ClinicalTrials.gg
CompletedNCT04549792Updated Feb 12, 2025Results posted

An Open-Label and Long-Term Extension Study to Evaluate the Efficacy and Safety of Ustekinumab in the Treatment of Patients With Ichthyoses

An Early Phase 1 interventional study of Ustekinumab in Ichthyosis, sponsored by Northwestern University. Completed at 1 site in United States. Open to participants aged 6 Years and older. Per ClinicalTrials.gov, last updated 2025-02-12.

Sponsored by Northwestern University · Early Phase 1, Interventional, and Treatment

Phase
Early Phase 1
Study type
Interventional
Enrollment
13
Allocation
Not applicable
Ages
6 Years and older
Sex
All
01

Study summary

The ichthyoses are a group of lifelong genetic disorders that share characteristics of generalized skin thickening, scaling and underlying cutaneous inflammation. The vast majority are orphan disorders and are associated with extremely poor quality of life related to social ostracism from altered appearance, associated itchiness and discomfort, and functional limitations from the skin disease. Among the more common "orphan" forms of ichthyosis are autosomal recessive congenital ichthyosis (ARCI; includes lamellar ichthyosis/LI and congenital ichthyosiform erythroderma/CIE), Netherton syndrome (NS) and epidermolytic ichthyosis (EI). However, there are dozens of other syndromic and non-syndromic ichthyotic disorders as well. Therapy is time-consuming for patients or parents and is supportive, focusing on clearance of the scaling. There are no therapies based on our growing understanding of what causes the disease. We have recently found marked elevations in Th17/IL-23 pathway cytokines and chemokines in the skin of individuals with ichthyosis, most similar to the inflammatory pattern of psoriasis. While the significance of the high expression of Th17/IL-23 pathway genes across all forms of ichthyosis studied to date is unknown, the high expression of genes of the Th17/IL-23 pathway in psoriasis is thought to be causative for the disease manifestations. We propose that IL-12/IL-23 -targeting therapeutics will safely suppress the inflammation and possibly the other features of ichthyosis, improving quality of life. As a proof-of-concept study, we propose to treat children (6 years of age and higher) and adults with ichthyotic disorders with ustekinumab in an open-label trial to serially assess clinical response to and safety of ustekinumab for this group of disorders.

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Conditions studied

  • Ichthyosis

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03

In context

Ichthyosis

33 studies on the registry are indexed under Ichthyosis; 11 are open to participants now.

This study's enrollment of 13 is below the median of 26 across 23 interventional studies indexed under Ichthyosis.

Browse Ichthyosis studies →

Lead sponsor

Northwestern University is the lead sponsor of 1,423 studies on the registry; 198 are open to participants now.

Of its 105 completed or terminated interventional studies of FDA-regulated products, 78 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
6 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Subject has provided ; parental consent for patients under 18 years of age (plus assent for subjects age ≥ 12 and \< 18).
  • Subjects are at least 6 years of age or older at the time of screening.
  • Before screening visit, females must be:

    • , defined as

      ≥ 45 years of age with amenorrhea for at least 18 months, OR

    • ≥ 45 years of age with amenorrhea for at least 6 months and a serum FSH level > 40 IU/mL OR
    • Of , in which case she must satisfy at least one of the below:

Surgically sterile (has had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy), or

If heterosexually active, practicing a highly effective method of , including hormonal prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double-barrier method (e.g., condoms, diaphragm, or cervical cap, with spermicidal foam, cream, film, gel or suppository), or male partner sterilization, consistent with local regulations regarding use of birth control methods for subjects participating in clinical trials, for a period of 16 weeks after the last administration of study agent,

OR

Not heterosexually active. Abstinence is allowed as an acceptable form of contraception.

Note: If a woman participant's childbearing potential changes after start of the study (e.g., a premenarchal woman experiences menarche) or if women of childbearing potential who are not heterosexually active at screening become heterosexually active, they must agree to utilize a highly effective method of birth control, as described above.

Female participants of childbearing potential (menstrual and not surgically sterile), must have a negative serum beta-human chorionic gonadotropin (ᵦ-hCG) pregnancy test at screening and a negative urine pregnancy test at Week 0 (prior to screening visit) and agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during the study and for a period of 16 weeks after the last administration of study agent.

  • Male participants who are not surgically sterilized and are heterosexually active with a woman of childbearing potential, must agree to use a barrier method of contraception (e.g., condom with spermicidal foam/gel/film/cream/suppository) and to not donate sperm during the study and for 16 weeks after last receiving study agent. Note that barrier methods must also be used in all male subjects sexually active with pregnant partners for at least 16 weeks after last study agent administration.
  • Subjects must have a confirmed clinical diagnosis of ichthyosis/ichthyotic disorder, and either have completed genotype or be willing to be genotyped (genotype results will not be required for entry into the study).
  • Subjects must have at least moderate erythema (ISS-erythema score ≥ 2) related to his/her ichthyosis/ichthyotic disorder.
  • Subjects must be clinically judged to be immunocompetent based on baseline laboratory testing (chemistry and hematology), medical history and physical examination.
  • Subjects will have baseline negative QuantiFERON®-TB gold, , , and laboratory testing.

