Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
Please note that the ANZCTR website will be unavailable from 1pm until 2pm (AEST) on Tuesday 19th August for website maintenance.
Please be sure to log out of the system in order to avoid any loss of data. Thank you and apologies for any inconvenience caused.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12610000689077
Ethics application status
Approved
Date submitted
19/08/2010
Date registered
20/08/2010
Date last updated
29/11/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised, double-blind, placebo controlled study to assess efficacy of oral nicotinamide (500mg daily) in the treatment and prevention of actinic keratoses.
Query!
Scientific title
Effect of nicotinamide versus placebo on numbers of actinic keratoses
Query!
Secondary ID [1]
252515
0
None
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Actinic keratoses
258004
0
Query!
Condition category
Condition code
Skin
258173
258173
0
0
Query!
Dermatological conditions
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Oral nicotinamide 500mg daily for four months
Query!
Intervention code [1]
257049
0
Treatment: Drugs
Query!
Comparator / control treatment
Placebo tablets (lactose tablets idetical in appearance and size to nicotinamide tablets but without active ingredient) daily for four months.
Query!
Control group
Placebo
Query!
Outcomes
Primary outcome [1]
259034
0
Reduction in total actinic keratosis (AK) count at 2 and 4 months from baseline
Query!
Assessment method [1]
259034
0
Query!
Timepoint [1]
259034
0
2 and 4 months
Query!
Secondary outcome [1]
265295
0
Nil
Query!
Assessment method [1]
265295
0
Query!
Timepoint [1]
265295
0
Nil
Query!
Eligibility
Key inclusion criteria
Men and women > 18 years old.
Symmetrically distributed non-hyperkeratotic AKs on face / scalp/ upper limbs.
Minimum of 4 AKs in one or more treatment areas.
Patients have received no other treatments for AKs within the last month.
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
Yes
Query!
Key exclusion criteria
Under 18 years old
Pregnant or lactating
Taking immunosuppressive or photosensitising medications
Immune suppressive concurrent illness (eg, human immunodeficiency virus- HIV- infection)
Malignancy (excluding nonmelanoma skin cancer) in the previous 5 years
Taking nicotinamide supplements within the last month
Patients unable to attend for regular follow up
Patients with active dermatitis in assessment areas
Liver disease (although hepatic effects of nicotinamide are rare, in contrast to nicotinic acid)
Currently taking carbamazepine (case reports of interaction with nicotinamide)
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sequentially numbered bottles (ie, numbered containers) will be randomised at source with patients and observers blinded to assignment. The person determing whether a subject is eligible for inclusion in the trial will be unaware, when this decision is made, as to which group the subject would be allocated. The randomisation code will be unbroken until the final patient completes the study.
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Unstratified, randomised blocks
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 2 / Phase 3
Query!
Type of endpoint/s
Efficacy
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Date of first participant enrolment
Anticipated
30/08/2010
Query!
Actual
1/09/2010
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
1/03/2011
Query!
Date of last data collection
Anticipated
Query!
Actual
Query!
Sample size
Target
40
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
Query!
Funding & Sponsors
Funding source category [1]
257497
0
Charities/Societies/Foundations
Query!
Name [1]
257497
0
Cancer Council NSW
Query!
Address [1]
257497
0
153 Dowling Street Woolloomooloo, NSW 2011 PO Box 572 Kings Cross NSW 1340 Australia
Query!
Country [1]
257497
0
Australia
Query!
Primary sponsor type
Hospital
Query!
Name
Royal Prince Alfred Hospital
Query!
Address
Sydney South West Area Health Service (SSWAHS) Ethics Committee
Level 3 Building 92
Royal Prince Alfred Hospital
Missenden Rd
Camperdown 2050
Query!
Country
Australia
Query!
Secondary sponsor category [1]
256729
0
Individual
Query!
Name [1]
256729
0
Diona Damian
Query!
Address [1]
256729
0
Dermatology Gloucester House Level 3 Royal Prince Alfred Hospital Missenden Rd Camperdown 2050
Query!
Country [1]
256729
0
Australia
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
259524
0
Sydney South West Area Health Service (SSWAHS) Ethics Committee
Query!
Ethics committee address [1]
259524
0
Building 92 Level 3 Royal Prince Alfred Hospital Missenden Rd Camperdown 2050
Query!
Ethics committee country [1]
259524
0
Australia
Query!
Date submitted for ethics approval [1]
259524
0
Query!
Approval date [1]
259524
0
09/08/2010
Query!
Ethics approval number [1]
259524
0
09/RPAH/2
Query!
