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FORMULA
EPICYN ;
——— Mex! CO
Cada 100 gramos contienen:
Sodio Magnesio Fluorosilicato 5.0000 %
> Polidimetitsiloxano 4.8000 %
Fosfato de Sodio 0.2000 %
Acido Hipocloroso 20,0032 %
Hipociorito de Sodio 20.0008 %
‘Agua de super-oxidacién c.b.p 100.000 %
‘QFB Maria
Cédula 5144662
Responsable SanitarioZZ
OCULUS
Innovative Sciences
STUDY TITLE A Double-blind, Randomized Study to Determine the
Substantial Equivalence of Microcyn Scar Management
HydroGel, K 103163 vs. Kelocote Scar Gel for the
Management of Hypertrophic or Keloid Scars
PROTOCOL NO. ‘TP-XX-XXX
SPONSOR Oculus Innovative Sciences, Ine.
1129N. McDowell Blvd,
Petaluma, CA 94954
Tel: 707-559-2445
Fax: 415-462-5163
ORIGINAL PROTOCOL DRAFT 18 April 2012
‘CONFIDENTIALITY STATEMENT
‘The information contained in this document, particularly unpublished data, is provided to you in
Investigator, potential Investigator, or consultant for review by you, your staff, and an
Review Board or Independent Ethics Committee. The information is only to be
1sed by you in connection with authorized clinical studies of the investigational product(s) described in the
Protocol. You will not disclose any of the information to others without written authorization, except to
‘the extent necessary to obtain informed consent from those persons to whom the investigational product(s)
may be administered.‘TP-XX.001
—_ DRAFT 19 ari 2011,
SIGNATURE PAGE
‘On behalf of Oculus Innovative Sciences, Inc., I confirm that is the final version of the
protocol which has been approved according to company operating procedures,
‘Clinical Operations Signature
‘Oculus Innovative Seiences, Ine.
(Printed Namey Date
Printed Name Dawe
Regulatory =
‘Oculus Innovative Seiences, Ine.
Prinied Namey Date
Oculus innovative Sciences, Ine CONFIDENTIAL Page 2 of 46TP-XX-001
RAPT ATE ILL
INVESTIGATOR’S AGREEMENT
I have carefully read the protocol entitled: “A Double-blind, Randomized Study to
Determine the Substantial Equivalence of Microcyn Scar Management HydroGel, K 103163
vs. Kelocote Scar Gel for the Management of Hypertrophic or Keloid Scars” and,
| agree that the protocol contains the necessary information required to conduct the study. 1
also agree to conduct this study as outlined in and according to the obligations of Clinical
Investigators and all other pertinent requirements in the International Conference on
Harmonisation (ICH) Good Clinical Practice (GCP) guideline,
1 agree to obtain approval of the protocol and informed consent prior to the start of the study
by an Institutional Review Board (IRB)/Independent Ethics Committee (IEC) that is
registered with the US Department of Health and Human Services (HHS).
| agree to obtain formal written informed consent in accordance with applicable federal and
local regulations and international guidelines from all subjects prior to their entry into the
study
Uhave received and reviewed the Microcyn and Kelocote Device Description including the
potential risks and side effects of the products and instructions for use.
I agree to report to Oculus Innovative Sciences, Ine. adverse events that occur during the
course of the study in accordance with the ICH GCP guideline and the protocol.
agree to ensure that all associates, colleagues, and employees assisting me with the conduct
of the study are informed of their responsibilities in meeting the above commitments and the
commitments set forth in the Investigator’s Agreement.
1 agree to maintain adequate and accurate records and to make those records available for
inspection in accordance with the ICH GCP guideline, and federal and local requirements
‘The Investigator, agreeing to be fully bound, hereby executes this agreement on the date as
set forth below
Tavestigator Signature
Printed Name Date
Aairess
Phone Number,
Oculus Innovative Sciences, Ine CONFIDENTIAL Page 3 0f 46‘TP-XX.001,
$v arn zo
PROTOCOL SYNOPSIS
Name of Sponsor/Company: Oculus Innovative Seienoes, Ine.
Name of Finished Product: Microcyn Scar Management HydtoGel, K103163
Title of Study:
A Double-blind, Randomized Study to Determine the Substantial Equivalence of Microcyn Sear Management
HydroGel vs. Silicon Gel for the Management of Hypertrophic or Keloid Sears
Investigator(s)
| Multiple investigators in the United States (US)
Study Center(s):
Upto 4 centers inthe US
[Number of Subjects Planned:
Up to 40 subjects will be enrolled
Publication (Reference): NA
Study Period!
112 days
Phase of Development: 3
Objective:
Evaluate the efficaey and tolerability of Microcyn Scar Management HydroGel_as compared to predicate device
[Kelocote Scar Gel in adult subjects with hypertrophic or keloid sears
Clinical Hypothesis:
Microcyn Scar Management Hy droGel is substantially equivalent to Kelocote Scar Gel forthe management of
old and new hypertrophic and keloid sears as measured by the modified Vancouver Sear Seale (VSS).
Design and Methodology:
This is a double-blind, multicenter study to evaluate the efficacy and tolerability of Microcyn Sear Management
HydroGel as compared to Kelocoe in up fo 40 adult subjecs with hypertophic or keloid scars. Qualified sears
include linear or widespread hypertrophic sears and major and minor Keoids. The age of target sears will ange
between 3 months ata minimurn fo 3 years a a maxim,
On the Baseline (Day 0) visit the target sear will be measured (Length, width and elevation) and classified ito one of
the four qualified types: widespread hypertrophic, linear hypertrophic, minor keloid, or major keloid as described by
Mustoe TA et al, 2002,
Linear hypertrophic scar: Red, raised scar confined to the border oF the original surgery or trauma
2. Widespread hyperrophie sear: A widespread reuse scr tht eis within the borders ofthe
evga jury asl cased by 4 bu,
3. Minor Keo: felis scar that extends ver ora tse =
4 Major Keo: lrg, used scar which may be sinful or ruts. Extend over Soi |
sie ew eye vei singe Vato See VS), Que
oes wil havea minimum total VSS score o 3. Pan and teh aptoms il be evaated byt sige
Female sujet wil be gven a wine prenane test. The bie ile rndomized to either Mispp elo
1:1. The investigator wl apey te Est one oft ati othe ret ear The subject lee oo oo,
15 nse ues of est aril wih he instructions aol th investigational roduc tenes Sy
proximately 8 hours apr. for 8 weeks The sujct wl be provided wih Sues plication nstvsns and
[Stet Restcions as oullned in Sections 3.23 4.2.4respevey. The sujet wl tun oh lin or
Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 4 0f46TP-XX-001
DRAFT 19 APRIL 201,
[Name of Sponsor/Company: Oculus Innovative Selenees, Ine.
[Name of Finished Product: Microcyn Scar Management HydroGel, K103163,
Tollow up visits on study Day 14 (Week 3), Day 28 (Week), Day 56 Week & ead af treatment) and Days $4 and
112 (Week 12 end Week 16 follow up). Investigator and subject will complete the VSS and symptom evaluations
at each study vist. Subject Satisfaction anda global assessment ofeicacy willbe assessed bythe investigator at
Day 56 (end of treatment) and Day 112 (or early termination). The investigator and the subject will ae the sear
tcatment results as follows: Very Good, Good, Moderate or Unsatisfactory. Digital photographs willbe taken at
each site at Baseline and each follow up vist (Day 14, 28, 36, 84 and 112) or eary termination.
Study Visits:
Baseline (Day 0, investigational product application, and follow-up visits at Day 14 (Week 2), Day 28 (Week 4),
Day 56 Week 8), Day 84 (Week 12) and Day 112 (Week 16)
Safety Evaluation
+ Adverse Events (AEs) starting at Baseline (Day 0, pre-and postapplication) and each study vist
‘+ Concomitant Therapy/Medication Baseline (Day 0, pre-application) and at each study visit
‘+ Urine pregnancy test (UPT) for women of childbearing potential (WOCBP) at Baseline (Day 0) and Final
Evaluation (Day 112 or Early Termination)
Efficacy Evaluations:
Investigator Evaluation: ‘The VSS evaluation will be performed at Baseline (Day 0, pre-application) and at Days
14, 28, $6, 84 and 112. Digital photographs will be taken at Baseline, Days 14, 28,56, 84 and 112 (or early
termination). Global assessment of efficacy will be performed at Day 56 (end of treatment) and Day 112 (or
early termination), At these visits, the Investigator wil rate the efficacy ofthe device as either I, Very Good, 2
|Good, 3. Moderate or 4, Unsatisfactory.
Patient Evaluation: The patient’ evaluation of pain and itch will be performed at Baseline (Day 0, pre-
pplication) and at Days 14, 28, 6, 84 and 112 (or early termination). Global patient satisfaction willbe
assessed at Day 56 (end of treatment) and Day 112 (or early termination) where the Patient will rate their
satisfaction ofthe treatment ofthe sar as either [Link] Good, 2. Good, 3. Moderate or 4. Unsatisfactory.
