ClinicalTrials.gg
CompletedNCT05580042Updated Oct 15, 2024

Study to Evaluate the Safety and Tolerability of AC-1101 Topical Gel in Patients with Granuloma Annulare

A Phase 1 interventional study of AC-1101 in Granuloma Annulare, sponsored by TWi Biotechnology, Inc.. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-15.

Sponsored by TWi Biotechnology, Inc. · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Nov 2023, 2 years 11 months ago, and no results have been posted to the registry.
Phase
Phase 1
Study type
Interventional
Enrollment
13
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Study AC-1101-GA-001 is an early phase open-label study with a 4-week treatment and 2-week follow-up period (without treatment) to assess the safety, tolerability, and efficacy of AC-1101 gel in patients with Granuloma Annulare.

02

Conditions studied

  • Granuloma Annulare

Keywords

  • Tofacitinib Topical Gel 2%
  • AC-1101 gel
03

In context

Lead sponsor

TWi Biotechnology, Inc. is the lead sponsor of 11 studies on the registry; none are open to participants now.

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

04

Who can participate

Ages eligible
18 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

  1. Patients 18 years of age or older, male or female, will be enrolled.
  2. Diagnosis of granuloma annulare with supportive skin (diagnostic shave biopsy or punch biopsy) or historical biopsy (a provided report would be sufficient and would not require to repeat the diagnostic biopsy). A biopsy at any point is sufficient. If a diagnostic biopsy has never been performed, one will be performed prior to enrollment in the study. Patients with both localized and generalized GA will be enrolled in the proposed study.
  3. Other subtypes of GA, such as linear, perforating, and subcutaneous will be excluded from the study. If there is suspicion that GA is medication-induced, the patient will not be enrolled. GA in association with (HIV) or will be excluded.
  4. Patients with 1-20% BSA of active Granuloma Annulare lesions will be enrolled.
  5. Duration of active GA must be at least two years with no significant change in size or number of lesions in the 6 months prior to treatment as supported by a combination of record review and history/patient interview.
  6. Patients who might be recalcitrant to or intolerant of conventional treatment, such as antibiotics (e.g., doxycycline or minocycline), triple antibiotic therapy of rifampin, ofloxacin, and minocycline, topical , topical calcineurin inhibitors, intralesional/intramuscular corticosteroid and/or phototherapy.
  7. Adequate organ function and marrow function meaured at screening (Visit 1) and enrollment (Visit 2) as defined below:

    • ≥ 12.0 g/dL for male and 10.5 g/dL for female;
    • ≥ 1,300 /µL;
    • Absolute lymphocytes: 1.0-4.0 x 109/L (1000-4000 cells/mm3) as the reference range;
    • ≥ 75,000/µL;
    • Total ≤ 1.5 x upper normal limit;
    • (SGOT)/ALT(SGPT) ≤ 2.5 x upper normal limit;
    • ≥ 60mL/min/1.73m2
  8. Females of who are sexually active with a male partner must be willing to use one of the following acceptable methods throughout the study and for 30 days after the last study drug administration.

    • Intra-uterine contraceptive device without hormone release system placed at least 4 weeks prior to study drug administration.
    • Male partner using condom with intravaginally applied spermicide started at least 21 days prior to study drug administration.
    • Sterile male partner (vasectomized since at least 6 months).
    • Barrier method of contraception: condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, bilateral tubal occlusion, sexual abstinence (when this is in line with preferred and usual lifestyle). No combined hormonal contraceptive methods (such as most oral pills, rings or patches) are permitted.
  9. Capable of consent: Able to read, understand, and sign the Form (ICF), answer the study questionnaires, communicate with the Investigator, and understand and comply with protocol requirements.
  10. Patients must speak English.
  11. Patients must have health insurance.

