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A Study to Examine the Safety and Efficacy of Drospirenone and Ethinyl Estradiol (YAZ) Compared With Placebo In The Treatment Of Hidradenitis Suppurativa
This study is currently recruiting participants.
Verified by Massachusetts General Hospital, March 2009
First Received: July 24, 2008   Last Updated: March 17, 2009   History of Changes
Sponsors and Collaborators: Massachusetts General Hospital
Bayer
Information provided by: Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT00722800
  Purpose

The purpose of this study is to find out if taking a birth control pill, YAZ, is safe and effective for treating hidradenitis suppurativa. Hidradenitis suppurativa (HS) is a chronic (long lasting) skin disorder that mostly affects the armpits and groin area. It appears as blackheads and one or more red, tender bumps that may enlarge, break open, and drain pus. Scarring may result after several attacks of the disease.

The exact cause of HS isn't known. However, it is believed that the plugging of hair follicles and bacterial infection that occur in acne also occur in HS. Many of the medications used for treating acne are also used for HS. However, none of the medications are consistently effective.

YAZ is a combination birth control pill. Nearly all birth control pills are made up of a combination of estrogen and progestin hormones. YAZ contains ethinyl estradiol (an estrogen) and drospirenone (a progestin). People who develop acne have sebaceous glands that are over-stimulated by male sex hormones (androgens). Sebaceous glands secrete an oily substance into a hair follicle to lubricate hair or skin. The progestin in YAZ actually blocks the male sex hormones (androgens) that cause acne. Hormones seem to play a role in HS as the condition occurs after puberty. It affects more women than men and HS often gets worse around the time a women has her menstrual period.

YAZ has been approved by the U.S. Food and Drug Administration (FDA) to treat moderate acne in women who desire an oral contraceptive for birth control.

This study uses a placebo. A placebo looks like the study drug but contains no active drug. We use placebos in research studies to learn if the effects seen in research subjects are truly from the study drug or from other reasons.


Condition Intervention Phase
Hidradenitis Suppurativa
Drug: drospirenone and ethinyl estradiol (YAZ)
Drug: Placebo
Phase II

MedlinePlus related topics: Acne Hidradenitis Suppurativa
Drug Information available for: Estradiol Estradiol 3-benzoate Ethinyl estradiol Polyestradiol phosphate Depogen 1,2-Dihydrospirorenone Estradiol dipropionate Estradiol cypionate Estradiol valerate Estradiol acetate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Single-Center, Randomized Double-Blind, Parallel-Group Study to Examine the Safety and Efficacy of YAZ Compared With Placebo In The Treatment Of Hidradenitis Suppurativa

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Mean improvement in the Sartorius severity score at Month 6. [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Additional efficacy evaluations through Month 6 will include the Dermatology Life Quality Index (DLQI) scores, and improvement in Visual Analogue Scale (VAS) scores. Safety evaluations will be conducted through Month 6. [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: July 2008
Estimated Study Completion Date: July 2010
Estimated Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental
drospirenone and ethinyl estradiol
Drug: drospirenone and ethinyl estradiol (YAZ)
1 tablet daily for 24 weeks
B: Placebo Comparator
Placebo
Drug: Placebo
1 tablet daily for 24 weeks

Detailed Description:

Hidradenitis suppurativa is a chronic suppurative and scarring disease primarily affecting the axillae and inguinal and perineal areas. The apocrine glands are the primary targets. It is characterized by firm, tender red nodules that soon become fluctuant and painful. Rupture of the lesion, suppuration, formation of sinus tracts and scarring may occur. The exact etiology of HS remains obscure. Proposed etiologic factors include follicular occlusion and bacterial infection, genetics, host defense defects, hormones, cigarette smoking, and irritants. Hormones seem to play a role, as the condition occurs after puberty, affects more women than men, and often flares in the perimenstrual period. Treating hidradenitis remains a challenge. Although many patients benefit from long-term treatment with systemic antibiotics (eg, tetracycline, minocycline, clindamycin, erythromycin in combination with metronidazole), no published evidence suggests that the long-term use of antibiotics alters the natural course of HS. Oral isotretinoin has been used, but is effective only in some cases. Some patients have had a beneficial response to biological agents, especially anti-TNF alpha biologicals such as infliximab. Oral contraceptives containing norgestrel or cyproterone acetate, alone or in combination with supplemental cyproterone acetate, spironolactone or dexamethasone (to block adrenal androgen production), have been shown to reduce the frequency and severity of attacks in women. YAZ is an oral contraceptive that is FDA approved for acne vulgaris. Unlike other progestins, drospirenone has unique antimineralocorticoid (mild diuretic effect) and antiandrogenic properties. The antiandrogenic property of drospirenone means that it blocks the male sex hormones that can cause acne. It is hoped that that YAZ will offer patients with hidradenitis suppurativa a safe and effective therapeutic option.

