Title

Cantharidin and Occlusion in Verruca Epithelium
A Phase 2, Open Label Study to Evaluate the Efficacy, Safety and Tolerability of VP-102 in Subjects With Common Warts (Verruca Vulgaris)
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    vp-102 ...
  • Study Participants

    56
This is a Phase 2, open label study (Study number VP-102-105; referred to as COVE-1 [Cantharidin and Occlusion in Verruca Epithelium]) to evaluate the efficacy, safety and tolerability of VP-102 treatment in subjects with common warts. This study has two Cohorts.
The first Cohort (Cohort 1) utilizes a treatment interval of at least 14 days between treatments with longer treatment intervals being allowed depending on a specific patient's clinical response.Twenty Subjects (2 years and older) are targeted completing End of Study (EOS) visit in Cohort 1.

The second Cohort (Cohort 2) utilizes a treatment interval of 21 days between treatments. Paring of lesions is allowed. Approximately 35 subjects (12 years and older) will be enrolled in Cohort 2. Up to 4 sites will participate in the study.
Study Started
Mar 27
2018
Primary Completion
May 16
2019
Study Completion
Jul 15
2019
Results Posted
Sep 01
2021
Last Update
Sep 01
2021

Combination Product VP-102 Cantharidin topical film forming solution

VP-102, a single-use drug device combination product containing (cantharidin) topical solution, 0.7% (w/v). Treatment interval of at least 14 days between treatments.

  • Other names: VP-102-Cantharidin, film forming solution, VP-102 - Cohort 1

Combination Product VP-102 Cantharidin, topical film forming solution

VP-102, a single-use drug device combination product containing (cantharidin) topical solution, 0.7% (w/v). Treatment interval of at least 21 days between treatments.

  • Other names: VP-102 Cantharidin, film forming solution, VP-102 - Cohort 2

VP-102 Experimental

Open label of VP-102 cantharidin topical film forming solution, using the VP-102 applicator.

Criteria

Inclusion Criteria:

Be healthy, immunocompetent males or females at least 2 years of age and older for Cohort 1 and 12 years of age and older for Cohort 2.
Present with 1-6 common warts (verruca vulgaris) located anywhere on the body except for the following prohibited areas: the eye area (including eyelids), lips, oral cavity, nasal cavity, inside of the ears, palms of the hands, volar surface of the fingers or toes, under the finger nails (near and on the sides of the nails is allowed for Cohort 1, but warts near and on the sides of the nail (e.g., periungual) are not allowed in Cohort 2), soles of the feet, or the anogenital area. (Warts within 10 mm of a mucosal surface should not be treated).
Have warts that are ≤10 mm in diameter and ≤3 mm in height. (Subjects with warts that are adjacent, touching or clustered may be included so long as the combined diameter in the longest direction does not exceed 10 mm. Individual lesions that are adjacent, touching or clustered should be counted as distinct lesions for the purposes of tracking, inclusion and clearance)(subjects in Cohort 2 can be pared, when necessary and appropriate, prior to evaluating height eligibility) .
Have warts that have been present for at least 4 weeks at the time of the baseline visit.
Consent to having all warts treated (the physician must also be willing to treat all warts initially present).
Be otherwise medically healthy with no clinically significant medical history, physical examination or vital signs as determined by the investigator.
Be free of any systemic or dermatologic disorder, which, in the opinion of the investigator, will interfere with the study results or increase the risk of Aes.
Refrain from swimming, bathing or prolonged immersion in water or any liquids until the Study drug is removed.
Have the ability, or have a guardian with the ability, to follow study instructions and be likely to complete all study requirements.
Agree to use no wart-removing product (prescription or over-the-counter [OTC]) other than the Study drug during the course of the study.
Provide written informed consent or assent in a manner approved by the institutional review board (IRB) and/or have a parent/guardian provide written informed consent as evidenced by the signature on an IRB approved assent/consent form.
Provide written authorization for use and disclosure of protected health information.
If participating in the optional photographic portion of the study, agree to allow photographs of warts to be taken at each Treatment Visit by the research team and agree to share photos taken at home with the research team via text, email or in-person upload.