The Vancouver Scar Scale (modified)
‘Scar characteristic ‘Score
Vascularity Normal 0
Pink 1
Red i
Purple 3
Pliability Normal 0
Supple 1
Yielding 2
Firm 3
Height Flat °
<2mm ‘ Aycine
2-5 mm 2 NNW
>5mm 3
(Oculus Innovative Seienees, Inc. CONFIDENTIAL Page 5 of 46‘TP-XX.001
DRAFT 19 APRIL 2011
Name of Sponsor/Company: Oculus Innovative Sciences
Name of Finished Product: Microcyn Se:
Management HyéroGel, K103163,
Explanation of Wem measurement
Vaseularity Presence of vessels in scar tissue assessed by the amount of redness
liability Suppleness of the scar tested by wrinkling the scar between the thumb and
index finger
© Height Average distance between the subcutical-dermal border and the epidermal
surface ofthe sear
Patient’s Assessment
Symptom _ Assessment ‘Score
Pain None 0
Intermittent (occurs sometimes, but not
bothersome)
Moderate (occurs almost daily) 2
Severe (requires medication or intervention) 3
Itch None °
Intermittent (occurs sometimes, but not
bothersome)
Moderate (occurs almost daily) 2
Severe (requires medication or intervention) 3
Diagnosis and Main Eligibility Criteri
Subjects must meet the following eligibility criteria to participate inthe study
inclusion Criteria:
Written informed consent including authorization to release health information
Female or male, 18 to 65 years of age and in good general health
Willing and able to follow study instructions and likely to complete all study requirements
Have a linear or widespread hypertophic or minor or major keloid scar with a minimum VSS total
score of 3 ina body area that ean be accessed for evaluation and thrice daly topial treatment;
5. WOCBP must have a negative UPT at the Baseline (Day 0) visit AN
6 WOCBP must agree to use an effective method of birth control during the course Shite day
Exclusion Criteria
1. History of allergy or sensitivity to any components ofthe investigational product
History of diabetes
3. History of collagen vascular disorders that impact healing and wound repair such as scleroderme,
systemic lupus erythematosus (SLE), Ehler-Danlos syndrome, ete.
4. Anticipated need for surgery or hospitalization during the study
5._Pregnant, nursing or planning a pregnancy during the study; or is a WOCBP but is not willing to use
(Oculus Innovative Sefenees, Inc. CONFIDENTIAL Page 6 0f 46‘TP-XX-001
DRAFT 19 APRIL 201
Name of Sponsor/Compa (Oculus Innovative Sciences, In.
Name of Finished Product: Microcyn Scar Management HydroGel, KL03163
‘a efiecive method of
16. Current enrollment in an investigational drug or device sty or participation in such a study within the|
last 30 days prior to Baseline (Day 0)
7. Any condition o situation wich, in the Investigators opinion, puts the subject at significant isk,
could confound the study results, o may interfere significantly with the subjest'spaicipaion inthe
study
‘8. Target sear on the face, of which spans over a joint or requires the use of pressure bandage.
9, Target sear which is newer than 3 months or older than 3 year,
Test Article, Dose, and Mode of Administration:
Microcyin Sear Treatment Hy droGel or Kelocote, applied three times daily, topical administration
‘sontrod
Statistical Analyses
Efficacy Analyses:
Etcacy analyses will consist of descriptive statistics forthe following assessments:
‘4 Comparison between the two dose groups inthe Vancouver Sear Scale total seore from Baseline (Day
Oto Day 112 (Week 16 of Early Termination),
. Comparison between the two dose groups inthe individual sign and symptom scores from Baseline
(Day'0) to Day 112 (or carly termination)
Comparison between the two dose groups inthe Investigators Global Assessment of Treatment at Day
56 and Day 112 (or easy termination)
44. Comparison berwecn the two dose groups inthe Patient’
(end of treatment) and Day 112 (Week 16 or Early Ter
faction of Treatment Results at Day's $6
ion)
Safety Analyses:
-The safety population wil include all subjects exposed to the investigational product who have provided any post-
treatment safety information,
Ja Sie Sasifeatoas
Up t0 40 subjects will be enrolled,
Oculus Innovative Scienees, Ine. CONFIDENTIAL Page 7 of 46‘TP-XX-001
DRAFT 19 apr 2001
LIST OF ABBREVIATIONS AND DEFINITIONS OF TERMS
Abbreviation Definition
AE ‘Adverse Event
crR Code of Federal Regulations
cre (Case Report Form
CTEP-CTCAE Cancer Therapy Evaluation Program ~ Common Terminology Criteria for Adverse Events
FDA Food and Drug Administration
ocr Good Clinical Practices
Has Health and Human Services
Ic International Conference on Harmonisation
EC Independent Ethics Committee
IGA Investigator Global Assessment
ea Investigator Pruitus Assessment
IRB Institutional Review Board
MedDRA Medical Dictionary for Regulatory Activites
SAE Serious Adverse Event
sas Statistical Analysis Software
sia Subject Itch Assessment
soP Standard Operating Procedure
upr Urine Pregnancy Test
us United States
vss ‘Vancouver Sear Seale
wocer ‘Woman of Cildbearing Potential
(cul Innovative Ssiences, Inc, CONFIDENTIAL Page 8 of 46TP-XX-001
DRAFT 19 APRIL 2011
TABLE OF CONTENTS
SIGNATURE PAGE.
INVESTIGATOR'S AGREEMEN’
PROTOCOL SYNOPSIS
LIST OF ABBREVIATIONS AND DEFINITIONS OF TERMS
TABLE OF CONTENTS
LIST OF TABLES.
1. INTRODUCTIOT
LL. Background.
1.2. Study Rationale.
1.3. Dose Rationale.
14. Study Objective.
1.5. Clinical Hypothesis.
2. STUDY DESIGN.
2.4. Overall Design
Dosage/Dose Regimen...
Visit Schedule
2.2. Test Article.
2.3. Study Population
2.4. Eligibility Criteria........ revenese ee .
2.4.1. Informed Consent and Authorization to Release Health Information
2.4.2. Inclusion Criteria
24.
3. STUDY PROCEDURES AND METHODS
3.1. Subject Entry Procedures...
3.2, Schedule of Visits and Procedures.
3.2.1. Baseline Visit (Day 0).
3.2.2. follow-up visits (Day 14, day 28, Day $6, Day 84).
3.2.3 Final Evaluation (Day 112/Early Termination)...
3.2.3. subject application instructions...
Exclusion Criteria...
‘Oculus Innovative Sciences, Ine CONFIDENTIAL Page 9 of 6,TP-XX-001
DRAFT 19 APRIL 2011
3.24. Discontinuation/ Withdrawal Procedures.
3.3. Variation from Scheduled Visit Days.
34. Safety Assessments
3.4.1. Pregnancy Test
3.4.2. Adverse Events
3.5. Efficacy Assessment
3.8.1. Vancouver Scar Scale (modified)...
patient assessments,
3.8.3. PHotography
3.6. Screen Failures.
3.7. Protocol Deviations,
4. PROHIBITED medications and treatment
3. EVALUATION OF ADVERSE EVENTS.
Definition
Adverse Event Severity Grades..
Investigational product Causality .
5.2. Reporting Adverse Events ...
5.3. Immediately Reportable Events.
54. Pregnancy...
5.5. Follow-Up of Adverse Events
5.8.1. Follow-Up of Non-Serious Adverse Events ...n-0
5.5.2. Follow-Up of Post Study Serious Adverse Events...
6. STATISTICAL ANALYSIS.
6.1, General Consideration:
Populations.
‘Overall Study Evaluations and Measurement
Safety
Efficacy.
Sample Size..
7. INVESTIGATIONAL product MANAGEMENT.
7.1. Receipt of Investigational PRODUCT.
7.2. Storage and dispensing of Investigational PRODUCT.
7.3. Investigational PRODUCT Accountability Ny
7.4, Returns and Destruction...
8. RECORDS MANAGEMENT.
8.1. Data Collection eae
8.2. File Management at the Study Site
38
(Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 10 of 468.3. Records Retention at the Study Sit
9. MONITORING, COMPLIANCE, AND QUALITY.
9.1. Quality Assurance Audits and Quality Control
10. ETHICS AND RESPONSIBILITY...
11, CONFIDENTIALITY
12, AMENDMENT POLIC’
13. USE OF INFORMATION AND PUBLICATION.
14, REFERENCES.
APPENDIX A: STUDY RESPONSIBILITY LIST,
Oculus Innovative Sciences, Ine CONFIDENTIAL Page 11 of 46TP-XX-001
$$$ __DAT
LIST OF TABLES.
Table 1: Schedule of Visits and Procedures.
‘Table 2: Allowed Variation from Scheduled Visit Days,
‘Table 3: Vancouver Scar Scale..
Table 4: Patient's Assessment.,
Oculus Innovative Seienees, Ine. CONFIDENTIAL Page 12 0f 46TP-XX-001
avo ar 2011
1. INTRODUCTION
LI. BACKGROUND
Hydrotropic scars commonly form after burns, surgical in
yns or other trauma that extends
into the reticular dermis. Once formed, there may be partial or complete resolution, oF they
may remain permanent. (Abn, etal, 1991). Keloid scarring is caused by the growth of dense
fibrous tissue developing from an abnormal healing response to a cutaneous injury, extending
beyond the original borders of the wound. (Brissett and Sherris, 2001). Scarring can cause
functional, cosmetic and psychological morbidity (Bock, et al, 2006). The clinical symptoms
Of scars include tenderness, discoloration, Pruritus and disfigurement. Several treatments are
used for scars including surgery, laser therapy, steroid injections and topical products
including onion extract gel and silicon gel. Perkins, Davey, and Wallis (1982) demonstrated
that split skin grafts treated with silicon gel refrain from shrinking while the arca around
bburns healed by epithelialization without hypertrophy
Oculus Innovative Sciences, Ine. (Oculus) has developed a topical device, Microcyn Scar
Management HydroGel for the management of old and new hypertrophic and keloid scarring
on sears resulting from bums, general surgical procedures and trauma wounds. The
anticipated clinical benefit is the improvement in the appearance and associated symptoms
(pain, and itching) of scars. This study will compare Microcyn Scar Management HydroGel
with the predicate device, Kelocote Scar Gel.
12, STUDY RATIONALE
Microcyn Sar Management HydroGel formulation is similar to Microcyn Skin and Wound
HydroGel which was cleared for commercial distribution for pain and itch. The new
formulation contains film forming agents and additional ingredients to address scar
management. The predicate device, Kelocote Scar Gel, has been cleared for commercial
distribution for scar treatment via K973572, October 21, 1997. ‘The purpose of this study is
to demonstrate substantial equivalence of Microcyn Scar Management HydroGel with the
predicate device, Kelocote Scar Gel. 2
Clinical studies of Microcyn Scar Management HydroGel will be conducted nde fee
application K103163 for dermatological uses.