Summary
Brief summary
More than 50% of all Caucasian Australians will develop non-melanoma skin cancer (NMSC) during their lifetime, and more than one in 30 will develop melanoma. Ultraviolet radiation (UVR) from sunlight is the major cause of NMSC. In humans, both the ultraviolet A (UVA) and ultraviolet B (UVB) wavebands cause immunosuppression and DNA damage and therefore both UVA and UVB are likely to contribute to induction and development of NMSC. Broad-spectrum sunscreens, which filter both UVB and UVA can reduce UV immunosuppression, but sunscreens are generally much better at preventing sunburn than immunosuppression. As immunosuppression can occur with less than half the amount of UV needed to cause sunburn, the immune protection afforded by sunscreens “in the field” is likely to be low. Oral nicotinamide (vitamin B3) is available as an over-the-counter vitamin supplement and has been effective for over 50 years in the treatment of autoimmune and inflammatory skin disorders including bullous pemphigoid and rosacea. Unlike nicotinic acid, nicotinamide does not cause significant vasodilation or flushing and has few or no potential side effects. The most commonly used dose in autoimmune blistering disorders is 1500mg daily, with these patients often taking nicotinamide for several months. Adverse effects are exceptionally rare at these doses. In mice, nicotinamide reduces skin cancer numbers by 60% when applied as a 2.5% lotion. Our group has demonstrated that nicotinamide lotion completely prevents UV immunosuppression when applied in a double-blinded placebo-controlled manner to the backs of healthy human volunteers. We subsequently found that oral nicotinamide was also immune protective in healthy, Mantoux-positive volunteers, without adverse effects, at doses of either 500mg daily or 1500mg daily. Recently, we tested topical 1% nicotinamide on numbers of actinic keratoses, and found a significant reduction in numbers of keratoses at 3 months compared to placebo. We now plan to assess the effects of oral nicotinamide at an intermediate dose (500mg daily) on AK numbers. We hypothesise that nicotinamide will be well-tolerated, and could be used together with sunscreens to reduce UV immunosuppression and potentially treat or prevent actinic keratosis, premalignant lesions which act as a surrogate marker for squamous cell skin cancers.
Query!
Trial website
Query!
Trial related presentations / publications
Surjana D, Halliday GM, Damian DL. Role of nicotinamide in DNA damage, mutagenesis, and DNA repair. [Invited review] Journal of Nucleic Acids Article ID 157591, 2010 Park J, Halliday GM, Surjana D, Damian DL. Nicotinamide prevents ultraviolet radiation-induced cellular energy loss. Photochemistry and Photobiology 86:942-8, 2010 Damian DL. Photoprotective effects of nicotinamide [Invited review]. Photochemical and Photobiological Sciences 9: 578-85, 2010 Moloney FJ, Vestergaard ME, Radojkovic BL, Damian DL. Randomised, double-blinded, placebo controlled study to assess the effect of topical 1% nicotinamide on actinic keratoses. British Journal of Dermatology 162:1138-9, 2010 Sivapirabu G, Yiasemides E, Halliday GM, Park J, Damian DL. Topical nicotinamide modulates cellular energy metabolism and provides broad-spectrum protection against ultraviolet radiation-induced immunosuppression in humans. British Journal of Dermatology 161:1357-1364, 2009 Yiasemides E, Sivapirabu G, Halliday GM, Park J, Damian DL. Oral nicotinamide protects against ultraviolet radiation-induced immunosuppression in humans. Carcinogenesis 30:101-5, 2009 Damian DL, Patterson CRS, Stapelberg M, Park J, Barnetson RStC, Halliday GM. Ultraviolet radiation-induced immunosuppression is greater in men and prevented by topical nicotinamide. Journal of Investigative Dermatology 128:447-454, 2008
Query!
Public notes
Query!
Contacts
Principal investigator
Name
31546
0
Prof Diona Damian
Query!
Address
31546
0
Dermatology, GH3 Royal Prince Alfred Hospital Camperdown NSW 2050
Query!
Country
31546
0
Australia
Query!
Phone
31546
0
+612 9515 8295
Query!
Fax
31546
0
+612 9565 1048
Query!
Email
31546
0
[email protected]
Query!
Contact person for public queries
Name
14793
0
Diona Damian
Query!
Address
14793
0
Dermatology Gloucester House Level 3 Royal Prince Alfred Hospital Missenden Rd Camperdown 2050
Query!
Country
14793
0
Australia
Query!
Phone
14793
0
612 9515 8295
Query!
Fax
14793
0
612 9565 1048
Query!
Email
14793
0
[email protected]
Query!
Contact person for scientific queries
Name
5721
0
Diona Damian
Query!
Address
5721
0
Dermatology Gloucester House Level 3 Royal Prince Alfred Hospital Missenden Rd Camperdown 2050
Query!
Country
5721
0
Australia
Query!
Phone
5721
0
612 9515 8295
Query!
Fax
5721
0
612 9565 1048
Query!
Email
5721
0
[email protected]
Query!
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Oral Nicotinamide Reduces Actinic Keratoses in Phase II Double-Blinded Randomized Controlled Trials
2012
https://doi.org/10.1038/jid.2011.459
N.B. These documents automatically identified may not have been verified by the study sponsor.
Download to PDF