Characteristics and outcomes for participants with congenital ichthyosis who responded to treatment with the topical isotretinoin formulation TMB-001: results from the Phase IIb CONTROL study.

Christopher G Bunick, Joyce M C Teng, Scott Guenthner, Kalyani Marathe, Steven Kempers, Kimmie Eads, Leslie Castelo-Soccio, Alan M Mendelsohn, Jessica Raiz, Dédée F Murrell

Journal: Clinical and experimental dermatology 2023;48(7):765-769

PMID: 36928932

Abstract

BACKGROUND

Emollients and keratolytics are frequently used to manage symptoms of congenital ichthyosis (CI). Systemic retinoid treatment is complicated by teratogenicity and dose-limiting adverse effects.

OBJECTIVES

This analysis from the randomized Phase IIb CONTROL study investigated the characteristics of participants who responded to treatment with TMB-001, a novel topical isotretinoin ointment formulation.

METHODS

Participants ≥ 9 years of age with genetically confirmed CI and ≥ 2 (out of 4) Visual Index for Ichthyosis Severity (VIIS) assessment areas with ≥ 3 scaling score were randomized 1 : 1 : 1 to TMB-001 0.05%, TMB-001 0.1% or vehicle, twice daily for 12 weeks. Efficacy endpoints included the proportion of participants with ≥ 50% reduction in VIIS-scaling (VIIS-50) compared with baseline and ≥ 2-grade reduction in Investigator's Global Assessment (IGA)-scaling score compared with baseline. Changes in body surface area (BSA) involvement, Dermatology Life Quality Index (DLQI) scores and Itch-Numeric Rating Scale (I-NRS) scores were assessed.

RESULTS

Among the 33 participants (11 randomized to TMB-001 0.05%, 10 to TMB-001 0.1% and 12 to vehicle), median age was 29 years (range 9-80), and most were male (64%) and White (79%). Baseline demographics were generally similar among participants who did or did not achieve TMB-001 treatment success. Participants who had lower mean BSA involvement and higher DLQI and I-NRS scores at baseline were more likely to achieve VIIS-50. Similarly, higher baseline DLQI and I-NRS scores were associated with IGA response; BSA involvement was similar for IGA responders vs. nonresponders.

CONCLUSIONS

Higher DLQI and I-NRS scores at baseline were associated with participants achieving treatment success by VIIS-50 and IGA response. Lower BSA involvement was associated with VIIS-50 success.

© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: [email protected].

Address: Yale University School of Medicine, New Haven, CT, USA.; Stanford School of Medicine, Stanford University, Palo Alto, CA, USA.; The Dermatology Center of Indiana, Plainfield, IN, USA.; The Indiana Clinical Trials Center, PC, Plainfield, IN, USA.; Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Associated Skin Care Specialists, New Brighton, MN, USA.; The Indiana Clinical Trials Center, PC, Plainfield, IN, USA.; Perelman School of Medicine at the University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Timber Pharmaceuticals, Basking Ridge, NJ, USA.; University of New South Wales School of Medicine & Health, Sydney, NSW, Australia.
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