Exclusion Criteria:

Are unable to cooperate with the requirements or visits of the study, as determined by the investigator.
Are systemically immunosuppressed or have required, or will require, systemic immunosuppressive or immunomodulatory medication (including oral or parenteral corticosteroids) within 30 days prior to enrollment or during the course of the study. (Routine use of inhaled or intranasal corticosteroids during the study is allowed)
Have any chronic or acute medical condition that, in the opinion of the investigator, may interfere with the study results or place the subject at undue risk. (e.g., human immunodeficiency virus, systemic lupus erythematosus, viral hepatitis, uncontrolled diabetes). NOTE: Immunizations and flu shots may be administered throughout the study, but not within 5 days before or after treatment.
Have more than 6 common warts at baseline.
Present with any verruca plana, mosaiform, filiform, subungual (under the nail), genital or anal warts. In Cohort 2, subjects with periungual warts are also excluded.
Have any warts present at baseline in an anatomic location that the subject, parent/guardian or the physician is unwilling to treat or are located in an area that cannot be easily occluded with tape.
Have had any previous treatment of common warts including, but not limited to, the use of cantharidin, antivirals, retinoids, salicylic acid, lactic acid, hydrogen peroxide, candida antigen, diphencyprone, dinitrochlorobenzene, sandalwood oil, thuja oil, squaric acid dibutyl ester, povidone iodine, nitric oxide, curettage or freezing of warts in the past 14 days. In addition, these treatments or any other over-the-counter wart treatment should not be implemented during the course of the study.
Have been treated within 14 days with a product that contains cantharidin (topical or homeopathic preparations) for any reason prior to screening.
Have received another investigational product as part of a clinical trial within 30 days prior to the first application of the Study drug.
Currently have or have a history of epidermodysplasia verruciformis.
Have a history of illness or any dermatologic disorder, which, in the opinion of the investigator, will interfere with accurate assessment of the warts or increase the risk of adverse events.
Have an active malignancy or are undergoing treatment for any malignancy.
Have a history or presence of clinically significant medical, psychiatric, or emotional condition or abnormality that, in the opinion of the investigator, would compromise the safety of the subject or the quality of the data.
Have a history or presence of hypersensitivity or an idiosyncratic reaction to the Study drug or related compounds, or drug product excipients (acetone, ethyl alcohol, nitrocellulose, hydroxypropyl cellulose, castor oil, camphor, gentian violet, and denatonium benzoate).
Have a condition or situation that may interfere significantly with the subject's participation in the study (e.g., subjects who required hospitalization in the 2 months prior to screening for an acute or chronic condition including alcohol or drug abuse), at the discretion of the investigator.
Are sexually active or may become sexually active and are unwilling to practice responsible birth control methods. (e.g., combination of condoms and foam, birth control pills, intrauterine device, patch, shot and vaginal ring, etc.). Withdrawal is not an acceptable method of birth control. Females that have reached menarche must have a negative urine pregnancy test at each visit prior to treatment with Study drug.
Are pregnant or breastfeeding.

Summary

Cohort 1

Cohort 2

All Events

Event Type Organ System Event Term Cohort 1 Cohort 2

Cohort 1: Proportion of Subjects Exhibiting Complete Clearance of All Treatable Warts (Baseline and New) at the EOS Visit (Day 84)

Cohort 1: Proportion of subjects exhibiting complete clearance of all treatable warts (baseline and new) at the EOS Visit (Day 84).

Cohort 1

Cohort 2: Proportion of Subjects Exhibiting Complete Clearance of All Treatable Warts (Baseline and New) at the EOT Visit (Day 84)

Cohort 2: Proportion of subjects exhibiting complete clearance of all treatable warts (baseline and new) at the EOT Visit (Day 84).

VP-102 - Cohort 2

Cohort 1: Change From Baseline in the Number of Treatable Warts (Baseline and New) at the EOS Visit (Day 84)

Cohort 1: Change from baseline in the number of treatable warts (baseline and new) at the EOS Visit (Day 84).

Cohort 1

Baseline

2.19
Number of warts (Mean)
Standard Deviation: 1.569

End of Treatment Visit

-0.95
Number of warts (Mean)
Standard Deviation: 1.658

Cohort 1: Percent Change From Baseline in the Number of Treatable Warts (Baseline and New) at the EOT Visit (Day 84).

Cohort 1: Assessing the percent change from Baseline in the number of treatable warts (Baseline and new) at the EOT visit (Day 84).

Cohort 1

-31.19
Percent change (Mean)
Standard Deviation: 42.776

Cohort 1: Proportion of Subjects Exhibiting Complete Clearance of All Treatable Warts (Baseline and New) at Visit 2, Visit 3, Visit 4 and Over the Duration of the Study

Cohort 1: Proportion of subjects exhibiting complete clearance of all treatable warts (baseline and new) at Visit 2, Visit 3, Visit 4 and over the duration of the study.

Cohort 1

Complete Clearance Reported at any Visit?

Complete Clearance Reported at Day 14

Complete Clearance Reported at Day 28

Complete Clearance Reported at Day 42

Complete Clearance Reported at Day 84 (EOS)

Cohort 2: Change From Baseline in the Number of Treatable Warts (Baseline and New) at the EOT Visit Day 84)

Cohort 2: Change from baseline in the number of treatable warts (baseline and new) at the EOT Visit Day 84).

