Effects of a Therapy With INTRAVIT® Tablets in Patients With Diabetic Retinopathy
Primary Purpose
Diabetic Retinopathy
Status
Unknown status
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
INTRAVIT ®
Sponsored by
About this trial
This is an interventional supportive care trial for Diabetic Retinopathy focused on measuring diabetic retinopathy, macula edema, microperimetry, curcumin, artemisin, piperine, bromelain
Eligibility Criteria
Inclusion Criteria:
- Diabetes type I and type II patients;
- Between 20 and 70 years of age;
- Age of diabetes not less than 5 years and not more than 15;
- Mild non-proliferating diabetic retinopathy, limited to the presence of some microaneurysms;
- Patients in diabetic compensation;
- Visual acuity 5/10 natural or correct;
- Patients even if hypertensive, with or without anti-hypertensive therapy in place, provided they are compensated;
- Patients with good visualization of the ocular fundus.
Exclusion Criteria:
- Patients with concurrent eye diseases outside diabetic retinopathy;
- Patients with less than natural or correct 5/10 visual acuity;
- Patients treated with other vasoprotective and antioxidant preparations or having taken them in the last month;
- Patients with significant systemic or metabolic diseases, except diabetes;
- Patients with unbalanced Diabetes disorder;
- Patients undergoing laser treatment or eye surgery (e.g. cataract);
- Patients who take or should take, during the observation period, preparations for direct or indirect activity on the retina of the type that can be superimposed on INTRAVIT ®.
Sites / Locations
- University of Molise
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
GROUP 1
GROUP 2
Arm Description
Patients treated with INTRAVIT® tablets
patients who will not take any medical therapy to overlap with the activity described for INTRAVIT® tablets.
Outcomes
Primary Outcome Measures
number of participants with signs of improvement/worsening of diabetic retinopathy
report presence/absence of signs with Yes/NO relative to: microaneurysms, haemorrhages, soft exudates, hard exudates, venous beading, IRMA, new vessels on optical discs, new vessels outside the optical discs, cystoid edema, capillary occlusions, degenerative alterations and vein size.
number of participants in a certain stage of diabetic retinopathy according to the ETDRS modified AAO 2003
careful evaluation of funduscopic signs (e.g exudates, neovases, micronaneurysms) to be able to stadiate patients
number of patients with improved/worsened visual acuity
visual acuity measurement with ETDRS boards. The number of letters seen by the patient at each check-up visit will be noted.
number of patients with improved/worsened macular edema
Foveal thickness (measured with Optical Coherence Tomography) at each check-up visit will be noted.
Secondary Outcome Measures
number of patients with improved/worsened blood parameters related to diabetes
blood sugar (mg/dl) using a rapid glucose test at each check-up visit will be noted and glycated hemoglobin (%) will be assesed with venous blood sampling at the beginning of the study and at 3 and 6 months.
Full Information
NCT ID
NCT04742829
First Posted
January 29, 2021
Last Updated
February 3, 2021
Sponsor
University of Molise
1. Study Identification
Unique Protocol Identification Number
NCT04742829
Brief Title
Effects of a Therapy With INTRAVIT® Tablets in Patients With Diabetic Retinopathy
Official Title
Evaluation of the Effect of a Therapy With INTRAVIT® Tablets on Retinal Edema, Retinal Sensitivity and Visual Acuity in the Course of Diabetic Retinopathy
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
October 1, 2020 (Actual)
Primary Completion Date
March 8, 2021 (Anticipated)
Study Completion Date
March 8, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Molise
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
Evaluation of the effect of a therapy with INTRAVIT® tablets, on retinal edema considering also the central retinal sensitivity (Microperimetry) and the visual acuity in course of diabetic retinopathy.
Detailed Description
Retinal edema is an abnormal accumulation of fluids in the retina, is a complication of certain eye diseases such as diabetic retinopathy, exudative macular degeneration, surgical or para - surgical practices and trauma. The main factors involved in the formation of retinal edema are due to structural alterations of blood vessels, formation of neovessels and phlogistic phenomena. INTRAVIT® is a product based on extracts of Artemisia, Turmeric, Pineapple and Black Pepper, formulated in a targeted way to support the treatment of retinal edema and treatments with intravitreal injections. Artemisia (artemisinin and its derivatives) has proven to be able to counteract the activity of VEGF, VEGFR, metal protein (MM2 and MMP9) and integrins αvβ3, all factors involved in the angiogenetic process. Turmeric (curcumin) has been shown to be able to counteract the phlogistic processes in various districts in addition to acting on the reduction of angiogenesis. The Pineapple (Bromelain) for its proteolytic activity has been able to favor the resorption of the edema and the reduction of the phlogistic phenomena. Black pepper (piperine) has proven to be able to counteract the phlogistic processes and encourage the bioavailability of some natural extracts such as curcumin.
The purpose of the study is to evaluate the effect of a therapy with INTRAVIT® tablets, on retinal edema considering also the central retinal sensitivity (Microperimetry) and visual acuity in the course of diabetic retinopathy. Diabetic patients with mild non-proliferant diabetic retinopathy (at an early stage) with macular edema will be enlisted. 40 patients, of which 20 will be treated with INTRAVIT® tablets (2 tablets per day morning and evening before meals), and 20 who will not take any medical therapy to overlap with the activity described for INTRAVIT® (control group). Patients covered by the inclusion criteria will undergo, before the start of treatment, a full eye examination and OCT (optical coherence tomography) for the measurement of foveal thickness. Based on the preordered randomization scheme they will be assigned to Group 1 or Group 2 (control group). Patients will undergo a first examination at the time of recruitment (T0), and subsequent visits (T1-T2) will fall to 3 and 6 months.The data collection sheet will report all adverse effects potentially attributable to the administration of the food supplement INTRAVIT® tablets.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Retinopathy
Keywords
diabetic retinopathy, macula edema, microperimetry, curcumin, artemisin, piperine, bromelain
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Observational study, open, controlled between homogeneous groups
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
GROUP 1
Arm Type
Experimental
Arm Description
Patients treated with INTRAVIT® tablets
Arm Title
GROUP 2
Arm Type
No Intervention
Arm Description
patients who will not take any medical therapy to overlap with the activity described for INTRAVIT® tablets.
