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OtomycosisPhase 2/3NCT04432376

Efficacy and Safety Study of Miconazole Oil Versus Vehicle on Fungal Infection of the Ear Canal (Otomycosis)

A Phase 2/3 study testing miconazole 2% oil in people with Otomycosis, run by Hill Dermaceuticals, Inc. at 12 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study involves two portions, a randomized, double-blind portion and an open-label portion, to evaluate the efficacy and safety of Miconazole oil 2% versus its Vehicle in the treatment of fungal infection of the outer ear canal (Otomycosis). Read more about this study

Who is it for?
Ages 7 years and olderHealthy volunteers can take part
Conditions the study is for
Otomycosis
What is being tested?
miconazole 2% oil
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
382 participants
Where
12 sitesUnited States
Study dates
8 Jul 2020to 1 Nov 2021
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 7 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Randomized blinded initial phase of study:
  • Male or non-pregnant, non-lactating females with a clinical diagnosis of uncomplicated otomycosis of the external ear only,
  • Intact tympanic membrane in the ear(s) to be treated with study drug,
  • In general good health as determined by medical examination and medical history,
  • Free of clinically significant disease, including diabetes mellitus, that is not well-controlled or that could interfere with the study.
  • Open-label second phase of study:
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  • Male or non-pregnant, non-lactating females with an intact tympanic membrane in the ear(s) to be treated with study drug,
  • In general good health as determined by medical examination and medical history,
  • Free of clinically significant disease, including diabetes mellitus, that is not well-controlled or that could interfere with the study.

Who cannot join

  • Presence of dermatoses or conditions of the ear that may interfere with evaluation of otomycosis or with safety evaluations, including concomitant otic infections that require antimicrobial treatment,
  • Disease that has spread beyond the external ear(s), or pre-existing skin atrophy of the affected ear(s);
  • Tympanostomy tube or perforated tympanic membrane;
  • History of prior surgery directly affecting and compromising the external auditory canal and/or tympanic membrane, except for prior tympanostomy tube(s) that have already been removed and completely healed;
  • Use of any topical medicated treatments for otomycosis within 14 days of study entry;
  • Use of any systemic antifungal therapy within 28 days of study entry, warfarin within 28 days of study entry, immunosuppressive or immune-stimulating drugs within 28 days of study entry, or systemic steroids within 3 months of study entry;
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  • Fever of ≥100°F at study entry;
  • Otomycosis that has been unresponsive to previous antifungal treatment;
  • Known hypersensitivity to any of the components in the test formulation;
  • Participation in another investigative trial within 28 days of study entry

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United States12 sites
  • Head and Neck Surgery Specialists

    Chula Vista, California, 91910

  • University of Missouri

    Columbia, Missouri, 65212

  • OnSite Clinical Solutions

    Dillon, South Carolina, 29536

  • West Houston Clinical Research Services

    Houston, Texas, 77055

  • UCSD

    La Jolla, California, 92037

  • Lake ENT & FPS

    Leesburg, Florida, 34748

  • Advanced ENT & Allergy

    Louisville, Kentucky, 40220

  • DelRicht Research

    New Orleans, Louisiana, 70124

  • Carolina ENT

    Orangeburg, South Carolina, 29118

  • Research Your Health

    Plano, Texas, 75093

  • DaVinci Research, LLC

    Roseville, California, 95661

  • Sacramento ENT / DaVinci Research

    Sacramento, California, 95815

Other trials in United States

About this study

Official title: Randomized, Double-blind, Phase III Study of the Efficacy and Safety of Miconazole Oil Versus Vehicle Oil in the Treatment of Otomycosis, Followed by an Open-label Safety Evaluation

This study involves two portions, a randomized, double-blind portion and an open-label portion, to evaluate the efficacy and safety of Miconazole oil 2% versus its Vehicle in the treatment of fungal infection of the outer ear canal (Otomycosis). The subjects randomized in the first portion of the study will have active fungal infection of the ear(s) and will be treated with either Miconazole Oil or the Vehicle for 14 days twice daily, 5 drops into the affected ear(s) per dose. The subjects enrolled in the open-label portion of the study may or may not have active fungal infection of the ear(s), and will be given the Miconazole Oil active drug following the same application of 5 drops into the ear(s) twice daily for 14 days.