VP-102 - Cohort 2

-0.85
change in wart count (Mean)
Standard Deviation: 1.064

Cohort 2: Change From Baseline in the Percent of Treatable Warts (Baseline and New) at the EOT Visit (Day 84)

Cohort 2: Change from baseline in the percent of treatable warts (baseline and new) at the EOT Visit (Day 84).

VP-102 - Cohort 2

-53.79
percentage of change in wart count (Mean)
Standard Deviation: 55.241

Cohort 2: Proportion of Subjects Exhibiting Complete Clearance of All Treatable Warts, (Baseline and New), at Visit 2, Visit 3, Visit 4 and Over the Duration of the Study

Cohort 2: Proportion of subjects exhibiting complete clearance of all treatable warts, (baseline and new), at Visit 2, Visit 3, Visit 4 and over the duration of the study.

VP-102 - Cohort 2

Complete Clearance Reported at Day 105

Complete Clearance Reported at Day 126

Complete Clearance Reported at Day 147

Complete Clearance Reported at Day 21 (Treatment Visit 2)

Complete Clearance Reported at Day 42 (Treatment Visit 3)

Complete Clearance Reported at Day 63 (Treatment Visit 4)

Complete Clearance Reported at Day 84 (EOT)

Cohort 1:Percent Reduction of All Treatable Warts (Baseline and New) From Baseline at Visit 2, Visit 3, Visit 4 and Over the Duration of the Study.

Cohort 1: Percent change from baseline in the number of treatable warts (Baseline and new) from Baseline at Visit 2, Visit 3, Visit 4 and over the duration of the study.

Cohort 1

EOS Day 84

-31.19
Percent change in number of warts (Mean)
Standard Deviation: 42.776

Treatment Visit 2 Day 14

-0.79
Percent change in number of warts (Mean)
Standard Deviation: 3.637

Treatment Visit 3 Day 28

-12.3
Percent change in number of warts (Mean)
Standard Deviation: 30.462

Treatment Visit 4 Day 42

-29.29
Percent change in number of warts (Mean)
Standard Deviation: 42.845

Cohort 1: Change From Baseline in the Number of Treatable Warts (Baseline and New) at Visit 2, Visit 3, Visit 4 and the EOS Visit

Cohort 1: Change from baseline in the number of treatable warts (baseline and new) at Visit 2, Visit 3, Visit 4 and the EOS Visit.

Cohort 1

End of Study

-0.95
change in wart count (Mean)
Standard Deviation: 1.658

Treatment Visit 2

-0.5
change in wart count (Mean)
Standard Deviation: 0.218

Treatment Visit 3

-0.43
change in wart count (Mean)
Standard Deviation: 1.326

Treatment Visit 4

-0.76
change in wart count (Mean)
Standard Deviation: 1.446

Cohort 1: Proportion of Subjects Exhibiting ≥ 50% Clearance of All Treatable Warts (Baseline and New) at the EOS Visit as Compared to Baseline

Cohort 1: Proportion of subjects exhibiting ≥ 50% clearance of all treatable warts (baseline and new) at the EOS visit as compared to baseline.

Cohort 1

Cohort 1-Proportion of Subjects Who Respond to Treatment Defined by a ≥ 50% Reduction in Total Wart Area at EOS Compared to Baseline

Cohort 1-Proportion of subjects who respond to treatment defined by a ≥ 50% reduction in total wart area at EOS compared to baseline.

Cohort 1

Cohort 1-Proportion of Subjects Exhibiting Reduction of at Least 1 Treatable Wart From Baseline at Visit 2, Visit 3, Visit 4 and at the EOS Visit (Day 84)

Cohort 1-Proportion of subjects exhibiting reduction of at least 1 treatable wart from baseline at Visit 2, Visit 3, Visit 4 and at the EOS Visit (Day 84).

Cohort 1

Reduction of >= 1 Wart from Baseline at any visit?

Wart Reduction >= 1 Reported at Day 14 (Visit 2)

Wart Reduction >= 1 Reported at Day 28 (Visit 3)

Wart Reduction >= 1 Reported at Day 42 (Visit 4)

Wart Reduction >= 1 Reported at Day 84 (EOS)

Cohort 2: Percent Reduction of All Treatable Warts (Baseline and New) From Baseline at Visit 2, Visit 3, Visit 4 and Over Duration of the Study.

Cohort 2: Intent to Treat population Cohort 2-Percent reduction of all treatable warts (baseline and new) from baseline at Visit 2, Visit 3, Visit 4 and over duration of the study.

