Alopecia AreataNCT01246284
The Efficacy and Safety of Different Concentrations of Localized Injections of Steroids in the Treatment of Alopecia Areata
A study testing Triamcinolone acetonide and Normal saline in people with Alopecia Areata, run by University of British Columbia at 1 site in Canada.
Trial summary
Alopecia areata (AA) is a disease characterized by areas of hair loss. Localized steroid injections is the standard treatment for limited disease. There are no existing studies that compare different concentrations of steroids in the treatment of AA. Read more about this study
- Who is it for?
- Ages 19 years and older
- Conditions the study is for
- Alopecia Areata
- What is being tested?
- Triamcinolone acetonide and Normal saline
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 5 participants
- Where
- 1 siteCanada
- Study dates
- Dec 2010to Jul 2014
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age > 18 years
- Less than 50% scalp involvement
- Patients should have a patch of at least 4.5 cm in the smallest diameter
Who cannot join
- Current episode of alopecia areata for longer than 2 years
- Evidence of hair regrowth at baseline
- Patients who received treatment with a topical, intralesional, or systemic agent within the past month
- Rapidly progressing disease
- Hypersensitivity to Triamcinolone acetonide or vehicle
- Pregnancy or breast-feeding
Trial locations and contacts
1 site in 1 country.
Canada1 site
The Skin Care Center, Vancouver General Hospital, 835 West 10th Ave
Vancouver, British Columbia
About this study
Official title: Efficacy and Safety of Different Concentrations of Intralesional Triamcinolone Acetonide in Alopecia Areata: A Prospective, Randomized, Double-blind, Placebo-controlled Study
Alopecia areata (AA) is a disease characterized by areas of hair loss. Localized steroid injections is the standard treatment for limited disease. There are no existing studies that compare different concentrations of steroids in the treatment of AA. This study will compare the efficacy and safety of different concentrations of localized steroid injections in the treatment of AA. Six treatment sessions will be done over 6 to 9 months. The investigators will compare the following concentrations: 2,5mg/ml, 5mg/ml, 10mg/ml, and normal saline.
Read the detailed description
Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss with varying degree of severity. It most commonly involves scalp hair. It was estimated to occur in 0.1% to 0.2% of the general population in the united states. Patchy hair loss is the most common pattern seen in AA.
There are many treatment modalities available for AA, however, none of them cure the disease. Given the potential for spontaneous recovery in AA, studies assessing the efficacy of a certain therapeutic modality must be conducted in a controlled fashion. Treatment with intralesional corticosteroids (ILCSs) is considered the first-line therapy in adult patients with less than 50% scalp involvement. Use of ILCSs in AA was first reported by Kalkoff in 1958 using hydrocortisone. There are no published randomized controlled trials on the use of ILCSs in AA. Triamcinolone acetonide (TA) is the most commonly used form of ILCSs. It is characterized by low solubility, being slowly absorbed from the injection site, prompting maximal local action, limiting diffusion and spread through tissue, and not giving rise to systemic side effects if used in therapeutic doses. Use of intralesional (IL) TA in AA was first described by Orentreich et al. in 1960. IL TA is usually used in concentrations ranging from 2.5 to 10 mg/ml. Injections (0.1 ml per injection site) are given intradermally every 4 to 6 weeks. Abell and Munro used IL TA in the treatment of AA of varying degree of severity in 84 patients. The concentration used was 5 mg/ml and injections were given three times every 1 to 2 weeks. Fifteen patients received injections with isotonic normal saline as a control. Seventy one percent of patients with limited AA have shown evidence of regrowth compared to only 7% of patients in the control group. They also noticed that IL TA injections failed in all patients with rapidly progressive disease.
Side effects of IL TA include pain at the injection site, mild bleeding, transient atrophy and telangiectasia, hypopigmentation, hyperpigmentation. Infection is uncommon but caution over bony prominences is recommended. Adrenal suppression is rare when using lower doses. It has been reported in one patient who received a total dose of 22.5 mg in one session and the serum cortisol level normalized after 3 days. It has been shown that TA at a dose of 20 mg does not result in adrenal suppression. Hypersensitivity reactions to TA or the vehicle carboxymethylcellulose are extremely rare.
To our knowledge, there are no prospective studies comparing the efficacy and safety of different concentrations of IL TA in the treatment of AA. Helfman compared the therapeutic effect of different concentrations of IL TA in the treatment of different dermatoses. He included only one patient with localized AA. He injected TA using three different concentrations (2.5, 5, and 10 mg) and a diluent as placebo. Injections were done in 4 different quadrants within the same patch. He noticed that there was an equivalent degree of hair regrowth in the three sites injected with TA, and no regrowth in the site injected with the diluent.
