A Phase 3 interventional study of Generic Azelaic Acid Foam and Finacea® (Azelaic Acid) Foam in Rosacea, sponsored by Actavis Inc.. Completed at 26 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-07-31.
Sponsored by Actavis Inc. · Phase 3, Interventional, and Treatment
The objectives of this study were to compare the safety and efficacy profiles of a generic Azelaic Acid Foam, 15% to the reference listed Finacea® (azelaic acid) Foam, 15% and to demonstrate therapeutic equivalence and safety of the two active foams in the treatment of moderate facial rosacea, and to demonstrate superiority of the Reference and Test products over the Vehicle.
Topical azelaic acid is used to treat inflammatory papules and pustules of mild to moderate rosacea. Other topical therapies and oral antibiotics are also used to treat rosacea symptoms. Finacea® (azelaic acid) Foam, 15% contains azelaic acid, a naturally occurring saturated dicarboxylic acid that has proven anti-inflammatory effects, as well as anti-keratinizing and antimicrobial actions.
Exclusion Criteria:
The use within 1 month prior to baseline of the following:
Use within two weeks prior to baseline of the following:
A thin layer of generic azelaic acid, 15% topical foam was to be gently massaged into the entire facial area twice daily, once in the morning and once in the evening, for 12 weeks. Contact with the mouth, eyes, and other mucous membranes was to be avoided. Hands were to be washed following application of study drug. Participants were instructed not to bathe, shower, wash, or swim for at least 4 hours after application of study drug. Participants were provided with mild cleanser, a towel, sunscreen, and moisturizing lotion to be used on treated areas while participating in the study.
Drug: Generic Azelaic Acid Foam · Other: Cleanser · Other: Sunscreen · Other: Towel · Other: Moisturizing Lotion
A thin layer of Finacea (azelaic acid), 15% topical foam was to be gently massaged into the entire facial area twice daily, once in the morning and once in the evening, for 12 weeks. Contact with the mouth, eyes, and other mucous membranes was to be avoided. Hands were to be washed following application of study drug. Participants were instructed not to bathe, shower, wash, or swim for at least 4 hours after application of study drug. Participants were provided with mild cleanser, a towel, sunscreen, and moisturizing lotion to be used on treated areas while participating in the study.
Drug: Finacea® (Azelaic Acid) Foam · Other: Cleanser · Other: Sunscreen · Other: Towel · Other: Moisturizing Lotion
A thin layer of the vehicle topical foam was to be gently massaged into the entire facial area twice daily, once in the morning and once in the evening, for 12 weeks. Contact with the mouth, eyes, and other mucous membranes was to be avoided. Hands were to be washed following application of study drug. Participants were instructed not to bathe, shower, wash, or swim for at least 4 hours after application of study drug. Participants were provided with mild cleanser, a towel, sunscreen, and moisturizing lotion to be used on treated areas while participating in the study.
Drug: Vehicle Foam · Other: Cleanser · Other: Sunscreen · Other: Towel · Other: Moisturizing Lotion
Topical foam, generic formulation of the brand product.
Topical foam, brand product.
Topical foam, placebo. Has no active ingredient.
A mild cleanser provided to participants, so they can wash their face prior to applying the study drug.
Sunscreen provided to participants, so they can apply it to their face when outdoors.
A soft towel provided to participants, so they can pat their face dry after washing and prior to applying the study drug.
Moisturizing lotion provided to participants, so they can apply it to their face, as needed.
Percent Change From Baseline in the Inflammatory Lesions (Papules and Pustules) Counts at Week 12
All facial papules, pustules, and nodules, located above the jaw line and extending to the hairline, were counted. When counting facial lesions, lesions present on the nose were included. The total count for each lesion type was recorded and the total number of inflammatory lesions (papules and pustules) were calculated. A papule with a pustule on its apex was counted as a pustule. Counts of nodules and cysts were reported separately and not included in the inflammatory counts. Papule defined as inflammatory lesion; small (≤5 mm in diameter), solid palpable lesion, usually with inflamed elevation of the skin that does not contain pus. Pustule defined as inflammatory lesion; small (≤5 mm in diameter), inflamed skin swelling that is filled with pus. Cyst and nodule defined as palpable solid or soft lesion \>5 mm in diameter.
Time frame: Baseline, 12 weeks
Percentage of Participants With Treatment Success Based on IGE Score
Treatment success defined as an Investigator's Global Evaluation (IGE) score at Week 12 of 0 (clear) or 1 (almost clear). Any other outcome was considered a failure. Participants who were discontinued prematurely from the study due to lack of treatment effect after at least 8 weeks of compliant treatment were considered as treatment failures. The IGE score was based on a 5-point scale ranging from 0 to 4 (0=clear, 1=almost clear, 2=mild, 3=moderate, and 4=severe).
