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BF-200 ALA and red light LED lamp

Phase 3

Actinic Keratoses | Small molecule | Dermatology |Biofrontera Inc.|Last Updated: Jul 7, 2026

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials2
Total Enrollment220

FDA Designations

No designations recorded

Clinical trial landscape

BF-200 ALA and red light LED lamp · 6 trials · 4 indications

Phase 3 4Phase 1 2
NCT05662202Study to Evaluate the Safety, Tolerability and Efficacy of BF-200 ALA (Ameluz®) in the Field-directed Treatment of Actinic Keratosis (AK) on the Extremities and Neck/Trunk With Photodynamic Therapy (PDT) Using a RhodoLED LampActinic Keratoses
COMPLETED172 Analytics
NCT01966120Safety and Efficacy Study for the Field-directed Treatment of Actinic Keratosis (AK) With Photodynamic Therapy (PDT)Actinic Keratosis
COMPLETED87 Analytics
NCT02799069Evaluation of Safety and Efficacy of BF-200 ALA for the Treatment of Actinic Keratosis With Photodynamic TherapyActinic Keratosis
COMPLETED571 Analytics
NCT02799082Evaluation of Efficacy and Safety of BF-200 ALA Used With Photodynamic Therapy in Patients With Actinic Keratosis.Actinic Keratosis
COMPLETED122 Analytics
PHASE3COMPLETED
Study to Evaluate the Safety, Tolerability and Efficacy of BF-200 ALA (Ameluz®) in the Field-directed Treatment of Actinic Keratosis (AK) on the Extremities and Neck/Trunk With Photodynamic Therapy (PDT) Using a RhodoLED Lamp
Actinic KeratosesUnlock trial analytics
PHASE3COMPLETED
Safety and Efficacy Study for the Field-directed Treatment of Actinic Keratosis (AK) With Photodynamic Therapy (PDT)
Actinic KeratosisUnlock trial analytics
PHASE3COMPLETED
Evaluation of Safety and Efficacy of BF-200 ALA for the Treatment of Actinic Keratosis With Photodynamic Therapy
Actinic KeratosisUnlock trial analytics
PHASE3COMPLETED
Evaluation of Efficacy and Safety of BF-200 ALA Used With Photodynamic Therapy in Patients With Actinic Keratosis.
Actinic KeratosisUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall subject complete response rate
12 weeks after the last PDT (Visit 4 or Visit 6)

Percentage of subjects with all AK target lesions clinically cleared after last PDT

Overall Patient Complete Response 12 Weeks After the Last Photodynamic Therapy (PDT)
12 weeks after PDT 1 or 12 weeks after PDT 2 which might have been necessary because not all lesions were cleared after the first PDT

All efficacy variables were evaluated for the FAS. The primary efficacy variable was also analyzed for the PP population. All subgroup analyses were carried out for the FAS. Data for size and grade of AK lesions were analyzed using the last observation carried forward (LOCF) approach, affecting the response rates evaluation. Due to the small amount of missing data in the study, which did not have any relevant impact on primary results, sensitivity analyses for missing data were not performed. The primary efficacy variable was the overall patient complete response 12 weeks after the last PDT. An overall complete responder was defined as a patient in whom all treated actinic keratosis (AK) lesions were cleared (Olsen score of 0) after the last PDT, i.e. after PDT 1 or after PDT 2 if re-treatment was performed.

Overall Patient Complete Response 12 Weeks After the Last PDT (PP)
12 weeks after PDT 1 or 12 weeks after PDT 2 which might have been necessary because not all lesions were cleared after the first PDT

All efficacy variables were evaluated for the FAS. The primary efficacy variable was also analyzed for the PP population. All subgroup analyses were carried out for the FAS. Data for size and grade of AK lesions were analyzed using the last observation carried forward (LOCF) approach, affecting the response rates evaluation. Due to the small amount of missing data in the study, which did not have any relevant impact on primary results, sensitivity analyses for missing data were not performed. The primary efficacy variable was the overall patient complete response 12 weeks after the last PDT. An overall complete responder was defined as a patient in whom all treated AK lesions were cleared (Olsen score of 0) after the last PDT, i.e. after PDT 1 or after PDT 2 if re-treatment was performed.

