The Diurnal and Nocturnal Effect of Pilocarpine on Intraocular Pressure and Ocular Perfusion Pressure
Primary Purpose
Glaucoma, Open-angle, Hypertension, Ocular
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Pilocarpine
Sponsored by
About this trial
This is an interventional treatment trial for Glaucoma, Open-angle focused on measuring Open-angle glaucoma, Ocular hypertension, Latanoprost, Pilocarpine
Eligibility Criteria
Inclusion Criteria:
Current confirmed diagnosis of:
- open angle glaucoma, or
- ocular hypertension including pigment dispersion glaucoma, and
- pseudoexfoliation glaucoma.
- Current use of topical latanoprost once a day in both eyes for at least 6 weeks
- any race/ethnicity
Exclusion Criteria:
- Females who are currently pregnant or planning to become pregnant during the study period
- Diagnosis of any other form of glaucoma other than open-angle
- Intraocular pressure readings of <14mmHg in either eye when measured during routine office visit in the past 12 months.
- Schaffer angle grade < 2 in either eye by gonioscopy
- Intraocular surgery within 6 months or laser within 3 months
- History of retinal tear or detachment in either eye
- Active iritis in either eye as determined by most recent eye examination
- Patients who smoke or have irregular daily sleep patterns
- Patients who have started or changed glucocorticoids therapy in the last 3 months
- Patients who are currently using medical or recreational marijuana
- Any use of a non-FDA approved medication for glaucoma in the last 3 months
Sites / Locations
- University of Colorado Denver Eye Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Pilocarpine group
Arm Description
Subjects with open-angle glaucoma and ocular hypertension that are currently taking latanoprost
Outcomes
Primary Outcome Measures
Change in Intraocular Pressure From Baseline at Visit 3
Subjects will be enrolled at the first visit. Patients already on latanoprost may proceed immediately with the second visit. Patients on a different prostaglandin analog medication will be switched to latanoprost for at least 6 weeks. At second visit, intraocular pressure and blood pressure will be measured every 2 hours for a 24-hour period. At any point over the next 4 weeks, another 24-hour visit will be performed. This time, a dose of pilocarpine 2% will be administered at 4 different times in addition to the latanoprost . As before, intraocular pressure and blood pressure will be measured every 2 hours. After visit 3, subjects will return to their prior treatment regimen. Change in the intraocular pressure from the second and the third visit will be determined. 8 diurnal readings and 4 nocturnal readings were averaged separately during both Visit 2 for the PGA Monotherapy and Visit 3 for Pilocarpine+PGA
Secondary Outcome Measures
Change in Ocular Perfusion Pressure
Ocular perfusion pressure will calculated from the intraocular pressure and blood pressure measurements. At Baseline/Visit 2, intraocular pressure and blood pressure will be measured every 2 hours for a 24-hour period. At any point over the next 4 weeks, another 24-hour visit (Visit 3) will be performed. This time, a dose of pilocarpine 2% will be administered at 4 different times in addition to the latanoprost (PGA monotherapy). As before, intraocular pressure and blood pressure will be measured every 2 hours. 8 diurnal readings and 4 nocturnal readings were averaged separately during both Visit 2 for the PGA Monotherapy and Visit 3 for Pilocarpine+PGA
Full Information
NCT ID
NCT02754570
First Posted
April 20, 2016
Last Updated
October 16, 2019
Sponsor
University of Colorado, Denver
1. Study Identification
Unique Protocol Identification Number
NCT02754570
Brief Title
The Diurnal and Nocturnal Effect of Pilocarpine on Intraocular Pressure and Ocular Perfusion Pressure
Official Title
The Diurnal and Nocturnal Effect of Pilocarpine on Intraocular Pressure and Ocular Perfusion Pressure
Study Type
Interventional
2. Study Status
Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
July 2016 (undefined)
Primary Completion Date
December 2017 (Actual)
Study Completion Date
February 21, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Colorado, Denver
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this study will be to determine the effects of pilocarpine as an adjunct medication to latanoprost monotherapy at multiple intervals throughout a 24-hour period and compare these effects to latanoprost alone.
Detailed Description
This study plans to learn more about the effect of pilocarpine on intraocular pressure and ocular perfusion pressure for a full twenty-four hour period.
