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

• Published in: Plastic and reconstructive surgery (1963) Vol. 126; no. 5; pp. 1604 - 1615
• Main Authors: Bush, James, Duncan, Jonathan A. L., Bond, Jeremy S., Durani, Piyush, So, Karen, Mason, Tracey, O'Kane, Sharon, Ferguson, Mark W. J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Hagerstown, MD American Society of Plastic Surgeons 01-11-2010; Lippincott Williams & Wilkins
• Subjects: Adolescent; Adult; Biological and medical sciences; Cicatrix - pathology; Cicatrix - prevention & control; Dermatologic Surgical Procedures; Double-Blind Method; Drug Administration Schedule; Humans; Injections, Intradermal; Male; Medical sciences; Middle Aged; Pain Measurement; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Transforming Growth Factor beta3 - administration & dosage; Wound Healing - drug effects; Young Adult; Incision; Treatment; Efficiency; Surgery; Scar; Phase II trial; Skin; Wound; Avotermin
• ISSN: 0032-1052; 1529-4242
• DOI: 10.1097/PRS.0b013e3181ef8e66

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.
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).
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.
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.