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Latanoprost Eluting Contact Lens for Treating Glaucoma and Ocular Hypertension

Primary Purpose

Glaucoma, Ocular Hypertension

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Latanoprost eluting contact lens
Topical Latanoprost
Sponsored by
Massachusetts Eye and Ear Infirmary
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glaucoma focused on measuring Latanoprost, Glaucoma, Ocular Hypertension, Drug eluting contact lens

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 18 - 85 years of age willing and able to give informed consent and in the investigator's judgment able to follow the study protocol
  • Ocular hypertension, primary open-angle glaucoma, pigmentary or pseudoexfoliation glaucoma, with mild to moderate glaucoma defined as Mean Deviation on Humphrey Visual Field testing no worse than -10 dB
  • Patients on latanoprost in the study eye with an adequate IOP control with latanoprost alone

Exclusion Criteria:

Systemic

  • Use of oral carbonic anhydrase inhibitors
  • Unstable dose of oral medication during the last 30 days that in the opinion of the Investigator may influence the IOP
  • Unstable dose of oral steroid at the time of enrollment
  • Use of immunosuppressants, immunomodulators, antimetabolites and/or alkylating agents within six months before screening or anticipated use at any time during the study
  • Known allergy or hypersensitivity to the study medication or its components
  • Female patients who are pregnant, nursing, or planning a pregnancy, or who are of childbearing potential and not using a reliable means of contraception
  • Participation in an investigational drug or device study within the 30 days before screening
  • Patient has a condition or is in a situation which, in the Investigator's opinion, may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study
  • Any condition (including the inability to read visual acuity charts or language barrier) which precludes a patient's ability to comply with study requirements including completion of the study

Study Eye

  • History of complex cataract surgery with vitreous loss
  • History of cystoid macular edema or uveitis
  • Corneal decompensation or edema
  • Corneal thickness <500 or > 600 μm in the study eye by pachymetry
  • Prior treatment-related adverse event or allergy to latanoprost
  • Evidence of macular edema/intraretinal fluid on screening macula optical coherence tomography (OCT)
  • Any ocular condition in the study eye that in the opinion of the investigator would prevent the eye from wearing a contact lens (e.g., ectropion, lid abnormality, or symblepharon)
  • Use of beta-blocker, alpha agonist, rho kinase inhibitor, or carbonic anhydrase inhibitor drops within 1 month prior to screening; the use of latanoprost must be stable for at least 4 weeks prior to screening
  • Use of latanoprost for < 4 weeks prior to screening
  • Use of topical steroids
  • Active optic disc or retinal neovascularization in the study eye at screening
  • Presence of rubeosis iridis in the study eye at screening
  • History of herpetic infection in the study eye or adnexa
  • Media opacity in the study eye at screening that precludes clinical and photographic evaluation (including but not limited to preretinal or vitreous hemorrhage, lens opacity)
  • Intraocular surgery, including cataract surgery, and/or laser of any type in the study eye within 30 days prior to screening
  • History of kerato-refractive surgery
  • Any prior filtering surgery, including trabeculectomy, glaucoma drainage device, or Xen implant
  • Inability to comfortably wear a commercial contact lens (C-CL) that has the same dimensions as the L-CL during the week-long run-in period

Both Eyes: any active ocular infection (i.e., bacterial, viral, parasitic, or fungal) in either eye at screening

Non-study Eye: Pinhole score < 19 letters (at least 20/400 Snellen equivalent) in the non-study eye at the screening visit

Sites / Locations

  • Massachusetts Eye and EarRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Latanoprost contact lens

Topical Latanoprost

Arm Description

The L-CL arm will have the drug-eluting latanoprost contact lens (L-CL) and a sham drop.

The placebo arm will have a commercial contact lens with no drug with a nightly 0.005% latanoprost drop.