Exclusion criteria

Exclusion Criteria:

  1. Patients with active will not be permitted to enroll in the proposed study. Patients with a history of treated nonmelanoma skin cancer will be eligible to enroll.
  2. Patients under treatment with biologics or other systemic medications (e.g., methotrexate (MTX), mycophenolate) within the last 3 months.
  3. Presence of any abnormality at physical examination, clinically significant abnormal laboratory assessment or positive test for (HBs-Ag), (HCV-Ab), or found during medical screening.
  4. History of allergic reactions to tofacitinib or other related drugs, or to any in the formulation.
  5. Positive pregnancy test at screening. If a woman becomes pregnant during the study, she will stop the study medication and be removed from the study. She will be urged to follow up with her Primary Care Physician or obstetrician-gynecologist. The study doctors will ask to follow the pregnancy to its outcome.
  6. Women of who are unable or unwilling to use (oral pills, rings or patches are not permitted) while taking the medication.
  7. Pregnant or breast-feeding women.
  8. Current active smokers.
  9. Participation in a clinical research study involving the administration of an or marketed drug or device within 30 days prior to the first dosing, administration of a biological product in the context of a clinical research study within 90 days prior to the first dosing, or concomitant participation in an investigational study involving drug or device administration.
  10. History of active tuberculosis or exposure to endemic areas within 8 weeks prior to QuantiFERON®-TB testing performed at screening.
  11. Positive QuantiFERON®-TB indicating possible tuberculosis infection.
  12. Immunization with a within 1 month prior to dosing or planned vaccination during the study.
  13. History of clinically significant opportunistic infection, e.g., invasive fungal infections or pneumocystis pneumonia.
  14. Serious local infection, e.g., cellulitis, abscess, or systemic infection, e.g., septicemia, within 3 months prior to screening.
  15. Use of medications for the timeframes specified below, with the exception of medications exempted by the Investigator on a case-by-case basis, such as Acetaminophen (2g in 24-hour period) because they are judged unlikely to affect the PK profile of the study drug or subject safety:

    1. Prescription medications within 14 days prior to the first dosing with the exception of on-going medications to treat existing comorbid disorders, as judged by the Investigator.
    2. Topical medications inlcuding antibiotics or corticosteriod applied to the designated treatment area.
    3. Depot injection or implant of any drug within 3 months prior to the first dosing.
    4. Any drugs known to significantly induce or inhibit hepatic drug metabolism via the and CYP2C19 enzymes within 30 days prior to first dosing.
  16. Fever associated with a symptomatic viral or bacterial infection, within 2 weeks prior to the first dosing.
  17. Subjects with a personal history of significant coronary heart disease, heart failure, and/or cerebrovascular disease.
  18. Any reason that, in the opinion of the Investigator, would prevent the subject from participating in the study.
Terms in these criteria, in plain language(21)

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.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

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.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

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.

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.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

05

Study design

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

Study arms

  • Experimental
    Patients with Granuloma Annulare

    4-week treatment and 2-week follow-up period (without treatment)

    Drug: AC-1101

Interventions

  • DrugAC-1101

    For each patient, once daily (QD)

    Also known as: Tofacitinib Topical Gel 2%, AC-1101 gel

06

What researchers measure

Primary outcomes

  1. Incidence and proportion of subjects with treatment emergent adverse events (TEAEs), AEs and serious adverse events (SAEs).

    Adverse events (AEs), Significant Adverse Events (SAEs), treatment emergent adverse events (TEAEs)

    Time frame: Up to 6 weeks

  2. Number of subjects with abnormal vital signs

    Vital sign parameters will be analyzed including oral temperature, pulse rate, respiratory rate, and blood pressure.

    Time frame: Up to 6 weeks

  3. Number of subjects with abnormal ECG

    ECGs will be obtained by using an automated ECG machine to measure PR, QRS, QT, and QTc intervals and calculates heart rate.

    Time frame: Up to 6 weeks

  4. Number of subjects with abnormal hematology parameters

    Hematology parameters will be analyzed including platelet count, RBC count, hemoglobin, hematocrit, MCV, MCH, percent reticulocytes, WBC count, neutrophils, lymphocytes, monocytes, eosinophils and basophils.

    Time frame: Up to 6 weeks

  5. Number of subjects with abnormal biochemistry parameters

    Biochemistry parameters will be analyzed including blood urea nitrogen (BUN), creatinine, glucose, phosphorus, calcium, phosphate, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase, creatine phosphokinase (CPK), total bilirubin, direct bilirubin, total protein, albumin to gloulin ratio, globulin, lipase, and Hemoglobin A1C..