1.3, DOSE RATIONALE
‘The dosing regimen Microcyn Scar Treatment HydroGel or Kelocote Scar Gel three G)
doses applied daily to the target scar, approximately 8 hours apart.
Oculus Innovative Sciences, Inc, CONFIDENTIAL Page 13 of 46‘TP-XX-001
DRAFT 9 ri 2011
14. STUDY OBJECTIVE
To evaluate the efficacy and tolerability of Microcyn Scar Management HydroGel as
compared to predicate device Kelocote Scar Gel in adult subjects
sears that are between 3 months and 3 years old.
ith hypertrophic or keloid
1.5. CLINICAL HYPOTHESIS
Microcyn Scar Management HydroGel is substantially equivalent to Kelocote Scar Gel for
the management of hypertrophic or keloid scars as measured by the following:
© Vancouver Scar Scale: Total score in the VSS at Day 56 (end of treatment) and Day
112 (or early termination) as compared to Baseline (Day 0) .Patient’s assessment of
pain and itch at Day 56 as compared to Day 0.
* Subject’s overall satisfaction of the scar treatment at Day 56 (end of treatment) and
Day 112 (or early termination).
* Investigator’s Global Assessment of Treatment Efficacy at Day 56 (end of treatment)
and Day 112 (or early termination),
(Oculus Innovative Seienees, Ine CONFIDENTIAL Page 14 of 46TP-XX-001
DRAFT 9 APRIL 2011
2. STUDY DESIGN
2.1, OVERALL DESIGN
21.1. STRUCTURE
This is a randomized, double-blind, multi-center cli
2.2, DURATION
‘The study duration is up to 112 days on study.
213. CONTROLS
An active control, Kelocote Scar Gel will be used as the predicate device.
2.14, DOSAGE/DOSE REGIMEN
Up to 40 subjects who have provided informed consent and have met the study el
rit
lity
ia will be randomized to receive one 1.5 ounce tube of either study device at the
Baseline (Day 0) visit. Subjects will apply the investigational product three times daily,
approximately 8 hours apart for 56 days. Subject Instructions described in Section 3.2.3 and
Subject Restrictions outlined in Section 3.2.4. will be provided to the subject at the baseline
visit.
‘The initial treatment will be applied to the affected areas by the Investigator at the Baseline
(Day 0) visit, The subject will then be instructed on the proper topical application of the
study device, All remaining treatments will be applied by the subject. Subjects will bring the
tube of study treatment to each follow-up visit (Days 14, 28 and 56).
2.45. VISIT SCHEDULE
Up to 6 study visits are planned for this study. Study visits will take place at Baseline (Day 0,
first investigational product application), Day 14 (Week 2), Day 28 (Week 4), Day 56 (Week 8),
Day 84 (Week 12) and a final evaluation on Day 112, Week 16 (or Early Termination),
(Oculus Innovative Sciences, Ine CONFIDENTIAL Page 15 of 46TP-XX-001
DRAFT 19 APRIL 2011
2.2. TEST ARTICLE
‘The test article, Microcyn Scar Management HydroGel, is a translucent, colorless emollient
containing gel comprised of hypochlorous acid and sodium hypochlorite generated through
‘an electrochemical process. It is non-oily and pH neutral. The predicate device, Kelocote
Scar Gel, isa similar appearing gel.
2.3. STUDY POPULATION
Up to 40 subjects, female or male, 18 to 65 years of age, in good general health, with a
hypertrophic or keloid sear present for at least 3 months but no more than 36 months
24. ELIGIBILITY CRITERIA
24.1. INFORMED CONSENT AND AUTHORIZATION TO RELEASE HEALTH
INFORMATION
Written informed consent will be obtained from all subjects before any study-related
procedures (including any pre-treatment screening procedures) are performed. The
Investigator may discuss the study and the possibility for entry with a potential subject
without first obtaining consent. However, a subject wishing to participate must give written
informed consent prior to any study-related procedures being conducted, including those
performed solely for the purpose of determining eligibility for study participation, including
‘withdrawal from current medication (if required prior to study entry), The Investigator has
both the ethical and legal responsibility to ensure that each subject being considered for
inclusion in this study has been given a full explanation of the procedures and expectations
for study participation.
The site-specific informed consent must be forwarded to Oculus for approval prior to
submission to an Institutional Review Board (IRB)/Independent Ethies Committee (IEC) that
is registered with the US Department of Health and Human Services (HHS). Each subject
will sign the consent form that has been approved by the same IRBJIEC that was responsible
for protocol approval. Each informed consent document must adhere to the ethical principles
stated in the Declaration of Helsinki and will include the elements required by FDA
regulations in [Link] Part $0, as well as the elements required by the Intemational
Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guideline, and applicable
federal and local regulatory requirements. The consent form must also include a statement
that Oculus, their designees, and auditing regulatory agencies will hay ifStt acs) t0 the
subject's records and medical history. ty
Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 16 0f 46‘TP-XX.001
$$ DRAFT 9 APRIL 2011
‘Once the appropriate essential information has been provided to the subject and fully
explained by the Investigator (or a qualified designee) and it is felt that the subject
understands the implications and risks of participating in the study, the IRB/IEC-approved
consent document shall be signed and dated by both the subject and the person obtaining
consent (Investigator or designee), and by any other parties required by the IRB/IEC or other
regulatory authorities. The subject will be given a copy of the signed informed consent
document with the original kept on file by the Investigator. All of the above activities must
bbe completed before any study related procedures are conducted (including any pre-treatment
study procedures).
2.4.2, INCLUSION CRITERIA
All subjects must meet the following inclusion criteria to participate in the study:
1. Written informed consent including authorization to release health information
2. Female or male, 18 to 65 years of age, and in good general health
3. Willing and able to follow study instructions and likely to complete all study
requirements
4, Have a hypertrophic (linear or widespread) or keloid (major or minor) scar in a body area
that can be accessed for evaluation and thrice daily topical treatment by the subject.
5, Women of childbearing potential (WOCBP) must have @ negative urine pregnancy test
(UPT) at the Baseline (Day 0) visit
6. WOCBP must agree to use an effective method of birth control during the course of the
study
2.4.3. EXCLUSION CRITERIA
Subjects will not be enrolled if they meet any of the following exclusion crite
1, History of allergy or sensitivity to any components of the investigational product
2. History of diabetes
3. History of collagen vascular disorders that impact healing and wound repair such as
scleroderma, systemic lupus erythematosus (SLE), Ehler-Danlos syndrome, etc.
4. Anticipated need for surgery or hospitalization during the study
5, Pregnant, nursing, or planning a pregnancy during the study, or is a WOCBP but
willing to use an effective method of birth control
not
6 Current enrllment in an investigational drug or device stay oF participation in such a
study within the last 30 days prior to Baseline (Day 0) WW
(Oculus Innovative Seienees, Inc. CONFIDENTIAL Page 17 of 46TP-XX-001
$$ RAF 9 aR 2011
7. Any condition or situation which, in the Investigator’s opinion, puts the subject at
ignificant risk, could confound the study results, or may interfere significantly with the
subject’s participation in the study
8, Target scar on the face, or which spans over a joint or requires the use of a pressure
bandage.
9. Target scar which is newer than 3 months or older than 3 years,
Oculus Innovative Seiences, Ine, CONFIDENTIAL Page 18 of 46$a ar 200
3. STUDY PROCEDURES AND METHODS
3.1. SUBJECT ENTRY PROCEDURES
Prospective subjects as defined by the eligibility criteria in Sections 2.4.2 and 2.4.3
(Inclusion/Exclusion Criteria) will be considered for entry into this study. Subject informed
cconsent must be obtained prior to condueting Baseline procedures.
After the required procedures are completed and study eligibility is confirmed,
investigational product will be administered at Baseline (Day 0).
3.2. SCHEDULE OF VISITS AND PROCEDURES
‘A schedule of visits and procedures is provided in Table 1.
Table 1: Schedule of Visits and Procedures
Baseline Treatment/Follow-up Post-Treatment
Day 14 | Day28 ] DayS6 | Day 4 | Day 112
Dayo | (Week2) | (Week 4) | (Weekes) | (Week 12) | (Week 16)
Procedures Early Tem
Informed Consent and Privacy
Authorization m
Inclusion/Exelusion *
Medical History x
Document Sear
type, size, age, location =
‘VSS and patient assessment of Pain and x x ™ x *
lich z
Investigators Global Assesiment x x
Patients Satisfaction of Sear Treatment x x
Photography z = T * x x
Urine Pregnaney Test (WOCBP only) x x
Tnvestigational Produst Application x x * x
‘Concomitant Therapy/Medicat x x * x x
‘Adverse Events ~ x x * x x
3.2.1. BASELINE VISIT (DAY 0)
The following procedures must be performed and recorded at the Baseline (Day 0) visit:
1, Review study procedures and information regarding the study with the subject and
obt
written informed consent
2. Review eligibility criteria; inclusior/exelusion
Oculus Innovative Scfences, Ine. CONFIDENTIAL
Page 19 oF 46TP-XX-001,
EEO
3. Obtain medical/surgical history including demographic informati
4. Obtain UPT (WOCBP only) and evaluate results. If UPT is positive, the subject will
not be allowed to participate in the study
5. Record concomitant therapy/medications documenting the dose and dosing regimen
of all prescription and non-prescription therapies and medications including herbs,
vitamins, or other nutritional supplements currently being used (refer to Section 4)
Document scar description: length, width, age, type, cause
Photograph the scar (selected sites)
‘Complete the VSS and patient’s assessment of scar pain and itch.
