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Effects Of Ciclesonide And Beclomethasone On Lens Opacification In Adult Subjects With Moderate To Severe Persistent Asthma

Primary Purpose

Respiratory Tract Diseases, Respiratory Hypersensitivity, Asthma

Status
Completed
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
ciclesonide (XRP1526)
Sponsored by
Sanofi
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Respiratory Tract Diseases focused on measuring Diseases, respiratory tract diseases, respiratory hypersensitivity, asthma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males or non-pregnant, non-lactating females 18 years of age and older with a history of moderate to severe persistent asthma for a duration of at least 2 months prior to screening. At screening, FEV1 must be ≥ 40% and ≤ 85% of predicted. Documented use of inhaled corticosteroid therapy at any dose for at least 1 month prior to screening. Able to demonstrate acceptable oral inhaler technique. Non-smoker for at least the past year and less than a 10 pack-year smoking history if previous smoker. Written informed consent agreement. Exclusion Criteria: History of prior cataract surgery in either eye. Evidence of congenital cortical cataract. Inability to grade nuclear, cortical, or posterior subcapsular opacities in either eye with LOCS III at the baseline slit lamp examination. Inability to dilate pupils to at least 6.0 mm. Nuclear opalescence with a LOCS III grade ≥ 4 in either eye at the baseline slit lamp examination. Cortical lens opacities with a LOCS III grade ≥ 3 in either eye at the baseline slit lamp examination. Posterior subcapsular lens opacities with a LOCS III grade ≥ 2 in either eye at the baseline slit lamp examination. Elevated intraocular pressure requiring treatment Best corrected visual acuity less than 74 letters (equivalent to vision worse than 20/30) in either eye at baseline. Females who are pregnant or lactating or have a positive pregnancy test at Visit 1 (Screening). Have had more than 1 in-patient hospitalization in the past year for asthma exacerbations. Have had more than 2 bursts of oral steroids per year for each of the past 2 years prior to screening. Chronic use of oral, injectable, or topical steroids except for inhaled corticosteroids for any condition. Topical corticosteroids designated as having a mild potency by the Stoughton-Cornell Scale or the European Guideline for levels of corticosteroid activity are allowed (see AppendixG). Any chronic condition that is likely to require treatment with oral or systemic corticosteroids other than asthma (e.g. systemic lupus, inflammatory bowel disease, rheumatoid arthritis). Topical ocular steroid treatment within 3 months prior to screening. Chronic or recurrent inflammatory disease in either eye likely to result in visual abnormalities or require treatment with ocular steroids. History of drug or alcohol abuse. Any clinically significant medical condition that would interfere with the subject's ability to participate in and comply with study protocol. Subject unlikely to comply with protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study. Subject is the investigator or any sub-investigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol. Hypersensitivity to the investigational products or to drugs with similar chemical structures. Have been treated with any investigational drug/product within 30 days prior to Visit 1 (Screening).

Sites / Locations

  • Sanofi-Aventis

Outcomes

Primary Outcome Measures

The primary endpoint is the occurrence of a Class I lens event for nuclear (NO), cortical (C), or posterior subcapsular (P) lens opacification within 12 months.
A Class I lens event is defined as any of the following events in either eye:
- 1.Increase from baseline in LOCS III grade of ≥ 0.5 (NO), ≥ 0.8 (C), or ≥ 0.5 (P)
- 2.Cataract surgery

Secondary Outcome Measures

- 1.Change from baseline to Month 12 in LOCS III grade for (a) nuclear opalescence, (b) cortical opacity, and (c) posterior subcapsular opacity.
- 2.Occurrence within 12 months in either eye of a Class II lens event: Increase from baseline in LOCS III grade of ≥ 0.9 (NO), ≥ 1.5 (C), or ≥ 0.9 (P), or cataract surgery.
- 3.Occurrence within 12 months in either eye of a Class III lens event: LOCS III grade ≥ 2.0 for any type of opacity (NO, C, or P) and a change in LOCS III grade of ≥ 0.9 for NO, ≥ 1.5 for C, and ≥ 0.9 for P, or cataract surgery.
- 4.Change from baseline to Month 12 in best-corrected visual acuity.
- 5.Change from baseline to Month 12 in intraocular pressure (mm Hg).
Tertiary endpoint:
- Change in post-bronchodilator FEV1 from baseline to Month 12.

Full Information

First Posted
November 15, 2005
Last Updated
April 7, 2009
Sponsor
Sanofi
Collaborators
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00254956
Brief Title
Effects Of Ciclesonide And Beclomethasone On Lens Opacification In Adult Subjects With Moderate To Severe Persistent Asthma
Official Title
A Multi-Center, Multinational, Randomized, Double-Blind, Parallel Group Study of the Effects of Ciclesonide Hfa-Mdi 640 μg/Day and Beclomethasone Hfa-Mdi 640 μg/Day on Lens Opacification in Adult Subjects With Moderate to Severe Persistent Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2009
Overall Recruitment Status
Completed
Study Start Date
January 2004 (undefined)
Primary Completion Date
June 2005 (Actual)
Study Completion Date
June 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Sanofi
Collaborators
Takeda

