Diacerein orphan drug development for epidermolysis bullosa simplex: A phase 2/3 randomized, placebo-controlled, double-blind clinical trial - 19/04/18
, Alain Hovnanian, MD b, c, d, Juliette Ly, PhD b, c, d, Hana Buckova, MD e, Victoria Brunner, MS a, Thomas Lettner, PhD a, Michael Ablinger, MS a, Thomas K. Felder, PhD f, Peter Hofbauer, MPharm g, Martin Wolkersdorfer, PhD g, Florian B. Lagler, MD h, i, Wolfgang Hitzl, PhD j, Martin Laimer, MD k, Sophie Kitzmüller, PhD a, Anja Diem, MD a, Johann W. Bauer, MD, MBA kAbstract |
Background |
Epidermolysis bullosa simplex (EBS) is a rare genetic, blistering skin disease for which there is no cure. Treatments that address the pathophysiology of EBS are needed.
Objective |
Compare the impact of 1% diacerein cream with placebo in reducing the number of blisters in EBS.
Methods |
In a randomized, placebo-controlled, phase 2/3 trial we used a 1% diacerein topical formulation to treat defined skin areas in 17 patients. In a 2-period crossover trial, patients were randomized to either placebo or diacerein for a 4-week treatment and a 3-month follow-up in period 1. After a washout, patients were crossed over during period 2. The prespecified primary end point was the proportion of patients with a reduction of number of blisters by more than 40% from baseline in selected areas over the treatment episode.
Results |
Of the patients receiving diacerein, 86% in episode 1 and 37.5% in episode 2 met the primary end point (vs 14% and 17% with placebo, respectively). This effect was still significant after the follow-up. Changes in absolute blister numbers were significant for the diacerein group only. No adverse effects were observed.
Limitations |
Low patient numbers and no invasive data acquisition because of clinical burden in children.
Conclusion |
This trial provides evidence of the impact of 1% diacerein cream in the treatment of EBS.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Key words : diacerein, epidermolysis bullosa, keratin, rare genodermatosis
Abbreviations used : AE, BSA, CI, EBS, EBS-gen/sev, IFN, IL, IMP, TP, TREP
Plan
| Funding sources: Supported by the Austrian Science Fund (FWF): KLI341, Paracelsus Medical University (grant A-14/01/010-BWA), and DEBRA Austria. |
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| Disclosure: Drs Wally and Bauer have shares of the company Diaderm, which receives license payments from Castle Creek Pharma, which will conduct a phase 2/3 study with a diacerein-containing ointment. Dr Bauer was holder of the European Medicines Agency orphan drug designation on diacerein in epidermolysis bullosa. Dr Hovnanian, Dr Ly, Dr Buckova, Ms Brunner, Dr Lettner, Mr Ablinger, Dr Felder, Mr Hofbauer, Dr Wolkersdorfer, Dr Lagler, Dr Hitzl, Dr Laimer, Dr Kitzmüller, and Dr Anja Diem have no conflicts of interest to disclose. |
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| Reprints not available from the authors. |
Vol 78 - N° 5
P. 892 - mai 2018 Retour au numéro
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