Collect Adverse Events (AEs) prior to test article application
10. Apply a thin film of assigned test article to the target scar
11, Assess for AEs (postapplication)
12. Provide 1 tube of test article to the subject
13. Review Subject Instructions, Subject Diary Completion and Subject Restrictions with
the subject
3.2.2, FOLLOW-UP VISITS (DAY 14, DAY 28, DAY 56, DAY 84)
The following procedures and information will be performed and recorded at the Day 14
(Week 2), Day 28 (Week 4), Day 56 (Week 8) and Day 84 (Week 12) visits
1, Record concomitant therapy/medications documenting the dose and dosing regimen of
all prescription and non-prescription therapies and medications including. herbs,
vitamins, or other nutritional supplements administered currently being used (refer to
Section 4)
2. Complete VSS and patient’s assessment of scar pain and itch.
3. Review subject diary for compliance with test article application. Dispense 1 new
tube on Day 14 and 2 new tubes on Day 28, Collect all used and unused tubes by Day
56.
4. Complete Investigator’s Global Assessment of Treatment Efficacy and Patient's
Satisfaction (Day 56 only).
5. Assess for AEs
6. Review Subject Instructions, Subject Diary Completion and Subject Restrictions with
the subject
7. Photograph scar
Oculus Innovative Sciences, Inc. CONFIDENTIAL Page-20 oF 46—. __——_ DRAFT 1 ar 2011
3.2.3 FINAL EVALUATION (DAY 112/EARLY TERMINATION)
- Record concomitant therapy/medications documenting the dose and dosing regimen of
all prescription and non-prescription therapies and medications including herbs,
vitamins, or other nutritional supplements administered currently being used (refer to
Section 4)
Complete VSS and patient’s assessment of pain and itch
Complete Investigator’s Global Assessment of Treatment Efficacy and Patient's
Satisfaction Assessment,
Fo
Photograph scar
Collect any used and unused test article tubes not collected at prior visit,
Obtain UPT (WOCBP only) and evaluate results,
2
32.3, SUBJECT APPLICATION INSTRUCTIONS
1. Apply a thin film of the test article to the scar
2, Wash your hands following application of the gel
3. Repeat this procedure three (3) times a day, approximately 8 hours apart
4. Do not apply any other topical products to the treatment area,
s
When bathing or swimming is necessary, apply the gel following bathing. The test
article should not be washed off for at least four (4) hours following application
6. Bring the test article tubes to every study visit
7. Do not allow anyone else to use the test article
Keep the gel away from your eyes, lips and mouth
9. Keep the test article out of reach of children
10. Continue to use the test article even if your scar has improved
11. If you experience unacceptable burning, stinging or irritation at the application site
which you believe to be due to the test article, discontinue use and contact the study
doctor
12, Store the test article in a secure location at room temperature. rc f
(Oculus Innovative Sciences, Ine (CONFIDENTIAL Page21 of 46‘TP-XX.001
BRA ar 2001
3.2.4. DISCONTINUATION/WITHDRAWAL PROCEDURES
A subject may voluntarily withdraw from study participation at any time. If the subject
withdraws consent and disco
wes from the study, the Investigator will attempt to
determine the reason for discontinuation and record the reason in the subject's study records
‘and on the case report form (CRF). Ifa subject withdraws consent because of an AE, that AE
should be indicated as the reason for withdrawal. In the event of early discontinuation, (i.e.,
prior to Day 112) and whenever possible, the subject should be asked to return to the study
center to complete the Day 112 evaluations. Subjects who withdraw from the study will not
be replaced.
Ifat any
1¢ during the study, the Investigator determines that it is not in the best interest of
the subject to continue, the subject will be discontinued from part
can discontinue a subject at any
ion. The Investigator
ime if medically necessary. The Investigator may
discontinue a subject's participation if the subject has failed to follow study procedures or to
keep follow-up appointments, Appropriate documentation in the subject’s study record and
CRF regarding the reason for discontinuation must be completed. Prior to discontinuing a
subject from study participation, the Investigator will discuss his/her intentions with the
Medical Monitor or designee.
All subjects who fail to return to the study center for follow-up on the Day 112 (Week 16)
visit will be contacted by phone to determine the reason(s) why the subject failed to return for
the necessary visit or elected to discontinue from the study. If a subject is unreachable by
telephone after a minimum of two documented attempts (one attempt on two different days),
a registered letter will be sent requesting that contact be made with the Investigator.
Oculus has the right to terminate of to stop the study at any time. Should this be necessary,
both Oculus and the Investigator will ensure that proper study discontinuation procedures are
completed.
33. VARIATION FROM SCHEDULED VISIT DAYS
To allow for scheduling flexibi
, limited variation will be permitted from the specified
calendar day of each visit as outline in Table 2.
Table 2: Allowed Variation from Scheduled Visit Days
Time Allowed Variation MENTO CO
Baseline (Day 0) — {
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—DRAFT 19 APRIL 2011
Time
Day 14 (Week 2)
Day28 (Week 4)
Day 56 (Week 8)
Day 84 (Week 12)
Day 112 (Week 16)
3.4. SAFETY ASSESSMENTS
34.1. PREGNANCY TESTING
All WOCBP will have a UPT at Baseline (Day 0) and if the result is positive, the subject will
not be allowed to participate in the study. WOCBP will also have a UPT at their Final
Evaluation visit, Day 112 (Week 16) or early discontinuation. If a UPT is positive at Week
16, the pregnancy must be confirmed by a serum pregnancy test. Refer to Section $.4 for
further information.
34.2, ADVERSE EVENTS
AEs will be graded based on the CTEP-CTCAE version 4.02 for severity, where applicable.
AEs for which the CTEP-CTCAE grading scale is not applicable will be graded as mild,
‘moderate, severe, or life-threatening as defined in Section 5.1.1 of this protocol.
AEs will be evaluated at the Baseline Visit (Day 0) subsequent to the subject signing the
informed consent, pre- and post-treatment and at Day 14, 28, 56, 84 and 112 (or early
discontinuation). Section 5 outlines the procedures for recording and reporting AEs.
3.5. EFFICACY ASSESSMENTS
3.5.1, VANCOUVER SCAR SCALE (MODIFIED)
‘The Vancouver Scar Scale (VSS) first described by Sullivan in 1990, is perhaps the most
recognized scar assessment method. It assesses 4 variables: vascularity, height/thickness,
pliability, and pigmentation, All items are scored on a scale of zero to three. This study
will not assess pigmentation since it is not as applicable to keloids and hypertrophic
sears. The VSS remains widely applicable to evaluate therapy and as a measure of
outcomes (Nedelec, et al, 2000). The VSS will be performed at Baseline (Day 0) pre-
treatment and follow-up visits, Day 14, Day 28, Day 56, Day 84 and Day 112 (or early
termination),
(Oculus Innovative Sciences, Ine CONFIDENTIAL Page 23 of 46‘TP-XX.001
19 APRIL 2011
Table 3: Vancouver Scar Scale (modified)
The Vancouver Scar Scale
‘Scar characteristic Score
Vascularity ‘Normal 0
Pink 1
Red 2
Purple 3
Pliability Normal 0
Supple 1
Yielding 2
Firm 3
Height Flat °
<2 mm 1
2-5 mm 2
>Smm 3
Explanation of item measurement:
Vascularity Presence of vessels in scar tissue assessed by the amount of redness
Pliability Suppleness of the scar tested by wrinkling the scar between the thumb and
index finger
‘+ Height Average distance between the subcutical-dermal border and the epidermal surface
of the scar
352, PATIENT ASSESSMENTS
‘The subject will be asked to assess the scar’s symptoms of itching and pain at Baseline (Day
0) pre-treatment and follow-up visits, Day 14, Day 28, Day 56, Day 84 and Day 112 (or early
termination). In addition, subjects will assess their overall satisfaction with the sear
treatment as Very Good, Good, Moderate or Unsatisfactory at Day 56 (end of treatment) and
Day 112 (or early termination).
Table 4: Patient Assessment
Patient's Assessment
Symptom Assessment Score '
Pain None 0
Intermittent (occurs sometimes, but not
bothersome)
Moderate (occurs almost daily) 2
Severe (requires medication or intervention) 3
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Itch None 0
Intermittent (occurs sometimes, but not
bothersome)
Moderate (occurs almost daily) 2
Severe (requires medication or intervention) 3
35.3, PHOTOGRAPHY
‘The Investigator will take digital photographs at the baseline (pre-treatment) and each
subsequent study visit to document the scar. No analysis of photographs is planned.
3.6. SCREEN FAILURES
A screen failure subject will be a person from whom informed consent is obtained and is
documented in writing (i.e., subject signs an informed consent form) but who does not meet
the study eligibility requirements.
3.7, PROTOCOL DEVIATIONS
This study will be conducted as described in this protocol, except for an emergency situation
in which the protection, safety, and well-being of the subject requires immediate intervention,
based on the judgment of the Investigator (or a responsible, appropriately trained professional
designated by the Investigator). In the event of a significant deviation from the protocol due
to an emergency, accident, or mistake, the Investigator or designee must contact Oculus at
the carliest possible time by telephone. This will allow an early joint decision regarding the
subject’s continuation in the study, ‘This decision will be documented by the Inve
the Medical Monitor.
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DRAFT 19 APRIL 2011
PROHIBITED MEDICATIONS AND TREATMENTS
Concomitant medications include any prescription or over-the-counter preparations. Use of
concomitant medications will be recorded on the Concomitant Medications CRF beginning at
Baseline (Day 0) until the Final Evaluation, Day 112 (Week 16 or early termination) visit.
No topical products other than the treatment gel are to be used near the treatment area.
