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Study of the Safety and Efficacy of RVL-1201 in the Treatment of Acquired Blepharoptosis

Primary Purpose

Acquired Blepharoptosis

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
RVL-1201
RVL-1201 Vehicle Placebo
Sponsored by
RVL Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acquired Blepharoptosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female subjects 18 years of age and older.
  2. Presence of all of the following at Screening :

    a. Loss on a reliable LPFT of ≥ 8 points in the top 2 rows (LPFT Eligibility Score); subjects must see at least 9 total points in the top 4 rows (LPFT Total Score).

    i. This criteria must be met at both the Visit 1 Hour 0 (V1H0) and Visit 1 Hour 6 (V1H6) LPFT assessments

    ii. There must be ≤ 4 points of variance between the V1H0 and the V1H6 LPFT Eligibility Score;; AND

    b. The MRD, the distance from the central pupillary light reflex to the central margin of the upper lid, must be ≤ 2 mm (no visible central pupillary light reflex defaults to 0) in the same eye as Inclusion Criterion #2a

    AND

    c. Snellen visual acuity (VA) of 20/80 or better in the same eye as Inclusion Criteria #2a and #2b.

  3. Presence of all of the following at Baseline:

    a. Loss on a reliable LPFT of ≥ 8 points in the top 2 rows (LPFT Eligibility Score) in the same eye as Inclusion Criterion #2a; subjects must see at least 9 total points in the top 4 rows (LPFT Total Score).

    i. This criteria must be met at the Visit 2 Hour 0 (V2H0) LPFT assessment. ii. There must be ≤ 4 points of variance between the V1H6 and the V2H0 LPFT Eligibility Score;

    AND

    b. Marginal Reflex Distance (MRD), the distance from the central pupillary light reflex to the central margin of the upper lid, must be ≤ 2 mm (no visible central pupillary light reflex defaults to 0) in the same eye as Inclusion Criterion #2a;

    AND

    c. Snellen VA of 20/80 or better in the same eye as Inclusion Criteria #2a and #2b.

  4. Female subjects must be 1 year postmenopausal, surgically sterilized, or women of childbearing potential with a negative urine pregnancy test at Visit 1. Women of childbearing potential must use an acceptable form of contraception throughout the study. Acceptable methods include the use of at least one of the following: intrauterine (intrauterine device), hormonal (oral, injection, patch, implant, ring), barrier with spermicide (condom, diaphragm), or abstinence.
  5. Able to self-administer study medication or to have the study medication administered by a caregiver throughout the study period.
  6. Subjects must be able to understand and sign an IRB approved informed consent form prior to participation in any study-related procedures.

Exclusion Criteria:

In either eye

  1. Congenital ptosis.
  2. Presence of either of the following:

    1. Pseudoptosis (upper eyelid dermatochalasis that overhangs the upper eyelid margin) or
    2. Dermatochalasis that extends less than 3 mm above the upper eyelid margin.
  3. Horner syndrome.
  4. Marcus Gunn jaw winking syndrome.
  5. Myasthenia gravis.
  6. Mechanical ptosis, including ptosis due to orbital or lid tumor, cicatricial processes affecting the movements of the upper lid, and enophthalmos.
  7. Previous ptosis surgery (previous blepharoplasty [only] is allowed provided the surgery took place > 3 months prior to Visit 1).
  8. Lid position affected by lid or conjunctival scarring.
  9. Visual field loss from any cause other than ptosis.
  10. History of herpes keratitis.
  11. History of closed/narrow angle glaucoma (unless patent peripheral iridotomy has been performed > 3 months prior to Visit 1).
  12. Periocular neurotoxin (eg, Botox, Xeomin, Dysport, Myobloc) injections within 3 months prior to Visit 1 and during the study.
  13. Topical application of bimatoprost (ie, Latisse®) to the eyelashes within 7 days prior to Visit 1 and during the study.
  14. Use of topical ophthalmic medications (including anti-allergy [eg, antihistamines], dry eye [ie, Restasis®] and anti-inflammatory drugs [including nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids] other than the assigned study medication within 7 days prior to Visit 1 and during the study. Topical ophthalmic prostaglandin analogues for the treatment of elevated intraocular pressure are permitted if dosed in the evening in accordance with the approved prescribing information. All other topical antiglaucoma medications are prohibited
  15. Intravitreal injections (eg, Lucentis®, Eylea®, Avastin®, Triesence®) within 7 days prior to Visit 1 and during the study.
  16. Current punctal plugs or placement of punctal plugs during the study.
  17. Use of over the counter (OTC) vasoconstrictor/decongestant eye medication (eg, Visine® L.R.®) or any ophthalmic or non-ophthalmic α adrenergic agonist including OTC products (eg, Afrin®) at any time during the study; nonpreserved artificial tears are allowed.

