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Use of 5.0% Lifitegrast Ophthalmic Solution for the Treatment of Dry Eye Disease in Contact Lens Wearers

Primary Purpose

Contact Lens Dry Eye

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Lifitegrast
Sponsored by
University of Alabama at Birmingham
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Contact Lens Dry Eye focused on measuring contact lens, discomfort, dry eye

Eligibility Criteria

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

Inclusion Criteria:

  • Has provided informed consent.
  • Age ≥ 18 years.
  • Have a diagnosis of CLDE based on Contact Lens Dry Eye Questionnaire (CLDEQ) results:

Answer to question #10 of "Yes" and score >-0.13, or Answer to Question #10 of "No" and score > 1.27, or Answer to #10 of "Unsure" and score > 1.44

  • Have a score of ≥ 2 on the Ocular Dryness Assessment at Visit 1.
  • Are willing and able to follow instructions and can be present for the required study visits for the duration of the study.
  • Are willing to avoid restricted medications for the time frames indicated during the study.
  • Wears soft contact lenses at least 4 days a week for at least 5 hours per day using the same brand of contact lenses for at least the last 30 days.

Exclusion Criteria:

  • Have a history of significant adverse reaction to lifitegrast or other components of the drug product, or contraindication to the use of lifitegrast or other components of the drug product.
  • Have changed the brand or material or design of soft contact lenses or care solutions within 30 days prior to screening or anticipates the need to change current type/brand of contact lenses or care solutions throughout the 84-day study.
  • Use contact lenses overnight.
  • Use rigid gas permeable contact lenses or hybrid lenses.
  • Have any uncontrolled systemic diseases that in the investigator's opinion could be expected to interfere with the study.
  • Have had cauterization of the punctum or have had punctal plugs (silicone or collagen) inserted or removed within the 90 days prior to the screening.
  • Have any active ongoing ocular infection, ocular disease or condition that would require treatment with topical ophthalmic medications.
  • Require any topically delivered ophthalmic medication for any condition during the study. This includes any preserved or unpreserved rewetting drops or artificial tears. The subject must not have used ophthalmic prescription medications for at least 30 continuous days prior to Visit 1, and must not have used rewetting drops or artificial tears for at least 5 continuous days prior to Visit 1.
  • Have recently started taking omega-3 fatty acids supplements within the past 2 months.
  • Are taking Omega-3 fatty acids supplements but unable to maintain consistent dosage for the duration of the study.
  • Are unwilling or unable to comply with the protocol.
  • Have been exposed to any investigational drug within the preceding 30 days.
  • Are an employee of the site that is directly involved in the management, administration, or support of this study or be an immediate family member of the same.
  • If female, participant must be non-pregnant and non-lactating, and those of childbearing potential must be using an acceptable method of birth control (i.e. an Intrauterine Contraceptive Device with failure rate of <1%, hormonal contraceptives, or a barrier method.) If a female subject is abstinent, she must agree to use one of the acceptable contraceptive methods if she becomes sexually active.
  • Have a clinically significant ophthalmic abnormality, infection, or disease noted by subject history or examination that would otherwise contraindicate contact lens wear and/or the use of lifitegrast (i.e., ≤ grade 3 giant papillary conjunctivitis, active ocular allergies, conjunctivitis, keratitis, uveitis).
  • Have had a history of corneal surgery (corneal transplants, LASIK, PRK).

Sites / Locations

  • University of Alabama at Birmingham

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment

Arm Description

lifitegrast ophthalmic solution 5.0%, to be instilled 1 drop in each eye, twice a day

Outcomes

Primary Outcome Measures

Number of hours related to comfort in wearing contact lenses.
The amount of comfortable lens wear time averaged over the 12th week of lens wear as reported with participant diary.