Oculus Innovative Sciences, Inc (CONFIDENTIAL Page 26 of 46TP-XX-001
ea a a SL SS et ate ae ame sete MARA
EVALUATION OF ADVERSE EVENTS
SLI. DEFINITIONS
For this protocol, an adverse event (AE) is any untoward medical occurrence (e.g., sign,
symptom, disease, syndrome, intercurrent illness, abnormal laboratory finding, injury, or
accident) that emerges or worsens following administration of the informed consent and until
the end of study participation. The untoward medical occurrence may not necessarily have a
causal relationship to the administration of the investigational product. An AE can therefore
bbe any unfavorable and/or unintended sign (including an abnormal laboratory result)
symptom, or disease temporally associated with the use of a medicinal (investigational)
product, whether or not related to the medicinal (investigational) product.
A pre-existing condition is one that is present prior to the start of the study and is to be
reported as part of the subject’s medical history. It should be reported as an AE only if the
frequency, severity, or the character of the condition worsens during the study.
An unexpected AE is one not identified in nature, severity, or frequency in the current
protocol.
A serious adverse event (SAE) includes any event that results in any of the following
outcomes:
* Death
© Life-threatening (‘e., the subject was, in the opinion of the Investigator, at immediate
risk of death from the event as it occurred. It does not apply to an AE that
hypothetically might have caused death if it were more severe.)
© Persistent or significant disability/ineapacity (i.e., the AE results in a substantial
disruption of the subject's ability to carry out normal life functions)
‘© Requires in-patient hospitalization or prolongs hospitalization (ie., the AE required at
least a 24-hour in-patient hospitalization or prolonged a hospitalization beyond the
expected length of stay; hospitalizations for elective medical/surgical procedures,
scheduled treatments, or routine check-ups are not SAEs by this criterion)
‘© Congenital anomaly/birth defect (ive. an adverse outcome in a child or fetus of a
subject exposed to the molecule or investigational produet before conception or
during pregnancy)
‘© Does not meet any of the above serious criteria but may jeopardize the subject or may.
require medical or surgical intervention to prevent one of the outcomes lise above
(‘e., is an important medical event)
(Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 27 of 46‘TP-XX.001
A,
$1.2. ADVERSE EVENT SEVERITY GRADES
‘The Investigator is responsible for evaluating all AES and determining the severity of the
event, Severity will be categorized by toxicity grade according to the CTEP-CTCAE version
4.02, when applicable. AEs not found in the list of AEs described in the CTEP-CTCAE
listing will be graded according to the following definitions:
© Mild — Grade 1: Event may be noticeable to subject; does not influence daily
activities; usually does not require intervention
* Moderate — Grade 2: Event may be of sufficient severity to make subject
uncomfortable; performance of daily activities may be influenced; intervention may
be needed
‘© Severe — Grade 3: Event may cause severe discomfort; usually interferes with daily
activities; subject may not be able to continue in the study; treatment or other
intervention usually needed
© Life-Threatening — Grade 4: Event that, in the view of the Investigator, places the
subject at immediate risk of death from the reaction as it occurred (ic., it does not
include a reaction that, had it occurred in a more severe form, might have caused
death)
‘The Investigator will follow all subjects who experience AEs until there is a return to the
subject's baseline condition or until a clinically satisfactory resolution is achieved. The
appropriate follow-up visits must be scheduled and the specific tests repeated or performed as
necessary.
5.3. INVESTIGATIONAL PRODUCT CAUSALITY
Relationship of an AE to investigational product will be assessed as follows:
* Definite: There is a clinically plausible time sequence between the onset of the AE
and the application of investigational product; when the event responds to withdrawal
of investigational product and recurs with re-administration of investigational product
© Probable: There is a clinically plausible time sequence between the onset of the AE
and the application of investigational product; the AE is unlikely to be caused by the
concurrent/underlying illness, other drugs or procedures
‘© Possible: There may or may not be a clinically plausible time sequence between the
onset of the AE and the application of investigational product and a cause cannot be
ruled out
* Unlikely: There is probably not a clinical plausible time sequence between the onset
of the AE and production administration; the AE is likely to be caused by a
concurrent/underlying illness, other drugs, or procedures (if applicable) and the AE
(Oculus Innovative Sciences, Ine CONFIDENTIAL Page 28 of 46TP-XX.001
DRAFT 19 April. 20)
does not follow a clinically consistent resolution pattern on withdrawal of the
product,
+ Unrelated: There is not a temporal or causal relationship to investigational product
administration
5.2, REPORTING ADVERSE EVENTS
The Investigator will assess subjects at each scheduled study visit for the occurrence of AEs,
In order to avoid bias in el ig AEs, subjects should be asked the following non-leading
question: “How have you felt since your last visit?” All AEs (serious and non-serious)
reported by the subject must be recorded on the source documents and CRFs.
In addition, Oculus must be notified within 24 hours of the Investigator’s knowledge of the
event by telephone or fax of any immediately reportable events according to the procedure
outlined below. Special attention should be paid to recording hospitalizations and
concomitant therapies and medications,
5.3. IMMEDIATELY REPORTABLE EVENTS
SAEs are considered immediately reportable events. If a subject experiences a SAE or
pregnancy the Investigator must:
1. Report the SAE or pregnancy by telephone to the Oculus Medical Monitor (refer to
Appendix C — Study Responsibility List) immediately (within 24 hours) after the
Investigator becomes aware of the event.
2. Complete an SAE or Pregnancy Notification Form and fax or overnight courier to
Oculus within 24 hours of knowledge of the event. Note: The SAE form is NOT the
AE CRF.
3. Obtain and maintain all pertinent medical records, information and medical
judgments of medical personne! who assisted in subject's treatment and follow-up.
and document on CRF as appropriate
4. Provide a more detailed report to both Oculus and the IRB/IEC no later than seven
days after the Investigator discovers the event as further information becomes
available, and when necessary update the information with follow-up information
including outcomes. This report should include a statement as to whether the event
was or was not related to the use of investigational product.
5. The Investigator will notify the IRB/IEC of the SAE or pregnancy according to
specific IRB/IEC requirements.
Oculus will submit a written report to the regulatory authorities as soon as possible but no
later than 15 calendar days after the initial receipt of the information tegarding any AE at
least possibly associated with the use of the investigational product that is not defined at fatal
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ee ee
or life threatening (based upon the FDA definition). Fatal or life threatening SAEs will be
reported within 7 calendar days after initial receipt of the information.
The Investigator will collect information on SAEs until subject’s health has returned to
baseline status, until all parameters have returned to normal, or remaining health issues have
otherwise been explained.
54. PREGNANCY
WOCBP must use an effective method of birth control during the course of the study, such as
the oral contraceptive pill, injection, implant, patch, vaginal ring, intrauterine coil,
intrauterine device, barrier method used with an additional form of contraception (¢.g.,
sponge, spermicide or condom). Females with a history of tubal ligation or a vasectomized
partner will undergo pregnaney testing. A female is considered to be of childbearing
potential UNLESS she is post-menopausal (no menses for 12 consecutive months) or without
a uterus and/or both ovaries.
Before enrolling WOCBP in this clinical trial, Investigators must review guidelines about
study participation for WOCBP. The topics should generally include:
‘© Informed consent document
‘* Pregnancy prevention information
‘© Risks to unborn et
i(ren)
© Any drug interactions with hormonal contraceptives
* Contraceptives in current use
‘* Guidelines for the follow-up of a reported pregnancy
Prior to study enrollment, WOCBP must be advised of the importance of avoiding pregnancy
ipation in this clinical study and the potential risk factors for an unintentional
‘The subject must sign an informed consent document stating that the above-
mentioned risk factors and the consequences were discussed with her.
During the study, all WOCBP should be instructed to contact the Investigator immediately if
they suspect they might be pregnant (e.g., missed or late menstrual cycle). The Investigator
must immediately notify Oculus of any female subject who becomes prégnant any time
during study participation, record the information on the Pregnancy Notification Form and
fax the form to the Oculus Medical Monitor. Oculus will ask the site to follow-up with the
(Oculus Innovative Seienees, Ine CONFIDENTIAL Page 30 of 46TP-XX-001
RAT io ar 20
subject periodically during the pregnancy for ongoing health and safety information through
term, as applicable. Subjects will remain on the study but will not receive re-treatment,
Protocol-required procedures for the final Day 14 (Week 2) evaluations must be performed
for the subject unless contraindicated by pregnancy.
5.8. FOLLOW-UP OF ADVERSE EVENTS
$5.1, FOLLOW-UP OF NON-SERIOUS ADVERSE EVENTS
Non-s
ious AEs that are identified during the last scheduled study visit (Day 112 or early
discontinuation) must be recorded on the AE CRF as ongoing,
55.2, FOLLOW-UP OF POST STUDY SERIOUS ADVERSE EVENTS
SAEs that are identified on the last scheduled contact (Day 112 or early discontinuation)
‘must be recorded on the AE CRF page and reported to Oculus according to the reporting
procedures outlined in Section 5,2. This may include unresolved previously reported SAEs,
or new SAEs. The Investigator should follow these SAEs until the events are resolved, or the
subject is lost to follow-up. The Investigator should continue to report any significant
follow-up information to Oculus and the IRB/IEC up to the point the event has been resolved.
Resolution means the subject has returned to the baseline state of health, or the Investigator
does not expect any further improvement or worsening of the subject's condition.
Any new SAEs reported by the subject to the Investigator that occur after the last scheduled
contact and are determined by the Investigator to be reasonably associated with the
application of investigational product should be reported to Oculus and the IRB/IEC.
Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 31 of 466
TP-XX001
—$ RAF roar zo
STATISTICAL ANALYSIS
6.1, GENERAL CONSIDERATIONS
All statistical programming will be performed using SAS version 9.1 or higher. Statistical
significance will be based on two-sided tests at the 5% level of significance.