    Time frame: Up to 6 weeks

  6. Number of subjects with abnormal urinalysis parameters

    Urinalysis parameters will be analyzed including specific gravity, urine creatinine, phosphate and pregnancy test..

    Time frame: Up to 6 weeks

  7. Change in skin irritation using Dermal Rating Scale (DRS)

    This is a 0-4 rating with 0 representing the best.

    Time frame: Up to 4 weeks

Secondary outcomes

  1. Plasma concentration of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

  2. Area under the plasma concentration-time curve from time 0 to last time of quantifiable concentration (AUC[0-t]) of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

  3. Area under the plasma concentration-time curve from time 0 to extrapolated to infinity (AUC[0-infinity]) of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

  4. Maximum observed plasma drug concentration (Cmax) of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

  5. Time to maximum observed plasma drug concentration (Tmax) of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

  6. Apparent terminal half-life (T1/2) of AC-1101

    Blood samples will be collected from patients from Visit 2 to Visit 5

    Time frame: Day 1, Day 14, Day 42:Pre-dose; Day 28: Pre-dose, 2 through 24 hours post-dose

Other outcomes

  1. Change in Patient Global Impression of Change in GA (PGIC-GA)

    This is a 1-5 rating with 1 representing the much improved.

    Time frame: Up to 4 weeks

  2. Change in Dermatology Life Quality Index (DLQI)

    The Dermatology life Quality Index (DLQI) is a ten-question questionnaire used to measure the impact of skin disease on the quality of life of an affected person. It is designed for people aged 16 years and above. There are 10 questions, covering the following topics: symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, treatment. Each question refers to the impact of the skin disease on the patient's life over the previous week. Each question is scored from 0 to 3, giving a possible score range form 0 (meaning no impact of skin disease on quality of life) to 30 (meaning maximum impact on quality of life).

    Time frame: Up to 4 weeks

  3. Change in Skindex-16

    This is a patient quality of life survey using the skindex 16 survey form. The 16-item Skindex questionnaire is divided into three domains: questions related to the participant's symptoms (1-4), emotions (5-11), and functioning (12-16). Each question asks the participant to quantify how much a specific aspect of their skin condition bothered them in the week prior to administration of the Skindex-16. The questions are answered on a scale from 0 (no impact) to 6 (significant) with a total possible score ranging from 0 (best) to 96 (worst). Each item is then transformed to a linear scale from 0 to 100.

    Time frame: Up to 4 weeks

  4. Change in GA-Investigator Global Assessment (GA-IGA) score for the treated GA lesions

    This is a 0-4 rating with 0 representing the clear.

    Time frame: Up to 4 weeks

  5. Change in Granuloma Annulare Severity and Morphology Instrument (GASMI) activity score for the treated GA lesions

    The GASMI includes ten body regions, scored by inflammation (scores 1, 2, 4), induration (scores 1, 2, 3), and area (scores 1, 2, 3, 5, 7). The total score may vary from 30 (best) to 140 (worst).

    Time frame: Up to 4 weeks

  6. Percent change in BSA of the treated GA lesions

    Time frame: Up to 4 weeks

  7. Proportion of patients who have complete response (defined as no active disease clinically) and partial response

    Time frame: Up to 4 weeks

07

Study locations

1 site
  • Yale Center for Clinical Investigation
    New Haven, Connecticut 06519, United States
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Oct 2022 to primary completion in Nov 2023, 13 months.

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

Registered
Oct 2, 2022
First posted
Oct 14, 2022
StartActual
Oct 3, 2022
Primary completionActual
Nov 15, 2023
CompletionActual
Nov 15, 2023
Last update
Oct 15, 2024
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 Oct 15, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05580042
Lead sponsor
TWi Biotechnology, Inc.
Responsible party
Sponsor
First posted
Oct 14, 2022
Start date
Oct 3, 2022
Primary completion
Nov 15, 2023
Completion
Nov 15, 2023
Last update
Oct 15, 2024

Study contacts

William Damsky, M.D., Ph.D.
principal investigator · Yale Department of Dermatology

Oversight

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

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This study is completed, as verified in Oct 2024. You cannot join it, but the record below documents what was studied.

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