    General

  18. Resting heart rate (HR) outside the normal range (60-100 beats per minute).
  19. Hypertension with resting diastolic blood pressure (BP) > 105 mm Hg.
  20. Use of monoamine oxidase inhibitors (MAOIs; eg, isocarboxazid, phenelzine, tranylcypromine) within 14 days prior to Visit 1 and during the study.
  21. Advanced arteriosclerotic disease or history of cerebrovascular accident (CVA).
  22. History of hyperthyroidism or thyroid eye disease (ie, exophthalmos, upper eyelid retraction, diplopia secondary to extraocular muscle involvement). Hypothyroidism that is controlled on medication is allowed.
  23. Patients with diabetic retinopathy may not be enrolled. However, patients with insulin dependent diabetes, diabetes requiring oral hypoglycemic drugs, or diet controlled diabetes are allowed.
  24. Pregnancy or lactation.
  25. Diagnosed benign prostatic hypertrophy requiring medicinal therapy; previous prostatectomy is allowed.
  26. History of contact or systemic allergic reaction to oxymetazoline or other sympathomimetic drugs (eg, phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine, fepradinol, or methoxamine).

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

RVL-1201

RVL-1201 Vehicle Placebo

Arm Description

RVL-1201 Ophthalmic Solution 0.1% 1 drop per eye QD for 6 weeks

RVL-1201 Ophthalmic Solution vehicle (placebo) 1 drop per eye QD for 6 weeks

Outcomes

Primary Outcome Measures

Mean Change in Number of Points Seen on the Leicester Peripheral Field Test (LPFT) in RVL-1201 Group vs. Vehicle Group
LPFT Total Score is the number of points seen in the top 4 rows on the LPFT. Possible scores range from 0 (no points seen) to 35 (all points seen).

Secondary Outcome Measures

Mean Change From Baseline in Marginal Reflex Distance (MRD) in the Study Eye
MRD is the distance from the center pupillary light reflex to the central margin of the upper eyelid. The MRD is measured from an external photograph.

