search
Back to results

Evaluation of Bromocriptine, Metoprolol and Tamsulosin in Eyes With Non-Central DME

Primary Purpose

Diabetic Macular Edema

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Bromocriptine 2.5 MG
Metoprolol 25 MG
Tamsulosin 0.4 MG
Placebo
Sponsored by
Andrew Moshfeghi, MD, MBA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Macular Edema

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age >18 years
  • Type 1 or type 2 diabetes mellitus
  • Best corrected visual acuity using the early treatment diabetic retinopathy study (ETDRS) visual acuity test letter score ≥ 74 (i.e., 20/32 or better) within 30 days of enrollment.
  • On clinical exam, definite retinal thickening due to DME within 3,000 μm of the center of the macula but not involving the 500 μm central subfield.
  • Thickened non-central macular subfields on the spectral domain OCT macular map
  • Central subfield thickness within threshold definition for normal central subfield thickness
  • No focal/grid laser within the last 6 months or other treatment for DME within the last 4 months.
  • Pseudophakia

Exclusion Criteria:

  • Patients with active proliferative diabetic retinopathy
  • Pan retinal photocoagulation within the last 12 months of study initiation
  • A condition that, in the opinion of the investigator, would preclude participation in the study, e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control.
  • Subjects experiencing poor glycemic control who, within the last 4 months, initiated intensive insulin treatment (a pump or multiple daily injections) or plan to do so in the next 4 months.
  • Use of systemic corticosteroids or anti-VEGF (vascular endothelial growth factor) therapy.
  • Participation in an investigational trial that involves treatment with any drug within 30 days of randomization that has not received regulatory approval at the time of study entry.

Note: study participants cannot receive another investigational drug while participating in this study.

  • Known allergy or hypersensitivity to any component of the study drugs.
  • Postpartum women with a history of coronary artery disease or other severe cardiovascular conditions (a bromocriptine contraindication).
  • Planned glaucoma surgery (floppy iris syndrome associated with tamsulosin therapy).
  • Blood pressure > 180/110 mmHg (systolic above 180 or diastolic above 110 mmHg).
  • If blood pressure is brought below 180/110 by anti-hypertensive treatment, an individual can become eligible.
  • Subjects with second or third degree heart block (metoprolol contraindication).
  • Subjects with asthma or other bronchospastic disease (metoprolol precaution).
  • Individuals currently taking one of the study medications or a medication in the same therapeutic class (beta receptor antagonists, alpha-1 receptor antagonists, or bromocriptine).
  • Participants expecting to move out of the area of the clinical center to an area not covered by another clinical center during the 12 months of the study.
  • For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 12 months. Women who are potential study participants should be questioned about the potential for pregnancy. Investigator judgment will be used to determine when a pregnancy test is needed.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    Combination regiment

    Placebo

    Arm Description

    A combination regiment of Bromocriptine (2.5 mg/day), Metoprolol (25 mg/day) and Tamsulosin (0.4 mg/day)

    Three placebo pills, matching the external appearance of active drugs

    Outcomes

    Primary Outcome Measures

    Change in retinal volume
    Effects of bromocriptine/metoprolol/tamsulosin combination therapy on macular retinal volume compared with placebo in eyes with non-central diabetic macular edema (DME)

    Secondary Outcome Measures

    Progression of non-central DME compared to central DME
    Effects of therapy with bromocriptine/metoprolol/tamsulosin on central subfield thickness and compare the progression of non-central DME to central DME as determined by stereoscopic fundus photographs.
    Progression of non-central DME compared to central DME
    Effects of therapy with bromocriptine/metoprolol/tamsulosin on central subfield thickness and compare the progression of non-central DME to central DME as determined by Optical Coherence Tomography (OCT).
    Change in retinal density
    Measured by OCT-angiography
    Foveal avascular changes
    Measured by fluorescein angiography.

    Full Information

    First Posted
    December 15, 2017
    Last Updated
    March 28, 2019
    Sponsor
    Andrew Moshfeghi, MD, MBA
    Collaborators
    Case Western Reserve University
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT03384524
    Brief Title
    Evaluation of Bromocriptine, Metoprolol and Tamsulosin in Eyes With Non-Central DME
    Official Title
    A Phase I/II Evaluation of Bromocriptine, Metoprolol and Tamsulosin Combination Therapy in Eyes With Non-Central Diabetic Macular Edema
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2019
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    withdrawn during planning stages
    Study Start Date
    March 2018 (Anticipated)
    Primary Completion Date
    May 2019 (Anticipated)
    Study Completion Date
    May 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Andrew Moshfeghi, MD, MBA
    Collaborators
    Case Western Reserve University