6.2. POPULATIONS
All subjects will be included in the summaries of demographic and other baseline
characteristics. The Safety population will include all subjects exposed to any investigational
product and have provided any post-treatment safety information. ‘The Efficacy population
will include all subjects who complete both a Baseline (Day 0) and Final Evaluation (Day
112) visit.
63. OVERALL STUDY EVALUATIONS AND MEASUREMENTS.
Descriptive statistics will be used to summarize demographic characteristics (age, gender,
race, baseline POSAS, ete.). Past or ongoing medical history, study treatment visit
‘compliance, and prior and concomitant medication usage will be summarized for all subjects
and presented in a listing by subject.
64. SAFETY
Adverse event analyses will be conducted. All treatment-emergent AEs occurring during the
study will be recorded and classified on the basis of MedDRA terminology for the safety
population. ‘Treatment-emergent AEs are those AEs with an onset on or after the date of
study treatment, All treatment-emergent AEs will be summarized for the entire study period,
presenting the number of subjects reporting treatment-emergent AEs by system organ class,
preferred term, severity, relationship, and seriousness, Each subject will be counted only
fonce within a system organ class or a preferred term using the event with the greatest
relationship and greatest severity for the respective summarization.
Serious adverse events (SAEs) will be listed by subject. SAEs will be summarized for the
‘entire study by severity and relationship to study treatment, Each subject will be counted
only once within a system organ class or a preferred term using the event with the greatest
relationship and greatest severity.
All information pertaining to AEs noted during the study will be listed by subject, detailing
Verbatim term given by the Investigator, prefered term, system organ class onset dae
resolution date, maximum severity, seriousness, action taken regarding investigational
product, corrective treatment, outcome, and relatedness.
(Oculus Innovative Sciences, Ine CONFIDENTIAL Page 32 of 46‘TP-XX-001
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6.8. EFFICACY
Efficacy analyses will consist of descriptive statistics for the following assessment:
a. Change from baseline
(Week 16),
VSS total score from Baseline (Day 0) to Day 112
b. Change from baseline in individual sign and symptom (pain, itch, vascularity,
pliability and height) score from Baseline (Day 0) to Day 112 (Week 16),
c. Investigator's Global Assessment and Patient's Satisfaction assessments at Day
56 and Day 112 (early termination).
6.6. SAMPLE SIZE
Up to 40 subjects will be enrolled.
‘Gculus Innovative Sciences, Ine. CONFIDENTIAL Page 33 of 46TP-XX.001
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INVESTIGATIONAL PRODUCT MANAGEMENT
7.1. RECEIPT OF INVESTIGATIONAL PRODUCT
‘Oculus will provide all investigational device product.
7.2, STORAGE AND DISPENSING OF INVESTIGATIONAL PRODUCT
Investigational product will be stored under controlled room temperature conditions until
«dispensing by the study site personnel to each subject. Subjects will be instructed to keep the
investigational product tubes at room temperature and to retum with all assigned
investigational product tothe investigative site at each scheduled visit, Subjects may need to
be called or emailed a periodic reminder to retum to investigative site with their
investigational product tubes as required by protocol.
Upon receipt from Oculus, a study staff member will place all investigational product in a
secure, locked location, Access to investigational product should be strictly limited to the
study staff, Neither the Investigator nor any member of the study staff will distribute any of
the investigational product to any person not participating in this study.
‘The investigational product will be dispensed at the discretion and by the direction of the
Investigator in accordance with the conditions specified in this protocol. It is the
Investigator’s responsibility to ensure that accurate records of investigational product
issuance and return are maintained.
7.3. INVESTIGATIONAL PRODUCT ACCOUNTABILITY
A study staff member will maintain an inventory of investigational product. This will
include:
* Dates and initials of person designated as responsible for the inventory of the
investigational product
© Amount received including date, and lot number
© Amount currently in storage
* Amounts dispensed to each subject, identified by subject initials and a unique subject
number
© Amount transferred to another location within the study site or destroyed — this
should not occur without prior notification to Oculus
© Non-study disposition (e.g., wasted, broken)
'* Amount returned to Oculus or designee, if applicable
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DRAFT 19 APRIL 2011
‘© Amount destroyed, if applicable
Oculus, of its designee, will provide forms to facilitate investigational product inventory
control. All investigational product accountability forms and treatment logs must be retained
in the Investigator’s permanent study file. These records must be available for inspection by
Oculus, its designees or by regulatory agencies at any time.
7.4. RETURNS AND DESTRUCTION
Upon completion or termination of the study, it is the Investigator’s responsibility to ensure
that all partially used investigational product is properly disposed of at the site, All used and
unused investigational product must be accounted for by the Oculus Study Monitor prior to
disposal. Oculus must approve the destruction of any investigational produet and receive a
copy of the destruction record(s).
(Oculus Innovative Seienees, Ine (CONFIDENTIAL Page 35 of 46TP-XX-001
RAPT APL,
8. RECORDS MANAGEMENT
8.1. DATA COLLECTION
A set of CRFs will be provided for each study subject and the data will be recorded on these
forms using a black or blue ballpoint pen. All corrections will be made by striking through
the error with a single line and writing the correct data above, beside, or below the erroneous
data so as not to obscure the original entry, Each correction must be initialed and dated by
the person making the correction, If corrections are made after review and signature by the
Investigator, he/she must be notified of the changes and document acknowledgment
accordingly. In addition to signature confirmation that a subject meets the study eligibility
criteria, upon each subject's completion of the study, the Investigator will sign a statement
indicating that all pages of the subject’s case report in the study binder have been reviewed,
Signature stamps and “per signatures” are not acceptable.
It is Oculus’s policy that the study data be verifiable with the source data that necessitates
access to all original recordings, laboratory reports, and other records for each subject. The
Investigator must therefore agree to allow access to subjects” records, and source data must
be made available for all study data. Subjects (or their legal representatives) must also allow
access to their medical records. Subjects will be informed of the importance of increased
record access and permission granted by signature on the informed consent document,
Before the CRFs are formally submitted to Oculus, the Study Monitor, Medical Monitor or
‘Oculus may request copies of the CRFs for preliminary medical review. The Study Monitor
will collect the original completed CRFs and forward to the data management group to be
logged, stamped, copied and reviewed prior to entry into a computer database. Checks will
be performed to ensure the quality, consistency, and completeness of the data. Instances of
missing or un-interpretable data will be resolved with the Investigator or Study Coordinator.
Data queries, documented on data query forms, will be sent to the research facility along with
copies of the CRF pages that require clarification or correction when appropriate, Site
personnel will be responsible for providing resolutions to the data queries and for correcting
the CRFS, as appropriate. All unused CRFs and binders must be retumed to Oculus upon
completion of the study.
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tor must keep written or electronic source documents for every subject
participating in the clinical study. The subject file that identifies the study in which the
subject is participating must include the subject's available demographic and medical
information including:
© Name
© Contact information
+ Date of birth
+ Sex
© Medical history
* Concomitant diseases
+ Concomitant therapies/medication
© Study visit dates
‘© Performed examinations, evaluations, and clinical findings
‘Investigational product administration
‘+ AEs, SAEs, or pregnancy (as applicable)
Additionally, any other documents with source data, especially original printouts of data that
‘were generated by technical equipment must be included in the subject's source document
(eg, laboratory value listings). All these documents must have at least the subject’s initials,
study number, and the date of the evaluation
‘The data recorded during the course of the study will be documented in the CRF and/or the
study-specifie forms. Before or at study termination, all data must be forwarded to Oculus
The data will then be recorded, evaluated, and stored in anonymous form in accordance with
data-protection regulations.
Subjects will authorize the use of their protected health information during the informed
consent process in accordance with the applicable privacy requirements, Subjects who deny
permission to use and disclose protected health information will not be eligible to participate
in the study. The Investigator will ensure that the CRFs forwarded to Oculus, and any other
documents, contain no mention of subject names.
Any amendments and corrections necessary will be undertaken in both the source ddcuments
and CRFs (as appropriate) and countersigned by the Investigator, or documented designee,
stating the date of the amendmenveorrection, Errors must remain legible afd: may not be
‘Oculus Innovative Seiences, Ine CONFIDENTIAL Page 37 of 46‘TP-XX.001,
19 APRIL 2011
deleted with correction aids. The Investigator must state his/her reason for the correction of
any data. In the case of missing data/remarks, the entry spaces provided in the CRF should
be cancelled out so as to avoid unnecessary follow-up inquiries.
Regulatory authorities, the IRB/IEC and/or the Oculus Quality Assurance group (or designee)
‘may request access to all source documents, CRFs, and other study documentation for on-site
audit or inspection. The Investigator must guarantee direct access to these documents. The
original set of CRFs will be kept by Oculus or an authorized designee in a secured area.
Clinical data will be recorded in a computer format for subsequent statistical analyses, Data
files will be stored on electronic media with a final master data file kept by Oculus after
descriptive and statistical analyses and reports have been generated and are complete.
8.2. FILE MANAGEMENT AT THE STUDY SITE
It is the responsibility of the Investigator to ensure that the study center file is maintained in
accordance with Section 8 — Essential Documents for the Conduct of a Clinical Trial of the
ICH Guidance for Industry E6 Good Clinical Practice: Consolidated Guidance,
8.3. RECORDS RETENTION AT THE STUDY SITE
It is an Oculus requirement that all Investigators participating in clinical studies maintain
detailed clinical data for one of the following periods:
© Country-specific requirements, or
* A period of at least 2 years following the last approval of a marketing application
approved by a Regulatory Authority in an ICH region or until there are no pending or
contemplated marketing applications in an ICH region, or,
‘* A period of two years after Oculus notifies the Investigator that the data will not be
submitted for review by any Regulatory Authority
‘The Investigator must not dispose of any records o essential documents relevant to this study
without either (1) written permission from Oculus, or (2) prov
Wg an opportunity for Oculus
to collect such records. The Investigator shall take responsibility for maintaining adequate
and accurate electronic or hard copy source documents of all observations and data generated
during this study. Such documentation is subject to inspection by Oculus and relevant
regulatory agencies. If the Investigator withdraws from the study (¢.g.. relocation,
retirement), all study-related records should be transferred to a mutually agreed upon,
designee. Notice of such transfer will be provided to Oculus in writing.