Secondary Outcome Measures

Number of hours related to comfort in wearing contact lenses.
The amount of comfortable lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Number of hours related to comfort in wearing contact lenses.
The amount of comfortable lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Number of hours related to total contact lens wear.
The amount of total lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Number of hours related to total contact lens wear.
The amount of total lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Number of hours related to total contact lens wear
The amount of total lens wear time averaged over the 12th week of lens wear as reported with participant diary.
Number of hours of overall eye dryness in the morning.
The amount of overall eye dryness experienced in the morning, averaged over the 2nd week of lens wear as reported with participant diary.
Number of hours of overall eye dryness in the morning.
The amount of overall eye dryness experienced in the morning, averaged over the 6th week of lens wear as reported with participant diary.
Number of hours of overall eye dryness in the morning.
The amount of overall eye dryness experienced in the morning, averaged over the 12th week of lens wear as reported with participant diary.
Number of hours of overall eye dryness in the evening.
The amount of overall eye dryness experienced in the evening, averaged over the 2nd week of lens wear as reported with participant diary.
Number of hours of overall eye dryness in the evening
The amount of overall eye dryness experienced in the evening, averaged over the 6th week of lens wear as reported with participant diary
Number of hours of overall eye dryness in the evening.
The amount of overall eye dryness experienced in the evening, averaged over the 12th week of lens wear as reported with participant diary.
Change in Contact Lens Dry Eye diagnosis.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 2.
Change in Contact Lens Dry Eye diagnosis.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 6.
Change in Contact Lens Dry Eye diagnosis.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 12.

Full Information

First Posted
February 6, 2018
Last Updated
October 23, 2018
Sponsor
University of Alabama at Birmingham
Collaborators
Shire
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1. Study Identification

Unique Protocol Identification Number
NCT03431272
Brief Title
Use of 5.0% Lifitegrast Ophthalmic Solution for the Treatment of Dry Eye Disease in Contact Lens Wearers
Official Title
Use of 5.0% Lifitegrast Ophthalmic Solution for the Treatment of Dry Eye Disease in Contact Lens Wearers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Withdrawn
Why Stopped
no longer interest / resources to start study
Study Start Date
November 1, 2018 (Anticipated)
Primary Completion Date
December 31, 2018 (Anticipated)
Study Completion Date
December 31, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Alabama at Birmingham
Collaborators
Shire

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Discomfort with contact lens wear is the biggest reason why people stop wearing contact lenses. The investigators believe that inflammation is one of the causes of discomfort, and by blocking the inflammation using lifitegrast, the investigators may be able to relieve some of that discomfort. This study will enroll 50 subjects with contact lens discomfort and will receive lifitegrast to use over a period of approximately 3 months.
Detailed Description
The most common reason for contact lens drop out is ocular discomfort, with patients identifying dryness as the major reason. Currently, many patients with contact lens dry eye (CLDE) utilize rewetting drops to relieve their symptoms. The problem with rewetting drops is that they fail as they are transient, and do not address the inflammatory component of contact lens discomfort. Lifitegrast 5.0% ophthalmic solution was approved and is now marketed as Xiidra, for the treatment of signs and symptoms of dry eye disease. Lifitegrast works by reducing inflammation, which suggests that it may be effective in patients with contact lens dry eye. More specifically, lifitegrast may work by blocking the interaction between ICAM-1 and LFA-1, which leads to a decrease in the activation and recruitment of T-cells, and a decrease in pro-inflammatory cytokines. The safety and efficacy of Xiidra has been studied in four, 12 week clinical trials involving over 2,100 patients. Each study assessed the effects of Xiidra on symptoms using an Eye Dryness Score (EDS), which is a visual analogue ranging from 0 (no discomfort) to 100 (maximal discomfort). In two of those studies, lifitegrast was shown to improve symptom relief at weeks 2, 6, and 12 compared to the placebo (https://www.xiidra-ecp.com/efficacy-symptom-improvement). Each of the four clinical trials mentioned above also assessed clinical signs of dry eye disease, with a particular focus on inferior corneal staining graded on 0.5 unit increments on a 0 (no staining) to 4 scale (coalescent). In three of the four clinical trials, lifitegrast reduced inferior corneal staining by week 12, compared to placebo (https://www.xiidra-ecp.com/efficacy-treating-signs). Contact lens dry eye is mediated by significant symptoms of ocular surface dryness, in addition to similar clinical signs of dry eye disease such as corneal staining and inflammation. Thus, the purpose of this interventional study is to examine the effect of lifitegrast ophthalmic solution in subjects with contact lens dry eye.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Contact Lens Dry Eye
Keywords
contact lens, discomfort, dry eye

