Topical Vitamin D in Acute Graft Versus Host Disease of the Skin

Overview

The purpose of this study is to evaluate the efficacy of Calcipotriene cream. This is a synthetic vitamin D3 derivative for topical use. It is used to treat grade 1-3 acute skin graft versus host disease (GVHD) in hematopoietic stem cell transplant (HSCT) recipients. Calcipotriene will be used as the exclusive topical therapy in addition to standard of care GVHD treatment prescribed for the study subject by the primary physician.

Full Title of Study: “Clinical Effectiveness of Calcipotriene in Acute Graft Versus Host Disease of the Skin: A Pilot Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: March 4, 2019

Detailed Description

Acute skin GVHD affects about one third of pediatric and adult transplant recipients. Chronic GVHD (cGVHD) affects 40-60% of adult patients who have undergone allogeneic HSCT. It is a major cause of non-relapse mortality and morbidity. Systemic prednisone is the first-line treatment for cGVHD; however, about one-half of all patients do not respond to this initial therapy, and there is no standard second-line therapy. Immunosuppressive therapy used for treatment of GVHD brings significant risk of infection, poorly affecting clinical outcomes.

Vitamin D affects immunoregulation, fibroblast proliferation, collagen synthesis and endothelial cell function, and the investigators hypothesize that topical vitamin D application will have a positive effect on acute and chronic skin GVHD. The investigators hypothesize that topical vitamin D cream may restore normal cell function and decrease the use of steroid creams in acute GVHD of the skin.

Interventions

  • Dietary Supplement: Calcipotriene
    • Topical vitamin D cream will be applied to affected areas of the skin.

Arms, Groups and Cohorts

  • Experimental: Calcipotriene
    • Patients will apply Calcipotriene cream 2 times per day for 7 days.

Clinical Trial Outcome Measures

Primary Measures

  • GVHD Grade
    • Time Frame: 7 days
    • Change in GVHD grade over 7 days. GVHD grade based on Glucksberg criteria

Participating in This Clinical Trial

Inclusion Criteria

  • HSCT recipients with acute Grade I through III GVHD based on Glucksberg criteria. Recipients of multiple transplants are still eligible to participate in this research study.
  • Each study subject is to have calcium and vitamin D level prior to starting study, if not obtained within 30 days of beginning treatment.

Exclusion Criteria

  • Patient with active cellulitis at the start of the treatment.
  • Patients with hypercalcemia or vitamin D levels above 100 μg/L.
  • Patients with known allergy to any of the topical therapy components.
  • Patients who have received previous treatment with topical vitamin D cream.

Gender Eligibility: All

Minimum Age: 3 Months

Maximum Age: 35 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Children’s Hospital Medical Center, Cincinnati
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Gregory Wallace, DO, Principal Investigator, Children’s Hospital Medical Center, Cincinnati

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.