(Oculus Innovative Sciences, Ine CONFIDENTIAL Page 38 of 469. MONITORING, COMPLIANCE, AND QUALITY
All aspeets of the study will be monitored by Oculus or authorized representatives of Oculus
according to Good Clinical Practices (GCP) and Standard Operating Procedures (SOPs) for
compliance with applicable government regulations, (ie., Informed Consent Regulations
[US 2ICFR, Part 50} and Institutional Review Board regulations [US 21CFR, Part 56.103]).
Access 10 all records, both during the trial and after trial completion, should be made
available to Oculus at any time for review and audit to ensure the integrity of the data. The
Investigator must notify Oculus immediately if the responsible IRB/IEC has been
disqualified or if proceedings leading to disqualification have begun
‘The Investigator must conduct the protocol in accordance with applicable GCP regulations
and guidelines; applicable informed consent regulations (US 2ICFR, Part $0); and in
compliance with the Declaration of Helsinki. Every attempt must be made to follow the
protocol and to obtain and record all data requested for each subject at the specified times. If
data is not recorded per protocol, the reasons must be clearly documented on the
CRFirecords
Before study initiation, at a site initiation visit or at a meeting with the Investigator(s), a
Oculus representative will review the protocol and study CRFs with the Investigator(s) and
their staff. During the study, the Study Monitor will visit the site regularly to check the
completeness of subject records, the accuracy of entries on the CRFs, the adherence to the
protocol and to GCP, the progress of enrollment, and to ensure that consent is being sought
and obtained in compliance with applicable regulations, and that the investigational product
is being stored, dispensed and accounted for according to specifications. ‘The Investigator
and key trial personnel must be available to assist the monitor during these visits.
The Investigator must give the monitor access to relevant hospital or clinical records, to
confirm their consistency with the CRF entries. No information in these records about the
identity of the subjects will leave the study center. Monitoring standards require full
verification for the presence of informed consent, adherence to the inclusion/exclusion
criteria, documentation of SAEs, and the recording of primary efficacy and safety variables.
Additional checks of the consistency of the source data with the CRFs will be performed
according to the study-specifie monitoring plan.
The Investigator must promptly complete the CRFS after the subject’s visit. The monitor is
responsible for reviewing them and clarifying and resolving any data queris, The completed
and corrected CRFs for completed visits will be either collected by the’ monitor or sent
(Oculus Innovative Sciences, Ine, CONFIDENTIAL Page 39 of 46‘TP-XX-001
ae:
directly for data processing, as arranged by the monitor. A copy of the CRFs will be retained
by the Investigator who must ensure that it is stored in a secure place with other study
documents, such as the protocol, and any protocol amendments
The Investigator must provide Oculus and the responsible IRB/IEC with a study summary
shortly after study completion, or as designated by Oculus,
9.1. QUALITY ASSURANCE AUDITS AND QUALITY CONTROL
In addition to the routine monitoring procedures, audits of clinical research activities in
accordance with SOPs may be performed to evaluate compliance with the principles of GCP.
A regulatory authority may also wish to conduct an inspection (during the study or even after
its completion), If' regulatory authori
Oculus immediately that this request has been made.
requests an inspection, the Investigator must inform.
Study conduct may be assessed during the course of the study by a Quality Assurance
representative(s) to ensure that the study is conducted in compliance with the protocol and
GCP. They will be permitted to inspect the study documents (study protocol, CRFs,
investigational product, original study-relevant medical records). All subject data will be
treated confidentially.
Oculus Innovative
22s, In, CONFIDENTIAL Page 40 0f 46‘TP-XX-001,
DRAFT 19 APRIL 201
10. ETHICS AND RESPONSIBILITY
This study must be conducted in compliance with the protocol, the ICH Guidance for
Industry E6 Good Clinical Practice: Consolidated Guidance and the applicable regulatory
requirements. Investigators must submit all essential regulatory documentation, as required
by local and national regulations (including approval of the protocol and informed consent
form by an HHS-registered IRB/IEC) to Oculus before investigational product will be
shipped to the study site
(Oculus Innovative Sciences, Ine. CONFIDENTIAL Page 41 of 4611, CONFIDENTIALITY
Al information generated in this study must be considered highly confidential and must not
be disclosed to any persons not directly concemed with the study without written prior
permission from Oculus. Authorized regulatory officials and Oculus personnel (or their
representatives) will be allowed full access to inspect and copy the records. All study
investigational products, subject bodily fluids, and/or other materials collected shall be used
solely in accordance with this protocol, unless otherwise agreed to in writing by Oculus.
Subjects will only be identified by initials and unique subject numbers on CRFS.
(culus Innovative Seiences, Ine CONFIDENTIAL Page 42 of 46TP-XX-001
—_—). DRAFT irri 200
12. AMENDMENT POLICY
Only Oculus may modify the protocol. Protocol amendments will only be made after
consultation and agreement between Oculus and the Investigator(s). Amendments may be
approved by all applicable national and local committees including, but not limited to, the
‘government regulatory authorities and/or regional IRB/IEC before implementation. ‘The only
exception is when an Investigator considers that a subject may be harmed and immediate
action is necessary. Under these circumstances, approval of the chairman of the IRB/IEC, or
‘an authorized designee must be sought immediately. The Investigator should inform Oculus,
and the full IRB/IEC, no later than five working days after the emergency occurs. Protocol-
specified safety reporting requirements must be adhered to independent of any other
variables, All amendments that have an impact on subject risk, the study objectives or that
require revision of the informed consent document must be approved by the IRB/IEC before
implementation, Administrative changes to the protocol and/or changes that do not impact
subject safety, risk, or comfort may be implemented prior to IRB/IEC approval if local
institutional policy permits. A copy of the written approval of the IRB/IEC, which becomes
part of the essential study documents file, must be given to the Study Monitor. Examples of
‘amendments requiring such approval are:
‘© A significant change in the study design
‘+ Am increase in the number of invasive procedures to which subjects are exposed
‘+ Anaddition or deletion ofa test procedure
The Principal Investigator at each study site must sign the Investigator’s Agreement page of
the amended protocol.
cals Innova
1 Sciences, Ine CONFIDENTIAL Page 43 of 46TP-XX.001
DRAFT 19 APRIL 2011
13. USE OF INFORMATION AND PUBLICATION
It is understood by the Investigator that the information generated in this study will be used
by Oculus in connection with the development of the product and therefore may be disclosed
to government agencies in various countries. To allow for the use of information derived
from the study, it is understood that the Investigator is obliged to provide Oculus with all
study data, and access to all study records.
Any results of medical investigations with Oculus products and/or publication/lecture/
manuscripts based thereon, shall be exchanged and discussed by the Investigator and Oculus
representative(s) 30 days before submission for publication or presentation, Due regard shall
be given to Cculus’s legitimate interests for example, manuscript authorship, obtaining
‘optimal patent protection, coordinating and maintaining the proprietary nature of submissions
to health authorities, coordinating with other ongoing studies in the same field, and protecting
confidential data and information. Oculus shall be furnished with a copy of any proposed
publication, Comments shall be rendered without undue delay.
In cases of publications or presentations of material arising from multi-center clinical
investigations, Oculus is to serve as coordinator and referee. Individual Investigators who
are part of a multi-center investigation may not publish or present data that are considered
common to a multi-center investigation without the consent of the other participating
Investigators and the prior review of Oculus.
In case of disagreement amongst the Investigators participating in a multi-center
investigation, Oculus will be the final arbiter, Comments shall be given without undue delay.
If they are not accepted, the senior author of the manuscript and representatives of Oculus
shall promptly meet to discuss further and endeavor to agree mutually on the final wording
and/or disposition of the publication. The above procedure also applies to information on
prematurely discontinued and other non-completed studies.
Results from investigations shall not be made available to any third party by the investigating
‘team outside the publication procedure as outlined previously. Oculus will not quote from
publications by Investigators in its scientific information and/or promotional material without
full acknowledgment of the source (i.e., author and reference).
Oculus Innovative Scfences, In. CONFIDENTIAL Page 44 0f 46,TP-XXx-001
$$ _____ DAF ar nn.
14. REFERENCES
Ahn ST, Monafo W, Mustoe T. Topical Silicone Gel for the Prevention and Treatment of
Hypertrophic Sear. Arch Surg. April 1991; 126: 499-504.
Bock O, Schmid-Ott G, Malewski P, et al.: Quality of life of patients with keloid and
hypertrophic scarring. Arch Dermatol Res 2006; 297:433-8
Brissett AE, Sherris DA: Scar contractures, hypertrophic scars and keloids. Facial Plast
Surg 2001, 17:263-72.
‘Common Terminology Criteria for Adverse Events (CTCAE), Version 4.02; US Department
of Health and Human Services, National Institutes of Health, National Cancer Institute;
September 2009
Declaration of Hel World Medical Associ
ttp/[Link],nete/ethiesunivhelsinki,htm
Nedelec B, Shankowsky A, Tredgett EE. Rating the resolving hypertrophic scar:
comparison of the Vancouver Scar Scale and scar volume. J. Burn Care Rehabil. 2000;
21:205-12.
ion, Available from:
Sullivan T, Smith J, Kermode J, et al. Rating the burn scar. J Burn Care Rehabil,
1990;11:256-60.
ICH Guidance for Industry E6 Good Clinical Practice: Consolidated Guidance; April 1996.
Perkins K, Davey RB, Wallis A. Silicone gel: a new treatment for burn scars and
contractures. Burns, 1982; 9:201-204.
