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Protocol Details

A Phase 2b, Double-Blind, Randomized, Placebo-Controlled Trial of Cardamom and Topical Roseomonas in Atopic Dermatitis

This study is currently recruiting participants.

Summary | Eligibility | Citations | Contacts

Summary

Number

001677-I

Sponsoring Institute

National Institute of Allergy and Infectious Diseases (NIAID)

Recruitment Detail

Type: Participants currently recruited/enrolled
Gender: Male & Female
Min Age: 2 Years
Max Age: 100 Years

Referral Letter Required

No

Population Exclusion(s)

Pregnant Women;
Non-English Speaking;
Adults who are or may become unable to consent;
Neonates;
Fetuses

Keywords

Eczema;
Atopic Dermatitis;
Roseomonas;
Cardamom;
Itch;
Rash

Recruitment Keyword(s)

None

Condition(s)

Atopic Dermatitis;
Eczema

Investigational Drug(s)

roseomonas with cardamom seeds

Investigational Device(s)

None

Intervention(s)

Drug: Roseomonas mucosa (RSM2015) and Cardamom seeds
Drug: Placebo (sucrose)

Supporting Site

National Institute of Allergy and Infectious Diseases

Background:

Atopic dermatitis (AD), also called eczema, is a chronic skin condition. AD can make skin dry and itchy, and sometimes it can lead to serious health problems, such as asthma, food allergies, eye infections, and sleep problems. No cure exists for AD. Researchers know that people with AD have different kinds of harmless bacteria on their skin than do people without AD. They want to see if adding a harmless bacteria (Roseomonas mucosa) to the skin can help people with AD.

Objective:

To test a skin treatment that contains R. mucosa and ground cardamom seeds in people with AD.

Eligibility:

People aged 2 years and older with AD.

Design:

All study visits will be remote. Participants will have 5 visits over about 7 months.

Participants will be screened. Researchers will review their AD and medical history.

Participants will receive a study product in the mail. The product comes as a powder in single-use packets. Participants will be shown how to mix the powder with water in a single-use spray vial. They will spray the solution onto their skin 2 to 3 times per week for 14 weeks.

Half of participants will receive the study powder. Half will receive a placebo; the placebo looks just like the study powder but contains no bacteria. They will not know which one they have.

During 3 study visits, participants will take a skin swab. They will receive supplies in the mail to rub a cotton swab on their skin and mail it back to the researchers.

Participants may opt to have pictures taken of their AD.

Participants will fill out 4 online questionnaires.

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Eligibility

INCLUSION CRITERIA:

To be eligible to participate in this study, an individual must meet all of the following criteria:

1. Aged >=2 years

2. Have a documented primary care provider near residence

3. Fluency in English (applicable to participant or caregiver who will be answering questionnaires)

4. Clinical diagnosis of AD, as defined by Hanifin and Rajka criteria, that has been present for >=3 months before the screening visit

- Major Criteria: Must have >=3 basic features:

-- Pruritus

-- Typical morphology and distribution (flexural lichenification in adults, facial and extensor eruptions in infants and children)

-- Chronic or chronically relapsing dermatitis

-- Personal or family history of atopy (asthma, allergic rhinitis, AD)

- Minor Criteria: Must have >=3 minor features:

-- Xerosis

-- Ichthyosis/palmar hyperlinearity, keratosis pilaris

-- Immediate (type 1) skin-test reactivity

-- Raised serum IgE

-- Early age of onset

-- Tendency toward cutaneous infections (especially Staphylococcus aureus and herpes simplex), impaired cell-mediated immunity

-- Tendency toward non-specific hand or foot dermatitis

-- Nipple eczema

-- Cheilitis

-- Recurrent conjunctivitis

-- Dennie-Morgan infraorbital fold

-- Keratoconus

-- Anterior subcapsular cataracts

-- Orbital darkening

-- Facial pallor, facial erythema

-- Pityriasis alba

-- Anterior neck folds

-- Itch when sweating

-- Intolerance to wool and lipid solvents

-- Perifollicular accentuation

-- Food intolerance

-- Course influenced by environmental or emotional factors

-- White dermographism, delayed blanch

5. EASI >5 and an IGA >=1 at time of enrollment.

6. Sexually active participants of childbearing potential must agree to use adequate methods of contraception from the screening visit continuously until 30 days after stopping treatment with the investigational product. Childbearing potential is defined for children as participants who have begun menstruating and for adults as participants who are not surgically sterile (hysterectomy and/or tubal ligation) or menopausal (age >=45 years plus no menses for 12 consecutive months without an alternative medical cause). Adequate contraception methods include: a barrier method (eg, condom use), oral contraceptive pill, hormonal patch or ring, hormonal injection, parenteral hormonal implant, or an intrauterine device.

7. Participants and parents/legal guardians (for minor participants) are willing and able to comply with all study visits and/or study-related procedures.

8. Participants/parents/guardians must have the ability to provide informed consent/assent as applicable.

9. Willingness to perform visits virtually.

EXCLUSION CRITERIA:

1. Previous treatment of AD:

- Within 4 weeks prior to the baseline visit with any of the following:

-- Immunosuppressive or immunomodulating systemic drugs such as systemic corticosteroids, azathioprine, methotrexate, cyclosporine

-- Phototherapy or photochemotherapy for AD

- Within 12 weeks prior to the baseline visit with any of the following having been newly initiated:

-- Topical steroids or topical calcineurin inhibitors

-- Janus kinase (JAK) inhibitors (oral or topical)

-- Dupilumab or any other biologic agent

-- Topical PDE4 inhibitor

-- Emollients containing ceramides, hyaluronic acid, urea or filaggrin degradation products.

