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CTRI Number  CTRI/2022/11/047272 [Registered on: 14/11/2022] Trial Registered Prospectively
Last Modified On: 23/10/2023
Post Graduate Thesis  No 
Type of Trial  BA/BE 
Type of Study    
Study Design  Other 
Public Title of Study   Comparison of Tretinoin Cream 0.025% from Encube Ethicals Pvt. India Ltd with RETIN-A (Tretinoin) Cream, 0.025% (Bausch Health US, LLC Bridgewater, NJ 08807 USA) and placebo in the treatment of acne vulgaris. 
Scientific Title of Study   A Randomized, Double-Blind, Multicenter, Three arm, Active and Placebo-Controlled, Parallel Design Study to Evaluate the Bioequivalence (with Clinical Endpoint) of Tretinoin Cream USP, 0.025% of Encube Ethicals Pvt. Ltd., India Versus RETIN-A® (Tretinoin) Cream, 0.025% of Bausch Health US, LLC Bridgewater, NJ 08807 USA in Subjects with Acne Vulgaris.  
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
Protocol No.: C2A02283 Version: 01 Date: 09 Aug 2022  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Dharmesh Domadia 
Designation  Vice President Global Clinical Operation 
Affiliation  Cliantha Research Limited 
Address  TP 86, FP 28/1, Off S.P. Ring Road, Sarkhej, Ahmedabad - 382 210, Gujarat, India

Ahmadabad
GUJARAT
382210
India 
Phone  9879590828  
Fax    
Email  ddomadia@cliantha.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Ankesh Barnwal 
Designation  Associate Director- I– Clinical Trial Medical Services 
Affiliation  Cliantha Research Limited 
Address  TP 86, FP 28/1, Off S.P. Ring Road, Sarkhej, Ahmedabad - 382 210, Gujarat, India

Ahmadabad
GUJARAT
382210
India 
Phone    
Fax    
Email  abarnwal@cliantha.com  
 
Details of Contact Person
Public Query
 
Name  Mr Devesh Verma 
Designation  Associate Director-I - Clinical Trials 
Affiliation  Cliantha Research Limited 
Address  TP 86, FP 28/1, Off S.P. Ring Road, Sarkhej, Ahmedabad - 382 210, Gujarat, India

Ahmadabad
GUJARAT
382210
India 
Phone    
Fax    
Email  dverma@cliantha.com  
 
Source of Monetary or Material Support  
Encube Ethicals Private Limited, Unit No. 24, Steelmade Industrial Estate, Marol Village, Andheri (E), Mumbai-400 059, Maharashtra, India. 
 
Primary Sponsor  
Name  Encube Ethicals Private Limited 
Address  Unit No. 24, Steelmade Industrial Estate, Marol Village, Andheri (E), Mumbai-400 059, Maharashtra, India. 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
Cliantha Research Limited  TP 86, FP 28/1, Off S.P. Ring Road, Sarkhej, Ahmedabad - 382 210, Gujarat, India 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 20  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Daxesh Patel  Anand Multispeciality Hospital   onsulting Room No. 04, Ground floor, Beside IOCL Petrol pump, near Gorwa ITI, Vadodara – 390016, Gujarat, India
Vadodara
GUJARAT 
9986018087

dax_rd@yahoo.com 
Dr Neetu Sidana  Apex Hospitals Pvt. Ltd.  SP - 4 & 6, MlA, Malviya Nagar, Room No:3, Basement, Dermatology Department, Main building Jaipur - 302017, Rajasthan, lndia.
Jaipur
RAJASTHAN 
9314661504

drneetusidhana95@gmail.com 
Dr Trupti Desale  Assured Care Plus Hospital  Star Plus Complex, 4th and 5th, Lam Road, Opp. to NMC,Divisional Office, Near Muktidham Temple, Nasik Road,Nashik – 422101, Maharashtra, India
Nashik
MAHARASHTRA 
9595789893

drtruptis232@gmail.com 
Dr Rashmi Mahajan  Baroda ENT & Skin Center  2nd Floor, Siddharth Crest, Nizampura Main Rd, Vadodara -390024, Gujarat, India
Vadodara
GUJARAT 
9227676607