4. Oversight

5. Study Description

Brief Summary
The primary objective is to demonstrate the non-inferiority of ciclesonide compared to beclomethasone-HFA in the occurrence of Class 1 lens event for nuclear (NO), cortical (C), or posterior subcapsular (P) lens opacification within 12 months. Secondary objectives are to compare ciclesonide and beclomethasone with respect to class II and class III best corrected visual acuity and intraocular pressure from baseline to 12 months.
Detailed Description
This is a multi-center, multinational, active-controlled, double-blind, randomized (1:1) parallel group study of the effects of inhaled ciclesonide HFA-MDI 640 mcg/day and beclomethasone HFA-MDI 640 mcg/day on lens opacification in adult subjects with moderate to severe persistent asthma. The study consists of a 1-14 day screening phase during which subject eligibility will be determined, followed by a 12-month double-blind treatment phase. Lens opacification will be evaluated by slit lamp examination performed after pupillary dilation to at least 6.0 mm before randomization and after 4 months, 8 months, and 12 months of treatment using the LOCS III system for grading lens opacities. Best-corrected visual acuity and intraocular pressure will be measured at each eye examination visit. An Independent Data Monitoring Committee (IDMC) will be constituted to monitor safety throughout the double-blind treatment phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Tract Diseases, Respiratory Hypersensitivity, Asthma
Keywords
Diseases, respiratory tract diseases, respiratory hypersensitivity, asthma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1568 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
ciclesonide (XRP1526)
Primary Outcome Measure Information:
Title
The primary endpoint is the occurrence of a Class I lens event for nuclear (NO), cortical (C), or posterior subcapsular (P) lens opacification within 12 months.
Title
A Class I lens event is defined as any of the following events in either eye:
Title
- 1.Increase from baseline in LOCS III grade of ≥ 0.5 (NO), ≥ 0.8 (C), or ≥ 0.5 (P)
Title
- 2.Cataract surgery
Secondary Outcome Measure Information:
Title
- 1.Change from baseline to Month 12 in LOCS III grade for (a) nuclear opalescence, (b) cortical opacity, and (c) posterior subcapsular opacity.
Title
- 2.Occurrence within 12 months in either eye of a Class II lens event: Increase from baseline in LOCS III grade of ≥ 0.9 (NO), ≥ 1.5 (C), or ≥ 0.9 (P), or cataract surgery.
Title
- 3.Occurrence within 12 months in either eye of a Class III lens event: LOCS III grade ≥ 2.0 for any type of opacity (NO, C, or P) and a change in LOCS III grade of ≥ 0.9 for NO, ≥ 1.5 for C, and ≥ 0.9 for P, or cataract surgery.
Title
- 4.Change from baseline to Month 12 in best-corrected visual acuity.
Title
- 5.Change from baseline to Month 12 in intraocular pressure (mm Hg).
Title
Tertiary endpoint:
Title
- Change in post-bronchodilator FEV1 from baseline to Month 12.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or non-pregnant, non-lactating females 18 years of age and older with a history of moderate to severe persistent asthma for a duration of at least 2 months prior to screening. At screening, FEV1 must be ≥ 40% and ≤ 85% of predicted. Documented use of inhaled corticosteroid therapy at any dose for at least 1 month prior to screening. Able to demonstrate acceptable oral inhaler technique. Non-smoker for at least the past year and less than a 10 pack-year smoking history if previous smoker. Written informed consent agreement. Exclusion Criteria: History of prior cataract surgery in either eye. Evidence of congenital cortical cataract. Inability to grade nuclear, cortical, or posterior subcapsular opacities in either eye with LOCS III at the baseline slit lamp examination. Inability to dilate pupils to at least 6.0 mm. Nuclear opalescence with a LOCS III grade ≥ 4 in either eye at the baseline slit lamp examination. Cortical lens opacities with a LOCS III grade ≥ 3 in either eye at the baseline slit lamp examination. Posterior subcapsular lens opacities with a LOCS III grade ≥ 2 in either eye at the baseline slit lamp examination. Elevated intraocular pressure requiring treatment Best corrected visual acuity less than 74 letters (equivalent to vision worse than 20/30) in either eye at baseline. Females who are pregnant or lactating or have a positive pregnancy test at Visit 1 (Screening). Have had more than 1 in-patient hospitalization in the past year for asthma exacerbations. Have had more than 2 bursts of oral steroids per year for each of the past 2 years prior to screening. Chronic use of oral, injectable, or topical steroids except for inhaled corticosteroids for any condition. Topical corticosteroids designated as having a mild potency by the Stoughton-Cornell Scale or the European Guideline for levels of corticosteroid activity are allowed (see AppendixG). Any chronic condition that is likely to require treatment with oral or systemic corticosteroids other than asthma (e.g. systemic lupus, inflammatory bowel disease, rheumatoid arthritis). Topical ocular steroid treatment within 3 months prior to screening. Chronic or recurrent inflammatory disease in either eye likely to result in visual abnormalities or require treatment with ocular steroids. History of drug or alcohol abuse. Any clinically significant medical condition that would interfere with the subject's ability to participate in and comply with study protocol. Subject unlikely to comply with protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study. Subject is the investigator or any sub-investigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol. Hypersensitivity to the investigational products or to drugs with similar chemical structures. Have been treated with any investigational drug/product within 30 days prior to Visit 1 (Screening).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
ICD CSD
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Sanofi-Aventis
City
Chilly-Mazarin
ZIP/Postal Code
91380
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
19085579
Citation
Chylack LT Jr, Gross GN, Pedinoff A; Ciclesonide Lenticular Safety Study Group. A randomized, controlled trial to investigate the effect of ciclesonide and beclomethasone dipropionate on eye lens opacity. J Asthma. 2008 Dec;45(10):893-902. doi: 10.1080/02770900802353636.
Results Reference
derived

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Effects Of Ciclesonide And Beclomethasone On Lens Opacification In Adult Subjects With Moderate To Severe Persistent Asthma

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