In this study, the investigators seek to better characterize the knowledge base of the intraocular pressure (IOP) lowering effects of pilocarpine in patients with open angle glaucoma or ocular hypertension who are currently taking latanoprost. The goal is to define the potential additive effect of pilocarpine throughout a 24-hour period, not only for IOP, but for ocular perfusion pressure (defined as 2/3[diastolicBP + 1/3(systolicBP - diastolicBP)] - IOP). These data will allow to expand current knowledge of the effects of pilocarpine and help determine if this medication has a useful role as an adjunctive treatment in glaucoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glaucoma, Open-angle, Hypertension, Ocular
Keywords
Open-angle glaucoma, Ocular hypertension, Latanoprost, Pilocarpine
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
27 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Pilocarpine group
Arm Type
Experimental
Arm Description
Subjects with open-angle glaucoma and ocular hypertension that are currently taking latanoprost
Intervention Type
Drug
Intervention Name(s)
Pilocarpine
Other Intervention Name(s)
Pilocarpine Hydrochloride
Intervention Description
Pilocarpine will be administered 4 times in addition to latanoprost.
Primary Outcome Measure Information:
Title
Change in Intraocular Pressure From Baseline at Visit 3
Description
Subjects will be enrolled at the first visit. Patients already on latanoprost may proceed immediately with the second visit. Patients on a different prostaglandin analog medication will be switched to latanoprost for at least 6 weeks. At second visit, intraocular pressure and blood pressure will be measured every 2 hours for a 24-hour period. At any point over the next 4 weeks, another 24-hour visit will be performed. This time, a dose of pilocarpine 2% will be administered at 4 different times in addition to the latanoprost . As before, intraocular pressure and blood pressure will be measured every 2 hours. After visit 3, subjects will return to their prior treatment regimen. Change in the intraocular pressure from the second and the third visit will be determined. 8 diurnal readings and 4 nocturnal readings were averaged separately during both Visit 2 for the PGA Monotherapy and Visit 3 for Pilocarpine+PGA
Time Frame
Two 24-hour visits: Baseline/Visit 2; Up to week 4/Visit 3
Secondary Outcome Measure Information:
Title
Change in Ocular Perfusion Pressure
Description
Ocular perfusion pressure will calculated from the intraocular pressure and blood pressure measurements. At Baseline/Visit 2, intraocular pressure and blood pressure will be measured every 2 hours for a 24-hour period. At any point over the next 4 weeks, another 24-hour visit (Visit 3) will be performed. This time, a dose of pilocarpine 2% will be administered at 4 different times in addition to the latanoprost (PGA monotherapy). As before, intraocular pressure and blood pressure will be measured every 2 hours. 8 diurnal readings and 4 nocturnal readings were averaged separately during both Visit 2 for the PGA Monotherapy and Visit 3 for Pilocarpine+PGA
Time Frame
Two 24-hour visits: Baseline/Visit 2; Up to week 4/Visit 3
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Current confirmed diagnosis of:
open angle glaucoma, or
ocular hypertension including pigment dispersion glaucoma, and
pseudoexfoliation glaucoma.
Current use of topical latanoprost once a day in both eyes for at least 6 weeks
any race/ethnicity
Exclusion Criteria:
Females who are currently pregnant or planning to become pregnant during the study period
Diagnosis of any other form of glaucoma other than open-angle
Intraocular pressure readings of <14mmHg in either eye when measured during routine office visit in the past 12 months.
Schaffer angle grade < 2 in either eye by gonioscopy
Intraocular surgery within 6 months or laser within 3 months
History of retinal tear or detachment in either eye
Active iritis in either eye as determined by most recent eye examination
Patients who smoke or have irregular daily sleep patterns
Patients who have started or changed glucocorticoids therapy in the last 3 months
Patients who are currently using medical or recreational marijuana
Any use of a non-FDA approved medication for glaucoma in the last 3 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonard Seibold, MD
Organizational Affiliation
University of Colorado, Denver
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Colorado Denver Eye Hospital
City
Denver
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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The Diurnal and Nocturnal Effect of Pilocarpine on Intraocular Pressure and Ocular Perfusion Pressure
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