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Safety and Efficacy Study of CF101 to Treat Keratoconjunctivitis Sicca

Primary Purpose

Keratoconjunctivitis Sicca

Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
CF101
Placebo
Sponsored by
Can-Fite BioPharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Keratoconjunctivitis Sicca focused on measuring Keratoconjunctivitis Sicca, KCS, Dry Eye

Eligibility Criteria

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

Inclusion Criteria: Male or female, 18 years of age and over; Have a diagnosis of moderate-to-severe KCS as defined by: (1) Schirmer Test (ST) (without anesthesia) < 7 mm/5 min in either eye; AND (2) Positive FS, defined as a corneal punctate fluorescein staining score of ≥1 in either eye, where 0 = none and 3= severe; AND (3) At least 1 of the following ocular symptoms scored at ≥2, where 0 = none and 4 = very severe/interferes with normal activities: photophobia, blurred vision, foreign body sensation, soreness or pain, itching, burning, dryness; Willing to use no topical ocular treatments except for the unpreserved artificial tears; Doses of unpreserved artificial tears have been stable for >2 weeks prior to Screening Visit; Females of child-bearing potential must have a negative urine pregnancy test at screening and throughout the study, to be eligible for, and continue participation in, the study; Females of child-bearing potential must be willing to use 2 methods of contraception deemed adequate by the Investigator (for example oral contraceptive pills plus a barrier method) to be eligible for, and continue participation in, the study; Ability to complete the study in compliance with the protocol; and Ability to understand and provide written informed consent. Exclusion Criteria: Has Sjögren's Syndrome with significant systemic non-exocrine gland involvement; Has Stevens-Johnson Syndrome; If KCS is due to rheumatoid arthritis or other autoimmune diseases, patient may not be receiving disease-modifying drugs, including methotrexate and biological agents; Use of systemic immunosuppressive drugs; Use of oral corticosteroids >10 mg prednisone, or equivalent, per day; Use of topical steroids within 2 weeks prior to the Screening Visit and for the duration of the study; Receipt of topical cyclosporine eye drops within 3 months prior to the Screening Visit and for the duration of the trial; Presence of chronic ocular disease other than KCS requiring topical treatment; Presence of post-burn ocular injury; Ocular herpes simplex virus infection; Concomitant use of contact lenses; Persistent intraocular inflammation or infection; Active blepharitis; Recent surgical occlusion of the lacrimal puncta; Subepithelial corneal scarring; Anesthetic or neurotrophic corneas; Hemoglobin level <9.0 gm/L; Platelet count <125,000/mm^3; White blood cell count <3500/mm^3; Serum creatinine level outside the laboratory's normal limits; Liver aminotransferase levels greater than 2 times the laboratory's upper limit of normal; Pregnancy, planned pregnancy, lactation, or inadequate contraception as judged by the Investigator; History of malignancy within the past 5 years (excluding basal cell carcinoma of the skin); Significant acute or chronic medical, ophthalmic, or psychiatric illness that, in the judgment of the Investigator, could compromise patient safety, limit the patient's ability to complete the study, and/or compromise the objectives of the study; Participation in another investigational drug or vaccine trial concurrently or within 30 days; or Other conditions which would confound the study evaluations or endanger the safety of the patient.

Sites / Locations

  • Meir Hospital
  • Sheba Medical Center
  • Assaf Harofeh Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CF101 1mg

Placebo

Arm Description

CF101 1 mg given orally every 12 hours for 12 weeks

Placebo given orally every 12 hours for 12 weeks

Outcomes

Primary Outcome Measures

Change From Baseline to Week 12 in Schirmer Test (ST) Score in Millimeters
Involved placing a standardized paper tear strip inside the lower eyelid for 5 minutes. The tear strip was then removed and the length of the strip that was wet from tears was measured in millimeters. Change from baseline is calculated. Scores range 0-35 mm, with higher scores indicating more (better) tear production.
Change From Baseline to Week 12 in Tear Break-Up Time (BUT) in Seconds
Time elapsed between a complete blink and the development of the first random dry spot on the tear film as seen under fluorescent light. Change from baseline is calculated. Scores range 0-30 seconds, with higher scores indicating better tear composition and function.
Number of Subjects With >25% Improvement in Fluorescein Staining of the Cornea (FS) at Week 12
Severity of corneal epithelial loss as graded by Fluorescein Staining of the cornea, assessed on a 0-4+ scale with 0 = none and 4+ = severe de-epithelialization (in other words, higher scores indicate worse disease), expressed as number of participants with >25% improvement at Week 12 relative to baseline.