Intervention Type
Dietary Supplement
Intervention Name(s)
INTRAVIT ®
Intervention Description
2 tablets per day morning and evening before meals
Primary Outcome Measure Information:
Title
number of participants with signs of improvement/worsening of diabetic retinopathy
Description
report presence/absence of signs with Yes/NO relative to: microaneurysms, haemorrhages, soft exudates, hard exudates, venous beading, IRMA, new vessels on optical discs, new vessels outside the optical discs, cystoid edema, capillary occlusions, degenerative alterations and vein size.
Time Frame
6 months
Title
number of participants in a certain stage of diabetic retinopathy according to the ETDRS modified AAO 2003
Description
careful evaluation of funduscopic signs (e.g exudates, neovases, micronaneurysms) to be able to stadiate patients
Time Frame
6 months
Title
number of patients with improved/worsened visual acuity
Description
visual acuity measurement with ETDRS boards. The number of letters seen by the patient at each check-up visit will be noted.
Time Frame
6 months
Title
number of patients with improved/worsened macular edema
Description
Foveal thickness (measured with Optical Coherence Tomography) at each check-up visit will be noted.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
number of patients with improved/worsened blood parameters related to diabetes
Description
blood sugar (mg/dl) using a rapid glucose test at each check-up visit will be noted and glycated hemoglobin (%) will be assesed with venous blood sampling at the beginning of the study and at 3 and 6 months.
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diabetes type I and type II patients;
Between 20 and 70 years of age;
Age of diabetes not less than 5 years and not more than 15;
Mild non-proliferating diabetic retinopathy, limited to the presence of some microaneurysms;
Patients in diabetic compensation;
Visual acuity 5/10 natural or correct;
Patients even if hypertensive, with or without anti-hypertensive therapy in place, provided they are compensated;
Patients with good visualization of the ocular fundus.
Exclusion Criteria:
Patients with concurrent eye diseases outside diabetic retinopathy;
Patients with less than natural or correct 5/10 visual acuity;
Patients treated with other vasoprotective and antioxidant preparations or having taken them in the last month;
Patients with significant systemic or metabolic diseases, except diabetes;
Patients with unbalanced Diabetes disorder;
Patients undergoing laser treatment or eye surgery (e.g. cataract);
Patients who take or should take, during the observation period, preparations for direct or indirect activity on the retina of the type that can be superimposed on INTRAVIT ®.
Facility Information:
Facility Name
University of Molise
City
Campobasso
Country
Italy
12. IPD Sharing Statement
Citations:
PubMed Identifier
29925789
Citation
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Results Reference
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20580421
Citation
Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010 Jul 10;376(9735):124-36. doi: 10.1016/S0140-6736(09)62124-3. Epub 2010 Jun 26.
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PubMed Identifier
29597206
Citation
Yang F, Yu J, Ke F, Lan M, Li D, Tan K, Ling J, Wang Y, Wu K, Li D. Curcumin Alleviates Diabetic Retinopathy in Experimental Diabetic Rats. Ophthalmic Res. 2018;60(1):43-54. doi: 10.1159/000486574. Epub 2018 Mar 29.
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PubMed Identifier
31530988
Citation
Radomska-Lesniewska DM, Osiecka-Iwan A, Hyc A, Gozdz A, Dabrowska AM, Skopinski P. Therapeutic potential of curcumin in eye diseases. Cent Eur J Immunol. 2019;44(2):181-189. doi: 10.5114/ceji.2019.87070. Epub 2019 Jul 30.
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PubMed Identifier
24053149
Citation
Mohr T, Desser L. Plant proteolytic enzyme papain abrogates angiogenic activation of human umbilical vein endothelial cells (HUVEC) in vitro. BMC Complement Altern Med. 2013 Sep 21;13:231. doi: 10.1186/1472-6882-13-231.
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PubMed Identifier
30227208
Citation
Al-Malki AL. Shikimic acid from Artemisia absinthium inhibits protein glycation in diabetic rats. Int J Biol Macromol. 2019 Feb 1;122:1212-1216. doi: 10.1016/j.ijbiomac.2018.09.072. Epub 2018 Sep 15.
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PubMed Identifier
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Citation
Kumar S, Sharma S, Vasudeva N. Screening of antidiabetic and antihyperlipidemic potential of oil from Piper longum and piperine with their possible mechanism. Expert Opin Pharmacother. 2013 Sep;14(13):1723-36. doi: 10.1517/14656566.2013.815725. Epub 2013 Jul 23.
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Citation
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Citation
Maugeri A, Mazzone MG, Giuliano F, Vinciguerra M, Basile G, Barchitta M, Agodi A. Curcumin Modulates DNA Methyltransferase Functions in a Cellular Model of Diabetic Retinopathy. Oxid Med Cell Longev. 2018 Jul 2;2018:5407482. doi: 10.1155/2018/5407482. eCollection 2018.
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Citation
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Effects of a Therapy With INTRAVIT® Tablets in Patients With Diabetic Retinopathy
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