membranes and may have significant benefit for the treatment of actinic keratosis (AK) by ablative fractional laser-primed photodynamic therapy (AFL-PDT).

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
45

participants targeted

Target at P50-P75 for phase_1

Timeline
Completed

Started Jun 2014

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2014

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2015

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

January 28, 2016

Completed
5 days until next milestone

First Posted

Study publicly available on registry

February 2, 2016

Completed
Last Updated

February 2, 2016

Status Verified

January 1, 2016

Enrollment Period

1.5 years

First QC Date

January 28, 2016

Last Update Submit

January 28, 2016

Conditions

Keywords

Ablative fractional laserIontophoresisActinic keratosisPhotodynamic therapy

Outcome Measures

Primary Outcomes (3)

  • Differences of short-term complete response rates between three groups

    The lesions were classified as either complete response (complete disappearance of the lesion) or incomplete response (incomplete disappearance of the lesion)

    Short-term complete response rates were evaluated at 3 months

  • Differences of long-term complete response rates between three groups

    The lesions were classified as either complete response (complete disappearance of the lesion) or incomplete response (incomplete disappearance of the lesion)

    Long-term complete response rates were evaluated at 12 months

  • Differences of recurrence rates between three groups

    In addition, the recurrence rate was evaluated 12 months after treatment. For the histopathologic evaluation of treatment response, at the 12-month follow-up visit, a 3-mm punch biopsy of the treated AK lesion was performed in all cases of clinically incomplete response.

    Recurrence rates were evaluated at 12 months

Secondary Outcomes (1)

  • Differences of cosmetic outcomes between three groups

    The overall cosmetic outcome was assessed 12 months after treatment

Other Outcomes (1)

  • Difference of adverse events (erythema, post-inflammatory hyperpigmentation, edema, itching, oozing, bleeding) rates between groups

    Within 12 months after each treatment

Study Arms (3)

Group A (short-time iontophoresis group)

EXPERIMENTAL

Group A was treated with iontophoresis-assisted AFL-PDT with a short incubation time (2 h)

Drug: lidocaine/prilocaine (5%) applicationDevice: 2940-nm Er:YAG AFL pretreatmentDrug: MAL applicationDevice: Iontophoresis applicationDevice: irradiation with red light-emitting diode lamp

Group B (short-time conventional group)

ACTIVE COMPARATOR

Group B was treated with conventional AFL-PDT with a short incubation time (2 h)

Drug: lidocaine/prilocaine (5%) applicationDevice: 2940-nm Er:YAG AFL pretreatmentDrug: MAL applicationDevice: irradiation with red light-emitting diode lamp

Group C (long-time conventional group)

ACTIVE COMPARATOR

Group C was treated with conventional AFL-PDT with a standard incubation time (3 h)

Drug: lidocaine/prilocaine (5%) applicationDevice: 2940-nm Er:YAG AFL pretreatmentDrug: MAL applicationDevice: irradiation with red light-emitting diode lamp

Interventions

For AFL pre-treatment, lidocaine/prilocaine (5%) cream (EMLA; Astra Pharmaceuticals, LP, Westborough, MA, USA) was applied to the treatment area under occlusion for 30 min

Group A (short-time iontophoresis group)Group B (short-time conventional group)Group C (long-time conventional group)

After the anaesthetic cream was removed, AFL therapy was performed using a 2940-nm Er:YAG AFL (Joule; Sciton Inc., Palo Alto, CA, USA) at 300-550 µm ablation depth, level 1 coagulation, 22% treatment density and a single pulse

Group A (short-time iontophoresis group)Group B (short-time conventional group)Group C (long-time conventional group)

Immediately after AFL treatment, an approximately 1-mm-thick layer of MAL (Metvix, PhotoCure ASA, Oslo, Norway) was applied to the lesion and on 5 mm of surrounding normal tissue.

Group A (short-time iontophoresis group)Group B (short-time conventional group)Group C (long-time conventional group)

In Group A, ionotophoresis was performed on MAL-applied sites. We used iontophoresis (vitaliont II®, ITC Inc, Korea) with a patch. The active electrode was the anode, and 0.50-mA/cm2 current was applied to each AK lesion for 10 min.

Group A (short-time iontophoresis group)

After incubation for 2 (Group A and B) or 3 hours (Group C), the dressing and cream were removed, and the area was cleansed with saline. The area was irradiated with a red light-emitting diode lamp (Aktilite CL 128; PhotoCure ASA, Oslo, Norway) with peak emission at 632 nm, placed 5 cm away from the skin surface, and a total light dose of 37 J/cm-2. All patients wore protective goggles during illumination.

Group A (short-time iontophoresis group)Group B (short-time conventional group)Group C (long-time conventional group)

Eligibility Criteria

Age65 Years - 84 Years
Sexall
Healthy VolunteersYes
Age GroupsOlder Adult (65+)

You may qualify if:

  • Korean patients aged ≥ 18 years who had biopsy-confirmed AK lesions

You may not qualify if:

  • lactating or pregnant women
  • patients with porphyria or a known allergy to any of the constituents of the MAL cream and lidocaine
  • patients with systemic disease, history of malignant melanoma, tendency of melasma development or keloid formation, any AK treatment of the area in the previous 4 weeks, or any conditions associated with a risk of poor protocol compliance; and patients on immunosuppressive treatment
  • metal-containing device (cardiac pacemaker, orthopaedic implants, gynaecological devices)
  • cardiac arrhythmia
  • large skin erosion

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Keratosis, Actinic

Interventions

LidocainePrilocaineRadiotherapy

Condition Hierarchy (Ancestors)

Precancerous ConditionsNeoplasmsKeratosisSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

AcetanilidesAnilidesAmidesOrganic ChemicalsAniline CompoundsAminesTherapeutics

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate professor

Study Record Dates

First Submitted

January 28, 2016

First Posted

February 2, 2016

Study Start

June 1, 2014

Primary Completion

December 1, 2015

Study Completion

December 1, 2015

Last Updated

February 2, 2016

Record last verified: 2016-01

Data Sharing

IPD Sharing
Will not share