Percentage of Participants With Complete Response 12 Weeks After the Last Photodynamic Therapy (PDT), ITT
12 weeks after the last PDT, up to 24 weeks after the first treatment

An overall complete responder was defined as a subject in whom all treated lesions were cleared (all lesions showing complete remission) 12 weeks after the last PDT. The outcome measure considered complete responders who were completely cleared 12 weeks after the first PDT and responders who were completely cleared 12 weeks after the second PDT if a re-treatment was necessary (in case of partial- or non-responding lesions 12 weeks after the first PDT)

Percentage of Participants With Complete Response 12 Weeks After the Last Photodynamic Therapy (PDT), PP
12 weeks after the last PDT, up to 24 weeks after the first treatment

An overall complete responder was defined as a subject in whom all treated lesions were cleared (all lesions showing complete remission) 12 weeks after the last PDT. The outcome measure considered complete responders who were completely cleared 12 weeks after the first PDT and responders who were completely cleared 12 weeks after the second PDT if a re-treatment was necessary (in case of partial- or non-responding lesions 12 weeks after the first PDT)

Percentage of Participants With Complete Response 12 Weeks After the Last Photodynamic Therapy (PDT) Illuminated With Narrow Spectrum Devices Only
12 weeks after the last PDT, up to 24 weeks after the first treatment

Subgroup analysis of patients treated with a narrow spectrum device for PDT Illumination (\~630 nm). An overall complete responder was defined as a subject in whom all treated lesions were cleared (all lesions showing complete remission) 12 weeks after the last PDT. The outcome measure considered complete responders who were completely cleared 12 weeks after the first PDT and responders who were completely cleared 12 weeks after the second PDT if a re-treatment was necessary (in case of partial- or non-responding lesions 12 weeks after the first PDT)

Total Patient Clearance Rate 12 Weeks After the Last Photodynamic Therapy (PDT)
12 weeks after the last photodynamic therapy (PDT), up to 24 weeks

AK clearance rate, defined as the percentage of subjects with complete remission of all AK lesions in the target area(s) assessed 12 weeks after the last PDT (12 weeks after the 1st PDT or 12 weeks after the 2nd PDT in case of retreatment).

Total Patient Clearance Rate Treated With Narrow Spectrum Lamp 12 Weeks After the Last Photodynamic Therapy (PDT)
12 weeks after the last PDT, up to 24 weeks

AK clearance rate, defined as the percentage of subjects with complete remission of all AK lesions in the target area(s) assessed 12 weeks after the last PDT (12 weeks after the 1st PDT or 12 weeks after the 2nd PDT in case of retreatment). Analysis was for the subgroup: treated by narrow spectrum lamps only \[n=15 (vehicle), n= 31 (BF-200 ALA)\]

Frequency and Severity of Adverse Events (AEs), Serious AEs (SAEs), and Treatment Emergent Adverse Events (TEAEs).
Through study completion, on average 6 weeks

TEAEs are defined as all AEs with onset or worsening after treatment with IMP up to Visit 5 (Final Visit). TEAEs are considered being related to IMP or medical device, if causal relationship between IMP or medical device and the TEAE is at least possible or relationship assessment is missing. If an AE occurs in different treatment areas (face, scalp, face and scalp), it is reported separately for each treatment area. Thus, some AEs are counted more than once.

Duration of TEAEs Including the Breakdown of Severity Category (Mild, Moderate, Severe).
From treatment day (day 1, Visit 2) up to Visit 5 (approx. 28 days post treatment)

The duration of TEAEs related to IMP and/or medical device which occurred in at least two subjects and with complete start and stop dates was analyzed. In addition, the proportion of the duration by severity was analyzed. Duration of severity per subject and preferred term is calculated in days counting all days and all episodes of one severity category together. Calculation is done referring to all subjects with occurrence of respective preferred term. If a severity category of a preferred term does not occur in a subject, the duration of this category is set to 0. If an AE occurs in different treatment areas, it is reported separately for each treatment area (face, scalp, face and scalp). Thus, some AEs are counted more than once for the analysis.

Assessment of New Lesions (AK, NMSC Such as BCC, SCC or Bowens Disease, and Melanoma) if They Occur Inside the Treatment Field
From treatment day (day 1, Visit 2) up to Visit 5 (approx. 28 days post treatment)

Assessed were newly occuring lesions of actinic keratosis (AK), non-melanoma skin cancer (NMSC) such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or Bowens disease, and melanoma inside the treatment field. Cumulative number of lesions is reported.