Secondary Outcome Measures

Number of Subjects Experiencing Clinical Success at Week 12
Proportion of subjects experiencing improvement of ≥25% over baseline at Week 12 in (a) tear breakup time (BUT), (b) superficial punctate keratitis as assessed by fluorescein staining (FS), or Schirmer Test (ST)
Change From Baseline to 12 Weeks in Dry Eye Symptom Score (DESS)
DESS consists of 12 questions designed to assess the symptoms of ocular irritation, covering three areas: ocular symptoms, environmental triggers and vision-related function. Each of the 12 symptoms can be graded 0-4, with 0 indicating no symptoms over the past week, and 4 meaning constant symptoms over the past week. Scores from all answered questions are summed. The final score is multiplied by (25/number of questions answered) to give an outcome between 0 (no symptoms) to 100 (worst possible symptoms). Change from baseline is calculated.
Change From Baseline to Week 12 in Tear Meniscus (TM) Height
Indicator of tear volume. TM was recorded on a scale from 0-3, with 0=none, 1=trace, 2=normal, and 3=high, with higher scores meaning better tear production and integrity. Change from baseline.
Percent Change From Baseline to Week 12 in the Use of Artificial Tears
Daily use of REFRESH TEARS® Lubricant Eye Drops artificial tears supplied to each patient was recorded in diaries provided to patients. Percent change from baseline is calculated.

Full Information

First Posted
July 6, 2006
Last Updated
April 13, 2022
Sponsor
Can-Fite BioPharma
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1. Study Identification

Unique Protocol Identification Number
NCT00349466
Brief Title
Safety and Efficacy Study of CF101 to Treat Keratoconjunctivitis Sicca
Official Title
A Phase 2, Randomized, Double-Masked, Placebo-Controlled, Parallel-Group Study of the Safety and Efficacy of Daily CF101 Administered Orally in Patients With Moderate-to-Severe Keratoconjunctivitis Sicca
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
January 2007 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
May 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Can-Fite BioPharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 2, randomized, double-masked, placebo-controlled, parallel-group study in adult males and females, aged 18 years and over, with a diagnosis of moderate-to-severe keratoconjunctivitis sicca (KCS). Patients will be randomized to receive either CF101 1 mg or matching placebo, given orally every 12 hours (q12h) for 12 weeks. A Screening Period of up to 4 weeks that includes a 2-week run-in period will precede a 12-week treatment period, followed by a 2-week follow-up period.
Detailed Description
At a Screening Visit, patients who provide written informed consent will have screening procedures performed, including a complete medical history, medication history, physical examination, including height, weight, sitting blood pressure, pulse rate and temperature, and clinical laboratory tests. Disease activity will be assessed using tear meniscus (TM) height, tear break-up time (BUT), fluorescein staining (FS), Schirmer test, and the Dry Eye Symptom Score (DESS). Doses of artificial tears must be stable for >2 weeks prior to the Screening Visit. Eligible patients will begin a 2-week run-in period, during which time they will be instructed to discontinue use of all topical ophthalmic medications except for lubricant eye drops. Patients who successfully complete the 2-week run-in period will be randomized to their assigned medication (CF101 1 mg or matching placebo) to be taken orally every q12h for 12 weeks. Patients will return for assessments and a new supply of study medication at Weeks 2, 4, 8 and 12, and at Week 14 for a final follow-up assessment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Keratoconjunctivitis Sicca
Keywords
Keratoconjunctivitis Sicca, KCS, Dry Eye

