Cantharidin Application in Molluscum Patients-1 (CAMP-1)

• ClinicalTrials.gov Identifier: NCT03377790
• Recruitment Status: Completed
• First Posted: December 19, 2017
• Results First Posted: December 14, 2021
• Last Update Posted: January 11, 2022
• Sponsor: Verrica Pharmaceuticals Inc.
• Collaborators: Instat Consulting, Inc.; Paidion Research, Inc.; Database Integrations, Inc.
• Information provided by (Responsible Party): Verrica Pharmaceuticals Inc.

Study Description

Brief Summary:

This study is a Phase 3, randomized, double-blind, placebo-controlled, pivotal study to evaluate the safety and efficacy of VP-102 topical film-forming solution in subjects with Molluscum Contagiosum. VP-102 will be applied once every 21 days for up to 4 applications, to treatable molluscum contagiosum (molluscum) lesions on subjects 2 years and older. Efficacy will be assessed as the proportion of subjects achieving complete clearance of all treatable molluscum lesions (baseline and new) on the Day 84 visit.

Condition or disease	Intervention/treatment	Phase
Molluscum Contagiosum	Combination Product: VP-102 - Cantharidin, Topical Film Forming Solution; Combination Product: Placebo -Topical Film Forming Solution without VP-102	Phase 3

Detailed Description:

This is a Phase 3, multi-center, randomized, double-blind, placebo (vehicle)-controlled, pivotal study that will be conducted in the United States to determine the efficacy and safety of VP-102 following treatment of molluscum lesions for up to 4 treatments, every 21 days, with VP-102/placebo in 250 subjects. Subjects will receive active VP-102 or placebo in a 3:2 ratio. Study drug (VP-102 or placebo) will be supplied in single-use applicators.

The film-forming Study drug solution will be applied and left on the lesions for 24 hours before the subject and/or parents/guardian washes the lesions. Study drug may be removed prior to the 24-hour time point in the event treatment-emergent AEs are experienced.

Molluscum lesions will be treated without occlusion in all anatomic areas including the face, trunk, back, arms, legs, hands, feet, anogenital region and buttocks.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 266 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Pivotal Study to Evaluate the Safety and Efficacy of VP-102 Topical Film-Forming Solution [0.7% (w/v) Cantharidin] in Subjects (2 Years and Older) With Molluscum Contagiosum
• Actual Study Start Date: March 21, 2018
• Actual Primary Completion Date: November 26, 2018
• Actual Study Completion Date: November 26, 2018

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: VP-102; VP-102 is contained within a single-use applicator. The VP-102 applicator consists of a plastic tube containing a sealed glass ampule and an applicator tip. One ampule contains 450 μL of VP-102 (0.7% [w/v] cantharidin) solution.	Combination Product: VP-102 - Cantharidin, Topical Film Forming Solution; VP-102, a single-use drug device combination product containing (cantharidin) topical solution, 0.7% (w/v). Up to 4 applications of VP-102 will be administered to Molluscum lesions at 21-day intervals.
Placebo Comparator: Placebo; Placebo is contained within a single-use applicator. The placebo applicator consists of a plastic tube containing a sealed glass ampule and an applicator tip. One ampule contains 450μl of placebo solution with the same color and consistency as VP-102.	Combination Product: Placebo -Topical Film Forming Solution without VP-102; Placebo a single-use drug device combination product containing only the vehicle. Up to 4 applications of Placebo will be administered to Molluscum lesions at 21-day intervals.

Outcome Measures

Primary Outcome Measures :

1. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 84 Visit (EOS) [ Time Frame: Day 1 (Baseline and new) compared to Day 84 (EOS) ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 84 visit (EOS).

Secondary Outcome Measures :

1. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 63 Visit [ Time Frame: Day 1 (Baseline and new) compared to Day 63 ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 63 visit.
2. Percentage of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 42 Visit [ Time Frame: Day 1 (Baseline and new) compared to Day 42 ]
   Percentage of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 42 visit.
3. Proportion of Subjects Exhibiting Complete Clearance of All Treatable Molluscum Lesions (Baseline and New) on the Day 21 Visit [ Time Frame: Day 1 (Baseline and new) compared to Day 21 ]
   Proportion of subjects exhibiting complete clearance of all treatable molluscum lesions (baseline and new) on the Day 21 visit.

Other Outcome Measures:

1. Change From Baseline to EOS Day 84 of the Composite Score From the Children's Dermatology Life Quality Index (CDLQI) Assessment at the EOS Visit to Measure the Quality of Life and Impact of Skin Disease in the Subset of Subjects 4 -16 Years of Age. [ Time Frame: Baseline to Day 84 (EOS) ]

   Change from Baseline to EOS Day 84 of the Composite Score From the Children's Dermatology Life Quality Index (CDLQI) Assessment at the EOS Visit to Measure the Quality of Life and Impact of Skin Disease in the Subset of Subjects 4 -16 Years of Age.

