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Myfortic for the Treatment of Non-infectious Intermediate Uveitis (MYCUV-IIT02)

Primary Purpose

Uveitis, Intermediate

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Myfortic
Decortin
Sponsored by
STZ eyetrial
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uveitis, Intermediate

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subjects with a documented at least 6 months history of unilateral or bilateral intermediate uveitis either idiopathic or due to non-infectious systemic disease (e.g. sarcoidosis, multiple sclerosis)
  • Uveitis has to be considered to be active at the timepoint of enrolment according to at least one of the following criteria:

    • Grade 2+ or higher for vitreous haze
    • Grade 2+ or higher for anterior chamber cells
    • Presence of cystoid macular edema in OCT
    • Presence of retinal vessel leakage in FA
  • Considered by the investigator to require systemic treatment.
  • At least 18 years of age
  • Not planning to undergo elective ocular surgery during the study
  • Capable of understanding the purposes and risks of the study, able to give informed consent and to comply with the study requirements
  • Subjects of both gender with reproductive potential who are sexually active agree to use contraception throughout the course of the study and for at least 3 months after completion of their study participation.
  • Women of childbearing potential have to use a highly effective method of birth control defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly, such as implants, injectables, combined oral contraceptives, hormonal IUDs combined with barrier methods (e.g. condom, diaphragm or spermicide), sexual abstinence or vasectomised partner.
  • Women of childbearing age must have a negative urine pregnancy test (UPT) within 48 hours prior to starting study drug and must not be lactating.

Female subjects of non-childbearing potential must meet at least one of the following criteria:

  1. Postmenopausal females, defined as:

    c. Females over the age of 60 years. d. Females who are 45 to 60 years of age must be amenorrheic for at least 2 years.

  2. Females who had a hysterectomy and/or bilateral oophorectomy.

Exclusion Criteria:

  • Uveitis of infectious etiology
  • Signs of tuberculosis in chest x-ray during the past 12 months before study entry
  • Clinically suspected or confirmed central nervous system or ocular lymphoma
  • Primary diagnosis of anterior or posterior uveitis
  • Uncontrolled glaucoma or known steroid response
  • Subjects who received treatment with a systemic immunosuppressive drug, a monoclonal antibody or any other biologic therapy within 90 days prior study entry
  • Treatment with mycophenolate mofetil or mycophenolate sodium in the past
  • Treatment with a periocular steroid injection within 6 weeks prior to study entry
  • Presence of absolute contraindications for Decortin H and/or Myfortic as mentioned in the product informations (Appendix 1 and 2)
  • Presence of relative contraindications for Decortin H and/or Myfortic as mentioned in the product information (Appendix 1 and 2) if the disorder leading to the relative contraindication can not sufficiently managed by concomitant medication.
  • Recipients of a solid organ transplant
  • Subjects with lens opacities or obscured ocular media upon enrolment making unable evaluation of the posterior eye segment
  • Subjects with a history of herpes zoster or varicella infection within 3 months before enrollment
  • Active, extraocular infection requiring the prolonged or chronic use of antimicrobial agents or the history/presence of active hepatitis A, B or C
  • Seropositivity for human immunodeficiency virus (HIV)
  • Alanine transaminase (ALT), aspartate transaminase (AST), or gamma-glutamyl transferase (GGT) ≥ 2x upper limit of normal (ULN)
  • Severe anemia (hemoglobin < 8 g/dL), leukopenia (white blood cell count [WBC] < 2500 mm3), thrombocytopenia (platelet count < 80,000 mm3)
  • Current malignancy or a history of malignancy within the previous 5 years
  • Pregnant or lactating women
  • Known allergy for fluorescein natrium
  • Currently participating in another clinical trial with an investigational agent in the 30 days prior to study participation and/or has not recovered from any reversible effects or side effects of prior investigational agent
  • Subjects with non-ocular, medically significant co-morbid conditions that impair normal activities, require systemic corticosteroids or immunosuppressives, or any medical condition that would likely have an impact on the participant´s ability to comply with the study visit schedule
  • Any current or history of substance abuse, psychiatric disorder or a condition that, in the opinion of the investigator, may invalidate communication

Sites / Locations

  • Charité Universitätsmedizin Berlin, Augenklinik
  • Universitäts-Augenklinik Freiburg
  • Universitätsklinikum Heidelberg, Interdisziplinäres Uveitiszentrum
  • Augenklinik der Ludwig-Maximilians-Universität München
  • Augenabteilung am St. Franziskus-Hospital Münster

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Mycophenolate sodium + Prednisolone

Prednisolone

Arm Description

Mycophenolate sodium 1440 mg/day Prednisolone: initial dose 1 mg/kg/day, maintenance dose 5 mg/day

Prednisolone: initial dose 1 mg/kg/day, maintenance dose 5 mg/day

Outcomes

Primary Outcome Measures

Time from study entry to first relapse
A log-rank test will be used to evaluate differences between the treatment and control group with the null hypothesis of no differences in the survival distributions between the two groups and the alternative hypothesis of different survival distributions. A two-sided log-rank test will be used at a significance level of 0.05.