-- Bleach baths

2. Active infection (chronic or acute) requiring treatment with systemic antibiotics, antivirals, or antifungals within 2 weeks before the baseline visit.

3. Superficial skin infection requiring topical treatment within 1 week of baseline visit.

4. Known or suspected history of immunosuppression or immunodeficiency.

5. Existence of indwelling central line.

6. Co-habitation with someone that has a known or suspected history of immunosuppression or immunodeficiency or has a central line.

7. Any clinically significant laboratory, history, or exam findings that, in the investigator s opinion, would suggest an increased risk to the participant.

8. Self-reported pregnancy or breastfeeding.

9. Menstruating females who have not menstruated within 6 weeks prior to screening. Participants who have an intrauterine device or implanted long-term contraceptive agent that prevents them from menstruating regularly will not be excluded.


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Citations:

Li L, Han Z, Niu X, Zhang G, Jia Y, Zhang S, He C. Probiotic Supplementation for Prevention of Atopic Dermatitis in Infants and Children: A Systematic Review and Meta-analysis. Am J Clin Dermatol. 2019 Jun;20(3):367-377. doi: 10.1007/s40257-018-0404-3. PMID: 30465329.

Mashiah J, Karady T, Fliss-Isakov N, Sprecher E, Slodownik D, Artzi O, Samuelov L, Ellenbogen E, Godneva A, Segal E, Maharshak N. Clinical efficacy of fecal microbial transplantation treatment in adults with moderate-to-severe atopic dermatitis. Immun Inflamm Dis. 2022 Mar;10(3):e570. doi: 10.1002/iid3.570. Epub 2021 Dec 20. PMID: 34931478; PMCID: PMC8926506.

Myles IA, Castillo CR, Barbian KD, Kanakabandi K, Virtaneva K, Fitzmeyer E, Paneru M, Otaizo-Carrasquero F, Myers TG, Markowitz TE, Moore IN, Liu X, Ferrer M, Sakamachi Y, Garantziotis S, Swamydas M, Lionakis MS, Anderson ED, Earland NJ, Ganesan S, Sun AA, Bergerson JRE, Silverman RA, Petersen M, Martens CA, Datta SK. Therapeutic responses to <i>Roseomonas mucosa</i> in atopic dermatitis may involve lipid-mediated TNF-related epithelial repair. Sci Transl Med. 2020 Sep 9;12(560):eaaz8631. doi: 10.1126/scitranslmed.aaz8631. PMID: 32908007; PMCID: PMC8571514.

Myles IA, Earland NJ, Anderson ED, Moore IN, Kieh MD, Williams KW, Saleem A, Fontecilla NM, Welch PA, Darnell DA, Barnhart LA, Sun AA, Uzel G, Datta SK. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI Insight. 2018 May 3;3(9):e120608. doi: 10.1172/jci.insight.120608. PMID: 29720571; PMCID: PMC6012572.

Nakatsuji T, Hata TR, Tong Y, Cheng JY, Shafiq F, Butcher AM, Salem SS, Brinton SL, Rudman Spergel AK, Johnson K, Jepson B, Calatroni A, David G, Ramirez-Gama M, Taylor P, Leung DYM, Gallo RL. Development of a human skin commensal microbe for bacteriotherapy of atopic dermatitis and use in a phase 1 randomized clinical trial. Nat Med. 2021 Apr;27(4):700-709. doi: 10.1038/s41591-021-01256-2. Epub 2021 Feb 22. PMID: 33619370; PMCID: PMC8052297.

Yadav M, Chaudhary PP, D'Souza BN, Ratley G, Spathies J, Ganesan S, Zeldin J, Myles IA. Diisocyanates influence models of atopic dermatitis through direct activation of TRPA1. PLoS One. 2023 Mar 6;18(3):e0282569. doi: 10.1371/journal.pone.0282569. PMID: 36877675; PMCID: PMC9987805.

Zeldin J, Chaudhary PP, Spathies J, Yadav M, D'Souza BN, Alishahedani ME, Gough P, Matriz J, Ghio AJ, Li Y, Sun AA, Eichenfield LF, Simpson EL, Myles IA. Exposure to isocyanates predicts atopic dermatitis prevalence and disrupts therapeutic pathways in commensal bacteria. Sci Adv. 2023 Jan 6;9(1):eade8898. doi: 10.1126/sciadv.ade8898. Epub 2023 Jan 6. PMID: 36608129; PMCID: PMC9821876.

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Contacts:

Principal Investigator

Referral Contact

For more information:

Ian A. Myles, M.D.
National Institute of Allergy and Infectious Diseases (NIAID)
NIHBC 29B BG RM 5NN24
9000 ROCKVILLE PIKE
BETHESDA MD 20892
(301) 451-8420
mylesi@niaid.nih.gov

Ashleigh A. Sun
National Institute of Allergy and Infectious Diseases (NIAID)
National Institutes of Health
Building 10
Room 12C103
10 Center Drive
Bethesda, Maryland 20892
(301) 605-2896
sunaa@niaid.nih.gov

None

Not Listed

Clinical Trials Number:

NCT06096857

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