Title 21 Code of Federal Regulations (CFR) Part 312. A\
hw w/seripts/edrh/cfdocs/efetr/
vailable from:
Oculus Innovative Sciences, Inc. CONFIDENTIAL Page #5 of 4601
DRAFT 19 APRIL 2011
APPENDIX A:
STUDY RESPONSIBILITY LIST
om a Suuly Se 10 Oculus, Contaet Medical Monitor, or Clin
tor, listed below. During
umes that may be diferent than the
Medical and Safety [TBD Consultant Medical Director
Monitor Fax: Oculus Innovative Sciences, Ine
Mobile HIN. MeDowell Blvd
e-mail: Petaluma, CA. 94954
Tap Clinieal Operations
Director Phone Oculus Innovative Sciences, Ine
Faw 1129. MeDowell Bld,
e-mail Petaluma, CA 94954
Tavestigator Tsp Dermatology Consuling Servioes
Phone: thd 22444 North Main Steet,
Fox: thd High Point, NC 27262
e-mail: tba
(cul Innovative Seiences, Ine CONFIDENTIAL Page 46 0f 46,usp 36
Table 4 (Continued)
Relative | Relative | Acceptance!
Retention | Response | Criteria,
Name Time Factor | _ NM (99) |
‘any vnspecied
impurity at 245
2 = 10 on
Total impartes = oa
170977 Bhydronrnety SAGE metivene Foxe Te-pegn-
ene BV argh oe, ore
Seppo s87B158 6b then Po peg toot
“SATIS 16SOmethfencandos sere: 17-done,
{ethan} mathyene sneer tne 2 cto
117d 78138 6B +10: 7gregn-ene 2a
ian sa silent epaspene :
i 7e.15816Bdimethyene 0x0 7e-pegn-ene2 cr
tao sae Silene sree —
£17ydroxy59 16Bmethyene3.ox0:7a-pregn-+-ene21-cafboyc
1th 158m ore of
[Link] 678 meinene 3-00-17. ae
serge 7eeteneo.-aregrtene
"17 neny Behigmethy.13816imeyene ox 17epren-tane
Tyco ac lane, 8 hve
\2-Rydroy-7Bchirometiy 158 16Smethyene-0%-17Bpregnene-
‘Webonte ts pacer Sn sbmenve sai
7 -Hyarony-7Bnyronymeng 158, 168-methylee-17a-pregn 3.56)
dene 2-carbonyc a6, atone
SPECIFIC TESTS
‘= Ormicat RorATION, Specific Rotation (7815)
‘Sample solution: 10 mg/ml. in methanol
‘Acceptance criteria: “187” to -193" at 20° on the an-
hydrous and solvent-free basis
‘+ MELTING RANGE OR TEMPERATURE, Class (741):
"198°-203, [NOTE—Dry over slca gel for NIT 24 h
before testing.]
‘+ WATER DETERMINATION, Method (921): NMT 0.29%
ADDITIONAL REQUIREMENTS
‘+ PACKAGING AND STORAGE: Preserve in tight containers,
‘and store at controlled room temperature.
‘+ USP REFERENCE STANDARDS (11)
USP Drospirenone RS
USP Drospirenone Related Compound A RS
17-Hydroxy-68,7215B,16Bdimethylene-3-0x0-17f-
regn-4-ene-21-carboxylic acid, lactone,
uO) 366.49
Drospirenone and Ethinyl Estradiol
Tablets
DEFINITION
Drospirenone and Ethiny! Estradiol Tablets contain. NLT
190.0% and NMT 110.086 of the labeled amount of dro-
spirenone (CuttioO)) and NLT 90.0% and NMT 110.08
Of the labeled amount of ethinyl estradiol (CisH:.0%).
IDENTIFICATION
A Te enn tines of he drperore and shiny
‘estradiol sample solution correspon
those of fhe Stondord solution, a obtained inthe Assy.
+ Procepure
Solution A: Dissolve 132 g of dibasic ammonium phos-
phate in 0.8 L of water, adjust with phosphoric acid to
8 pH of 6.8, and dilute to 1 L.
lution A and water (1:24)
: Acetonitrile and Solution B (1:1). Adjust
‘with phosphoric acid to a pH of 68,
Official from A
Official Monographs / Drospirenone 3351
Standard solution: (1/25) mg/mL of USP Drospirenone
‘RS and of USP Ethinyl Estradiol RSin Mobile phase,
Wwihere L's the Tablet label claim, in mg/Table, of each
‘compound
Sample solution: Transfer 10 Tablets to a 250smt yolu:
‘mete flask, dd 230 mL of Mabie prose, and sonicate
So nein shaking for CT 10, rl he
ablets are completely dispersed. Equiforate to room
Temperature ite wth Hobie phe to wolume and
entfuge the sample until a cletr supernatant Is'ob-
Bind. Use the supernatant.
chromatographic system
Cae Crematorophy (62), System Suit)
Detector 1: UV 270 nm for drospitenone
Detector 2: Fluorescence, exctation wavelensth at 285
rim emision wavelength at 315 nm for ethinyl e+
tradi [NoTe~Detector I and Detector 2are Cone
clare Sant < 12cm 34um packing At
‘olumn: 4-mm x 12.S-cm, 34um packing
Column temperature: 254 3°
Flow rate: 122 mL/min
Injection size: 20 ul
system suitability
fample:_ Standard solution
Sultaility requirements
Talling factor: Between 0.8 and 1.8 for both drospire-
Tone and ethinyl estradiol
Relative standard deviation: NMT 2.0% for both
‘drospirenone and ethinyl estradiol
Analysis
Samples: Standard solution and Sample solution
Calculate the percentage of the labeled amount of dro-
Spirenone (CisHi:0s) in the portion of Tablets taken
(uri) x (CG) x 100
1y = peak response of drospirenone from the
‘Sample solution,
yeak response of drospirenone from the
Cs = concentration of USP Drosptenone RS in the
Sond dln gn
minal concentrator of drosp
Semple suition (mg/m
ples: Standard solaion and Sample solution
Caltlte the percentage ofthe labeled amount of
thy esrdol (aff. in the portion of Tes
‘Sten
none in the
Result = (rut) x (CJC) x 100
fy = peak response of ethinyl estradiol from the
ak response ethinyl estracil rom th
15 = peak Fesponse of ethinyl estradiol from the
Standard solution
C= concentration of USP Ethiny Estradiol RS in
the Standard solution (mg/ml)
Gy —_-= nominal concenvation of ethinyl estradiol in
the Sample solution (mg/ml)
‘Acceptance criteria: $0.0%-110.0% of ethinyl estradiol;
'90.0%6-110.0% of drospirenone
PERFORMANCE TESTS
S"Dusoumon (711)
"Test 1: For drug products labeled to contain 3 mg of
arspenone and 0,03 mg of ey eal Sng
fosprenone and 0 ethinyl estradia
Mediums Water: 900 m2
230 pm
30 min
Standard solution: (1/900) mg/ml. of USP Drospre-
none RS and US ethinyl fn Medan,
‘Where Lis the Tabet label claim of each compound. A
Volume of methanol not exceeding 296 of the nal3352 Drospirenone / Official Monographs
total volume of solution may be wed toad in dsl
Ing there compounds,
Sample solution: Post portion of the solution under
‘est tough suitable cellos iter of OAS pore
1, dsaraing the fet 10 mL
Mobite phase: Acetonitile and water (40:60)
(sce certo SN, Sater Sta
(See Chromatc ), System Suitability.)
Mode: LC ae
Detector: UV 270 nm (for drospirenone), in series
with a fluorescence detector (for ethinyl estradiol),
with excitation at 210 nm and detection at 315 nm,
‘or with excitation at 281 nm and detection at 305,
Column: 4,[Link] x 6-cm; 3-um packing LI
Chew eee
Flow rate: 1/ml/min
Injection size: 100 ul.
System suitably
imple: Standard solution
Suitability requirements
ILT 2000 for both drospirenone
Column efficien
‘and ethinyl estradiol
Talling factor: Between 0.8 and 1.5 for both drospi-
enone and ethinyl estradiol
Relative standard deviation: NMT 3% for both dro-
spirenone and ethinyl estradiol
Samples: Standard solution and Sample solution
INOTE—in Medium, drospirenone is partially converted,
into 17-epidrospirenone, which has a relative reten-
tion time of approximately 1.2 relative to drospire-
‘none. The amount of drospirenone dissolved is calcu:
lated from the sum of drospirenone and 17-epidros-
jrenone |
Calculate the percentage of drospirenone and ethinyl
estradiol dissolved:
Result = (raft) x (Gill) x Vx 100
‘uy =peak response from the Sample soliton
Deak reponse from the Stondord solution
Concent ote tnd’ sin
= labeP aim (mg/Tablet)
V2 volume of Medury, 960 mb
ee NEP HB (othe bed amount of
one and NLT 25% (G) ofthe abled smount
we think ada alec, ™
rest 3: For drug products absied to contain. 3.
ef Serb ona 3 ma
product complies with tne test, the labeling Indicates
Gist itmeets USP Dissolution Test 2
Machu ving 906m
Apparatus 256 rpm
mes 30 min
Standard solution: (1/900) mat of USP Drospire-
one RS and of USP Ethnyt Eatradot Rs In edu,
tnre isthe Tabet label cai of eath compourd.
sample solution: Centifuge a porton of the Soluton
under testa 3500 rpm for 13" and use the
stpemetant
Mobile phase: Acetonitrile, methanol, and water
ees
romatographlc sytem
Gee hroneisrpiy (SN, Stem stain)
Mode:
Detector: UV 260 nm (for drospirenone), in series
with a fluorescence detector (for ethinyl estradiol),
with excitation at 280 nm and detection at 310 nim
UsP 36
Column: 4.6mm x 10. | FANOS
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Pagina 42 de 97