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events as assessed by ocular infection, corneal epithelial defects, or cystoid macular edema - Phase A
Safety assessed by the occurrence of the following adverse events: ocular infection, corneal epithelial defects or signs of corneal toxicity that are not contact lens staining patterns, superficial punctate or vortex, cystoid macular edema
Incidence of Treatment-Emergent Adverse Events as assessed by ocular infection, corneal epithelial defects, or cystoid macular edema - Phase B
Safety assessed by the occurrence of the following adverse events: ocular infection, corneal epithelial defects or signs of corneal toxicity that are not contact lens staining patterns, superficial punctate or vortex, cystoid macular edema
Efficacy assessed by changes in intraocular pressure - Phase B
Effectiveness: % change in intraocular pressure (IOP) from baseline (following washout, i.e., on no medications) in each arm ; Difference in mean intraocular pressure comparing the L-CL arm to the topical latanoprost arm; % change in IOP in each arm compared to baseline IOP on topical latanoprost

Secondary Outcome Measures

Preliminary efficacy - Phase A: % change in IOP from baseline
Assess by comparing % change in IOP from baseline following washout (i.e., on no medications), % change in IOP from topical latanoprost compared to the L-CL
Tolerability and comfort: questionnaire
We will assess the tolerability and comfort of the L-CL by using the validated questionnaire Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). The CLDEQ-8 has as a minimum value a score of 1 and as a maximum value a score of 37. A higher score means a worse outcome.

Full Information

First Posted
July 28, 2020
Last Updated
April 4, 2023
Sponsor
Massachusetts Eye and Ear Infirmary
Collaborators
Harvard University
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1. Study Identification

Unique Protocol Identification Number
NCT04500574
Brief Title
Latanoprost Eluting Contact Lens for Treating Glaucoma and Ocular Hypertension
Official Title
Latanoprost Eluting Contact Lens for Treating Glaucoma and Ocular Hypertension
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 3, 2023 (Anticipated)
Primary Completion Date
July 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts Eye and Ear Infirmary
Collaborators
Harvard University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this research study, we will assess the safety, tolerability, comfort, and feasibility of lowering intraocular pressure using a novel Contact Lens Drug Delivery System with latanoprost. Latanoprost is a well-studied medication and has been used to treat glaucoma for decades. Currently, latanoprost is FDA-approved to be administered to patients as eye drops, but using eye drops has challenges (having to remember to take the drop, getting the drop in the eye). This clinical trial is being done to determine the safety, tolerability, and effectiveness of using latanoprost to deliver latanoprost in a new way (through a drug-eluting contact lens). The study includes two phases. Phase A is intended to assess safety and tolerability and Phase B to assess safety and effectiveness.
Detailed Description
In Phase A of this study, five subjects will wear the latanoprost-eluting contact lens (L-CL) for one week. Phase A is designed to assess for safety and tolerability. In Phase B of this research study, we will compare the L-CL to placebo. Patients will be randomized to one of 2 groups. Subjects in Group 1 will receive the contact lens with latanoprost in it (latanoprost contact lens, or "L-CL") and placebo eye drops. Subjects in Group 2 will receive a standard, commercial contact lens (or "C-CL) that contains no latanoprost but will be given latanoprost eye drops. The placebo contact lens (C-CL) is highly similar to the latanoprost-eluting contact lens but contains no latanoprost. The placebo eye drops look just like latanoprost eye drops but contain no latanoprost.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glaucoma, Ocular Hypertension
Keywords
Latanoprost, Glaucoma, Ocular Hypertension, Drug eluting contact lens

