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Clinical Efficacy of Amniotic Membrane Extract Eye Drops in Dry Eye Treatment

Primary Purpose

Dry Eyes Chronic

Status
Withdrawn
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
RegenerEyes
Sponsored by
University of California, Los Angeles
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dry Eyes Chronic

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Adults (18 years or older)
  • Presence of dry eye disease as defined as:

    1. Ocular Suface Disease Index (OSDI) score >13 AND EITHER i: Non-contact tear break-up time (NITBUT) < 10 seconds OR ii: Ocular Surface Staining (OSS) score > 1 in either eye

Exclusion Criteria:

  1. Systemic diseases or comorbidities that may cause severe or secondary dry eye:

    1. Previous diagnosis of lymphoma, hepatitis C, HIV/AIDS, sarcoidosis, or amyloidosis that involves lacrimal glands
    2. Previous diagnosis of graft versus host disease (e.g., after bone marrow transplantation treatment for cancer) or cicatrizing conjunctivitis (e.g., Steven Johnson Syndrome, mucous membrane pemphigoid, trachoma)
    3. Anatomical or neurological lid closure problems (e.g., Bell's palsy, cicatricial ectropion, Alzheimer's disease, Parkinson's disease) 4
    4. Any history of chemotherapy, head or neck radiation treatment, or radioactive iodine treatment within 1 year prior to enrollment
    5. High dose oral or systemic steroids (equivalent to or greater than 5 mg prednisone) or immunosuppressive medication within 30 days prior to enrollment. Patients who are on stable dosing are eligible.
    6. Frequent or recent change in systemic medication regimen (e.g., diuretics, beta blockers, immunosuppressive medications, antidepressants that are known to interfere with dry eye) within 3 months prior to enrollment that may influence the ocular surface.
  2. Other ocular surface diseases or surgical history that may cause severe or secondary dry eye:

    1. History of corneal dystrophy that in the opinion of the investigator is significantly affecting the ocular surface (e.g., significant anterior basement membrane dystrophy, Fuch's dystrophy with significant corneal edema and bullae, neurotrophic keratoconjunctivitis or corneal/conjunctival scarring including herpes simplex virus [HSV] or varicella zoster virus [VZV] keratitis)
    2. Any history of surgery for glaucoma (e.g., trabeculectomy, tube shunt)
    3. Corneal refractive surgery (e.g., laser in-situ keratomileusis [LASIK], photorefractive keratectomy [PRK], Intacs) within 6 months prior to enrollment
    4. Cataract, eyelid surgery, or retinal surgery (in operating room) within 6 months prior to enrollment
  3. Use of treatments that may interfere with the ocular surface and/or treatment efficacy:

    1. Any in-office dry eye procedures (e.g., Intense Pulsed Light [IPL], LipiFlow®, nasolacrimal duct probing) within 30 days prior to enrollment
    2. Use of anti-glaucoma drops, topical antihistamines drops, or topical steroid drops within 7 days prior to enrollment
    3. Use of contact lenses. Patients willing to discontinue usage for 48 hours prior to each study visit will be eligible.
    4. Use of scleral lens, such as the prosthetic replacement of the ocular surface ecosystem (PROSE) lens
    5. Current use of topical lifitegrast (Xiidra®), topical cyclosporine (Restasis®), topical tacrolimus, or topical pimecrolimus. Patients willing to discontinue their due to insufficient benefit will be eligible.
  4. Other important exclusion criteria:

    1. Current smoker (within 1 year prior to enrollment).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Study group

    Arm Description

    Treatment group to receive study drops (RegenerEyes) twice daily for 12 weeks

    Outcomes

    Primary Outcome Measures

    Ocular Surface Disease Index
    Symptom Questionnaire

    Secondary Outcome Measures

    Ocular Surface Staining Score
    Schirmer Score
    Schirmer score after 5 minutes with anesthesia
    Non-contact Tear Break-up Time

    Full Information

    First Posted
    December 14, 2021
    Last Updated
    November 7, 2022
    Sponsor
    University of California, Los Angeles
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05169931
    Brief Title
    Clinical Efficacy of Amniotic Membrane Extract Eye Drops in Dry Eye Treatment
    Official Title
    Clinical Efficacy of Amniotic Membrane Extract Eye Drops in Dry Eye Treatment
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Lack of funding/support
    Study Start Date
    January 2022 (Anticipated)
    Primary Completion Date
    April 2022 (Anticipated)
    Study Completion Date
    May 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of California, Los Angeles

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This prospective longitudinal study aims at evaluating the clinical efficacy of human amniotic fluid extract eye drops in the treatment of dry eye disease. 25 patients who are diagnosed with dry eye disease as defined by our criteria will be recruited from the cornea and dry eye clinic at Stein Eye Institute, UCLA. Pre-treatment baseline evaluations, 6 weeks, 12 weeks, and 24 weeks post treatment assessments will be performed by the principle investigator and co-investigator. All tests are considered non-invasive and are within the standard of practice in the evaluation for dry eye disease: (1) Ocular Surface Disease Index Questionnaire (OSDI); (2) Non-contact Tear Break-up Time (NITBUT); (3) Shirmer's test without anesthesia; (4) Ocular Surface Staining with Fluorescein and Lissamine green. Result of each test will be compared and analyzed to provide evidence of treatment efficacy. Treatment will be initiated for 12 weeks at a self-administered dose of one drop in both eyes two times per day. A follow-up of the study will be observed at the 24th week from the first day of treatment. All side effects and adverse events will be carefully observed and documented. Patients will be able to discontinue using the medication if they are not tolerating any side effects.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Dry Eyes Chronic