Full Information

First Posted
May 4, 2015
Last Updated
October 26, 2021
Sponsor
RVL Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02436759
Brief Title
Study of the Safety and Efficacy of RVL-1201 in the Treatment of Acquired Blepharoptosis
Official Title
A Randomized, Double-Masked, Placebo-Controlled Phase 3 Study of the Safety and Efficacy of RVL-1201 in the Treatment of Acquired Blepharoptosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
May 2015 (undefined)
Primary Completion Date
November 2016 (Actual)
Study Completion Date
November 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RVL Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 3 study is to evaluate the safety and efficacy of RVL-1201 Ophthalmic Solution in the treatment of acquired blepharoptosis (ptosis) and to assess the safety and comfort of RVL-1201 Ophthalmic Solution for an extended dosing period of 6 weeks.
Detailed Description
Ptosis is experienced by approximately 12% of adults over the age of 50 . It is a unilateral or bilateral abnormal drooping of the upper eyelid that usually occurs from a partial or complete dysfunction of the muscle(s) that elevate the upper eyelid: the levator palpebrae superioris and/or Müller's muscle. Treatment for acquired ptosis usually involves surgery, with risks of infection, bleeding, over or undercorrection, reduced vision, and lagophthalmos (inability to close the eyelids completely) or mechanical treatment e.g scleral contact lenses with a bar to lift the eyelid, eyelid ptosis crutches attached to glasses, or adhesive tape or putty to affix the upper eyelid to the supraorbital structures. RVL-201 ophthalmic solution is being developed to provide a reversible pharmacologic option for patients with acquired ptosis who are not candidates for surgery or do not wish to undergo surgery. The objective of this study is to evaluate the safety and efficacy of RVL-1201 ophthalmic solution in the treatment of acquired blepharoptosis and to assess the safety and comfort of RVL-1201 ophthalmic solution for an extended dosing period of 6 weeks. Subjects will be randomized (2:1) to one of 2 treatment arms and treated for 42 days: RVL-1201 0.1% one full drop in each eye QD in the morning (N = 100) RVL-1201 vehicle (placebo) 1 full drop per eye QD in the morning (N = 50) Efficacy will be assessed with the LPFT, a validated visual field test using the HVF Analyzer and photographic measurement of MRD (the distance from the pupillary light reflex to the central margin of the upper lid) and PFD (the distance from the upper lid margin to the lower lid margin through the central visual axis). Safety assessment will include bilateral SLE/CFS, measurement of PD from external photographs, dilated ophthalmoscopy/fundus examination, tonometry, Snellen VA using recent correction, vital signs (BP/HR), and collection of adverse events (AEs).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acquired Blepharoptosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
140 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RVL-1201
Arm Type
Experimental
Arm Description
RVL-1201 Ophthalmic Solution 0.1% 1 drop per eye QD for 6 weeks
Arm Title
RVL-1201 Vehicle Placebo
Arm Type
Placebo Comparator
Arm Description
RVL-1201 Ophthalmic Solution vehicle (placebo) 1 drop per eye QD for 6 weeks
Intervention Type
Drug
Intervention Name(s)
RVL-1201
Other Intervention Name(s)
Oxymetazoline Hydrochloride Ophthalmic Solution 0.1%
Intervention Description
RVL-1201 Ophthalmic Solution 0.1%
Intervention Type
Drug
Intervention Name(s)
RVL-1201 Vehicle Placebo
Other Intervention Name(s)
RVL-1201 Ophthalmic Solution 0.1% Placebo
Intervention Description
RVL-1201 Vehicle Placebo
Primary Outcome Measure Information:
Title
Mean Change in Number of Points Seen on the Leicester Peripheral Field Test (LPFT) in RVL-1201 Group vs. Vehicle Group
Description
LPFT Total Score is the number of points seen in the top 4 rows on the LPFT. Possible scores range from 0 (no points seen) to 35 (all points seen).
Time Frame
Mean change from Baseline (Day 1, Hour 0) compared with Day 1, Hour 6 and Day 14, Hour 2
Secondary Outcome Measure Information:
Title
Mean Change From Baseline in Marginal Reflex Distance (MRD) in the Study Eye
Description
MRD is the distance from the center pupillary light reflex to the central margin of the upper eyelid. The MRD is measured from an external photograph.
Time Frame
Baseline Day 1 (Hour 0) and Day 1, Day 14, and Day 42