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
lifitegrast ophthalmic solution 5.0%, to be instilled 1 drop in each eye, twice a day
Intervention Type
Drug
Intervention Name(s)
Lifitegrast
Other Intervention Name(s)
Xiidra
Intervention Description
Eye drop
Primary Outcome Measure Information:
Title
Number of hours related to comfort in wearing contact lenses.
Description
The amount of comfortable lens wear time averaged over the 12th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 12.
Secondary Outcome Measure Information:
Title
Number of hours related to comfort in wearing contact lenses.
Description
The amount of comfortable lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 2.
Title
Number of hours related to comfort in wearing contact lenses.
Description
The amount of comfortable lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 6.
Title
Number of hours related to total contact lens wear.
Description
The amount of total lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 2.
Title
Number of hours related to total contact lens wear.
Description
The amount of total lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 6.
Title
Number of hours related to total contact lens wear
Description
The amount of total lens wear time averaged over the 12th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 12
Title
Number of hours of overall eye dryness in the morning.
Description
The amount of overall eye dryness experienced in the morning, averaged over the 2nd week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 2.
Title
Number of hours of overall eye dryness in the morning.
Description
The amount of overall eye dryness experienced in the morning, averaged over the 6th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 6th.
Title
Number of hours of overall eye dryness in the morning.
Description
The amount of overall eye dryness experienced in the morning, averaged over the 12th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 12th.
Title
Number of hours of overall eye dryness in the evening.
Description
The amount of overall eye dryness experienced in the evening, averaged over the 2nd week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 2.
Title
Number of hours of overall eye dryness in the evening
Description
The amount of overall eye dryness experienced in the evening, averaged over the 6th week of lens wear as reported with participant diary
Time Frame
Baseline to Week 6
Title
Number of hours of overall eye dryness in the evening.
Description
The amount of overall eye dryness experienced in the evening, averaged over the 12th week of lens wear as reported with participant diary.
Time Frame
Baseline to Week 12.
Title
Change in Contact Lens Dry Eye diagnosis.
Description
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 2.
Time Frame
Baseline to Week 2.
Title
Change in Contact Lens Dry Eye diagnosis.
Description
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 6.
Time Frame
Baseline to Week 6.
Title
Change in Contact Lens Dry Eye diagnosis.
Description
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 12.
Time Frame
Baseline to Week 12.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has provided informed consent. Age ≥ 18 years. Have a diagnosis of CLDE based on Contact Lens Dry Eye Questionnaire (CLDEQ) results: Answer to question #10 of "Yes" and score >-0.13, or Answer to Question #10 of "No" and score > 1.27, or Answer to #10 of "Unsure" and score > 1.44 Have a score of ≥ 2 on the Ocular Dryness Assessment at Visit 1. Are willing and able to follow instructions and can be present for the required study visits for the duration of the study. Are willing to avoid restricted medications for the time frames indicated during the study. Wears soft contact lenses at least 4 days a week for at least 5 hours per day using the same brand of contact lenses for at least the last 30 days. Exclusion Criteria: Have a history of significant adverse reaction to lifitegrast or other components of the drug product, or contraindication to the use of lifitegrast or other components of the drug product. Have changed the brand or material or design of soft contact lenses or care solutions within 30 days prior to screening or anticipates the need to change current type/brand