   From responses to that questionnaire, a composite score was calculated. The calculated composite score was the sum of the individual 10 items of the CDLQI and could range from 0-30. For each item on the

   CDLQI, a score of 0-3 was assigned using the following scores per response:

   • 3: Very much (or Prevented School, Question 7 only)
   • 2: Quite a lot
   • 1: Only a little
   • 0: Not at all Larger composite CDLQI scores indicate skin condition is having more effect on subjects' lives (worse outcome).
2. Percent Change of All Treatable Molluscum Lesions (Baseline and New) From Baseline at the EOS Visit [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percent change of all treatable molluscum lesions (baseline and new) from baseline at the EOS visit.
3. Change From Baseline in the Number of Treatable Molluscum Lesions (Baseline and New) at the EOS Visit. [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Change from baseline in the number of treatable molluscum lesions (baseline and new) at the EOS visit.
4. Percentage of Subjects Exhibiting a 75% or Greater Reduction of All Treatable Molluscum Lesions (Baseline and New) at the EOS Visit. [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percentage of subjects that exhibited a 75% or greater clearance of all treatable molluscum lesions (baseline and new) at the EOS visit.
5. Percentage of Subjects Exhibiting a 90% or Greater Reduction of All Treatable Molluscum Lesions (Baseline and New) at the EOS Visit. [ Time Frame: Day 1 (Baseline) compared to Day 84 (EOS) ]
   Percentage of subjects that exhibited a 90% or greater clearance of all treatable molluscum lesions (baseline and new) at the EOS visit.
6. Subject Reported Spread to Household Members as Measured by Any New Occurrence of Molluscum in Household Members of Subject. [ Time Frame: Days 1, 21, 42, 63 and 84 (EOS). ]
   Subject reported spread to household members as measured by any new occurrence of molluscum in household members of subject. To be eligible for assessment, subjects had to have at least one household member free of lesions at baseline and have at least 1 post baseline assessment of spread of molluscum lesions.

Eligibility Criteria

• Ages Eligible for Study: 2 Years and older (Child, Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

To qualify for inclusion in this study, subjects must:

1. Be healthy subjects, at least 2 years of age or older.
2. Consent to having all molluscum lesions treated and the physician must be willing to treat all molluscum lesions initially present. Lesions within 10mm of the eyelid margins or the margin of any mucosal membrane should be evaluated carefully to ensure that they can be safely treated. Non-mucosal genital area lesions and inflamed lesions are considered treatable.
3. Be otherwise medically healthy with no clinically significant medical history as determined by the investigator. Subjects exhibiting active Atopic Dermatitis may be enrolled.
4. On day of treatment refrain from application of all topical agents including alcohol-based sanitary products and sunscreens for a minimum of 4 hours before Study drug application. Topical agents including alcohol-based sanitary products and sunscreens may be used after application of the study drug so long as they are not applied within 5cm of treated skin lesions.
5. Refrain from swimming, bathing or prolonged immersion in water or any liquids until the Study drug is removed.
6. Have the ability or have a guardian with the ability to follow study instructions and be likely to complete all study requirements.
7. Provide written informed consent or assent in a manner approved by the institutional review board (IRB) and/or have a parent/guardian provide written informed consent as evidenced by the signature on an IRB approved assent/consent form.
8. Provide written authorization for use and disclosure of protected health information.
9. Agree to allow photographs to be taken, (selected sites only) of selected lesions at every visit that will be used for training, publication and future marketing brochures.

Exclusion Criteria:

Subjects will be excluded from the study if they:

1. Are unable to cooperate with the requirements or visits of the study, as determined by the investigator.
2. Are systemically immunosuppressed or are receiving treatments such as chemotherapy or other non-topical immunosuppressive agents.
3. Have any lesions present at baseline in anatomic locations that the subject/parent/guardian or the physician is unwilling to treat.
4. Have had any previous treatment of molluscum including the use of cantharidin, antivirals, retinoids, curettage or freezing of lesions in the past 14 days. Additional treatments should not be implemented during the course of the study.
5. Have a history of illness or any dermatologic disorder which, in the opinion of the investigator, will interfere with accurate counting of lesions or increase the risk of adverse events.
6. History or presence of clinically significant medical, psychiatric, or emotional condition or abnormality that, in the opinion of the investigator, would compromise the safety of the subject or the quality of the data.
7. Have a history or presence of hypersensitivity or an idiosyncratic reaction to the Study drug or related compounds, or drug product excipients (acetone, ethyl alcohol, nitrocellulose, hydroxypropyl cellulose, castor oil, camphor, gentian violet, and denatonium benzoate).
8. Have a condition or situation that may interfere significantly with the subject's participation in the study (e.g., subjects who required hospitalization in the 2 months prior to screening for an acute or chronic condition including alcohol or drug abuse), at the discretion of the investigator.
9. Have received another investigational product within 14 days prior to the first application of the Study drug.
10. Have been treated within 14 days with a product that contains cantharidin (topical or homeopathic preparations) for any reason prior to screening.
11. Are sexually active or may become sexually active and are unwilling to practice responsible birth control methods. (e.g., combination of condoms and foam, birth control pills, intrauterine device, patch, shot and vaginal ring, etc.). Withdrawal is not an acceptable method of birth control. Females that have reached menarche must have a negative urine pregnancy test at each visit prior to treatment with Study drug.
12. Are pregnant or breastfeeding.

