Scar-improving efficacy of avotermin administered into the wound margins of skin incisions as evaluated by a randomized, double-blind, placebo-controlled, phase II clinical trial.
BACKGROUND
The authors report on a prospective, randomized, placebo-controlled phase II trial to investigate avotermin (transforming growth factor beta-3) for reducing scarring resulting from acute incised skin wounds.


METHODS
Seventy-one healthy male subjects (18 to 45 years) received avotermin at 50 or 200 ng/100 μl/linear centimeter of wound margin. Subjects received three standardized 1-cm incisional wounds on the inner aspect of each upper arm. Wounds were randomized to receive (into each margin): no injection (standard wound care only), one intradermal injection of avotermin or placebo (immediately before surgery), or two injections of avotermin or placebo (immediately before surgery and 24 hours later). The primary efficacy variable was a 10-cm visual analog scale score, which assessed how closely scars resembled normal skin, administered at month 12 by an independent external scar assessment panel (a panel of lay public individuals).


RESULTS
Avotermin at 200 ng/100 μl/linear centimeter, administered once or twice, achieved significant improvements in scar appearance compared with controls (p<0.02 for all comparisons). The 50-ng dose, administered twice, achieved significant improvements in scar appearance versus placebo (p=0.043). Treatment was well tolerated.


CONCLUSIONS
These results confirm that avotermin is the first of a new class of regenerative medicines that reduce scarring when administered once or twice to the approximated margins of acute skin incisions.
Manchester and Belfast, Northern Ireland, United Kingdom From Renovo; the Department of Plastic and Reconstructive Surgery, Faculty of Medical and Human Sciences, and the Faculty of Life Sciences, University of Manchester; and the Northern Ireland Plastic and Maxillofacial Service, The Ulster Hospital, Dundonald.
James
J
Bush
Jonathan A L
JAL
Duncan
Jeremy S
JS
Bond
Piyush
P
Durani
Karen
K
So
Tracey
T
Mason
Sharon
S
O'Kane
Mark W J
MWJ
Ferguson
D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000473:pathology / Q000517:prevention & control*; D062109:Dermatologic Surgical Procedures; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D053782:Transforming Growth Factor beta3 / Q000008:administration & dosage*; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
D053782:Transforming Growth Factor beta3