Assessment of New Lesions (AK, NMSC, and Melanoma) if They Occur Around the Treatment Field at a Distance of <10 cm
From treatment day (day 1, Visit 2) up to Visit 5 (approx. 28 days post treatment)

Assessed were newly occuring lesions of actinic keratosis (AK), non-melanoma skin cancer (NMSC) such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or Bowens disease, and melanoma inside the treatment field. Cumulative number of lesions is reported.

Application Site Skin Reactions During and Post PDT, Assessed by the Investigator
From treatment day (day 1, Visit 2) up to Visit 5 (approx. 28 days post treatment)

Application site skin reaction categories: discharge, erosion, erythema, exfoliation, fissure, induration, oedema, scabbing, skin flaking, ulceration, vesicles, other; severity of AE: mild, moderate or severe

Application Site Discomfort During and Post PDT, Reported by the Subjects
From treatment day (day 1, Visit 2) up to Visit 5 (approx. 28 days post treatment)

Application site discomfort categories: burning, hyperaesthesia, pain, paraesthesia, pruritus, stinging, warmth, other; severity of AE: mild, moderate or severe

Application Site Pain During Illumination
At treatment day (day 1, Visit 2) after end of illumination

Assessed by the subjects using an 11-point numeric rating scale (NRS), where a score of 0 means "no pain" and a score of 10 means "worst imaginable pain".

Changes in Blood Pressure (Systolic and Diastolic)
All visits through study completion after Visit 1: Visit 2, baseline, treatment day; Visit 3, approx. 7 days post treatment; Visit 4, approx.14 days post treatment; Visit 5, approx. 28 days post treatment

Change from baseline is presented. The first measurement at Visit 2 (arrival at site) was considered as baseline value for all following measurements. Blood pressure was measured in mmHg. At Visit 2, photodynamic therapy was performed.

Changes in Pulse Rate
All visits through study completion after Visit 1: Visit 2, baseline, treatment day; Visit 3, approx. 7 days post treatment; Visit 4, approx.14 days post treatment; Visit 5, approx. 28 days post treatment

Change from baseline is presented. The first measurement at Visit 2 (arrival at the site) was considered as baseline value for all following measurements. Pulse rate was measures in beats/min. At Visit 2, photodynamic therapy was performed.

Changes in Body Temperature
All visits through study completion after Visit 1: Visit 2, baseline, treatment day; Visit 3, approx. 7 days post treatment; Visit 4, approx.14 days post treatment; Visit 5, approx. 28 days post treatment

Change from baseline is presented. The first measurement at Visit 2 (arrival at site) was considered as baseline value for all following measurements. Body temperature was measured in °F and was converted to °C in the electronic Case Report Form. At Visit 2, photodynamic therapy was performed.

Investigation of Clinical Chemistry Parameters
At screening (Visit 1, up to 14 days before treatment) and at Visit 5 (approx. 28 days post treatment)

Findings which differ from reference range and are considered to be clinically significant are to be reported. Clinical chemistry parameters include glucose, creatinine, total bilirubin, aspartate aminotransferase (AST), alanineaminotransferase (ALT), lactate dehydrogenase (LDH), alkalinephosphatase (AP),gamma glutamyl transferase (GGT), potassium, sodium, calcium, total protein, albumin.

Investigation of Hematology Parameters
At screening (Visit 1, up to 14 days before treatment) and at Visit 5 (approx. 28 days post treatment)

Findings which differ from reference range and are considered to be clinically significant are to be reported. Hematology parameters include hemoglobin, hematocrit, red blood cell count, leukocyte count (white blood cells(WBC)) with differential count (neutrophils, lymphocytes, monocytes, eosinophils, basophils), and platelet count.