rsoodmahajan@gmail.com 
Dr Bhavarth Kalaria  Care and Cure Multispeciality Hospital  Besides Nilamkunj Society, Nr. Gokulnathji Haveli, Mira Cinema Cross Road, Bhairavnath, Maninagar, Ahmedabad, Gujarat 380028, India.
Ahmadabad
GUJARAT 
8866220033

bhavarthkalaria@gmail.com 
Dr Shrinivas Yadav  Ford Hospital  Balaji Colony, Samneghat, Varanasi - 221005, Uttar Pradesh, India
Varanasi
UTTAR PRADESH 
7058349029

dermahealth2015@gmail.com 
Dr Nipul Vara  Government Medical College and Sir Sayajirao General Hospital  Ground floor, Department of Dermatology, Jail Road, Indira Avenue, Sayajigunj, Vadodara – 390001, Gujarat
Vadodara
GUJARAT 
9426074084

nipulvara@gmail.com 
Dr DoiMo Shadab M Rafik Ahmedbhai  HCC (Happiness Care and Cure) Multispeciality Hospital LLP.  302,303,305 & 407 Shital Varsha mall - 5, Shivranjani cross road, Ahmedabad -380015, Gujarat, India.
Ahmadabad
GUJARAT 
9104040404

drshdab.cr@gmail.com 
Dr Saurabh Kapadiya  Kanoria Hospital & Research Centre   Airport-Gandhinagar Highway, Village - Bhat, Gandhinagar - 382428, Gujarat, India
Gandhinagar
GUJARAT 
9824261031

dr.saurabhkapadia@yahoo.com 
Dr Bhavik Bhavsar  Lavanya Skin Clinic & Laser Center  Room no:-303,3rd floor PI OPD Room, Lavanya Skin Clinic & Laser Center, 303, Aishwarya complex, Jawahar chowk, opp. Shell petrol Pump, Maninagar , Ahmedabad, Gujarat,
Ahmadabad
GUJARAT 
9825953263

bhavikbhavsar78@gmail.com 
Dr Anshul Warman  Netaji Polyclinic  Block No. 50, Meghaninagar Last Bus Stop, Meghaninagar, Ahemdabad – 382475, Gujarat India
Ahmadabad
GUJARAT 
9426064246

anshulwarman@rediffmail.com 
Dr Manjunath Shenoy  Omega Hospital  Room No: B11, Basement, Mahaveer Circle, Kankanady, Mangalore - 575002, Karnataka, India
Bangalore
KARNATAKA 
9845009976

manjunathshenoy.dermatology@gmail.com 
Dr Kishan Ninama  Rudra Multispeciality Hospital  1st and 2nd floor, Narayan Resi Complex, near Vaikunth Township, Gate No. 02, Khodiyar Nagar, New VIP Road, Vadodara – 390018, Gujarat, India
Vadodara
GUJARAT 
9099025287

drkishanninama.dermatologist@gmail.com 
Dr Neela Patel  Sheth L. G Municipal General Hospital  Near Rambaug, Maninagar
Ahmadabad
GUJARAT 
9824058208

patelneela1974@yahoo.co.in 
Dr Swati Engineer  Shraddha Multispeciality Hospital   Vaibhav Complex, Near Municipal Hospital, Kalol, Gandhinagar – 382721, Gujarat, India
Gandhinagar
GUJARAT 
9824021254

srengineer6@gmail.com 
Dr Shyamal Balki  Shree Hospital and Critical Care Center  799, OM Nagar, Opposite Tajshree Building, Sakkardara Square, Nagpur Maharashtra-440009
Nagpur
MAHARASHTRA 
9850853253

drshyamalb@gmail.com 
Dr Milap Jolapara  Shubham Multispeciality Hospital  ABC Complex, Rabari Colony Char Rasta, N. H. No. 8, Amraiwadi, Ahmedabad-380026, Gujarat, India
Ahmadabad
GUJARAT 
9825926996