Subjects will be assigned to a treatment group upon randomization. Bayer HealthCare Pharmaceuticals personnel, investigators, subjects and study nurse/coordinators will be blinded to the study product treatment assignment. The study duration will be 24 weeks with visits at screening, baseline (week 0), week 6, week 12, week 18, and week 24. Lesion counts (total, inflammatory, non-inflammatory) and an ISGA, and photography will be performed on every visit. A physical examination will be done at baseline and Week 24. Safety will be assessed from reported adverse events (AEs).

  Eligibility

Ages Eligible for Study:   14 Years to 45 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

INCLUSION CRITERIA

  1. Female Subjects 14-45 years of age who have achieved spontaneous menarche.
  2. Clinical diagnosis of hidradenitis suppurativa of stage II or greater on the Hurley scale.
  3. Willing and able to understand and sign informed consent.
  4. Able to complete study and comply with study procedures.

EXCLUSION CRITERIA

  1. Change is use of oral or topical antibiotics in past 90 days.
  2. Use of intralesional steroids within 30 days.
  3. Use of isotretinoin in past six months.
  4. Use of biologics such as Infliximab (Remicade®) or Etanercept (Enbrel®) within the past 3 months or 5 half lives (whichever is shorter).
  5. History of renal insufficiency
  6. History of hepatic dysfunction
  7. History of adrenal Insufficiency
  8. History of vascular or metabolic disease including existing or previous arterial thromboembolic diseases (myocardial infarction, stroke), existing or previous venous thromboembolic diseases (deep vein thrombosis, pulmonary embolism), and any condition which could increase the risk to suffer any of the above mentioned disorders
  9. History of hypertension
  10. History of Diabetes mellitus with vascular involvement
  11. Migraine headaches with focal neurological symptoms
  12. Major surgery with prolonged immobilization
  13. Known or suspected carcinoma of the breast
  14. History of Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
  15. Undiagnosed abnormal genital bleeding
  16. Cholestatic jaundice of pregnancy or jaundice with prior pill use
  17. History of Liver tumor (benign or malignant) or active liver disease
  18. Smokers
  19. Regular intake of medications that may increase potassium levels such as NSAIDS, potassium sparing diuretics, potassium supplementation, ACE inhibitors, Angiotensin-II receptor antagonists, heparin and aldosterone antagonists.
  20. Hypersensitivity to any component of the study drug
  21. Clinically significant abnormal findings or conditions (other than acne), which might, in the opinion of the Principal Investigator, interfere with study evaluations or pose a risk to subject safety during the study.
  22. Subjects who are known to be pregnant or planning a pregnancy.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00722800

Contacts
Contact: Lynne M Hermosilla 617-726-5066 harvardskinstudies@partners.org

Locations
United States, Massachusetts
Clinical Unit for Research Trials in Skin Recruiting
Boston, Massachusetts, United States, 02114
Contact: Lynne M Hermosilla     617-726-5066     harvardskinstudies@partners.org    
Principal Investigator: Alexandra B Kimball, MD, MPH            
Sub-Investigator: Maria B Alora-Palli, MD            
Sponsors and Collaborators
Massachusetts General Hospital
Bayer
Investigators
Principal Investigator: Alexandra B Kimball, MD, MPH Massachusetts General Hospital
  More Information

Additional Information:
No publications provided

Responsible Party: Massachusetts General Hospital ( Alexandra B. Kimball, MD, MPH )
Study ID Numbers: 20080p-000843
Study First Received: July 24, 2008
Last Updated: March 17, 2009
ClinicalTrials.gov Identifier: NCT00722800     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Massachusetts General Hospital:
YAZ
oral contraceptive
hidradenitis suppurativa

Study placed in the following topic categories:
Bacterial Infections
Estrogens
Skin Diseases
Contraceptive Agents
Hormone Antagonists
Estradiol valerate
Contraceptives, Oral
Hormones, Hormone Substitutes, and Hormone Antagonists
Ethinyl Estradiol
Hidradenitis
Estradiol 17 beta-cypionate
Hormones
Hidradenitis Suppurativa
Estradiol
Skin Diseases, Infectious
Aldosterone Antagonists
Skin Diseases, Bacterial
Estradiol 3-benzoate
Drospirenone
Suppuration
Polyestradiol phosphate

Additional relevant MeSH terms:
Bacterial Infections
Estrogens
Skin Diseases
Hormone Antagonists
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Ethinyl Estradiol
Hidradenitis
Infection
Hormones
Hidradenitis Suppurativa
Pharmacologic Actions
Estradiol
Skin Diseases, Infectious
Aldosterone Antagonists
Skin Diseases, Bacterial
Drospirenone
Suppuration
Sweat Gland Diseases

ClinicalTrials.gov processed this record on May 07, 2009