Study Objectives
- To compare the efficacy of different concentrations of IL TA in the treatment of AA.
- To compare the side effect profile of different concentrations of IL TA when used in the treatment of AA.
- Conditions
- Alopecia Areata
- Being tested
- Triamcinolone acetonide, Normal saline
- Keywords
- Alopecia areata, Intralesional, Triamcinolone acetonide, Concentration
- Medical subject headings
- Alopecia Areata
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Triamcinolone acetonideDrug
Injections will be given within a 3 cm2 area of alopecia which will be divided into 4 quadrants. Three different concentrations of triamcinolone acetonide will be used: 2.5, 5, and 10 mg/ml. Each quadrant will receive injections with either triamcinolone acetonide 2.5 mg/ml, triamcinolone acetonide 5 mg/ml, triamcinolone acetonide 10 mg/ml, or normal saline as a control. Injection of 0.1 ml will be given intradermally using a 30 gauge half inch long needle attached to a 3 ml syringe. Each quadrant will receive approximately 7 injections per treatment session so the total dose of triamcinolone acetonide will be around 13 mg. Injections will be given vertically, with the beveled side of the needle directed to the opposite side and 2 mm away from the margin of the adjacent quadrant to avoid a diffusion effect. The treatment will be repeated every 4 to 6 weeks for a total of 6 treatment sessions.
Normal salineOther
| Study group | Role | What they receive |
|---|---|---|
| A | Active comparator | Please note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment Receives: Drug: Triamcinolone acetonide |
| B | Active comparator | Please note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment Receives: Drug: Triamcinolone acetonide |
| C | Active comparator | Please note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment Receives: Drug: Triamcinolone acetonide |
| D | Placebo comparator | Please note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment. Receives: Other: Normal saline |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hair growth
Measured: 4-6 weeks after each treatment session
Secondary outcomes (1)
Side effects
Measured: 4-6 weeks after each treatment session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Nov 2010 (estimated)
- Study startDec 2010
- Primary completionJul 2014
- Study completionJul 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Alopecia AreataStudies of the same condition, open and under way.
- More trials run by University of British ColumbiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 5 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of British Columbia
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jerry Shapiro, MD FRCPC, Principal investigator, University of British Columbia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01246284
- Sponsor's protocol ID
- H10-02231
- Status last verified
- Jun 2015
- First submitted
- 8 Nov 2010
- Last updated
- 8 Jun 2015
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Jun 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy and Safety of Different Concentrations of Intralesional Triamcinolone Acetonide in Alopecia Areata: A Prospective, Randomized, Double-blind, Placebo-controlled Study
- ClinicalTrials.gov ID
- NCT01246284
- Acronym / sponsor ID
- H10-02231
- Conditions
- Alopecia Areata
- Keywords
- Alopecia areata, Intralesional, Triamcinolone acetonide, Concentration
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 5 participants (actual)
- Lead sponsor
- University of British ColumbiaUniversity, hospital or other
- Study start
- Dec 2010
- Primary completion
- Jul 2014 (actual)
- Study completion
- Jul 2014 (actual)
- First posted
- 23 Nov 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Alopecia areata (AA) is a disease characterized by areas of hair loss. Localized steroid injections is the standard treatment for limited disease. There are no existing studies that compare different concentrations of steroids in the treatment of AA. This study will compare the efficacy and safety of different concentrations of localized steroid injections in the treatment of AA. Six treatment sessions will be done over 6 to 9 months. The investigators will compare the following concentrations: 2,5mg/ml, 5mg/ml, 10mg/ml, and normal saline.
Detailed description
Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss with varying degree of severity. It most commonly involves scalp hair. It was estimated to occur in 0.1% to 0.2% of the general population in the united states. Patchy hair loss is the most common pattern seen in AA.