shubhamclinicalresearch@gmail.com 
Dr Rashmi Singh  Shubham Sadbhawana Super Speciality Hospital  OPD Room,1st Floor, Shubham Sudbhawana Super Speciality Hospital, B31/80, 23B-Bhogabir, Lanka Varanasi-221005, Uttar Pradesh, India Varanasi Uttar Pradesh.
Varanasi
UTTAR PRADESH 
9386233538

sweetrashmi4364@gmail.com 
Dr Arpitha Shettar  Sushruta Multispeciality Hospital & Research Centre PVT. LTD  P.B Road, Vidyanagar, Hubbali-580021
Bangalore
KARNATAKA 
8217356417

arpithar24@gmail.com 
Dr Chetan Kakadiya  Velocity Multispecialty Hospital   VHM healthcare & Research Center LLP, 3rd Floor, Velocity business Hub, Near Madhuvan Circle, LP Savani Road, PAL, Surat - 395009, Gujarat, India
Surat
GUJARAT 
9925714269

dr.chetankakadiya@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 20  
Name of Committee  Approval Status 
AMC MET Ethics Committee  Approved 
Anand Institutional Ethics Committee  Approved 
Anand Institutional Ethics Committee  Approved 
Anand Institutional Ethics Committee  Approved 
Ford Hospital Ethics Committee  Approved 
Institutional Ethics Committee Apex Hospitals Private Limited  Approved 
Institutional Ethics Committee For Human Research  Approved 
Kanoria Ethics Committee  Approved 
Omega Ethical Committee  Approved 
Parth Hospital Ethics Committee  Approved 
Parth Hospital Ethics Committee  Approved 
Parth Hospital Ethics Committee  Approved 
Riddhi Medical Nursing Home IEC  Approved 
Riddhi Medical Nursing Home IEC   Approved 
Shree Hospital Ethics Committee  Approved 
Shubham Institutional Ethics Committee  Approved 
Shubham Sudbhawana Super. Hosp. Ethics Committee  Approved 
Sushruta Hospitals Ethics Committee  Approved 
VMH Institutional Ethics Committee  Approved 
YashSocietysSujata Birla Hospital Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: L700||Acne vulgaris,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Placebo Cream (vehicle) for Tretinoin Cream USP, 0.025% of Encube Ethicals Private Limited, India   Subjects or guardian will be instructed to apply a small amount of IP topically once daily at bedtime for 84 consecutive days from Day 0 as per randomization schedule  
Comparator Agent  RETIN-A® (Tretinoin) Cream, 0.025%,   Subjects or guardian will be instructed to apply a small amount of IP topically once daily at bedtime for 84 consecutive days from Day 0 as per randomization schedule  
Intervention  Tretinoin Cream USP, 0.025% of Encube Ethicals Pvt. Ltd., India  Subjects or guardian will be instructed to apply a small amount of IP topically once daily at bedtime for 84 consecutive days from Day 0 as per randomization schedule  
 
Inclusion Criteria  
Age From  12.00 Year(s)
Age To  40.00 Year(s)
Gender  Both 
Details  Subjects will be eligible for inclusion in this study only if all of the following criteria apply:
1. Male or non-pregnant, non-lactating female aged ≥ 12 and ≤ 40 years with a clinical diagnosis of acne vulgaris.
2. On the face, ≥ 25 non-inflammatory lesions (i.e., open and closed comedones) AND ≥ 20 inflammatory lesions (i.e., papules and pustules) AND ≤ 2 nodulocystic lesions (i.e., nodules and cysts).
3. Investigator’s Global Assessment (IGA) of acne severity grade 2, 3 OR 4 (Refer Table 8-2).
4. Willing and able to refrain from use of all other topical products, all acne medications and all antibiotics (other than study treatment) during the 12-week treatment period.
5. Willing to provide written informed consent or assent (as applicable).
6. If female of childbearing potential, willing to use an acceptable form of birth control during the entire study duration.
7. Have used the same brand of make-up for a minimum period of 2 weeks prior to randomization, for subjects who use make-up and agree to not change make-up brands or types during the study.
8. Subject who received COVID-19 vaccine should have recovered from vaccine related side effects prior to screening.
 