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
This is a single-center study to assess the safety and feasibility of delivering latanoprost using the latanoprost contact lens (L-CL) delivery system as a treatment for glaucoma or ocular hypertension. The study has two phases. Phase A is an open-label study with 5 participants; these individuals will wear the L-CL in one eye for one week during which time they will be closely followed with examinations for evaluation of safety. If the L-CL is found to be safe after review of the clinical data by a data and safety monitoring board, phase B will be initiated to assess the safety and effectiveness of delivering latanoprost through the L-CL. This is a double-masked double-dummy study. The L-CL arm will have the drug-eluting latanoprost contact lens (L-CL) and a sham drop, and the latanoprost arm will have a C-CL (no drug) with a nightly 0.005% latanoprost drop.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
31 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Latanoprost contact lens
Arm Type
Experimental
Arm Description
The L-CL arm will have the drug-eluting latanoprost contact lens (L-CL) and a sham drop.
Arm Title
Topical Latanoprost
Arm Type
Placebo Comparator
Arm Description
The placebo arm will have a commercial contact lens with no drug with a nightly 0.005% latanoprost drop.
Intervention Type
Drug
Intervention Name(s)
Latanoprost eluting contact lens
Intervention Description
The latanoprost-contact lens will be worn in one eye for one week.
Intervention Type
Drug
Intervention Name(s)
Topical Latanoprost
Intervention Description
A commercial contact lens with no drug will be worn in one eye for one week.
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events as assessed by ocular infection, corneal epithelial defects, or cystoid macular edema - Phase A
Description
Safety assessed by the occurrence of the following adverse events: ocular infection, corneal epithelial defects or signs of corneal toxicity that are not contact lens staining patterns, superficial punctate or vortex, cystoid macular edema
Time Frame
6 - 14 weeks
Title
Incidence of Treatment-Emergent Adverse Events as assessed by ocular infection, corneal epithelial defects, or cystoid macular edema - Phase B
Description
Safety assessed by the occurrence of the following adverse events: ocular infection, corneal epithelial defects or signs of corneal toxicity that are not contact lens staining patterns, superficial punctate or vortex, cystoid macular edema
Time Frame
6 weeks
Title
Efficacy assessed by changes in intraocular pressure - Phase B
Description
Effectiveness: % change in intraocular pressure (IOP) from baseline (following washout, i.e., on no medications) in each arm ; Difference in mean intraocular pressure comparing the L-CL arm to the topical latanoprost arm; % change in IOP in each arm compared to baseline IOP on topical latanoprost
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Preliminary efficacy - Phase A: % change in IOP from baseline
Description
Assess by comparing % change in IOP from baseline following washout (i.e., on no medications), % change in IOP from topical latanoprost compared to the L-CL
Time Frame
6 - 14 weeks
Title
Tolerability and comfort: questionnaire
Description
We will assess the tolerability and comfort of the L-CL by using the validated questionnaire Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). The CLDEQ-8 has as a minimum value a score of 1 and as a maximum value a score of 37. A higher score means a worse outcome.
Time Frame
6- 14 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 - 85 years of age willing and able to give informed consent and in the investigator's judgment able to follow the study protocol Ocular hypertension, primary open-angle glaucoma, pigmentary or pseudoexfoliation glaucoma, with mild to moderate glaucoma defined as Mean Deviation on Humphrey Visual Field testing no worse than -10 dB Patients on latanoprost in the study eye with an adequate IOP control with latanoprost alone Exclusion Criteria: Systemic Use of oral carbonic anhydrase inhibitors Unstable dose of oral medication during the last 30 days that in the opinion of the Investigator may influence the IOP Unstable dose of oral steroid at the time of enrollment Use of immunosuppressants, immunomodulators, antimetabolites and/or alkylating agents within six months before screening or anticipated use at any time during the study Known allergy or hypersensitivity to the study medication or its components Female patients who are pregnant, nursing, or planning a pregnancy, or who are of childbearing potential and not using a reliable means of contraception Participation in an investigational drug or device study within the 30 days before screening Patient has a condition or is in a situation which, in the Investigator's opinion, may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study Any condition (including the inability to read visual acuity charts or language barrier) which precludes a patient's ability to comply with study requirements including completion of the study Study Eye History of complex cataract surgery with vitreous loss History of cystoid macular edema or uveitis Corneal decompensation or edema Corneal thickness <500 or > 600 μm in the study eye by pachymetry Prior treatment-related adverse event or allergy to latanoprost Evidence of macular edema/intraretinal fluid on screening macula optical coherence tomography (OCT) Any ocular condition in the study eye that in the opinion of the investigator would prevent the eye from wearing a contact lens (e.g., ectropion, lid abnormality, or symblepharon) Use of beta-blocker, alpha agonist, rho kinase inhibitor, or carbonic anhydrase inhibitor drops within 1 month prior to screening; the use of latanoprost must be stable for at least 4 weeks prior to screening Use of latanoprost for < 4 weeks prior to screening Use of topical steroids Active optic disc or retinal neovascularization in the study eye at screening Presence of rubeosis iridis in the study eye at screening History of herpetic infection in the study eye or adnexa Media opacity in the study eye at screening that precludes clinical and photographic evaluation (including but not limited to preretinal or vitreous hemorrhage, lens opacity) Intraocular surgery, including cataract surgery, and/or laser of any type in the study eye within 30 days prior to screening History of kerato-refractive surgery Any prior filtering surgery, including trabeculectomy, glaucoma drainage device, or Xen implant Inability to comfortably wear a commercial contact lens (C-CL) that has the same dimensions as the L-CL during the week-long run-in period Both Eyes: any active ocular infection (i.e., bacterial, viral, parasitic, or fungal) in either eye at screening Non-study Eye: Pinhole score < 19 letters (at least 20/400 Snellen equivalent) in the non-study eye at the screening visit
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
David S Friedman, MD, PhD, MPH
Phone
(617) 573-3202
Email
david_friedman@meei.harvard.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Courtney L Ondeck, MD, MPhil
Phone
(617) 573-3202
Email
courtney_ondeck@meei.harvard.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David S Friedman, MD, PhD, MPH
Organizational Affiliation
Massachusetts Eye and Ear
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts Eye and Ear
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David Friedman, MD
Phone
617-573-3202
Email
David_Friedman@MEEI.HARVARD.EDU

