Dermatology practice at Aiken Dermatology and Skin Cancer Clinic Aiken, South Carolina July 1989 July 1991
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1 CURRICULUM VITAE DOUGLASS WILLIAM FORSHA, M.D. OFFICE: Jordan Valley Dermatology 3570 West 9000 South, Suite 220 West Jordan, Utah Phone: (801) Research Direct phone: (801) FAX: (801) DEGREES EARNED M.D.: Vanderbilt University School of Medicine, Nashville, Tennessee 1985 B.A. (cum laude): Asian Studies Brigham Young University, Provo, Utah 1979 EDUCATION Residency: Dermatology University of Illinois College of Medicine at Chicago Postgraduate Internship: Internal Medicine Vanderbilt University and Affiliated Hospitals Graduate: Vanderbilt University School of Medicine Undergraduate: Brigham Young University, Provo, Utah PROFESSIONAL MEMBERSHIPS American Academy of Dermatology American Medical Association EXPERIENCE Jordan Valley Dermatology, West Jordan, Utah January 2014 Medical Director and Principal Investigator Founded South Valley Dermatology, West Jordan, Utah July 1991 Medical Director and Principal Investigator Dermatology practice at Aiken Dermatology and Skin Cancer Clinic Aiken, South Carolina July 1989 July 1991 CERTIFICATION AND LICENSURE Medical License State of Utah ( ) State of Wyoming (8010A) National Board of Medical Examiners Diplomate 1986 HOSPITAL PRIVILEGES Intermountain Medical Center, Murray, Utah Courtesy Staff Jordan Valley Medical Center, West Jordan, Utah Active Staff Pioneer Valley Hospital, West Valley City, Utah Active Staff Douglass W. Forsha, M.D. May 2014 Page 1
2 OTHER ACTIVITIES Chief Organist at church in Aiken, South Carolina Lived in Thailand Speak fluent Thai Member of the Mormon Tabernacle Choir, Salt Lake City, Utah Enjoy snow skiing, swimming and racquetball PREVIOUS AND ONGOING RESEARCH EXPERIENCE DOUGLASS WILLIAM FORSHA, M.D. Enrolled 4 patients in a 52 Week, Phase III, Randomized, Active Comparator and Placebo- Controlled, Parallel Design Study to Evaluate the Efficacy and Safety/Tolerability of Subcutaneous of XXX/XXX, Followed by an Optional Long-Term Safety Extension Study, in Subjects with Moderate-to- Severe Chronic Plaque Psoriasis CRO Parexel. Sponsored by Merck. Enrolled 21 subjects in 13 months (contracted for 15) in a Phase III Biologic, 12-week Randomized, Double-blind, Placebo-controlled Study Comparing the Efficacy and Safety of XXX to Etanercept and Placebo in Patients with Moderate-to-Severe Plaque Psoriasis with a Long-term Extension Period. Completed Enrollment February CRO-Parexel. Sponsored by Eli Lily. Randomized 8 subjects, screened 13, (randomization closed early), in one month in a Phase II, Multicenter, Randomized, Placebo-controlled, Double-blind, Parallel-group Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of ASBI Capsules in Adult Subjects with Atopic Dermatitis. October CRO-TKL. Sponsored by Asubio. Contracted for 18, enrolled 19 in 7 months in a Biologic Phase III Study to Evaluate the Efficacy and Safety of Induction and Maintenance Regimens of Brodalumab Compared with Placebo and Ustekinumab in Subjects with Moderate to Severe Plaque Psoriasis. Photography site. Started and completed in CRO-Quintiles. Sponsored by Amgen. Enrolled 9 subjects in 2 months in a Randomized, Double-blind, Multiple-site, Placebo-controlled, Parallel-design Study Comparing XXX (XXX) to Solaraze (diclofenac sodium) Gel 3% in the Treatment of Actinic Keratosis CRO-Novum Pharmaceuticals Research Services. Sponsored by XXX. Enrolled 7 patients for a PHASE III Randomized, Double-blind, Placebo-controlled, Multiple-site Study Comparing xxx to xxx in the Treatment of Moderate-to-Severe Rosacea Sponsored by Novum Pharmaceuticals. Contracted for 16 patients, enrolled 21 in a Phase III, Randomized, Double-blind, Parallel-group, Vehicle-controlled, Multicenter Study of NB-001 in the Treatment of Recurrent Herpes Labialis Sponsored by NanoBio. Douglass W. Forsha, M.D. May 2014 Page 2
3 Contracted for 8 patients, enrolled 10 in a Phase II, Randomized, Double-blind, Dose-ranging Study Evaluating IDP-107 Versus Placebo in the Treatment of Severe Acne Vulgaris with Nodules. Photos. Completed December Sponsored by DOW. Contracted for 8 patients, enrolled 11 within 12 weeks in a Phase III Study Evaluating Imiquimod Cream 5% Compared to Aldara 5% Cream in Patients with Actinic Keratosis. Completed April CRO-Novum Pharmaceuticals Research Services. Sponsored by XXX. Contracted for 5 patients, enrolled 5 within two weeks in a Phase IV Study Evaluating Epicream Emulsion in the Clinic When Used as Monotherapy for Atopic Dermatitis. Completed March Sponsored by Promius Pharma. Contracted for 5 patients, enrolled 5 within three weeks in a Phase IV, Open-label, Multicenter, Community-based, 12-week Assessment of Effectiveness, Safety, and Subject Satisfaction with Oracea Capsules 40 mg., (30 mg. immediate release plus 10 mg. delayed-release beads) when Used as Monotherapy or as Add-on Therapy to Existing Topical Regimens for the Treatment of Rosacea. Completed November Sponsored by Galderma. Contracted for 12 patients, enrolled 14 in four