 
ExclusionCriteria 
Details  Subjects will be eligible for inclusion in this study only if all of the following criteria apply:
1. Male or non-pregnant, non-lactating female aged ≥ 12 and ≤ 40 years with a clinical diagnosis of acne vulgaris.
2. On the face, ≥ 25 non-inflammatory lesions (i.e., open and closed comedones) AND ≥ 20 inflammatory lesions (i.e., papules and pustules) AND ≤ 2 nodulocystic lesions (i.e., nodules and cysts).
3. Investigator’s Global Assessment (IGA) of acne severity grade 2, 3 OR 4 (Refer Table 8-2).
4. Willing and able to refrain from use of all other topical products, all acne medications and all antibiotics (other than study treatment) during the 12-week treatment period.
5. Willing to provide written informed consent or assent (as applicable).
6. If female of childbearing potential, willing to use an acceptable form of birth control during the entire study duration.
7. Have used the same brand of make-up for a minimum period of 2 weeks prior to randomization, for subjects who use make-up and agree to not change make-up brands or types during the study.
8. Subject who received COVID-19 vaccine should have recovered from vaccine related side effects prior to screening.

Exclusion Criteria:

Subjects will not be eligible for inclusion in this study if any of the following criteria apply:
1. Female who is breastfeeding, pregnant or planning to become pregnant.
2. Subject who has acne conglobata, acne fulminans, nodulocystic acne and secondary acne (e.g., chloracne and drug induced acne).
3. Subject who has clear symptoms of severe or intense irritation on the face.
4. Presence of any skin condition that would interfere with the diagnosis or assessment of acne vulgaris (e.g., on the face: rosacea, dermatitis, psoriasis, squamous cell carcinoma, eczema, acne form eruptions caused by medications, steroid acne, steroid folliculitis, or bacterial folliculitis).
5. Excessive facial hair (e.g., beards, sideburns, moustaches, etc.) that would interfere with the diagnosis or assessment of acne vulgaris. Well-trimmed moustaches are allowed.
6. History of hypersensitivity or allergy to tretinoin, retinoids, or any of the investigational product ingredients.
7. Use within 6 months prior to the baseline of oral retinoids (e.g., Accutane®) or therapeutic Vitamin A supplements of greater than 10,000 units/day (multivitamins are allowed).
8. Use for less than 3 months prior to the baseline of estrogens or oral contraceptives; use of such therapy must remain constant throughout the study.
9. Use on the face within 1 month prior to baseline of 1) Cryodestruction or Chemodestruction, 2) Dermabrasion, 3) Photodynamic therapy, 4) Acne surgery, 5) Intralesional steroids, or 6) X-ray therapy.
10. Use within 1 month prior to baseline of 1) Spironolactone 2) Systemic steroids 3) Systemic (e.g., oral or injectable) antibiotics 4) Systemic treatment for acne vulgaris (other than oral retinoids which require a 6-month washout) or 5) Systemic anti-inflammatory agents or immunosuppressive drugs.
11. Use within 2 weeks prior to baseline of 1) Topical steroids, 2) Topical retinoid 3) Topical acne treatments including over-the-counter preparations 4) Topical anti-inflammatory agents, or 5) Topical antibiotics 6) Astringents and toners 7) abradants, facials, peels containing glycolic or other acids 8) masks 9) washes or soaps containing benzoyl peroxide, salicylic acid, or sulfacetamide sodium 10) non-mild facial cleansers 11) moisturizers that contained retinol 12) moisturizers that contained retinol, salicylic acid or α- or β-hydroxy acids.
12. Concomitant use/planned to use of mega-doses of certain vitamins (such as vitamin D [> 2000 IU/day], vitamin B6 [> 2 mg/day] and vitamin B12 [> 1 mg/day]), haloperidol, halogens such as iodide and bromide, lithium, hydantoin and phenobarbital.
13. A significant medical history of or are currently immunocompromised or receiving immunomodulators/biologics since last 3 months.
14. Subject who has been treated with an investigational product or investigational device within a period of 30 days prior to study enrollment.
15. Have any systemic or dermatologic disease that may affect the evaluation of study results.
16. Subject who has been previously enrolled in this study.
17. Subject who engage in activities that involve excessive or prolonged exposure to sunlight or weather extremes, such as wind or cold.
18. Current drug abuse (including, but not limited to, cannabinoids and cocaine) or alcohol abuse (greater than two drinks per day) or relevant abuse history (within the past year).
19. Subject with any application site reaction assessment score 3 (severe, marked/intense). (Refer to Table 8-3)
20. Use of Anti-pruritic, including antihistamines, within 24 hours of baseline visit.
21. Use of tanning booths or tanning lamps within one week prior to baseline and an unwillingness to refrain from use during the study.
22. Subject with clinically significant unstable medical disorders, life-threatening disease, or current malignancies.
23. Subject with signs and symptoms suggestive of COVID 19 infection.
24. Institutionalized subject.
25. Living in the same household of a subject who is currently participating or living in the same household of a subject who has previously participated in the study.
26. Clinically significant abnormal findings or condition (other than acne vulgaris), which might, in the opinion of the Investigator, interfere with study evaluations or pose a risk to subject safety during the study.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Centralized 
Blinding/Masking   Participant and Investigator Blinded 
Primary Outcome  
Outcome  TimePoints 
Mean percent change from baseline to Week 12 (Day 84) for inflammatory (papules and pustules) lesion count.
2. Mean percent change from baseline to Week 12 (Day 84) in the non-inflammatory (open and closed comedones) lesion count.
 