There are many treatment modalities available for AA, however, none of them cure the disease. Given the potential for spontaneous recovery in AA, studies assessing the efficacy of a certain therapeutic modality must be conducted in a controlled fashion. Treatment with intralesional corticosteroids (ILCSs) is considered the first-line therapy in adult patients with less than 50% scalp involvement. Use of ILCSs in AA was first reported by Kalkoff in 1958 using hydrocortisone. There are no published randomized controlled trials on the use of ILCSs in AA. Triamcinolone acetonide (TA) is the most commonly used form of ILCSs. It is characterized by low solubility, being slowly absorbed from the injection site, prompting maximal local action, limiting diffusion and spread through tissue, and not giving rise to systemic side effects if used in therapeutic doses. Use of intralesional (IL) TA in AA was first described by Orentreich et al. in 1960. IL TA is usually used in concentrations ranging from 2.5 to 10 mg/ml. Injections (0.1 ml per injection site) are given intradermally every 4 to 6 weeks. Abell and Munro used IL TA in the treatment of AA of varying degree of severity in 84 patients. The concentration used was 5 mg/ml and injections were given three times every 1 to 2 weeks. Fifteen patients received injections with isotonic normal saline as a control. Seventy one percent of patients with limited AA have shown evidence of regrowth compared to only 7% of patients in the control group. They also noticed that IL TA injections failed in all patients with rapidly progressive disease.
Side effects of IL TA include pain at the injection site, mild bleeding, transient atrophy and telangiectasia, hypopigmentation, hyperpigmentation. Infection is uncommon but caution over bony prominences is recommended. Adrenal suppression is rare when using lower doses. It has been reported in one patient who received a total dose of 22.5 mg in one session and the serum cortisol level normalized after 3 days. It has been shown that TA at a dose of 20 mg does not result in adrenal suppression. Hypersensitivity reactions to TA or the vehicle carboxymethylcellulose are extremely rare.
To our knowledge, there are no prospective studies comparing the efficacy and safety of different concentrations of IL TA in the treatment of AA. Helfman compared the therapeutic effect of different concentrations of IL TA in the treatment of different dermatoses. He included only one patient with localized AA. He injected TA using three different concentrations (2.5, 5, and 10 mg) and a diluent as placebo. Injections were done in 4 different quadrants within the same patch. He noticed that there was an equivalent degree of hair regrowth in the three sites injected with TA, and no regrowth in the site injected with the diluent.
Study Objectives
- To compare the efficacy of different concentrations of IL TA in the treatment of AA.
- To compare the side effect profile of different concentrations of IL TA when used in the treatment of AA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| A | Active comparator | Drug: Triamcinolone acetonidePlease note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment |
| B | Active comparator | Drug: Triamcinolone acetonidePlease note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment |
| C | Active comparator | Drug: Triamcinolone acetonidePlease note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment |
| D | Placebo comparator | Other: Normal salinePlease note that the letter are assigned to different areas of injections within the same patient. All patients will be receiving the same treatment. |
Who may qualify
- Ages
- 19 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Age > 18 years
- Less than 50% scalp involvement
- Patients should have a patch of at least 4.5 cm in the smallest diameter
Key exclusion criteria (6 listed)
- Current episode of alopecia areata for longer than 2 years
- Evidence of hair regrowth at baseline
- Patients who received treatment with a topical, intralesional, or systemic agent within the past month
- Rapidly progressing disease
- Hypersensitivity to Triamcinolone acetonide or vehicle
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Triamcinolone acetonideInjections will be given within a 3 cm2 area of alopecia which will be divided into 4 quadrants. Three different concentrations of triamcinolone acetonide will be used: 2.5, 5, and 10 mg/ml. Each quadrant will receive injections with either triamcinolone acetonide 2.5 mg/ml, triamcinolone acetonide 5 mg/ml, triamcinolone acetonide 10 mg/ml, or normal saline as a control. Injection of 0.1 ml will be given intradermally using a 30 gauge half inch long needle attached to a 3 ml syringe. Each quadrant will receive approximately 7 injections per treatment session so the total dose of triamcinolone acetonide will be around 13 mg. Injections will be given vertically, with the beveled side of the needle directed to the opposite side and 2 mm away from the margin of the adjacent quadrant to avoid a diffusion effect. The treatment will be repeated every 4 to 6 weeks for a total of 6 treatment sessions. | Drug | A, B, C |
| Normal saline | Other | D |
Primary outcome
Hair growth
Time frame: 4-6 weeks after each treatment session
1 secondary outcome
Side effects
Time frame: 4-6 weeks after each treatment session
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jun 2015.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jerry Shapiro, MD FRCPC principal investigator
University of British Columbia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Triamcinolone acetonide and Normal saline in people with Alopecia Areata, run by University of British Columbia at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Jun 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Hair growth (time frame: 4-6 weeks after each treatment session). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jun 2015.