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects 18 years of age and older. Presence of all of the following at Screening : a. Loss on a reliable LPFT of ≥ 8 points in the top 2 rows (LPFT Eligibility Score); subjects must see at least 9 total points in the top 4 rows (LPFT Total Score). i. This criteria must be met at both the Visit 1 Hour 0 (V1H0) and Visit 1 Hour 6 (V1H6) LPFT assessments ii. There must be ≤ 4 points of variance between the V1H0 and the V1H6 LPFT Eligibility Score;; AND b. The MRD, the distance from the central pupillary light reflex to the central margin of the upper lid, must be ≤ 2 mm (no visible central pupillary light reflex defaults to 0) in the same eye as Inclusion Criterion #2a AND c. Snellen visual acuity (VA) of 20/80 or better in the same eye as Inclusion Criteria #2a and #2b. Presence of all of the following at Baseline: a. Loss on a reliable LPFT of ≥ 8 points in the top 2 rows (LPFT Eligibility Score) in the same eye as Inclusion Criterion #2a; subjects must see at least 9 total points in the top 4 rows (LPFT Total Score). i. This criteria must be met at the Visit 2 Hour 0 (V2H0) LPFT assessment. ii. There must be ≤ 4 points of variance between the V1H6 and the V2H0 LPFT Eligibility Score; AND b. Marginal Reflex Distance (MRD), the distance from the central pupillary light reflex to the central margin of the upper lid, must be ≤ 2 mm (no visible central pupillary light reflex defaults to 0) in the same eye as Inclusion Criterion #2a; AND c. Snellen VA of 20/80 or better in the same eye as Inclusion Criteria #2a and #2b. Female subjects must be 1 year postmenopausal, surgically sterilized, or women of childbearing potential with a negative urine pregnancy test at Visit 1. Women of childbearing potential must use an acceptable form of contraception throughout the study. Acceptable methods include the use of at least one of the following: intrauterine (intrauterine device), hormonal (oral, injection, patch, implant, ring), barrier with spermicide (condom, diaphragm), or abstinence. Able to self-administer study medication or to have the study medication administered by a caregiver throughout the study period. Subjects must be able to understand and sign an IRB approved informed consent form prior to participation in any study-related procedures. Exclusion Criteria: In either eye Congenital ptosis. Presence of either of the following: Pseudoptosis (upper eyelid dermatochalasis that overhangs the upper eyelid margin) or Dermatochalasis that extends less than 3 mm above the upper eyelid margin. Horner syndrome. Marcus Gunn jaw winking syndrome. Myasthenia gravis. Mechanical ptosis, including ptosis due to orbital or lid tumor, cicatricial processes affecting the movements of the upper lid, and enophthalmos. Previous ptosis surgery (previous blepharoplasty [only] is allowed provided the surgery took place > 3 months prior to Visit 1). Lid position affected by lid or conjunctival scarring. Visual field loss from any cause other than ptosis. History of herpes keratitis. History of closed/narrow angle glaucoma (unless patent peripheral iridotomy has been performed > 3 months prior to Visit 1). Periocular neurotoxin (eg, Botox, Xeomin, Dysport, Myobloc) injections within 3 months prior to Visit 1 and during the study. Topical application of bimatoprost (ie, Latisse®) to the eyelashes within 7 days prior to Visit 1 and during the study. Use of topical ophthalmic medications (including anti-allergy [eg, antihistamines], dry eye [ie, Restasis®] and anti-inflammatory drugs [including nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids] other than the assigned study medication within 7 days prior to Visit 1 and during the study. Topical ophthalmic prostaglandin analogues for the treatment of elevated intraocular pressure are permitted if dosed in the evening in accordance with the approved prescribing information. All other topical antiglaucoma medications are prohibited Intravitreal injections (eg, Lucentis®, Eylea®, Avastin®, Triesence®) within 7 days prior to Visit 1 and during the study. Current punctal plugs or placement of punctal plugs during the study. Use of over the counter (OTC) vasoconstrictor/decongestant eye medication (eg, Visine® L.R.®) or any ophthalmic or non-ophthalmic α adrenergic agonist including OTC products (eg, Afrin®) at any time during the study; nonpreserved artificial tears are allowed. General Resting heart rate (HR) outside the normal range (60-100 beats per minute). Hypertension with resting diastolic blood pressure (BP) > 105 mm Hg. Use of monoamine oxidase inhibitors (MAOIs; eg, isocarboxazid, phenelzine, tranylcypromine) within 14 days prior to Visit 1 and during the study. Advanced arteriosclerotic disease or history of cerebrovascular accident (CVA). History of hyperthyroidism or thyroid eye disease (ie, exophthalmos, upper eyelid retraction, diplopia secondary to extraocular muscle involvement). Hypothyroidism that is controlled on medication is allowed. Patients with diabetic retinopathy may not be enrolled. However, patients with insulin dependent diabetes, diabetes requiring oral hypoglycemic drugs, or diet controlled diabetes are allowed. Pregnancy or lactation. Diagnosed benign prostatic hypertrophy requiring medicinal therapy; previous prostatectomy is allowed. History of contact or systemic allergic reaction to oxymetazoline or other sympathomimetic drugs (eg, phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine, fepradinol, or methoxamine).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chuck Slonim, MD
Organizational Affiliation
Oculos Clinical Research
Official's Role
Principal Investigator
Facility Information:
City
Artesia
State/Province
California
ZIP/Postal Code
90701
Country
United States
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
City
Rancho Cordova
State/Province
California
ZIP/Postal Code
95670
Country
United States
City
Santa Maria
State/Province
California
ZIP/Postal Code
93454
Country
United States
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33901
Country
United States
City
Largo
State/Province
Florida
ZIP/Postal Code
33773
Country
United States
City
Plantation
State/Province
Florida
ZIP/Postal Code
33324
Country
United States
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
City
Pittsburg
State/Province
Kansas
ZIP/Postal Code
66762
Country
United States
City
Shawnee Mission
State/Province
Kansas
ZIP/Postal Code
66204
Country
United States
City
Mason
State/Province
Ohio
ZIP/Postal Code
45040
Country
United States
City
Kingston
State/Province
Pennsylvania
ZIP/Postal Code
18704
Country
United States
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37215
Country
United States

12. IPD Sharing Statement

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Study of the Safety and Efficacy of RVL-1201 in the Treatment of Acquired Blepharoptosis

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