Exclusion criteria

Exclusion Criteria:

  • Subjects who are unable to provide or assent (or who do not have consent from a Legally Authorized Representative if \< 18 years).
  • Subjects with ichthyosis vulgaris or X-linked recessive ichthyosis.
  • Subjects who have a known allergy to ustekinumab or its products.
  • Female subjects who are pregnant or breastfeeding, or who are considering becoming pregnant.
  • Subjects who have prior biologic use targeting IL-12/IL-23 monoclonal antibody.
  • Subjects who have used a systemic retinoid or systemic anti-inflammatory agent within 4 weeks prior to baseline.
  • Subjects who have used topical in the previous week, retinoid or keratolytic agent in the previous 24 hours.
  • Subjects with active infections or recent history of serious infections, or history of malignancies, recent immunizations with , or any severe, progressive, or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurologic, psychiatric, or cerebral disease, or signs or symptoms thereof
  • Subjects who are under 6 years of age at the time of screening.
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

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Study design

Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
13 participants (actual)

Study arms

  • Experimental
    Open Label

    Drug: Ustekinumab

Interventions

  • Each subject will receive ustekinumab at Baseline (Day 0) and Months 1, 3, 5, 7, 9, and 11. During the LTE, subjects will receive injections every 8 weeks for one year: Month 13, Month 15, Month 17, Month 19, Month 21, and Month 23. Subjects will come back in for a follow-up visit at Month 25 for an end of study visit (no drug administration).

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What researchers measure

Primary outcomes

  1. Reduction in Total Ichthyosis Severity Score

    To evaluate the efficacy of ustekinumab for ichthyosis, as measured by an at least 50% reduction in severity using the Ichthyosis Severity Score (ISS) measure. The ISS measures from 0-32, with 0 being the least clinically severe and 32 being the most clinically severe.

    Time frame: 7 months after initiation of study drug

  2. Occurence of Bacterial and Fungal Infections

    To evaluate the safety of ustekinumab for ichthyosis, based on occurrence of bacterial and fungal infections

    Time frame: 7 months after initiation of study drug

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Results

Posted Feb 12, 2025

Participant flow

Participant flow — Overall Study
MilestoneOpen Label
Started13
Completed13
Not completed0

Outcome measures

PrimaryReduction in Total Ichthyosis Severity Score

To evaluate the efficacy of ustekinumab for ichthyosis, as measured by an at least 50% reduction in severity using the Ichthyosis Severity Score (ISS) measure. The ISS measures from 0-32, with 0 being the least clinically severe and 32 being the most clinically severe.

Time frame:
7 months after initiation of study drug
Reported as:
Mean · units on a scale
Reduction in Total Ichthyosis Severity Score
units on a scaleOpen Label
Reduction in Total Ichthyosis Severity Score-12.2 ± 29.9
PrimaryOccurence of Bacterial and Fungal Infections

To evaluate the safety of ustekinumab for ichthyosis, based on occurrence of bacterial and fungal infections

Time frame:
7 months after initiation of study drug
Reported as:
Number · infections
Occurence of Bacterial and Fungal Infections
infectionsOpen Label
Superficial skin infections3
Streptococcal throat infection2
Onychomycosis1

Adverse events

Collected over 100 weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Open Label0/13 (0%)2/13 (15.4%)10/13 (76.9%)
Most frequent serious events
Most frequent serious events
EventOpen Label
Hospitalization secondary to sepsisInfections and infestations2/13
Most frequent other events
Showing 10 of 18
Most frequent other events
EventOpen Label
Skin InfectionSkin and subcutaneous tissue disorders4/13
HeadacheGeneral disorders3/13
Viral upper respiratory infectionSkin and subcutaneous tissue disorders3/13
Abdominal painGastrointestinal disorders1/13
AmenorrheaReproductive system and breast disorders1/13
Broken wristMusculoskeletal and connective tissue disorders1/13
COVID-19 InfectionInfections and infestations1/13
Dry eyesEye disorders1/13
Pustular psoriasis like eruptionSkin and subcutaneous tissue disorders1/13
Heat exhaustionGeneral disorders1/13

Baseline characteristics

Age, Continuous
Age, Continuous(years)Open Label
Mean11.8 ± 7.8
Sex: Female, Male
Sex: Female, Male(Participants)Open Label
Female7
Male6
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Open Label
Hispanic or Latino2
Not Hispanic or Latino11
Unknown or Not Reported0
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Open Label
Race — Black1
Race — White9
Race — Asian1
Race — Mixed2
Region of Enrollment
Region of Enrollment(participants)Open Label
United States13
Subtype
Subtype(Participants)Open Label
Harlequin Ichthyosis (HI)6
Netherton Syndrome (NS)3
KRT10-EI/KRT1-EI2
NIPAL4-CIE1
GJA-1-Erythrokeratodermia variabilis et progressiva1
08

Study locations

1 site
  • Northwestern University/Lurie Children's Hospital
    Chicago, Illinois 60611, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Apr 2021 to primary completion in Jan 2024, 33 months.

Results were first posted in Feb 2025, 1 year 1 month after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 9, 2020
First posted
Sep 16, 2020
StartActual
Apr 1, 2021
Primary completionActual
Jan 12, 2024
CompletionActual
Jun 26, 2024
Results first posted
Feb 12, 2025
Last update
Feb 12, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 12, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04549792
Responsible party
Amy Paller (Principal Investigator, Northwestern University) — Principal investigator
First posted
Sep 16, 2020
Start date
Apr 1, 2021
Primary completion
Jan 12, 2024
Completion
Jun 26, 2024
Results posted
Feb 12, 2025
Last update
Feb 12, 2025

Study contacts

Amy Paller, MD
principal investigator · Northwestern University

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Ustekinumab

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