The intention of the study is to evaluate the efficacy of Miconazole Oil on fungal infection of the ears when applied using 5 drops into the ear(s) twice daily for 14 days continuously. This study also intends to show safety of Miconazole Oil 5 drops into each ear twice a day for 14 consecutive days.

Read the detailed description

This study will be conducted in 2 portions:

  1. Enrollment A, which will consist of 2 treatment periods as follows and will be conducted in subjects with otomycosis:
  2. A randomized, double-blind, parallel-group treatment period. This treatment period will be referred to as the "Randomization Period" and will be followed by:
  3. An optional, open-label treatment period with miconazole oil. This treatment period will be referred to as the "Optional Open-label Extension."
  4. Enrollment B will consist of open-label treatment with miconazole oil in subjects who will not be required to have signs and symptoms of otomycosis.

The study will start with Enrollment A, with an estimated 220 male or female subjects with otomycosis. Subjects will be randomly assigned in a 1:1 ratio to receive miconazole oil or vehicle (placebo), for 14 days. The study drug will be administered as 5 drops per ear at ~30 mg per drop instilled into the external ear canal of the ear(s) affected by otomycosis.

In the Randomization Period, both the subject and the investigator and study staff are blinded to the contents of the study drug.

At Screening/Baseline (Day 1), assessment of the signs and symptoms of otomycosis (pruritus, debris, visual examination for presence of fungal elements, and aural fullness), evaluation of medical history, pregnancy screening in female of childbearing potential, and, prior and concomitant medications, will be collected. Subjects with positive signs and symptoms of otomycosis and who meet all eligibility criteria will enter the study. Fungal culture of affected ear(s) will be taken, debris will be cleaned from the affected ear(s), and subject will be randomized and study drug dispensed. Treatment will be for 14 days. Day 8 On Treatment Visit will include clinical evaluation of otomycosis, cleaning of ear(s), and assessment of Adverse Events (AEs) and concomitant medications, and continue treatment up to Day 14. Day 15 End of Treatment Visit will include clinical evaluation of otomycosis and fungal culture, adverse events including Treatment emergent adverse events (TEAEs) and concomitant medications assessed. Day 22 Test of Cure Visit is an assessment of clinical signs and symptoms of otomycosis and fungal culture, AEs and concomitant medications assessed, and urine pregnancy test performed in women of childbearing potential.

Only the subjects that had positive fungal (mycological) culture at Baseline will be evaluated for efficacy. This is the Modified intent-to-treat (MITT) population.

The Optional Open-label Extension period will allow subjects to get miconazole oil for 14 days. No unblinding of the subject's treatment in the Randomization Period will occur at this time.

For Enrollment B, male or female subjects will be enrolled to receive miconazole oil to use for 14 days and will be evaluated for safety.

Intent-to-Treat (ITT) population are all subjects enrolled and randomized to treatment. Modified Intent-to-Treat (MITT) population are subjects in the ITT population with a clinical diagnosis of otomycosis confirmed by positive fungal culture at Baseline.

Conditions
Otomycosis
Being tested
miconazole 2% oil, vehicle oil
Medical subject headings
Otomycosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • miconazole 2% oilDrug

    Also called active treatment

    Drug treatment of otomycosis for 14 days

  • vehicle oilDrug

    Also called placebo treatment

    Placebo treatment of otomycosis for 14 days

Study groups in NCT04432376
Study groupRoleWhat they receive
Active treatment armActive comparatorTreatment with miconazole 2% oil, 5 drops into each ear twice daily for 14 consecutive days
Receives: Drug: miconazole 2% oil
Placebo treatment armPlacebo comparatorTreatment with the vehicle oil, placebo, 5 drops into each ear twice daily for 14 consecutive days
Receives: Drug: vehicle oil
Open-label treatment armOtherApplication of miconazole 2% oil, 5 drops into each ear twice daily for 14 consecutive days
Receives: Drug: miconazole 2% oil

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Subjects With Therapeutic Cure

    "therapeutic cure" is "mycological cure" plus "clinical cure, in the Modified intent to treat (MITT) only: patients with + fungal culture at baseline. Fungal culture results verified as (+) or (-) after enrollment.