Secondary Outcome Measures

Full Information

First Posted
March 23, 2010
Last Updated
May 5, 2017
Sponsor
STZ eyetrial
Collaborators
Novartis Pharmaceuticals, University Hospital Tuebingen
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1. Study Identification

Unique Protocol Identification Number
NCT01092533
Brief Title
Myfortic for the Treatment of Non-infectious Intermediate Uveitis
Acronym
MYCUV-IIT02
Official Title
Myfortic (Enteric-coated Mycophenolate Sodium) for the Treatment of Non-infectious Intermediate Uveitis - a Prospective, Controlled, Randomized Multicenter Trial
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
March 2010 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
STZ eyetrial
Collaborators
Novartis Pharmaceuticals, University Hospital Tuebingen

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this clinical trial is to evaluate the efficacy, safety and tolerability of enteric-coated mycophenolate sodium (Myfortic®) in combination with low-dose corticosteroids (Decortin H®) compared to a monotherapy with low-dose corticosteroids (Decortin H®) in subjects with chronic intraocular inflammation (non-infectious intermediate uveitis).
Detailed Description
Mycophenolate mofetil (MMF), a pro-drug containing mycophenolic acid (MPA) as active agent, is approved for the treatment of acute graft rejection after kidney-, heart- and liver-transplantation, and was shown in 1995 to be effective in inhibiting the development of experimental autoimmune uveoretinitis. Further studies proved it to be a safe and effective steroid-sparing immunomodulatory for reducing the recurrence rate of non-infectious intermediate uveitis in humans. Although the adverse effect profile of MMF is comparatively benign, gastrointestinal adverse effects are a major concern and may limit its clinical benefit, because they may necessitate dose reduction, interruption, or even discontinuation of MMF. An enteric-coated formulation of mycophenolate sodium (EC-MPS, Myfortic) has been developed especially to reduce MPA-related gastrointestinal adverse events. This clinical trial is a prospective controlled study to evaluate whether a Myfortic based regimen will be able to reduce the probability of a relapse compared to steroid therapy alone and to test whether a Myfortic based therapy provides a superior behaviour compared to a steroid regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Uveitis, Intermediate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Masking Description
Open Label
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Mycophenolate sodium + Prednisolone
Arm Type
Experimental
Arm Description
Mycophenolate sodium 1440 mg/day Prednisolone: initial dose 1 mg/kg/day, maintenance dose 5 mg/day
Arm Title
Prednisolone
Arm Type
Active Comparator
Arm Description
Prednisolone: initial dose 1 mg/kg/day, maintenance dose 5 mg/day
Intervention Type
Drug
Intervention Name(s)
Myfortic
Other Intervention Name(s)
Mycophenolate Sodium
Intervention Description
Myfortic 360 mg BID (during week 1) Myfortic 720 mg BID (from week 2 on) Maintenance dose Decortin 5mg/d
Intervention Type
Drug
Intervention Name(s)
Decortin
Other Intervention Name(s)
Prednisolone
Intervention Description
Maintenance dose 5 mg/d
Primary Outcome Measure Information:
Title
Time from study entry to first relapse
Description
A log-rank test will be used to evaluate differences between the treatment and control group with the null hypothesis of no differences in the survival distributions between the two groups and the alternative hypothesis of different survival distributions. A two-sided log-rank test will be used at a significance level of 0.05.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with a documented at least 6 months history of unilateral or bilateral intermediate uveitis either idiopathic or due to non-infectious systemic disease (e.g. sarcoidosis, multiple sclerosis) Uveitis has to be considered to be active at the timepoint of enrolment according to at least one of the following criteria: Grade 2+ or higher for vitreous haze Grade 2+ or higher for anterior chamber cells Presence of cystoid macular edema in OCT Presence of retinal vessel leakage in FA Considered by the investigator to require systemic treatment. At least 18 years of age Not planning to undergo elective ocular surgery during the study Capable of understanding the purposes and risks of the study, able to give informed consent and to comply with the study requirements Subjects of both gender with reproductive potential who are sexually active agree to use contraception throughout the course of the study and for at least 3 months after completion of their study participation. Women of childbearing potential have to use a highly effective method of birth control defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly, such as implants, injectables, combined oral contraceptives, hormonal IUDs combined with barrier methods (e.g. condom, diaphragm or spermicide), sexual abstinence or vasectomised partner. Women of childbearing age must have a negative urine pregnancy test (UPT) within 48 hours prior to starting study drug and must not be lactating. Female subjects of non-childbearing potential must meet at least one of the following criteria: Postmenopausal females, defined as: c. Females over the age of 60 