UMIN-CTR Clinical Trial

Public title

Study of 5-aminolevulinic acid ointment and 410 nm LED photodynamic therapy for treatment of skin ulcers infected with methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, or both bacteria

Acronym

ALA-PDT for ulcers infected with MRSA or Pseudomonas aeruginosa

Scientific Title

Study of 5-aminolevulinic acid ointment and 410 nm LED photodynamic therapy for treatment of skin ulcers infected with methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, or both bacteria

Scientific Title:Acronym

ALA-PDT for ulcers infected with MRSA or Pseudomonas aeruginosa

Region

Japan

Condition

Skin ulcers infected with methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, or both bacteria.

Classification by specialty

Dermatology

Classification by malignancy

Others

Genomic information

NO

Narrative objectives1

In patients who have skin ulcers infected by MRSA, Pseudomonas aeruginosa, or both bacteria, treatment with 5-aminolevulinic acid (ALA) ointment and 410 nm LED photodynamic therapy will be conducted to evaluate its efficacy and safety.

Basic objectives2

Safety,Efficacy

Basic objectives -Others

Trial characteristics_1

Trial characteristics_2

Developmental phase

Primary outcomes

Overall assessment of safety will be conducted on the basis of laboratory test results and adverse events, and a rating will be assigned on the following 4-item scale:
1. Completely safe, 2. Almost safe, 3. Possibly unsafe, 4. Unsafe
Assessment of clinical data and lesion photographs will be performed independently by 3 dermatologists in a blinded manner. If the 3 dermatologists do not agree about an assessment, it will be determined through deliberation. If the rating is 1 or 2 above in more over 80% of the patients, it will be concluded that the treatment is safe.

Key secondary outcomes

1) clinical assessment of ulcers
the following assessment will be conducted at initiation of treatment and every week after initiation. a scale and a color assessment sticker will be placed near each ulcer and photographs will be obtained under the same conditions each time.
･ulcer area (mm2): longer diameter x shorter diameter.･ulcer depth (mm): the deepest site will be measured.
･granulation:･extent of good granulation: ･formation of new epidermis: ･serous secretions: ･purulent secretions:･color of pus:･necrotic tissue: ･severity of infection:
2) bacterial testing
identification of bacterial strains in the ulcers and determination of the colony count will be performed before treatment, in weeks 2 and 4 of treatment, and at the end of treatment. this should also be done in weeks 1 and 3, if possible.
3) improvement of symptoms
improvement of each symptom versus the severity at initiation of treatment will be assessed by using the following 5-item scale:
1. markedly improved, 2. moderately improved, 3. slightly improved, 4. no change, 5. worse
assessment of clinical data and lesion photographs will be performed independently by 3 dermatologists in a blinded manner.
4) assessment of overall efficacy
assessment will be done by using the following 5-item scale:
1. very effective, 2. effective, 3. slightly effective, 4. not effective, 5. worse
assessment of clinical data and lesion photographs will be performed independently by 3 dermatologists in a blinded manner.
5) assessment of usefulness
based on the results for overall efficacy and overall safety, usefulness will be assessed by employing the following 5-item scale:
assessment of data and photographs will be conducted independently by 3 dermatologists.
1. very useful, 2. useful, 3. slightly useful, 4. not useful, 5. harmful
assessment of clinical data and lesion photographs will be performed independently by 3 dermatologists in a blinded manner.

Study type

Interventional

Basic design

Single arm

Randomization

Non-randomized

Randomization unit

Blinding

Open -no one is blinded

Control

Uncontrolled

Stratification

Dynamic allocation

Institution consideration

Blocking

Concealment

No. of arms

1

Purpose of intervention

Treatment

Type of intervention

Medicine	Device,equipment	Maneuver

Interventions/Control_1

Patients will receive treatment with ALA ointment and 410 nm LED photodynamic therapy for skin ulcers infected by MRSA, Pseudomonas aeruginosa, or both bacteria.

Interventions/Control_2

Interventions/Control_3

Interventions/Control_4

Interventions/Control_5

Interventions/Control_6

Interventions/Control_7

Interventions/Control_8

Interventions/Control_9

Interventions/Control_10

Age-lower limit

20

years-old

<=

Age-upper limit

Not applicable

Gender

Male and Female

Key inclusion criteria

Patients who meet all of the following criteria will be eligible for the study.
1) Patients who have a skin ulcer infected with MRSA, Pseudomonas aeruginosa, or both bacteria.
2) Patients aged 20 years or older at the time of giving informed consent.
3) Patients who have bedsores, burn ulcers, or lower limb ulcers with the longer diameter greater than 20 mm and less than or equal to 120 mm.
Each patient should have one ulcer as the study lesion. If a patient has multiple ulcers, one that is considered suitable for this study should be selected and the reason for selection should be recorded.
4) Patients who need hospitalization for treatment of the study lesion.

Key exclusion criteria

Patients who meet any of the following criteria will be excluded from the study.
1) Patients with a history of hypersensitivity to ALA ointment or porphyrin.
2) Patients with porphyria.
3) Patients who are using or are expected to receive any of the following drugs known to induce photosensitivity: tetracyclines, sulfonamides, new quinolone, hypericin (Hypericum perforatum extract, etc.), and foods containing Hypericum perforatum (St. John's Wort).
4) Pregnant women, nursing women, and women who plan to become pregnant during the study period.
5) Patients who have received oral or IV antibiotics within 14 days prior to treatment initiation.
6) Patients who are expected to receive antibiotics for greater than 7 days during hospitalization.
In addition, patients who are considered unsuitable for this study by the investigator or subinvestigator (doctor) should be excluded.

Target sample size

12

Name of lead principal investigator

1st name
Middle name
Last name	Toshiyuki Ozawa

Organization

Osaka city university hospital

Division name

Department of dermatorogy

Zip code

Address

545-8586 1-4-3asahi-machi ,abeno-ku,osaka city,osaka,Japan

TEL

06-6645-3826

Email

aaa@aaa

Name of contact person

1st name
Middle name
Last name	Toshiyuki Ozawa

Organization

Osaka city university hospital

Division name

Department of dermatorogy

Zip code

Address

545-8586 1-4-3asahi-machi ,abeno-ku,osaka city,osaka,Japan

TEL

06-6645-3826

Homepage URL

http://www.med.osaka-cu.ac.jp/Derma/

Email

aaa@aaa

Institute

Osaka City University Graduate school of Medicine

Institute

Department

Personal name

Organization

Osaka City University Graduate school of Medicine

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization

Co-sponsor

Name of secondary funder(s)

Organization

Address

Tel

Email

Secondary IDs

NO

Study ID_1

Org. issuing International ID_1

Study ID_2

Org. issuing International ID_2

IND to MHLW

Institutions

Date of disclosure of the study information

2018

Year

03

Month

14

Day

URL releasing protocol

Publication of results

Unpublished

URL related to results and publications

Number of participants that the trial has enrolled

Results

Results date posted

Results Delayed

Results Delay Reason

Date of the first journal publication of results

Baseline Characteristics

Participant flow

Adverse events

Outcome measures

Plan to share IPD

IPD sharing Plan description

Recruitment status

Open public recruiting

Date of protocol fixation

2018

Year

01

Month

30

Day

Date of IRB

Anticipated trial start date

2018

Year

03

Month

14

Day

Last follow-up date

Date of closure to data entry

Date trial data considered complete

Date analysis concluded

Other related information

Registered date

2018

Year

03

Month

14

Day

Last modified on

2018

Year

03

Month

14

Day

Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036086