Oleogel-S10 Reduces Daily Dressing Need in EB Study

Additional data from the phase 3 EASE study conducted in patients with epidermolysis bullosa (EB) show that regular application of the topical gel Oleogel-S10 (Filsuvez) is associated with a reduced need for daily dressing changes when compared with a control gel.

In a final, post-hoc analysis to come from the trial, 15 of 45 (33%) patients treated with Oleogel-S10 vs 5 of 48 (10.4%) treated with the control gel were reported as no longer needing daily dressing changes at 45 days of follow-up.

Moreover, the effect was sustained, with similar percentages of patients no longer requiring daily dressing changes at 60 days (34% vs 13%, respectively) and 90 days (36% vs11%) of follow-up.

The mean reduction in daily dressing changes was 1.36 for Oleogel-S10 and 0.41 for the control gel (P = .005).

"Patients who, in the beginning, had daily dressing changes had almost three fewer dressing changes every 2 weeks if they were treated with Oleogel-S10," Dimitra Kiritsi, MD, PhD, of the Department of Dermatology at the University of Freiburg, Freiburg, Germany, reported at the annual meeting of the European Academy of Dermatology and Venereology. By comparison, patients in the control group had just one fewer daily dressing change in 2 weeks.

"You might say okay, but what does this mean in terms of time?" added Kiritsi. Using historical data on the time required for whole body care, it was estimated that treatment with Oleogel-S10 was associated with an overall time-saving per week of 11 hours (6.6 hours for the patient and 4.4 hours for the caregiver) and use of the control gel was associated with an overall time-saving of 4 hours (2.4 hours for the patient and 1.6 hours for the caregiver).

"This is, for our patients, important," said Kiritsi, as "it is time that they can spend doing something nice with the family" instead, avoiding the pain and distress associated with frequent dressing changes.

Approved in Europe, not in the United States

Oleogel-S10, classified as an herbal product, contains triterpenes derived from birch bark extract, which have been formulated with sunflower oil to form a gel.

Despite being approved for use in Europe, Oleogel-S10 has not yet been approved to treat EB in the United States. The FDA did not approve Amryt Pharma's new drug application in February 2022. The application had included data from the EASE trial.

EASE included 223 patients with dystrophic or junctional EB, including 156 children, at 58 sites in 28 countries. As such, this makes it the largest treatment study in this rare genetic disease to date.

The trial had consisted of an initial 90-day, double-blind treatment period, during which time 109 patients had used Oleogel-S10 and 114 had used a control gel. This was followed by a 24-month open-label phase, during which time all remaining patients (n = 205) had used Oleogel-S10 on top of their standard of care.

Kiritsi summarized the main results of the EASE trial as follows.

Complete healing of target wounds (primary endpoint) in 41.3% of patients treated with Oleogel-S10 and 28.9% of patients treated with the control gel (P = .013).
Improved total body wound burden measured by both Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) and Body Surface Area Percentage (BSAP) scores.
Reduced frequency of dressing changes (1 less per 2 weeks for Oleogel-S10 vs 0 less per 2 weeks for control gel).
Improved pain among participants aged 4 years and older while their dressings were being changed.
Reduced rates of wound infection (0.9% Oleogel-S10 vs 4.4% control gel)
Similar rates of treatment-emergent adverse events (24.8% vs 22.8%, respectively), which were mostly deemed to be mild or moderate.

The EASE Study — An Important Trial for EB

EASE is an important trial for EB, the study's principal investigator Dédée Murrell, MD, DSc, University of New South Wales, Sydney, Australia, has pointed out previously.

"This was the first EB study to meet its primary endpoint and demonstrated a statistically significant acceleration of target wound healing by day 45," Murrell said in a press release issued by Amryt Pharma to coincide with the online publication of the trial results in October 2022.

"In addition, the favorable trends we see with key secondary endpoints such as reduced wound burden, pain, and frequency of dressing changes are considered as being very meaningful for patients," Murrell said.

The EASE study was funded by Amryt Research Limited. Kiritsi reported receiving honoraria or consultation fees from Amryt, RHEACELL GmbH, and Fibrx Derm Inc. She also acknowledged grant or research support from DEBRA International, EB Research Partnership, Fritz-Thyssen Foundation, German Research Foundation, and RHEACELL GmbH. Murrell has ties to Amryt and Amicus and is a co-owner of the patent for topical sirolimus for EB simplex.

European Academy of Dermatology and Venereology (EADV) 2023 Annual Meeting: Abstract 6745. Presented October 13, 2023.

Sara Freeman is a medical journalist based in London, England.

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