Efficacy of different photoprotection strategies in preventing actinic keratosis recurrence after photodynamic therapy

ISRCTN ISRCTN16168548
DOI https://doi.org/10.1186/ISRCTN16168548
Secondary identifying numbers ACTX-01-2017
Submission date
07/05/2018
Registration date
21/05/2018
Last edited
28/04/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Skin and Connective Tissue Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Actinic keratosis (AK) is a common pre-cancer (with increased risk of developing into cancer) skin change that is caused by due to sun exposure over many years with no sun protection. AK appears as patches of thick, scaly, or crusty skin that feel rough or dry. Several treatments are available for this skin condition. Photodynamic therapy (PDT) using a photosensitizer (a drug that is activated only in the areas of AK using a special type of light), can cure AK patches. After PDT has cleared the AK, patients must protect their skin from the sun to prevent AK coming back. In this study (called ATHENA), we want to test a cream containing sunscreen and piroxicam (a drug that can reduce the risk of skin cancer) in comparison to standard sunscreen-only products in preventing AK coming back after PDT.

Who can participate?
Adults who have at least 6 patches of AK on their scalp or face.

What does the study involve?
All patients will be treated with PDT. They will be randomly allocated to apply to either sunscreen alone or sunscreen containing piroxicam to the affected area twice daily for 6 days.

What are the possible benefits and risks of participating?
If the piroxicam-containing sunscreen is more effective than sunscreen alone in preventing AK coming back, then the participants in this group will benefit from a reduced need for PDT, which can be time-consuming and painful. The standard prevention is to use sunscreen, so participants in the sunscreen-only group will not receive worse treatment than if they were not in the study. There is no increased risk of side effects for the sunscreen containing piroxicam.

Where is the study run from?
Erba-Rinaldi Hospital and DermoLaser Office Verona.

When is the study starting and how long is it expected to run for?
March 2017 to April 2018

Who is funding the study?
The study is funded by Cantabria Labs Difa Cooper, the company that makes the sunscreen containing piroxicam.

Who is the main contact?
Dr Massimo Milani, massimo.milani@difacooper.com

Contact information

Dr Massimo Milani
Public

Via Milano 160
Caronno Pertusella
21042
Italy

ORCiD logoORCID ID 0000-0001-7559-1202
Phone +39029659031
Email massimo.milani@difacooper.com

Study information

Study designPragmatic randomized open-label assessor-masked trial
Primary study designInterventional
Secondary study designRandomised parallel trial
Study setting(s)GP practice
Study typePrevention
Participant information sheet No participant information sheet available
Scientific titleThe ATHENA Trial: Actixicam after photo-dynamic therapy for multiple actinic keratosis lesions. A randomized open-label assessor-masked outcome evaluation superiority trial vs. standard care in actinic keratosis subjects after phtotodynamic therapies
Study acronymATHENA
Study objectivesAfter photodynamic therapy (PDT) for multiple actinic keratosis (AK), lesion photoprotection strategies (i.e. use of sunscreen) is mandatory in order to reduce actinic damage and recurrence of new lesions. Recurrence of new AK lesions after PDT are common after 6-9 months after PDT. A sunscreen cream (SPF50+) containing piroxicam 0.8% has shown to be effective in reducing AK lesions as a monotherapy. There are no data comparing different photoprotection strategies (i.e sunscreen only, sunscreen with photolyase etc) comparing the efficacy in reducing AK recurrence after PDT. In this study, we wanted to assess if the use of SPF50+ and piroxicam cream could be more effective than standard photoprotection in reducing recurrence of AK after successful PDT.
Ethics approval(s)IRB Dermolaser Clinic, Verona, Italy, 15/01/2017, RS: 01-DLC-17
Health condition(s) or problem(s) studiedActinic keratosis recurrence after photodynamic therapy
InterventionRandomization was performed using a randomization list with an allocation ratio of 1:1.
Actixicam: sunscreen SPF50+ and piroxicam 0.8% cream formulation, applied twice daily 0.5 g (1 finger tip unit) per application for 6 consecutive days after successful PDT
Sunscreen: sunscreen cream (SPF50+ or SPF100+ and photolyase) applied twice daily 0.5 g (1 finger tip unit) per application for 6 consecutive days after successful PDT
Intervention typeDrug
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)Piroxicam
Primary outcome measureClinical count (assessor masked for allocation treatments) of actinic keratosis lesions 6 months after last PDT session
Secondary outcome measuresLocal tolerability (patient’s self-reported complaints e.g. burning, itching etc) will be evaluated at visit 2 (1 month after baseline visit), at visit 2 (3 months after baseline) and at visit 3 (6 months after baseline)
Overall study start date01/12/2016
Completion date25/04/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants64 evaluable subject
Total final enrolment68
Key inclusion criteria1. At least 6 AK lesions (scalp or face) suitable for PDT treatment
2. Aged >18 years
3. Willing to participate in the trial (giving written informed consent)
Key exclusion criteria1. Other acute skin diseases other than AK
2. Known allergy to one of the components of products used in the trial
Date of first enrolment01/03/2017
Date of final enrolment30/09/2017

Locations

Countries of recruitment

  • Italy

Study participating centres

Erba-Rinaldi Hospital
Dermatology Unit
Erba-Rinaldi Hospital
Via Casartelli Menaggio
Menaggio
20126
Italy
DermoLaser Office Verona
Piazza Cittadella
Verona
10090
Italy

Sponsor information

Cantabria Labs Difa Cooper
Industry

Via Milano 160
Caronno Pertusella
21042
Italy

Phone +39029659031
Email massimo.milani@difacooper.com
ROR logo "ROR" https://ror.org/044sr7e96

Funders

Funder type

Not defined

Cantabria Labs Difa Cooper

No information available

Results and Publications

Intention to publish date25/04/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planThe datasets generated and/or analysed during the current study during this study will be included in the subsequent results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/01/2019 28/04/2020 Yes No

Editorial Notes

28/04/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.