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NCT03521687

Apremilast in the Treatment of Central Centrifugal Cicatricial Alopecia (CCCA)

Completed Phase 4 Results posted Last updated 9 May 2022
What this trial tests

Phase 4 trial testing Apremilast in Central Centrifugal Cicatricial Alopecia in 20 participants. Completed in 12 February 2021.

Timeline
15 November 2018
Primary endpoint
12 February 2021
12 February 2021

Quick facts

Lead sponsorIcahn School of Medicine at Mount Sinai
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment20
Start date15 November 2018
Primary completion12 February 2021
Estimated completion12 February 2021
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Icahn School of Medicine at Mount Sinai

Who can join

18 and older, female only, with Central Centrifugal Cicatricial Alopecia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Mean Change in Physician Global Assessment of Improvement (PGA-I) Primary · Week 0 and Week 24

Mean change in PGA-I at Week 24 compared to Baseline. Trained study personnel will take standardized photographs of the scalp. These photographs will be provided to a panel of three dermatologists with expertise in CCCA, each of whom will review the photographs at these time points. Investigators will assess the improvement in hair loss severity using PGA-I. PGA-I will range from -3 (significant worsening) to 3 (significant improvement).

GroupValue95% CI
Apremilast0.07± 0.51
Mean Change in CCCA Investigator Global Severity Score (IGSS) Secondary · Week 0 and Week 24

Mean change in IGSS at Week 24 compared to Baseline. Treatment response will be considered no change or improvement in IGSS. CCCA Investigator Global Severity Score (IGSS) assess subjects on a scale of 0 (no hair loss) to 6 (severe CCCA, e.g. \>75% involvement of vertex).

GroupValue95% CI
Apremilast-0.31± 0.65
Mean Change in Central Hair Loss Grade (CHLG) Secondary · Week 0 and week 24

Mean change in CHLG at Week 24 compared to Baseline. Degree of severity of hair loss is graded on a 6-point visual scale (pattern 0: no hair loss, pattern 1-2: mild hair loss, pattern 3-5: more severe hair loss).

GroupValue95% CI
Apremilast-0.44± 0.86
Mean Change in Subject Visual Analog Scale (VAS) of Hair Loss Severity Secondary · Week 0 and Week 24

Mean change in VAS at Week 24 compared to Baseline. The VAS is a numerical scale used to assess patients' perception of hair loss severity. The evaluation is a 10cm long line on which the subjects indicate the severity of their condition from "0" (complete loss of hair in affected area - ie no visible hairs on central scalp) to "10" (full growth/regrowth in affected area-ie no visible hair loss on central scalp).

GroupValue95% CI
Apremilast-1.94± 1.86
Mean Change in Subject Global Assessment of Improvement Secondary · Week 0 and Week 24

Mean change in PaGA-I at Week 24 as compared to Baseline. PaGA-I will range from -3 (significant worsening) to 3 (significant improvement).

GroupValue95% CI
Apremilast1± 1.45
Change in Subject Rating of Symptom Severity Questionnaire (NRS) Secondary · Week 0 and Week 24

Change in NRS at Week 24 as compared to Baseline. Subjects will complete a symptom severity questionnaire consisting of 3 numeric rating scales (NRS) measuring severity of pruritus, burning, and pain. The NRS will range from 0 (no symptoms) to 10 (severe symptoms). Patients indicate the intensity of each symptom (pruritus, burning, or pain) by choosing a number from 0 to 10 that corresponds to the severity of that symptom.

GroupValue95% CI
Apremilast0.94± 3.99
Mean Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score Secondary · Week 0 and Week 24

Mean change in DLQI total score at Week 24 as compared to Baseline. DLQi is a 10-item questionnaire, each question is scored from 0 to 3, giving a possible score range from 0 (meaning no impact of skin disease on quality of life) to 30 (meaning maximum impact on quality of life).

GroupValue95% CI
Apremilast-2.18± 3.79

Adverse events — posted to ClinicalTrials.gov

Time frame: 24 weeks. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Apremilast
Serious: 0/20 (0%)
Deaths: 0/20
Other adverse events (38 terms — click to expand)

ReactionSystemApremilast
NauseaGastrointestinal disorders
HeadacheNervous system disorders
Loose stoolsGastrointestinal disorders
Decreased appetiteGeneral disorders
Increased bowel movementsGastrointestinal disorders
Abdominal painGastrointestinal disorders
FlatulenceGastrointestinal disorders
DiarrheaGastrointestinal disorders
DepressionPsychiatric disorders
Weight LossGeneral disorders
Upper respiratory infectionInfections and infestations
Covid like illnessInfections and infestations
RefluxGastrointestinal disorders
Common coldInfections and infestations
TirednessGeneral disorders
CoughRespiratory, thoracic and mediastinal disorders
Increased hair lossSkin and subcutaneous tissue disorders
Nasal congestionGeneral disorders
Cracked toothGeneral disorders
AnxietyPsychiatric disorders
Lower back muscle strainMusculoskeletal and connective tissue disorders
left knee painMusculoskeletal and connective tissue disorders
Itchy scalpSkin and subcutaneous tissue disorders
Seasonal allergiesGeneral disorders
Sinus headacheGeneral disorders
Hair breakagePsychiatric disorders
SinusitisGeneral disorders
Scalp painSkin and subcutaneous tissue disorders
Worsening urticariaSkin and subcutaneous tissue disorders
Intention tremorNervous system disorders
InsomniaPsychiatric disorders
Subjective PIHSkin and subcutaneous tissue disorders
HyperactivityPsychiatric disorders
Abnormal mammogramReproductive system and breast disorders
Post nasal dripGeneral disorders
Irregular periodsReproductive system and breast disorders
Perioral dermatitisSkin and subcutaneous tissue disorders
Eye InfectionEye disorders

Data from ClinicalTrials.gov NCT03521687 adverse events section.

Sponsor's own description

This is a single-center, open-label clinical study to study the efficacy of apremilast in the treatment of mild to moderate central centrifugal cicatricial alopecia. The investigators hypothesize that the anti-inflammatory properties of apremilast may play a role in the decreasing scalp inflammation in patients with CCCA and may prevent further hair loss and potentially induce hair regrowth in patients with mild to moderate disease.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Off-label studies on apremilast in dermatology: a review.
    Maloney NJ, Zhao J, Tegtmeyer K, Lee EY, et al · · 2020 · cited 26× · PMID 30935262 · DOI 10.1080/09546634.2019.1589641
  2. Exploring the Therapeutic Landscape: A Narrative Review on Topical and Oral Phosphodiesterase-4 Inhibitors in Dermatology.
    Carmona-Rocha E, Rusiñol L, Puig L. · · 2025 · cited 11× · PMID 39861739 · DOI 10.3390/pharmaceutics17010091

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Other trials of Apremilast

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