Mean percent change from baseline to Week 12 (Day 84) 
 
Secondary Outcome  
Outcome  TimePoints 
Proportion of subjects with a clinical response (IGA) of “Success” at Week 12.

Note: Success will be defined as an IGA score that is at least 2 grades less than the baseline assessment. Failure will be defined as an IGA score that is the same, higher or one grade lower than the baseline assessment.
 
Change from baseline to Week 12 (Day 84) 
 
Target Sample Size   Total Sample Size="1060"
Sample Size from India="1060" 
Final Enrollment numbers achieved (Total)= "1060"
Final Enrollment numbers achieved (India)="1060" 
Phase of Trial   N/A 
Date of First Enrollment (India)   15/11/2022 
Date of Study Completion (India) 14/08/2023 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="11"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   Nill 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

This clinical trial intended to Evaluate the Efficacy and Safety of Tretinoin cream USP, 0.025%) of Encube Ethicals Pvt. Ltd., India with reference product (RETIN-A® Cream, 0.025%) of Bausch Health US, LLC Bridgewater, NJ 08807 USA. in Subjects with Acne Vulgaris.

 

Objectives:

 

1.      To evaluate bioequivalence (with clinical endpoint) of test product (Tretinoin Cream USP, 0.025%) of Encube Ethicals Pvt. Ltd., India with reference product (RETIN-A® Cream, 0.25%) of Bausch Health US, LLC Bridgewater, NJ 08807 USA.

2.      To evaluate the superiority in efficacy of test and reference products over the placebo.

3.      To assess safety and tolerability of the study treatments.  

 

Number of Subjects:

 

Approximately 1060 subjects shall be enrolled/randomized into the study with 2:2:1 allocation ratio (i.e. Test product: 424 subjects, Reference product: 424 subjects and Placebo: 212 subjects).

 

Clinical evaluations will be performed at the following visits:

Visit 1#: Screening visit (Up to 3 Days prior to Randomization)

Visit 2#/ Day 0: Baseline / Randomization visit

Visit 3/ Week 2/ Day 14 (± 2 days): Interim Visit

Visit 4/ Week 4/ Day 28 (± 2 days): Interim Visit

Visit 5/ Week 8/ Day 56 (± 4 days): Interim Visit

Visit 6/ Week 12/ Day 84 (± 4 days): End of Treatment Visit *

# Visit 1 & 2 activities can be performed on same day. Common

activities will be performed only once.

*Activities to be performed in case of early termination as per end

of treatment visit.

Safety Follow-up/ End of Study: 7 days (± 2 days) after the last

application of study treatment. It may be performed telephonically

or subject may visit the study site. 
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