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There is not a plan to make individual participant data (IPD) available.
Citations:
PubMed Identifier
27586444
Citation
Ciolino JB, Ross AE, Tulsan R, Watts AC, Wang RF, Zurakowski D, Serle JB, Kohane DS. Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys. Ophthalmology. 2016 Oct;123(10):2085-92. doi: 10.1016/j.ophtha.2016.06.038. Epub 2016 Aug 29.
Results Reference
background
PubMed Identifier
24094935
Citation
Ciolino JB, Stefanescu CF, Ross AE, Salvador-Culla B, Cortez P, Ford EM, Wymbs KA, Sprague SL, Mascoop DR, Rudina SS, Trauger SA, Cade F, Kohane DS. In vivo performance of a drug-eluting contact lens to treat glaucoma for a month. Biomaterials. 2014 Jan;35(1):432-9. doi: 10.1016/j.biomaterials.2013.09.032. Epub 2013 Oct 4.
Results Reference
background
PubMed Identifier
15078671
Citation
Friedman DS, Wolfs RC, O'Colmain BJ, Klein BE, Taylor HR, West S, Leske MC, Mitchell P, Congdon N, Kempen J; Eye Diseases Prevalence Research Group. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004 Apr;122(4):532-8. doi: 10.1001/archopht.122.4.532. Erratum In: Arch Ophthalmol. 2011 Sep;129(9):1224.
Results Reference
background
PubMed Identifier
21856009
Citation
Sleath B, Blalock S, Covert D, Stone JL, Skinner AC, Muir K, Robin AL. The relationship between glaucoma medication adherence, eye drop technique, and visual field defect severity. Ophthalmology. 2011 Dec;118(12):2398-402. doi: 10.1016/j.ophtha.2011.05.013.
Results Reference
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Latanoprost Eluting Contact Lens for Treating Glaucoma and Ocular Hypertension

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