Investigation of Urinalysis Parameters
At screening (Visit 1, up to 14 days before treatment) and at Visit 5 (approx. 28 days post treatment)

Findings which differ from reference range and are considered to be clinically significant (CS) are to be reported

Physical Examination of Head, Neck, Skin, Lymph Nodes, Thorax Including Heart and Lungs, Abdomen, and Musculoskeletal, Peripheral Vascular and Nervous System Status
At screening (Visit 1, up to 14 days before treatment) and at Visit 5 (approx. 28 days post treatment)

Abnormal findings, considered to be clinically significant (CS), are to be reported

Memory Tests
At screening (Visit 1, up to 14 days before treatment) and at Visit 2 (treatment day 1)

Including picture- and question-based memory tasks; abnormal findings that are considered clinically significant will be documented

Neurological Investigations
At screening (Visit 1, up to 14 days before treatment) and at Visit 2 (treatment day 1)

Including investigation of pupils (equality), coordination (finger-nose test), gait (balance), and sensitivity (cheeks, arms, legs); abnormal findings that are considered clinically significant (CS) will be documented

Assessment of Baseline-adjusted Plasma Concentration-time Curves for ALA After a Single PDT Treatment Applying 3 Tubes of BF-200 ALA in Conjunction With the BF-RhodoLED® Under Maximal Use Conditions in Subjects With Mild to Severe Actinic Keratosis.
On treatment day (day 0): 0.5, 1, 1.5, 2, 2.5, 3*, 3.5, 4, 5, 6, 8, 10 hours post-dose (*prior to illumination)

Blood samples for ALA analysis for each subject were collected, starting at Visit 1 and then 0.5h prior to BF-200 ALA application for up to 10h afterwards. The concentrations of ALA in plasma were measured by an analytical laboratory using validated, internally standardized liquid chromatography-tandem mass spectrometry methods.

Assessment of Baseline-adjusted Plasma Concentration-time Curves for PpIX After a Single PDT Treatment Applying 3 Tubes of BF-200 ALA in Conjunction With the BF-RhodoLED® Under Maximal Use Conditions in Subjects With Mild to Severe Actinic Keratosis.
On treatment day (day 0): 0.5, 1, 1.5, 2, 2.5, 3*, 3.5, 4, 5, 6, 8, 10 hours post-dose (*prior to illumination)

Blood samples for PpIX analysis for each subject were collected, starting at Visit 1 and then 0.5h prior to BF-200 ALA application for up to 10h afterwards. The concentrations of PpIX in plasma were measured by an analytical laboratory using validated, internally standardized liquid chromatography-tandem mass spectrometry methods.

Secondary Endpoints

Overall subject complete response rate for subjects with lesions treated on extremities
12 weeks after the last PDT (Visit 4 or Visit 6)
Overall subject complete response rate for subjects with lesions treated on neck/trunk
12 weeks after the last PDT (Visit 4 or Visit 6)
Lesion complete response rate
12 weeks after the last PDT (Visit 4 or Visit 6)
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
BF-200 ALAEXPERIMENTALTopical application of BF-200 ALA containing 7.8% 5-ALA (5-aminolevulinic acid). Red light photodynamic therapy (PDT)
VehiclePLACEBO_COMPARATORTopical application of vehicle to BF-200 ALA containing no active ingredient. Red light photodynamic therapy (PDT)
BF-200 ALA gelACTIVE_COMPARATORPhotodynamic therapy with BF-RhodoLED in combination with BF-200 ALA.
Placebo to BF-200 ALA gelPLACEBO_COMPARATORPhotodynamic therapy with BF-RhodoLED in combination with a nanoemulsion gel formulation similar to BF-200 ALA, but without the active ingredient 5-aminolevulinic acid.
MAL CreamACTIVE_COMPARATORTopical application of MAL cream (Metvix) containing 160 mg/g methyl-aminolevulinate (MAL). Application of a 1 mm thick layer covering each lesion and a 0.5 cm to 1 cm surrounding margin.