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
80 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CF101 1mg
Arm Type
Experimental
Arm Description
CF101 1 mg given orally every 12 hours for 12 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given orally every 12 hours for 12 weeks
Intervention Type
Drug
Intervention Name(s)
CF101
Other Intervention Name(s)
Piclidenoson
Intervention Description
Orally CF101 1mg
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Inactive pill
Intervention Description
Orally matching Placebo
Primary Outcome Measure Information:
Title
Change From Baseline to Week 12 in Schirmer Test (ST) Score in Millimeters
Description
Involved placing a standardized paper tear strip inside the lower eyelid for 5 minutes. The tear strip was then removed and the length of the strip that was wet from tears was measured in millimeters. Change from baseline is calculated. Scores range 0-35 mm, with higher scores indicating more (better) tear production.
Time Frame
12 weeks
Title
Change From Baseline to Week 12 in Tear Break-Up Time (BUT) in Seconds
Description
Time elapsed between a complete blink and the development of the first random dry spot on the tear film as seen under fluorescent light. Change from baseline is calculated. Scores range 0-30 seconds, with higher scores indicating better tear composition and function.
Time Frame
12 weeks
Title
Number of Subjects With >25% Improvement in Fluorescein Staining of the Cornea (FS) at Week 12
Description
Severity of corneal epithelial loss as graded by Fluorescein Staining of the cornea, assessed on a 0-4+ scale with 0 = none and 4+ = severe de-epithelialization (in other words, higher scores indicate worse disease), expressed as number of participants with >25% improvement at Week 12 relative to baseline.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Number of Subjects Experiencing Clinical Success at Week 12
Description
Proportion of subjects experiencing improvement of ≥25% over baseline at Week 12 in (a) tear breakup time (BUT), (b) superficial punctate keratitis as assessed by fluorescein staining (FS), or Schirmer Test (ST)
Time Frame
12 weeks
Title
Change From Baseline to 12 Weeks in Dry Eye Symptom Score (DESS)
Description
DESS consists of 12 questions designed to assess the symptoms of ocular irritation, covering three areas: ocular symptoms, environmental triggers and vision-related function. Each of the 12 symptoms can be graded 0-4, with 0 indicating no symptoms over the past week, and 4 meaning constant symptoms over the past week. Scores from all answered questions are summed. The final score is multiplied by (25/number of questions answered) to give an outcome between 0 (no symptoms) to 100 (worst possible symptoms). Change from baseline is calculated.
Time Frame
12 weeks
Title
Change From Baseline to Week 12 in Tear Meniscus (TM) Height
Description
Indicator of tear volume. TM was recorded on a scale from 0-3, with 0=none, 1=trace, 2=normal, and 3=high, with higher scores meaning better tear production and integrity. Change from baseline.
Time Frame
12 weeks
Title
Percent Change From Baseline to Week 12 in the Use of Artificial Tears
Description
Daily use of REFRESH TEARS® Lubricant Eye Drops artificial tears supplied to each patient was recorded in diaries provided to patients. Percent change from baseline is calculated.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, 18 years of age and over; Have a diagnosis of moderate-to-severe KCS as defined by: (1) Schirmer Test (ST) (without anesthesia) < 7 mm/5 min in either eye; AND (2) Positive FS, defined as a corneal punctate fluorescein staining score of ≥1 in either eye, where 0 = none and 3= severe; AND (3) At least 1 of the following ocular symptoms scored at ≥2, where 0 = none and 4 = very severe/interferes with normal activities: photophobia, blurred vision, foreign body sensation, soreness or pain, itching, burning, dryness; Willing to use no topical ocular treatments except for the unpreserved artificial tears; Doses of unpreserved artificial tears have been stable for >2 weeks prior to Screening Visit; Females of child-bearing potential must have a negative urine pregnancy test at screening and throughout the study, to be eligible for, and continue participation in, the study; Females of child-bearing potential must be willing to use 2 methods of contraception deemed adequate by the Investigator (for example oral contraceptive pills plus a barrier method) to be eligible for, and continue participation in, the study; Ability to complete the study in compliance with the protocol; and Ability to understand and provide written informed consent. Exclusion Criteria: Has Sjögren's Syndrome with significant systemic non-exocrine gland involvement; Has Stevens-Johnson Syndrome; If KCS is due to rheumatoid arthritis or other autoimmune diseases, patient may not be receiving disease-modifying drugs, including methotrexate and biological agents; Use of systemic immunosuppressive drugs; Use of oral corticosteroids >10 mg prednisone, or equivalent, per day; Use of topical steroids within 2 weeks prior to the Screening Visit and for the duration of the study; Receipt of topical cyclosporine eye drops within 3 months prior to the Screening Visit and for the duration of the trial; Presence of chronic ocular disease other than KCS requiring topical treatment; Presence of post-burn ocular injury; Ocular herpes simplex virus infection; Concomitant use of contact lenses; Persistent intraocular inflammation or infection; Active blepharitis; Recent surgical occlusion of the lacrimal puncta; Subepithelial corneal scarring; Anesthetic or neurotrophic corneas; Hemoglobin level <9.0 gm/L; Platelet count <125,000/mm^3; White blood cell count <3500/mm^3; Serum creatinine level outside the laboratory's normal limits; Liver aminotransferase levels greater than 2 times the laboratory's upper limit of normal; Pregnancy, planned pregnancy, lactation, or inadequate contraception as judged by the Investigator; History of malignancy within the past 5 years (excluding basal cell carcinoma of the skin); Significant acute or chronic medical, ophthalmic, or psychiatric illness that, in the judgment of the Investigator, could compromise patient safety, limit the patient's ability to complete the study, and/or compromise the objectives of the study; Participation in another investigational drug or vaccine trial concurrently or within 30 days; or Other conditions which would confound the study evaluations or endanger the safety of the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Irit Bareket, MD
Organizational Affiliation
Sheba Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Meir Hospital
City
Kfar-Saba
ZIP/Postal Code
44281
Country
Israel
Facility Name
Sheba Medical Center
City
Tel Hashomer
ZIP/Postal Code
5262
Country
Israel
Facility Name
Assaf Harofeh Medical Center
City
Tsrifin
ZIP/Postal Code
70300
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
20304499
Citation
Avni I, Garzozi HJ, Barequet IS, Segev F, Varssano D, Sartani G, Chetrit N, Bakshi E, Zadok D, Tomkins O, Litvin G, Jacobson KA, Fishman S, Harpaz Z, Farbstein M, Yehuda SB, Silverman MH, Kerns WD, Bristol DR, Cohn I, Fishman P. Treatment of dry eye syndrome with orally administered CF101: data from a phase 2 clinical trial. Ophthalmology. 2010 Jul;117(7):1287-93. doi: 10.1016/j.ophtha.2009.11.029. Epub 2010 Mar 20.
Results Reference
result
Links:
URL
http://www.canfite.com/
Description
Can-Fite BioPharma web site

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Safety and Efficacy Study of CF101 to Treat Keratoconjunctivitis Sicca

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