Characteristics and outcomes for participants with congenital ichthyosis who responded to treatment with the topical isotretinoin formulation TMB-001: results from the Phase IIb CONTROL study

This analysis from the randomized Phase IIb CONTROL study investigated the characteristics of participants [at least 9 years of age with genetically confirmed congenital ichthyosis and at least 2 (out of 4) Visual Index for Ichthyosis Severity (VIIS) assessment areas with at least a scaling score of 3)] who responded to treatment with TMB-001, a novel topical isotretinoin ointment formulation. Baseline demographics were generally similar among participants who did or did not achieve TMB-001 treatment success, and higher baseline Dermatology Life Quality Index and Itch-Numeric Rating Scale scores were associated with participants achieving treatment success. Lower body surface area involvement was also associated with TMB-001 treatment success. Background Emollients and keratolytics are frequently used to manage symptoms of congenital ichthyosis (CI). Systemic retinoid treatment is complicated by teratogenicity and dose-limiting adverse effects. Objectives This analysis from the randomized Phase IIb CONTROL study investigated the characteristics of participants who responded to treatment with TMB-001, a novel topical isotretinoin ointment formulation. Methods Participants >= 9 years of age with genetically confirmed CI and >= 2 (out of 4) Visual Index for Ichthyosis Severity (VIIS) assessment areas with >= 3 scaling score were randomized 1 : 1 : 1 to TMB-001 0.05%, TMB-001 0.1% or vehicle, twice daily for 12 weeks. Efficacy endpoints included the proportion of participants with >= 50% reduction in VIIS-scaling (VIIS-50) compared with baseline and >= 2-grade reduction in Investigator's Global Assessment (IGA)-scaling score compared with baseline. Changes in body surface area (BSA) involvement, Dermatology Life Quality Index (DLQI) scores and Itch-Numeric Rating Scale (I-NRS) scores were assessed. Results Among the 33 participants (11 randomized to TMB-001 0.05%, 10 to TMB-001 0.1% and 12 to vehicle), median age was 29 years (range 9-80), and most were male (64%) and White (79%). Baseline demographics were generally similar among participants who did or did not achieve TMB-001 treatment success. Participants who had lower mean BSA involvement and higher DLQI and I-NRS scores at baseline were more likely to achieve VIIS-50. Similarly, higher baseline DLQI and I-NRS scores were associated with IGA response; BSA involvement was similar for IGA responders vs. nonresponders. Conclusions Higher DLQI and I-NRS scores at baseline were associated with participants achieving treatment success by VIIS-50 and IGA response. Lower BSA involvement was associated with VIIS-50 success.

Automated summary

This study analyzed the characteristics of participants who responded to treatment with TMB-001, a novel topical isotretinoin ointment formulation, in the CONTROL study. Baseline demographics did not affect treatment success, but higher baseline Dermatology Life Quality Index and Itch-Numeric Rating Scale scores were associated with success. Lower body surface area involvement was also linked to treatment success.