Interventions

NameTypeDescription
BF-200 ALA and red light LED lampCOMBINATION_PRODUCTUp to two PDTs using a RhodoLED lamp (RhodoLED® XL or BF-RhodoLED®) (ALA-PDT, Ameluz®-PDT): Topical application of up to 3 tubes BF-200 ALA on the expanded treatment field (up to 240 cm²), followed by red light illumination with a RhodoLED lamp after 3 h incubation of study medication under occlusive dressing. PDT-1 will be performed at Visit 2. Clinical clearance will be assessed 12 weeks after PDT-1 (Visit 4). In case of remaining lesions at Visit 4, PDT-2 will be performed at the same visit.
Vehicle and red light LED lampCOMBINATION_PRODUCTUp to two PDTs using a RhodoLED lamp (RhodoLED® XL or BF-RhodoLED®) (Vehicle-PDT): Topical application of up to 3 tubes vehicle on the expanded treatment field (up to 240 cm²), followed by red light illumination with a RhodoLED lamp after 3 h incubation of study medication under occlusive dressing. PDT-1 will be performed at Visit 2. Clinical clearance will be assessed 12 weeks after PDT-1 (Visit 4). In case of remaining lesions at Visit 4, PDT-2 will be performed at the same visit.
BF-200 ALA gelDRUGBF-200 ALA was applied over 1-2 fields of approximately 20 cm² in total, allowed to dry for approximately 10 minutes, and covered with occlusive tape material for 3 h.
Placebo to BF-200 ALA gelDRUGThe reference product was a placebo (a nanoemulsion gel formulation similar to the Investigational Medicinal Product (IMP), but without the active ingredient). The placebo was packaged, assigned to each patient, and administered in the same way as the IMP.
Photodynamic therapy with BF-RhodoLEDPROCEDUREAfter cleaning the lesions, the entire treatment field(s) were illuminated using the novel narrow spectrum BF-RhodoLED lamp, a red light illumination source (approximately 635 nm) developed by Biofrontera, until a total light dose of 37 J/cm² (per treated field) was achieved.
BF-200 ALADRUGtopical treatment for photodynamic therapy combining drug application and after a 3 h incubation subsequent illumination with a broad or narrow spectrum light source.
MAL CreamDRUGtopical treatment for photodynamic therapy combining drug application and after a 3 h incubation subsequent illumination with a broad or narrow spectrum light source.
VehicleDRUGtopical treatment for photodynamic therapy combining vehicle application and after a 3 h incubation subsequent illumination with a broad or narrow spectrum light source.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites14

Inclusion Criteria: 1. Willingness and ability of subjects to provide informed consent and sign the Health Insurance Portability and Accountability Act (HIPAA) form. A study-specific informed consent and HIPAA form must be obtained in writing prior to starting any study procedures. 2. 4 - 15 mild t...

Countries:United StatesGermany
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Recent Changes (Last 90 Days)

HIGHJul 7, 2026NCT05662202Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHJul 7, 2026NCT05662202Status: ACTIVE_NOT_RECRUITING → COMPLETED
LOWMay 26, 2026NCT05662202primaryCompletionDate: changed
LOWMay 24, 2026NCT05662202studyFirstPostDate: changed

Frequently asked questions about BF-200 ALA and red light LED lamp

What is BF-200 ALA used for?

BF-200 ALA is an investigational small molecule being developed for the treatment of basal cell carcinoma (BCC) and actinic keratosis, a skin condition caused by sun damage. It is administered as a topical gel and used in combination with photodynamic therapy (PDT), a light-based treatment that activates the drug to target diseased skin cells.

What does BF-200 ALA target?

BF-200 ALA is a photosensitizing agent that is applied topically and activated by light during photodynamic therapy. It is designed to accumulate in abnormal skin cells, such as those in actinic keratosis and basal cell carcinoma, and when exposed to a specific light source, it produces a therapeutic effect that helps destroy these cells.

Who makes BF-200 ALA?

BF-200 ALA is being developed by Biofrontera Inc., a biopharmaceutical company. The company's stock is traded under the ticker symbol BFRI on the Nasdaq. Biofrontera is focused on dermatological treatments and is advancing BF-200 ALA through clinical development for skin conditions.

What phase is BF-200 ALA in?

BF-200 ALA is in Phase 3 clinical development for the treatment of actinic keratosis and basal cell carcinoma. It is an investigational drug, meaning it has not yet been approved by regulatory authorities. The Phase 3 trials are designed to evaluate its safety and efficacy in larger patient populations.

What clinical trials is BF-200 ALA in?

BF-200 ALA has been studied in four clinical trials, all of which are completed. These include Phase 3 trials (NCT01966120 and NCT05662202) and Phase 1 trials (NCT04319159 and NCT05060237) evaluating its safety and efficacy in treating actinic keratosis. The trials enrolled a total of 892 participants across the United States and Germany.

Is BF-200 ALA the same as Ameluz?

Yes, BF-200 ALA is also known as Ameluz. In clinical trial records, the drug is referred to as BF-200 ALA (Ameluz) for photodynamic therapy. This alternative name is used in studies evaluating its safety and efficacy for treating actinic keratosis and other skin conditions.