Contacts and Locations

Locations

United States, Alabama

Alabama Clinical Therapeutics

Birmingham, Alabama, United States, 35205

Southeastern Pediatric Associates

Dothan, Alabama, United States, 36305

United States, Arkansas

Applied Research Center of Arkansas

Little Rock, Arkansas, United States, 72212

United States, Florida

Study Protocol, Inc.,

Boynton Beach, Florida, United States, 33437

Skin Research Institute

Coral Gables, Florida, United States, 33146

ASCLEPES Research Center

Spring Hill, Florida, United States, 34609

Olympian Clinical Research

Tampa, Florida, United States, 33609

United States, Illinois

Summit Dermatology

Oakbrook Terrace, Illinois, United States, 60181

United States, Michigan

Clarkston Skin Research

Clarkston, Michigan, United States, 48346

United States, Missouri

St Louis Children's Hospital

Saint Louis, Missouri, United States, 63104

United States, Nebraska

Midwest Children's Hospital

Lincoln, Nebraska, United States, 68522

United States, New York

Kings County Hospital

Brooklyn, New York, United States, 11203

United States, North Carolina

University North Carolina Dermatology Center

Chapel Hill, North Carolina, United States, 27516

United States, Ohio

The Pediatric Associates of Fairfield, Inc

Fairfield, Ohio, United States, 45014

United States, Tennessee

Holston Medical Group

Bristol, Tennessee, United States, 37620

United States, Texas

Arlington Research Center

Arlington, Texas, United States, 66011

Center for Skin Research

Houston, Texas, United States, 77056

ACRC Trials Plano Pediatrics

Plano, Texas, United States, 75093

Sponsors and Collaborators

Verrica Pharmaceuticals Inc.

Instat Consulting, Inc.

Paidion Research, Inc.

Database Integrations, Inc.

Investigators

• Principal Investigator: Lawrence Eichenfield, MD; Rady Children's Hospital; San Diego, California

  Study Documents (Full-Text)

Documents provided by Verrica Pharmaceuticals Inc.:

Study Protocol  [PDF] February 1, 2018

Statistical Analysis Plan  [PDF] February 1, 2018

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Eichenfield LF, Kwong P, Gonzalez ME, Yan A, D'Arnaud P, Burnett P, Olivadoti M. Safety and Efficacy of VP-102 (Cantharidin, 0.7% w/v) in Molluscum Contagiosum by Body Region: Post hoc Pooled Analyses from Two Phase III Randomized Trials. J Clin Aesthet Dermatol. 2021 Oct;14(10):42-47.

Eichenfield LF, Siegfried E, Kwong P, McBride M, Rieger J, Glover D, Willson C, Davidson M, Burnett P, Olivadoti M. Pooled Results of Two Randomized Phase III Trials Evaluating VP-102, a Drug-Device Combination Product Containing Cantharidin 0.7% (w/v) for the Treatment of Molluscum Contagiosum. Am J Clin Dermatol. 2021 Mar;22(2):257-265. doi: 10.1007/s40257-020-00570-8. Epub 2021 Feb 18.

Eichenfield LF, McFalda W, Brabec B, Siegfried E, Kwong P, McBride M, Rieger J, Willson C, Davidson M, Burnett P. Safety and Efficacy of VP-102, a Proprietary, Drug-Device Combination Product Containing Cantharidin, 0.7% (w/v), in Children and Adults With Molluscum Contagiosum: Two Phase 3 Randomized Clinical Trials. JAMA Dermatol. 2020 Dec 1;156(12):1315-1323. doi: 10.1001/jamadermatol.2020.3238.

• Responsible Party: Verrica Pharmaceuticals Inc.
• ClinicalTrials.gov Identifier: NCT03377790
• Other Study ID Numbers: VP-102-101
• First Posted: December 19, 2017
• Results First Posted: December 14, 2021
• Last Update Posted: January 11, 2022
• Last Verified: December 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: Yes
• Device Product Not Approved or Cleared by U.S. FDA: Yes

Keywords provided by Verrica Pharmaceuticals Inc.:

Molluscum; Skin Diseases; Poxviridae Infections; Skin Diseases; Infectious; Skin Diseases; Viral; DNA Poxvirus

Additional relevant MeSH terms:

Molluscum Contagiosum; Poxviridae Infections; DNA Virus Infections; Virus Diseases; Infections; Skin Diseases, Viral; Skin Diseases, Infectious; Skin Diseases; Pharmaceutical Solutions; Cantharidin; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action