    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
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This phase I/II trial is designed to provide proof of concept evidence that combination therapy can have a beneficial effect on DME and possibly prevent increases in retinal volume or progression of non-central DME into the central subfield of the macula. If a beneficial effect is apparent in this phase I/II study involving a relatively small sample size and short follow-up period, its results could be used to in plan future phase III trials. We believe this study will be the first to show that a systems pharmacology approach can successfully address diabetic macular edema, and thus revolutionize the treatment of complex retinal diseases for which there are a paucity of effective treatment options.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diabetic Macular Edema

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Combination regiment
    Arm Type
    Active Comparator
    Arm Description
    A combination regiment of Bromocriptine (2.5 mg/day), Metoprolol (25 mg/day) and Tamsulosin (0.4 mg/day)
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Three placebo pills, matching the external appearance of active drugs
    Intervention Type
    Drug
    Intervention Name(s)
    Bromocriptine 2.5 MG
    Other Intervention Name(s)
    Bromocriptine Mesylate
    Intervention Description
    Administered daily
    Intervention Type
    Drug
    Intervention Name(s)
    Metoprolol 25 MG
    Other Intervention Name(s)
    Metoprolol Tartrate
    Intervention Description
    Administered daily
    Intervention Type
    Drug
    Intervention Name(s)
    Tamsulosin 0.4 MG
    Other Intervention Name(s)
    Tamsulosin HCL, Tamsulosin Hydrochloride
    Intervention Description
    Administered daily
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Three pills, matching active drugs to be administered daily
    Primary Outcome Measure Information:
    Title
    Change in retinal volume
    Description
    Effects of bromocriptine/metoprolol/tamsulosin combination therapy on macular retinal volume compared with placebo in eyes with non-central diabetic macular edema (DME)
    Time Frame
    14 months
    Secondary Outcome Measure Information:
    Title
    Progression of non-central DME compared to central DME
    Description
    Effects of therapy with bromocriptine/metoprolol/tamsulosin on central subfield thickness and compare the progression of non-central DME to central DME as determined by stereoscopic fundus photographs.
    Time Frame
    14 months
    Title
    Progression of non-central DME compared to central DME
    Description
    Effects of therapy with bromocriptine/metoprolol/tamsulosin on central subfield thickness and compare the progression of non-central DME to central DME as determined by Optical Coherence Tomography (OCT).
    Time Frame
    14 months
    Title
    Change in retinal density
    Description
    Measured by OCT-angiography
    Time Frame
    14 months
    Title
    Foveal avascular changes
    Description
    Measured by fluorescein angiography.
    Time Frame
    14 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age >18 years Type 1 or type 2 diabetes mellitus Best corrected visual acuity using the early treatment diabetic retinopathy study (ETDRS) visual acuity test letter score ≥ 74 (i.e., 20/32 or better) within 30 days of enrollment. On clinical exam, definite retinal thickening due to DME within 3,000 μm of the center of the macula but not involving the 500 μm central subfield. Thickened non-central macular subfields on the spectral domain OCT macular map Central subfield thickness within threshold definition for normal central subfield thickness No focal/grid laser within the last 6 months or other treatment for DME within the last 4 months. Pseudophakia Exclusion Criteria: Patients with active proliferative diabetic retinopathy Pan retinal photocoagulation within the last 12 months of study initiation A condition that, in the opinion of the investigator, would preclude participation in the study, e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control. Subjects experiencing poor glycemic control who, within the last 4 months, initiated intensive insulin treatment (a pump or multiple daily injections) or plan to do so in the next 4 months. Use of systemic corticosteroids or anti-VEGF (vascular endothelial growth factor) therapy. Participation in an investigational trial that involves treatment with any drug within 30 days of randomization that has not received regulatory approval at the time of study entry. Note: study participants cannot receive another investigational drug while participating in this study. Known allergy or hypersensitivity to any component of the study drugs. Postpartum women with a history of coronary artery disease or other severe cardiovascular conditions (a bromocriptine contraindication). Planned glaucoma surgery (floppy iris syndrome associated with tamsulosin therapy). Blood pressure > 180/110 mmHg (systolic above 180 or diastolic above 110 mmHg). If blood pressure is brought below 180/110 by anti-hypertensive treatment, an individual can become eligible. Subjects with second or third degree heart block (metoprolol contraindication). Subjects with asthma or other bronchospastic disease (metoprolol precaution). Individuals currently taking one of the study medications or a medication in the same therapeutic class (beta receptor antagonists, alpha-1 receptor antagonists, or bromocriptine). Participants expecting to move out of the area of the clinical center to an area not covered by another clinical center during the 12 months of the study. For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 12 months. Women who are potential study participants should be questioned about the potential for pregnancy. Investigator judgment will be used to determine when a pregnancy test is needed.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Andrew A. Moshfeghi, MD, MBA
    Organizational Affiliation
    Associate Professor of Ophthalmology; Director of Vitreoretinal Surgery and Medical Retina Fellowship; Director of Clinical Trials Unit
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Evaluation of Bromocriptine, Metoprolol and Tamsulosin in Eyes With Non-Central DME

    We'll reach out to this number within 24 hrs