    Intent to treat (ITT) population were all subjects enrolled and randomized. Active group: ITT=89 (100%), MITT=67 (75.3%); Placebo Group: ITT=90 (100%), MITT=64 (71.1%).

    Mycological cure is a negative mycological culture (culture is either positive or negative). Score=0 is best.

    Clinical cure is absence of all otomycosis signs and symptoms (s/s) of Pruritus, Debris, and Aural fullness, graded as (scores) 0=none, 1=mild, 2=moderate, 3=severe; and Presence of fungal elements, score 0=No fungal elements, 1=fungal elements present on visual inspection. Score=0 is best.

    Efficacy analysis was performed only on MITT (modified intent-to-treat) population, consisting of only those patients that had positive fungal culture at Baseline.

    Measured: 21 days from first day of drug application

Secondary outcomes (2)
  1. Percentage of Subjects With Mycological Cure

    Mycological cure is a negative mycological culture for the study ear at test of cure visit, in Modified intent to treat (MITT) only: patients with + fungal culture at baseline. Subjects that had negative fungal culture at Baseline were not included in MITT. Fungal culture results verified as (+) or (-) after enrollment.

    Grading is based on positive or negative mycological (fungal) culture. Negative culture is required.

    Efficacy analysis was performed only on MITT (modified intent-to-treat) population, consisting of only those patients that had positive fungal culture at Baseline.

    Intent to treat (ITT) population were all subjects enrolled and randomized. Active group: ITT=89 (100%), MITT=67 (75.3%); Placebo Group: ITT=90 (100%), MITT=64 (71.1%).

    Measured: 21 days from first day of drug application

  2. Percentage of Subjects With Clinical Cure

    Absence of all otomycosis signs and symptoms according to the scales for each individual sign/symptom. Score=0 is best.

    Clinical cure is absence of all otomycosis signs and symptoms of Pruritus, Debris, and Aural fullness, graded as (scores) 0=none, 1=mild, 2=moderate, 3=severe; and Presence of fungal elements, score 0=No fungal elements, 1=fungal elements present on visual inspection. Score=0 is best.

    Efficacy analysis was performed only on MITT (modified intent-to-treat) population, consisting of only those patients that had positive fungal culture at Baseline. Subjects that had negative fungal culture at Baseline were not included in MITT. Fungal culture results verified as (+) or (-) after enrollment.

    ITT (intent to treat) population were all subjects enrolled and randomized. Active group: ITT=89 (100%), MITT=67 (75.3%); Placebo Group: ITT=90 (100%), MITT=64 (71.1%).

    Measured: 21 days from first day of drug application

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jun 2020
  2. Study start8 Jul 2020
  3. Primary completion1 Nov 2021
  4. Study completion1 Nov 2021

Resources

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Two phases; initial is randomized double-blind active vs placebo on a pre-determined number of subjects with otomycosis, to finish before starting second phase. Second phase is open-label use on diseased or healthy subjects to evaluate safety. Subjects from initial phase may crossover to second phase open-label if they meet the requirements, and new diseased or healthy subjects meeting requirements may enroll in this open-label phase.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
382 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04432376
Sponsor's protocol ID
MZ-0120-ESP3-052
Status last verified
Jan 2024
First submitted
11 Jun 2020
Last updated
19 Jan 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing miconazole 2% oil in people with Otomycosis, run by Hill Dermaceuticals, Inc. at 12 sites in United States.

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 9 inclusion and 10 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 19 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States. 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.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Nov 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Percentage of Subjects With Therapeutic Cure (time frame: 21 days from first day of drug application). 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 19 Jan 2024.

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