VP-102 - Cohort 2

Day 21 (Treatment Visit 2)

-18.18
percentage of change in wart count (Mean)
Standard Deviation: 37.119

Day 42 (Treatment Visit 3)

-29.85
percentage of change in wart count (Mean)
Standard Deviation: 41.392

Day 63 (Treatment Visit 4)

-37.12
percentage of change in wart count (Mean)
Standard Deviation: 53.078

Day 84 (End of Treatment Visit)

-53.79
percentage of change in wart count (Mean)
Standard Deviation: 55.241

Cohort 2: Change From Baseline in the Number of Treatable Warts (Baseline and New) at Treatment Visit 2, Treatment Visit 3, Treatment Visit 4 and the EOT Visit (Day 84)

Cohort 2: Change from baseline in the number of treatable warts (baseline and new) at Treatment Visit 2, Treatment Visit 3, Treatment Visit 4 and the EOT Visit (Day 84).

VP-102 - Cohort 2

Day 21 (Treatment Visit 2)

-0.39
change in wart count (Mean)
Standard Deviation: 0.998

Day 42 (Treatment Visit 3)

-0.48
change in wart count (Mean)
Standard Deviation: 0.712

Day 63 (Treatment Visit 4)

-0.52
change in wart count (Mean)
Standard Deviation: 0.712

Day 84 (End of Treatment Visit)

-0.85
change in wart count (Mean)
Standard Deviation: 1.064

Cohort 2: Proportion of Subjects Exhibiting ≥ 50 % Clearance of All Treatable Warts (Baseline and New) at the EOT Visit (Day 84) as Compared to Baseline

Cohort 2: Proportion of subjects exhibiting ≥ 50 % clearance of all treatable warts (baseline and new) at the EOT Visit (Day 84) as compared to baseline.

VP-102 - Cohort 2

Cohort 2: Proportion of Subjects Who Respond to Treatment Defined by a ≥ 50% Reduction in Total Wart Area at EOT Compared to Baseline

Cohort 2: Proportion of subjects who respond to treatment defined by a ≥ 50% reduction in total wart area at EOT compared to baseline.

VP-102 - Cohort 2

Cohort 2: Proportion of Subjects Exhibiting Reduction of at Least 1 Treatable Wart From Baseline at Visit 2, Visit 3, Visit 4 and at the EOT Visit (Day 84)

Cohort 2: Proportion of subjects exhibiting reduction of at least 1 treatable wart from baseline at Visit 2, Visit 3, Visit 4 and at the EOT Visit (Day 84).

VP-102 - Cohort 2

Day 21 (Treatment Visit 2)

Day 42 (Treatment Visit 3)

Day 63 (Treatment Visit 4)

Day 84 (End of Treatment Visit)

Cohort 2: Proportion of Subjects Exhibiting Complete Clearance of All Treatable Warts (Baseline and New) at Follow-up Visits on Day 105, Day 126 and Day 147

Cohort 2: Proportion of subjects exhibiting complete clearance of all treatable warts (baseline and new) at follow-up visits on Day 105, Day 126 and Day 147.

VP-102 - Cohort 2

Complete Clearance Reported at Day 105

Complete Clearance Reported at Day 126

Complete Clearance Reported at Day 147

Cohort 2: Percent Reduction of All Treatable Warts (Baseline and New) From Baseline at Follow-up Visits on Day 105, Day 126 and Day 147

Cohort 2: Percent reduction of all treatable warts (baseline and new) from baseline at follow-up visits on Day 105, Day 126 and Day 147.

VP-102 - Cohort 2

Day 105

-50.91
percentage change from Baseline (Mean)
Standard Deviation: 54.736

Day 126

-45.61
percentage change from Baseline (Mean)
Standard Deviation: 52.556

Day 147

-45.61
percentage change from Baseline (Mean)
Standard Deviation: 52.556

Cohort 2: Change From Baseline in the Number of Treatable Warts (Baseline and New) at Follow-up Visits on Day 105, Day 126 and Day 147

Cohort 2: Change from baseline in the number of treatable warts (baseline and new) at follow-up visits on Day 105, Day 126 and Day 147.

VP-102 - Cohort 2

Day 105

-0.82
change in wart count (Mean)
Standard Deviation: 0.983

Day 126

-0.73
change in wart count (Mean)
Standard Deviation: 0.911

Day 147

-0.73
change in wart count (Mean)
Standard Deviation: 0.911

Total

56
Participants

Age, Continuous

37.75
years (Mean)
Standard Deviation: 18.212

Baseline wart count

1.85
Baseline wart count (Mean)
Standard Deviation: 1.311

Age, Categorical

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Cohort 1

Cohort 2

Drop/Withdrawal Reasons

Cohort 1

Cohort 2