Time frame: Baseline and 12 Weeks
The populations for this study included the Safety Population, the modified Intent-to-Treat (mITT) population, and the Per-Protocol (PP) Population.
| Milestone | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam |
|---|---|---|---|
| Started | 312 | 312 | 300 |
| Safety population | 306 | 297 | 291 |
| Mitt population | 291 | 291 | 283 |
| Pp population | 262 | 259 | 245 |
| Completed | 280 | 276 | 264 |
| Not completed | 32 | 36 | 36 |
| Withdrew: Insufficient therapeutic response | 0 | 0 | 1 |
| Withdrew: Adverse event | 0 | 4 | 3 |
| Withdrew: Withdrawal by subject | 12 | 12 | 17 |
| Withdrew: Missed more than 6 consecutive doses | 3 | 2 | 2 |
| Withdrew: Lost to follow-up | 8 | 14 | 11 |
| Withdrew: Protocol violation | 7 | 2 | 1 |
| Withdrew: Participant was enrolled at 2 sites | 1 | 0 | 1 |
| Withdrew: Too much time between 2 visits | 0 | 1 | 0 |
| Withdrew: Non-compliance | 0 | 1 | 0 |
| Withdrew: Did not meet inclusion criteria | 1 | 0 | 0 |
All facial papules, pustules, and nodules, located above the jaw line and extending to the hairline, were counted. When counting facial lesions, lesions present on the nose were included. The total count for each lesion type was recorded and the total number of inflammatory lesions (papules and pustules) were calculated. A papule with a pustule on its apex was counted as a pustule. Counts of nodules and cysts were reported separately and not included in the inflammatory counts. Papule defined as inflammatory lesion; small (≤5 mm in diameter), solid palpable lesion, usually with inflamed elevation of the skin that does not contain pus. Pustule defined as inflammatory lesion; small (≤5 mm in diameter), inflamed skin swelling that is filled with pus. Cyst and nodule defined as palpable solid or soft lesion \>5 mm in diameter.
| percent change | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam |
|---|---|---|---|
| Percent Change From Baseline in the Inflammatory Lesions (Papules and Pustules) Counts at Week 12 | -64.28 ± 25.050 | -65.15 ± 26.419 | -57.84 ± 30.626 |
Treatment success defined as an Investigator's Global Evaluation (IGE) score at Week 12 of 0 (clear) or 1 (almost clear). Any other outcome was considered a failure. Participants who were discontinued prematurely from the study due to lack of treatment effect after at least 8 weeks of compliant treatment were considered as treatment failures. The IGE score was based on a 5-point scale ranging from 0 to 4 (0=clear, 1=almost clear, 2=mild, 3=moderate, and 4=severe).
| percentage of participants | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam |
|---|---|---|---|
| Percentage of Participants With Treatment Success Based on IGE Score | 39.7 | 48.3 | 33.5 |
Collected over Baseline up to Day 84. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Generic Azelaic Acid Foam | 0/306 (0%) | 0/306 (0%) | 129/306 (42.2%) |
| Finacea (Azelaic Acid) Foam | 0/297 (0%) | 2/297 (0.7%) | 128/297 (43.1%) |
| Vehicle Foam | 0/291 (0%) | 1/291 (0.3%) | 125/291 (43%) |
| Event | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam |
|---|---|---|---|
| HypocalcaemiaEndocrine disorders | 0/306 | 0/297 | 1/291 |
| Prostate cancerRenal and urinary disorders | 0/306 | 1/297 | 0/291 |
| CellulitisImmune system disorders | 0/306 | 1/297 | 0/291 |
| Event | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam |
|---|---|---|---|
| Application site drynessGeneral disorders | 45/306 | 29/297 | 52/291 |
| Application site pruritusGeneral disorders | 51/306 | 43/297 | 28/291 |
| Application site painGeneral disorders | 47/306 | 41/297 | 28/291 |
| Application site erythemaGeneral disorders | 30/306 | 28/297 | 34/291 |
| Application site reactionGeneral disorders | 22/306 | 19/297 | 20/291 |
| HeadacheNervous system disorders | 15/306 | 9/297 | 12/291 |
| Application site swellingGeneral disorders | 2/306 | 6/297 | 8/291 |
| InfluenzaInfections and infestations | 6/306 | 0/297 | 2/291 |
| Application site oedemaGeneral disorders | 3/306 | 4/297 | 5/291 |
| SinusitisInfections and infestations | 1/306 | 5/297 | 0/291 |
Randomized participants with evidence in diary card of using ≥1 dose of study drug (Safety Population).
| Age, Continuous(years) | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam | Total |
|---|---|---|---|---|
| Mean | 51.6 ± 14.20 | 52.3 ± 15.14 | 51.0 ± 15.09 | 51.6 ± 14.80 |
| Sex: Female, Male(Participants) | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam | Total |
|---|---|---|---|---|
| Female | 212 | 220 | 204 | 636 |
| Male | 94 | 77 | 87 | 258 |
| Ethnicity (NIH/OMB)(Participants) | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam | Total |
|---|---|---|---|---|
| Hispanic or Latino | 185 | 177 | 180 | 542 |
| Not Hispanic or Latino | 121 | 120 | 111 | 352 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 |
| Asian | 0 | 1 | 0 | 1 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 4 | 4 | 3 | 11 |
| White | 302 | 292 | 288 | 882 |
| More than one race | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| Inflammatory Lesion Count(inflammatory lesions) | Generic Azelaic Acid Foam | Finacea (Azelaic Acid) Foam | Vehicle Foam | Total |
|---|---|---|---|---|
| Mean | 17.1 ± 8.85 | 16.7 ± 7.88 | 17.7 ± 8.88 | 17.1 ± 8.55 |
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Actavis Inc.