of contact lenses or care solutions throughout the 84-day study. Use contact lenses overnight. Use rigid gas permeable contact lenses or hybrid lenses. Have any uncontrolled systemic diseases that in the investigator's opinion could be expected to interfere with the study. Have had cauterization of the punctum or have had punctal plugs (silicone or collagen) inserted or removed within the 90 days prior to the screening. Have any active ongoing ocular infection, ocular disease or condition that would require treatment with topical ophthalmic medications. Require any topically delivered ophthalmic medication for any condition during the study. This includes any preserved or unpreserved rewetting drops or artificial tears. The subject must not have used ophthalmic prescription medications for at least 30 continuous days prior to Visit 1, and must not have used rewetting drops or artificial tears for at least 5 continuous days prior to Visit 1. Have recently started taking omega-3 fatty acids supplements within the past 2 months. Are taking Omega-3 fatty acids supplements but unable to maintain consistent dosage for the duration of the study. Are unwilling or unable to comply with the protocol. Have been exposed to any investigational drug within the preceding 30 days. Are an employee of the site that is directly involved in the management, administration, or support of this study or be an immediate family member of the same. If female, participant must be non-pregnant and non-lactating, and those of childbearing potential must be using an acceptable method of birth control (i.e. an Intrauterine Contraceptive Device with failure rate of <1%, hormonal contraceptives, or a barrier method.) If a female subject is abstinent, she must agree to use one of the acceptable contraceptive methods if she becomes sexually active. Have a clinically significant ophthalmic abnormality, infection, or disease noted by subject history or examination that would otherwise contraindicate contact lens wear and/or the use of lifitegrast (i.e., ≤ grade 3 giant papillary conjunctivitis, active ocular allergies, conjunctivitis, keratitis, uveitis). Have had a history of corneal surgery (corneal transplants, LASIK, PRK).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jason J Nichols, OD PhD MPH
Organizational Affiliation
University of Alabama at Birmingham
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
17251807
Citation
Richdale K, Sinnott LT, Skadahl E, Nichols JJ. Frequency of and factors associated with contact lens dissatisfaction and discontinuation. Cornea. 2007 Feb;26(2):168-74. doi: 10.1097/01.ico.0000248382.32143.86.
Results Reference
background
PubMed Identifier
27806431
Citation
Efron N. Contact lens wear is intrinsically inflammatory. Clin Exp Optom. 2017 Jan;100(1):3-19. doi: 10.1111/cxo.12487. Epub 2016 Nov 2.
Results Reference
background
PubMed Identifier
15037117
Citation
Gao J, Morgan G, Tieu D, Schwalb TA, Luo JY, Wheeler LA, Stern ME. ICAM-1 expression predisposes ocular tissues to immune-based inflammation in dry eye patients and Sjogrens syndrome-like MRL/lpr mice. Exp Eye Res. 2004 Apr;78(4):823-35. doi: 10.1016/j.exer.2003.10.024.
Results Reference
background
PubMed Identifier
22211918
Citation
Zhang Y, Wang H. Integrin signalling and function in immune cells. Immunology. 2012 Apr;135(4):268-75. doi: 10.1111/j.1365-2567.2011.03549.x.
Results Reference
background
Citation
Shire. Efficacy Info. 2017; https://www.xiidra-ecp.com/efficacy-symptom-improvement. Accessed 12/21/2017, 2017.
Results Reference
background
Citation
Shire. Xiidra and ICSS. 2017; https://www.xiidra-ecp.com/efficacy-treating-signs. Accessed 12/21/2017, 2017.
Results Reference
background
Citation
Shire. Mechanism of Action. 2017; https://www.xiidra-ecp.com/mechanism-of-action. Accessed 12/21/2017, 2017.
Results Reference
background
Citation
U.S. Food & Drug Administration. What is a Serious Adverse Event? 2016; https://www.fda.gov/Safety/MedWatch/HowToReport/ucm053087.htm. Accessed 12/11/2017, 2017.
Results Reference
background

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Use of 5.0% Lifitegrast Ophthalmic Solution for the Treatment of Dry Eye Disease in Contact Lens Wearers

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