PEARLS study

Proactive against reactive therapy for the prevention of lichen sclerosus exacerbation and progression of disease – a pragmatic, parallel group randomised controlled trial with embedded economic evaluation and process evaluation

Abbreviations: LS – Lichen Sclerosus; TCS – Topical Corticosteroid; SCC - Squamous Cell Carcinoma; PIC - Participant Identification Centre

  

PEARLS study is open to recruitment

No. of participants recruited: 192

 

About PEARLS

Vulval Lichen Sclerosus (LS) is a chronic inflammatory condition, with incidence peaking in childhood and post-menopause. Reported prevalence is up to 3%, affecting around 1 million women in the UK. Inflammation causes whitening of vulval tissue, bleeding under the skin, texture change and cuts. Patients report itching, pain (particularly during sex) and discomfort in daily activities. Untreated LS can cause progressive loss of vulval architecture. Scarring may occur early in the disease and is irreversible without surgery. LS persisting beyond puberty may prevent normal vulval anatomical development.

LS is associated with risk of vulval intraepithelial neoplasia and vulval Squamous Cell Cancer. Rates of vulval SCC with LS are 20 times higher than in the general population with higher mortality than vulval SCC without LS.

The impact of LS is considerable due to the intimate and ‘taboo’ nature of the problem. LS affects psycho-social and sexual functioning and leads to embarrassment, isolation and relationship breakdown/difficulty in forming new relationships.

Watch Dr Rosalind Simpson, the study Chief Investigator, speaking in this video about lichen sclerosus.

Organisation and funding of study

The trial is being organised by the University of Nottingham (the Sponsor) and coordinated centrally by the Nottingham Clinical Trials Unit (NCTU).

This study is funded by National Institute for Health and Care Research (NIHR) Heath Technology Assessment (HTA) Ref: NIHR135121.

Chief Investigator: Dr Rosalind Simpson, Associate Professor and Consultant Dermatologist

Link to PEARLS NIHR Research Award

UoN logo 24/05/2023  NIHR-White-Background NCTU-white-background 

 

 

Overview

We are conducting a 2-arm, parallel-group, individually randomised, unblinded, multicentre, superiority trial with an internal pilot phase. The trial aims to recruit 400 female participants (aged 5 years and older) over a 12 month period. Each participant will be followed up for 24 months. 

The trial will compare a topical corticosteroid (TCS) applied on two non-consecutive days per week, even in absence of symptoms, (‘proactive treatment’) versus TCS as required to use only to treat a flare until symptoms resolve (‘reactive treatment’), for 12 months. The treatments will not be blinded. Choice of potent/superpotent TCS preparation is tailored to the patient as not all patients can tolerate a specific formulation. 

Trial Intervention

Intervention: Potent or superpotent Topical Corticosteroid (TCS) used for two non-consecutive days per week even in absence of symptoms (‘proactive treatment’).

Comparator: treatmeant of flare as required with potent or superpotent TCS, i.e. ‘reactive treatment’, daily until flare resolves (typically up to 7 days).

Trial Sites

The trial participants will be recruited from across the UK.  The trial plans to open at least 15 recruiting centres (sites).  Click on a pin on the map for details of selected trial sites.

List of Currently Open Trial Sites                                                                                                    
Site Date opened
Nottingham University Hospitals NHS Trust 10/04/2024
South Tees Hospital NHS Trust - James Cook 17/04/2024
Liverpool Women's NHS Foundation Trust  29/04/2024
Surrey and Sussex Healthcare NHS Trust 10/05/2024
Gateshead Health NHS Foundation Trust  15/05/2024
Shrewsbury and Telford NHS Trust  20/05/2024
Leicester - University Hospitals Leicester 24/05/2024
Oxford University Hospitals NHS Foundation trust 20/06/2024
Manchester University NHS Foundation Trust  27/06/2024
Barts Health NHS Trust 01/07/2024
Oxleas NHS Foundation Trust 08/07/2024
Liverpool Axess - Royal Liverpool University Hospitals NHS Foundation Trust 02/08/2024
Blackburn - East Lancashire Hospitals NHS Trust 05/08/2024
Derby - University Hospitals Derby and Burton 05/08/2024
Aberdeen - NHS Grampian 23/10/2024
Norwich - Norfolk and Norwich University Hospitals NHS Foundation Trust 11/11/2024
 

 

Participant Identification Centres (PICs) will be set up at GP practices where potential participants will be identified with pre-defined eligibility criteria. Initially only PICs sites that are in the proximity of three sites, Nottingham University Hospital, Liverpool Womens' Hospital and Liverpool University Hospitals, will be in operation. Patients will also be able to self-refer to these three sites

 

Inclusion and Exclusion Criteria

 

 

Trial Outcomes

 

 

Information for Participants

The information here is to help you understand why the research is being carried out and what it will involve for you if you decide to take part. Please ask us if you would like to have more information, or if there is anything that is unclear to you.

Watch this short video about the PEARLS study

 
Further Information for Participants
 

Information for Healthcare Professionals

If you would like to read more about the PEARLS Trial, click below

PEARLS PROTOCOL v3.0

REC reference: 24/SW/0016

IRAS project ID: 1008267

ISCRTN: ISRCTN72275160

Clinical Trials Unit: Nottingham Clinical Trials Unit

Sponsor: University of Nottingham

Funder: National Institute for Health and Care Research (NIHR)

Recruitment Target: 400

Recruitment end date: 01 September 2025

 

Meet Our Team

Meet our Trial Team
 

Contact Us

If you have any queries, please contact the PEARLS trial team.

Email: PEARLS@nottingham.ac.uk

Tel: 0115 8231609 / SKYPE 01157485961

Address: Nottingham Clinical Trials Unit, Applied Health Research Building, University Park, The University of Nottingham, Nottingham, NG7 2RD

Important Links:

http://www.ukdctn.org/news/pearls-study-funded-by-nihr.aspx 

 Follow Us on: 

     @PEARLS_Trial

  @PEARLS_Nottingham

  @PEARLS_Trial_Nottingham