months in a Phase IIB, Multicenter, Double-blind, Randomized, Dose-ranging Trial to Evaluate IDP-107 in the Treatment of Moderate-to-Severe Acne Vulgaris with Nodular Involvement. Completed August Sponsored by Dow. Contracted for 8 patients, enrolled 7 within two months in a Phase II, Multicenter, Double-blind, Placebo-controlled, Parallel Group Efficacy and Safety Study of Two Doses of S (400 mg. BID and 800 mg. BID) in patients with Atopic Dermatitis. Completed July Sponsored by Shionogi U.S.A. Contracted for 18 patients, enrolled 34 within six weeks in a Phase III, Double-blind, Randomized, Placebo-controlled, Multicenter Trial to Assess the Efficacy and Safety of Four Weeks of Treatment with Imiquimod Cream for Actinic Keratoses. One of the top enrollers in the nation. Photos Sponsored by Graceway Pharmaceuticals. Contracted for 16 patients, enrolled 20 within five months in a Phase IV, Double-blind Trial to Determine the Effects of Doxycycline 40 mg. Modified-release Capsules vs. Doxycycline 100 mg. Immediate-release in Patients with Moderate-to-Severe Rosacea Sponsored by CollaGenex Pharmaceuticals. Enrolled 7 subjects in an Observational Post-marketing Safety Surveillance Registry of Enbrel (etanercept) for the Treatment of Psoriasis. Five-year study Sponsored by Amgen. Contracted for 14 patients, enrolled 63 in a 5-month period in a Phase IIB Study of Subjects with Recurrent Herpes Labialis. One of the top enrollers in the nation. September Sponsored by NanoBio Corporation. Douglass W. Forsha, M.D. May 2014 Page 3
4 Enrolled 9 patients who had positive KOH and Mycology in a Phase III, Evaluator-blind Study to Assess the Safety and Efficacy of Itraconazole Tablets, Capsules, and Placebo in the Treatment of Onychomycosis of the Toenail Sponsored by Barrier Therapeutics. Contracted for 10 patients, enrolled 15 in 6 weeks in a Phase IV Open-label Study for Facial Improvement with Use of Retin-A Microsphere Pump. One of the top enrollers in the nation. December Sponsored by Johnson & Johnson. Contracted for 24 patients, enrolled 40 in a Phase III Study of the Safety and Efficacy Evaluation of Tretinoin Gel, 0.05%, versus Tretinoin Gel Vehicle in the Treatment of Mild-to-Moderate Acne Vulgaris. Ages 10 and older Sponsored by Healthpoint. Enrolled 7 patients in one month for a Phase IV Trial of Differin Gel for Moderate-to-Moderately Severe Facial Acne Sponsored by Galderma. XXX vs. YYY Topical Gel for the Treatment of Acne Vulgaris Sponsored by Medicis Pharmaceutical Corp. Contracted for 20 patients, enrolled 37 in a 52-week Open-label Study of the Safety of Ketoconazole USP 2% Topical Gel in the Treatment of Seborrheic Dermatitis. First in nation asked to enroll Sponsored by Barrier Therapeutics, Inc. Contracted for 16 patients, enrolled 24 in a Double-blind, Randomized, Vehicle-controlled, Parallelgroup, Multicenter Study to Assess the Efficacy and Safety of a Topical Gel Product Containing Ketoconazole USP 2% in the Treatment of Seborrheic Dermatitis Sponsored by Barrier Therapeutics, Inc. XXX in a Three-stage Dose-escalating Study to Assess Efficacy and Safety for the Treatment of Common Warts in Adults Sponsored by 3M Pharmaceuticals. XXX for the Treatment of Menstrual Cycles in Women with Mild-to-Moderate Acne Vulgaris Sponsored by Berlex through Averion. XXX in the Treatment of Chronic Plaque Psoriasis Sponsored by GlaxoSmithKline. XXX Applied Topically for 12 Weeks to Subjects with Acne Vulgaris Sponsored by Micrologix BioTech. Terbinafine HCI Pulse-dosing as Treatment of Onychomycosis of the Toenails Sponsored by Novartis. Douglass W. Forsha, M.D. May 2014 Page 4
5 15% Azeleic Acid Cream vs. Vehicle Cream as Topical Treatment for Mild-to-Moderate Acne of the Face Sponsored by Berlex Corporation. Topical Patch Application of Fluconazole for Treatment of Onychomycosis Sponsored by Watson Pharmaceuticals. Faropenem Daloxate vs. Cephalexin in the Treatment of Uncomplicated Skin and Skin Structure Infections Sponsored by Bayer Corporation through Concepts in Pharmaceutical Research. Mentax Cream vs. Vehicle Cream in the Treatment of Plantar Tinea Pedis Sponsored by Schering-Plough through TKL Research. Contracted for 12 patients, enrolled 50 in a study of Levonorgestrel vs. Placebo in the Treatment of Patients with Moderate Acne Second-highest enroller in the nation. Sponsored by Wyeth-Ayerst Laboratories through Medex. Cefditoren Pivoxil vs. Cefuroxime Axetil in the Treatment of Patients with Uncomplicated Skin or Skin Structure Infections Sponsored by Tap Holdings, Inc. through The Phoenix. Transdermal Delivery of Phenobarbital in Neonates. Manipal, India Efficacy and Safety of 2% Topical Minoxidil Solution for the Treatment of Male Pattern Alopecia. University of Illinois College of Medicine, Department of Dermatology Immunohistochemical Staining for EGF Receptors in Nonmalignant Dermatoses with Lloyd E. King, Jr., M.D., Professor in Chief, Division of Dermatology, Vanderbilt University School of Medicine, Nashville, Tennessee Douglass W. Forsha, M.D. May 2014 Page 5
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