A dose-finding study for hemoporfin in photodynamic therapy for port-wine stain: A multicenter randomized double-blind phase IIb trial

Photodermatol Photoimmunol Photomed. 2018 Sep;34(5):314-321. doi: 10.1111/phpp.12384. Epub 2018 Apr 22.

Abstract

Background/purpose: Previous studies have shown that hemoporfin-mediated photodynamic therapy (PDT) was a treatment for port-wine stain (PWS). Our current study aimed to identify optimal hemoporfin dose.

Methods: A prospective, multicenter, double-blind, randomized clinical trial was conducted. Patients were assigned into low- or high-dose hemoporfin (2.5 mg/kg and 5 mg/kg intravenously, respectively), or control (placebo) group, at a rate of 2:2:1. Treatment efficacy was evaluated at week 8. Then, patients in control group were randomly assigned into either high- or low-dose hemoporfin group. Treatment reactions and adverse events were analyzed at week 16.

Results: A total of 100 patients (40, 40, 20 in low-, high-dose hemoporfin, and control group, respectively) were enrolled. Compared to low dose (40%) and control group (15%), a higher proportion of patients in high-dose group (75%) had achieved skin lesion improvements. Treatment satisfactions were graded highest in high-dose group. Compared to low-dose group (14.3%), high-dose group (46.0%) had more frequent skin hyperpigmentation, which disappeared 3-6 months after treatment. Other treatment reactions and adverse events were comparable between two groups.

Conclusions: Photodynamic therapy with 5 mg/kg hemoporfin could be an effective and safe treatment for PWS.

Keywords: clinical trial; hemoporfin; photodynamic therapy; port-wine stain.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Hematoporphyrins / administration & dosage*
  • Hematoporphyrins / adverse effects
  • Humans
  • Male
  • Photochemotherapy*
  • Port-Wine Stain / drug therapy*
  • Port-Wine Stain / metabolism
  • Port-Wine Stain / pathology

Substances

  • Hematoporphyrins
  • hematoporphyrin monomethyl ether