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Early Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Study group
    Arm Type
    Experimental
    Arm Description
    Treatment group to receive study drops (RegenerEyes) twice daily for 12 weeks
    Intervention Type
    Biological
    Intervention Name(s)
    RegenerEyes
    Intervention Description
    Biologic eye drop
    Primary Outcome Measure Information:
    Title
    Ocular Surface Disease Index
    Description
    Symptom Questionnaire
    Time Frame
    12 weeks
    Secondary Outcome Measure Information:
    Title
    Ocular Surface Staining Score
    Time Frame
    12 weeks
    Title
    Schirmer Score
    Description
    Schirmer score after 5 minutes with anesthesia
    Time Frame
    12 weeks
    Title
    Non-contact Tear Break-up Time
    Time Frame
    12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Adults (18 years or older) Presence of dry eye disease as defined as: Ocular Suface Disease Index (OSDI) score >13 AND EITHER i: Non-contact tear break-up time (NITBUT) < 10 seconds OR ii: Ocular Surface Staining (OSS) score > 1 in either eye Exclusion Criteria: Systemic diseases or comorbidities that may cause severe or secondary dry eye: Previous diagnosis of lymphoma, hepatitis C, HIV/AIDS, sarcoidosis, or amyloidosis that involves lacrimal glands Previous diagnosis of graft versus host disease (e.g., after bone marrow transplantation treatment for cancer) or cicatrizing conjunctivitis (e.g., Steven Johnson Syndrome, mucous membrane pemphigoid, trachoma) Anatomical or neurological lid closure problems (e.g., Bell's palsy, cicatricial ectropion, Alzheimer's disease, Parkinson's disease) 4 Any history of chemotherapy, head or neck radiation treatment, or radioactive iodine treatment within 1 year prior to enrollment High dose oral or systemic steroids (equivalent to or greater than 5 mg prednisone) or immunosuppressive medication within 30 days prior to enrollment. Patients who are on stable dosing are eligible. Frequent or recent change in systemic medication regimen (e.g., diuretics, beta blockers, immunosuppressive medications, antidepressants that are known to interfere with dry eye) within 3 months prior to enrollment that may influence the ocular surface. Other ocular surface diseases or surgical history that may cause severe or secondary dry eye: History of corneal dystrophy that in the opinion of the investigator is significantly affecting the ocular surface (e.g., significant anterior basement membrane dystrophy, Fuch's dystrophy with significant corneal edema and bullae, neurotrophic keratoconjunctivitis or corneal/conjunctival scarring including herpes simplex virus [HSV] or varicella zoster virus [VZV] keratitis) Any history of surgery for glaucoma (e.g., trabeculectomy, tube shunt) Corneal refractive surgery (e.g., laser in-situ keratomileusis [LASIK], photorefractive keratectomy [PRK], Intacs) within 6 months prior to enrollment Cataract, eyelid surgery, or retinal surgery (in operating room) within 6 months prior to enrollment Use of treatments that may interfere with the ocular surface and/or treatment efficacy: Any in-office dry eye procedures (e.g., Intense Pulsed Light [IPL], LipiFlow®, nasolacrimal duct probing) within 30 days prior to enrollment Use of anti-glaucoma drops, topical antihistamines drops, or topical steroid drops within 7 days prior to enrollment Use of contact lenses. Patients willing to discontinue usage for 48 hours prior to each study visit will be eligible. Use of scleral lens, such as the prosthetic replacement of the ocular surface ecosystem (PROSE) lens Current use of topical lifitegrast (Xiidra®), topical cyclosporine (Restasis®), topical tacrolimus, or topical pimecrolimus. Patients willing to discontinue their due to insufficient benefit will be eligible. Other important exclusion criteria: Current smoker (within 1 year prior to enrollment).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Saba Al-Hashimi, M.D
    Organizational Affiliation
    University of California, Los Angeles
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    30883442
    Citation
    O'Neil EC, Henderson M, Massaro-Giordano M, Bunya VY. Advances in dry eye disease treatment. Curr Opin Ophthalmol. 2019 May;30(3):166-178. doi: 10.1097/ICU.0000000000000569.
    Results Reference
    background
    PubMed Identifier
    29950805
    Citation
    Murri MS, Moshirfar M, Birdsong OC, Ronquillo YC, Ding Y, Hoopes PC. Amniotic membrane extract and eye drops: a review of literature and clinical application. Clin Ophthalmol. 2018 Jun 18;12:1105-1112. doi: 10.2147/OPTH.S165553. eCollection 2018.
    Results Reference
    background
    PubMed Identifier
    22290385
    Citation
    Quinto GG, Camacho W, Castro-Combs J, Li L, Martins SA, Wittmann P, Campos M, Behrens A. Effects of topical human amniotic fluid and human serum in a mouse model of keratoconjunctivitis sicca. Cornea. 2012 Apr;31(4):424-30. doi: 10.1097/ICO.0b013e31823f0a64.
    Results Reference
    background
    PubMed Identifier
    31213759
    Citation
    Yeu E, Goldberg DF, Mah FS, Beckman KA, Luchs JI, Solomon JD, White DE, Gupta PK. Safety and efficacy of amniotic cytokine extract in the treatment of dry eye disease. Clin Ophthalmol. 2019 May 27;13:887-894. doi: 10.2147/OPTH.S203510. eCollection 2019.
    Results Reference
    background
    PubMed Identifier
    31263717
    Citation
    Chen M, Chang CK, Lin SY, Chen M. A Pilot Study of the Short Term Effectiveness and Safety of Amniotic Fluid in Severe Dry Eye Disease. Med Hypothesis Discov Innov Ophthalmol. 2019 Summer;8(2):81-84.
    Results Reference
    background

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    Clinical Efficacy of Amniotic Membrane Extract Eye Drops in Dry Eye Treatment

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