years. d. Females who are 45 to 60 years of age must be amenorrheic for at least 2 years. Females who had a hysterectomy and/or bilateral oophorectomy. Exclusion Criteria: Uveitis of infectious etiology Signs of tuberculosis in chest x-ray during the past 12 months before study entry Clinically suspected or confirmed central nervous system or ocular lymphoma Primary diagnosis of anterior or posterior uveitis Uncontrolled glaucoma or known steroid response Subjects who received treatment with a systemic immunosuppressive drug, a monoclonal antibody or any other biologic therapy within 90 days prior study entry Treatment with mycophenolate mofetil or mycophenolate sodium in the past Treatment with a periocular steroid injection within 6 weeks prior to study entry Presence of absolute contraindications for Decortin H and/or Myfortic as mentioned in the product informations (Appendix 1 and 2) Presence of relative contraindications for Decortin H and/or Myfortic as mentioned in the product information (Appendix 1 and 2) if the disorder leading to the relative contraindication can not sufficiently managed by concomitant medication. Recipients of a solid organ transplant Subjects with lens opacities or obscured ocular media upon enrolment making unable evaluation of the posterior eye segment Subjects with a history of herpes zoster or varicella infection within 3 months before enrollment Active, extraocular infection requiring the prolonged or chronic use of antimicrobial agents or the history/presence of active hepatitis A, B or C Seropositivity for human immunodeficiency virus (HIV) Alanine transaminase (ALT), aspartate transaminase (AST), or gamma-glutamyl transferase (GGT) ≥ 2x upper limit of normal (ULN) Severe anemia (hemoglobin < 8 g/dL), leukopenia (white blood cell count [WBC] < 2500 mm3), thrombocytopenia (platelet count < 80,000 mm3) Current malignancy or a history of malignancy within the previous 5 years Pregnant or lactating women Known allergy for fluorescein natrium Currently participating in another clinical trial with an investigational agent in the 30 days prior to study participation and/or has not recovered from any reversible effects or side effects of prior investigational agent Subjects with non-ocular, medically significant co-morbid conditions that impair normal activities, require systemic corticosteroids or immunosuppressives, or any medical condition that would likely have an impact on the participant´s ability to comply with the study visit schedule Any current or history of substance abuse, psychiatric disorder or a condition that, in the opinion of the investigator, may invalidate communication
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christoph Deuter, Dr.
Organizational Affiliation
Centre for Ophthalmology, University of Tuebingen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Charité Universitätsmedizin Berlin, Augenklinik
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Universitäts-Augenklinik Freiburg
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Universitätsklinikum Heidelberg, Interdisziplinäres Uveitiszentrum
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Augenklinik der Ludwig-Maximilians-Universität München
City
München
ZIP/Postal Code
80336
Country
Germany
Facility Name
Augenabteilung am St. Franziskus-Hospital Münster
City
Münster
ZIP/Postal Code
48145
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
16196117
Citation
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Results Reference
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Citation
Whitcup SM. Intermediate uveitis. In: Nussenblatt RB, Whitcup SM (eds.). Uveitis. Fundamentals and clinical practice. Elsevier publishers 2004: 291-300
Results Reference
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PubMed Identifier
8549684
Citation
Chanaud NP 3rd, Vistica BP, Eugui E, Nussenblatt RB, Allison AC, Gery I. Inhibition of experimental autoimmune uveoretinitis by mycophenolate mofetil, an inhibitor of purine metabolism. Exp Eye Res. 1995 Oct;61(4):429-34. doi: 10.1016/s0014-4835(05)80138-1.
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PubMed Identifier
11490743
Citation
Zierhut M, Stubiger N, Aboalchamat W, Landenberger H, Bialasiewicz AA, Engelmann K. [Immunosuppressive therapy with mycophenolate mofetil (CellCept) in treatment of uveitis]. Ophthalmologe. 2001 Jul;98(7):647-51. doi: 10.1007/s003470170101. German.
Results Reference
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PubMed Identifier
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Citation
Baltatzis S, Tufail F, Yu EN, Vredeveld CM, Foster CS. Mycophenolate mofetil as an immunomodulatory agent in the treatment of chronic ocular inflammatory disorders. Ophthalmology. 2003 May;110(5):1061-5. doi: 10.1016/S0161-6420(03)00092-7.
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Siepmann K, Huber M, Stubiger N, Deuter C, Zierhut M. Mycophenolate mofetil is a highly effective and safe immunosuppressive agent for the treatment of uveitis : a retrospective analysis of 106 patients. Graefes Arch Clin Exp Ophthalmol. 2006 Jul;244(7):788-94. doi: 10.1007/s00417-005-0066-8. Epub 2005 Sep 15.
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Myfortic for the Treatment of Non-infectious Intermediate Uveitis

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