A Phase II, Placebo Controlled, Clinical Trial of Topical TolaSure Targeting Aggregated Mutant Keratin in Epidermolysis Bullosa Simplex
Start Date
9/11/2025
Completion Date
9/1/2027
Summary
This Phase II clinical study will assess the efficacy, safety and tolerability of topical TolaSure Gel in adults and pediatric patients (2 years of age and older) diagnosed with localized, intermediate, or severe epidermolysis bullosa simplex (EBS). Each patient (40 to complete) will be enrolled in the study and will be randomized to receive either TolaSure Gel or a topical Placebo for daily application for 2-months. After 2-months, all patients will receive TolaSure Gel to daily apply for an additional 2-months. A remote follow-up visit will occur 2-months after the end of study. Total time in the study is 6-months. Localized patients will be applying study medication to their feet, with the option to treat their hands as well throughout the study. Intermediate and severe EBS patients will be applying study medication to randomized treatment area(s) (a minimum of \~2-3% Body Surface Area (BSA)), with the option to treat their feet as well throughout the study.
Detailed Description
This is a closed-label, Phase II clinical study to assess the efficacy, safety and tolerability of the investigational product (IP), topical TolaSure Gel, 5% w/w, in adults and pediatric patients diagnosed with localized, intermediate, or severe epidermolysis bullosa simplex (EBS). TolaSure Gel, 5% w/w and Placebo tubes will be placed into kits where all labels (tubes and kit labels) will be blinded for drug content. Kits will be bundled (based on expected amount of study gel usage) and distributed randomly to patients \[Goal of patient population, 1:1 M:F and approximately 70% pediatric patients\]. Each patient (40 to complete) will be enrolled in the study and once a blistering flare is confirmed by the clinical study team, and the patient will be randomized to receive either TolaSure Gel, 5% w/w or Placebo (50:50 chance). For Part I of the study, participants apply the randomized study treatment once daily for 2 months to a defined Target Lesional Area (TLA). The TLA and clinical presentation required for enrollment for each EBS subtype is described below. For localized EBS subjects, the TLA will consist of daily treating the feet (tops and bottoms) which is approximately 7% body surface area (BSA). At the Baseline Visit, localized EBS subjects must have at least moderate plantar disease activity, defined as ≥15% involvement of the plantar surface of at least one foot, as assessed by clinical examination or standardized imaging, with evidence of active disease (e.g., blisters, erosions, or crusting). Localized EBS subjects will also have the option to treat their hands (tops and bottoms), which is approximately an additional 6% BSA. Palmoplantar evaluations for localized EBS subjects are separate from the intermediate to severe EBS subjects' TLA-treated regions per protocol. For intermediate to severe EBS subject, the TLA can be a contiguous or non-contiguous region totaling up to approximately 15-20% BSA, excluding palmoplantar surfaces, groin, and apocrine areas. At the subject Baseline Visit, intermediate to severe EBS subject's TLA must consist of a 2-3% BSA active flaring sub-region consisting mainly of intact or freshly ruptured blisters. Subjects have the option to treat their feet, but plantar evaluation for intermediate to severe EBS subjects is separate from the TLA per protocol. Study drug (TolaSure Gel, 5% w/w or Placebo Gel) is applied to the entire TLA, not just the symptomatic regions (e.g., blistering, keratoderma, erosions, crusting). If symptoms resolve, treatment continues daily on all assigned TLAs. For Part 2 of the study, a single arm crossover will then allow those subjects that received Placebo to go on TolaSure Gel, 5% w/w for a subsequent 2 months. The subjects already in the TolaSure Gel, 5% w/w cohort will continue with daily IP application for an additional 2 months as well. At End of Study (EOS), subjects will cease IP application and EOS procedures will be completed. A subject follow-up visit will occur after 6 months. The primary endpoint will assess changes in disease severity within the TLAs (excluding palmoplantar surfaces) and recurrence of blistering using clinical imaging of blister surface area over time. The secondary efficacy endpoints will evaluate blistering on the feet, subject self-assessments including pain, itch, modified Foot Function Index (mFFI), and Quality of Life (QoL) assessment. An exploratory endpoint will examine blistering and keratoderma of localized EBS subjects that treat their hands. Safety endpoints will include the incidence of treatment-emergent adverse events (TEAEs). In order to provide adequate assurance of subject safety, safety monitoring will include physical exams, vital sign measurements, clinical laboratory testing (blood and urinalysis), and urine pregnancy testing (as appropriate). These safety assessments in addition to AE reviews will be sufficient to identify potential TEAEs. The information obtained from these assessments will be utilized to examine the efficacy of TolaSure treatment in ameliorating EBS symptoms as well as the accuracy of the proposed mechanism of action (MOA) of TolaSure for this disease indication.
Eligibility Criteria
Age Range: 2 years to No maximum
Interventions
5% TolaSure Topical Gel
Topical Placebo Gel
Conditions
Locations
Stanford University School of Medicine, Dermatology Department
Palo Alto, California 94304
United States
NU Dermatolgy CTU
Chicago, Illinois 60611
United States