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Oral Hydroxychloroquine (HCQ) for Retinitis Pigmentosa Caused by P23H- Rhodopsin (RHO)

Primary Purpose

Retinitis Pigmentosa

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hydroxychloroquine lower dose
Hydroxychloroquine higher dose
Sponsored by
University of Michigan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retinitis Pigmentosa focused on measuring P23H-RHO, eye disease

Eligibility Criteria

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

Inclusion Criteria:

  • Stated willingness to comply with all study procedures and availability for the duration of the study
  • Signed and dated informed consent form
  • Early Treatment Diabetic Retinopathy Study Best Corrected Visual Acuity (ETDRS BCVA) of 20 letters (approximately 20/400 Snellen) or better in at least one eye
  • Clinical diagnosis of autosomal dominant retinitis pigmentosa
  • Confirmed to have one copy of the P23H-RHO pathogenic variant by genetic testing at a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory
  • Clarity of ocular media and adequate pupillary dilation to allow for adequate clinical ocular examination and retinal imaging
  • Ability to perform testing required by the study as determined by the investigator
  • Ability to take oral medication (medication tablets must be swallowed whole) and be willing to adhere to the daily medication regimen
  • For females of reproductive potential: use of highly effective contraception beginning no later than 1 week after the first screening visit, and agreement to use such a method during study participation and through the end of the washout period (6 months after the end of HCQ administration)
  • Agreement to adhere to Lifestyle Considerations throughout study duration (take the study drug with meals, avoid taking over-the-counter antacids or kaolin-containing products 4 hours before or after taking the study drug)

Exclusion Criteria:

  • Use of any other drugs which are known to prolong the QT interval
  • Concurrent use of any of the following drugs, if the drug cannot be discontinued or substituted: digoxin, antiepileptic medications, cimetidine, methotrexate, cyclosporine, praziquantel, ampicillin
  • Current or previous use of tamoxifen
  • Pregnancy or lactation
  • Known allergy or hypersensitivity to hydroxychloroquine or any other 4-aminoquinoline drugs (chloroquine, amodiaquine, mefloquine, quinacrine, etc.), or known history of glucose-6-phosphate dehydrogenase deficiency
  • Treatment with another investigational medical intervention for retinitis pigmentosa within 3 months, or any ever previous treatment with an investigational surgical intervention
  • Any pre-existing cardiac, renal, hepatic, or hematologic disease, any prior history of psoriasis or porphyria, or any alcoholism
  • Abnormal screening laboratory values including aspartate transaminase (AST) or alanine transaminase (ALT) > 2.0 x upper limit of normal, subnormal glomerular filtration rate (< 90 mL/min/1.73m2) or abnormal complete blood count attributable to underlying hematologic disease such as malignancy, aplastic anemia, agranulocytosis, leukopenia, or thrombocytopenia.

Sites / Locations

  • University of MichiganRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

HCQ treatment 1

HCQ treatment 2

Arm Description

In treatment arm 1, the dose of study drug will be 4 mg/kg/day. The daily dose will not exceed 400 mg. In both groups, the dose will be rounded down to 100, 200, 300, or 400 mg/day.

In treatment arm 2, the dose of the study drug will be 5 mg/kg/day. The daily dose will not exceed 400 mg. In both groups, the dose will be rounded down to 100, 200, 300, or 400 mg/day.

Outcomes

Primary Outcome Measures

Change in Ellipsoid zone area measured by Spectral-Domain Optical Coherence Tomography (SD-OCT)
These will be performed at: screening, baseline, 4 months, 12 months, and 18 months
Change in Retinal sensitivity (decibels) measured by scotopic and mesopic microperimetry
These will be performed at: screening, baseline, 4 months, 12 months, and 18 months

Secondary Outcome Measures

Full Information

First Posted
October 8, 2019
Last Updated
February 8, 2023
Sponsor
University of Michigan
Collaborators
Cures Within Reach
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1. Study Identification

Unique Protocol Identification Number
NCT04120883
Brief Title
Oral Hydroxychloroquine (HCQ) for Retinitis Pigmentosa Caused by P23H- Rhodopsin (RHO)
Official Title
Oral Hydroxychloroquine for Retinitis Pigmentosa Caused by P23H-RHO (Substitution of Proline to Histidine at Codon 23 of the Rhodopsin Protein)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 25, 2020 (Actual)
Primary Completion Date
October 2025 (Anticipated)
Study Completion Date
October 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Michigan
Collaborators
Cures Within Reach

4. Oversight

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

5. Study Description

Brief Summary
This research study is being done to learn what effect 12 months of treatment with oral hydroxychloroquine (HCQ) will have on the retina in people with retinitis pigmentosa (RP). The hypothesis is that treatment with HCQ is safe and tolerable in patients with autosomal dominant retinitis pigmentosa (adRP) caused by P23H-RHO, and may arrest progression of retinal degeneration by altering the autophagy pathway in photoreceptors. Participants that meet eligibility and agree to the study will be asked to take the study medication (HCQ) for 12 months and have evaluations for up to approximately 18 months from the baseline visit. There will be a total of 6 visits (1 is a phone visit) and will include general examinations, blood work, electrocardiograms, along with special testing of the retina.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retinitis Pigmentosa
Keywords
P23H-RHO, eye disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
The start of intervention for treatment arm 2 of the study will be delayed until preliminary safety of the drug is established with the 6 patients in treatment arm 1 at the first follow-up visit (4 months).
Masking
Outcomes Assessor
Allocation
Non-Randomized
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HCQ treatment 1
Arm Type
Experimental
Arm Description
In treatment arm 1, the dose of study drug will be 4 mg/kg/day. The daily dose will not exceed 400 mg. In both groups, the dose will be rounded down to 100, 200, 300, or 400 mg/day.
Arm Title
HCQ treatment 2
Arm Type
Experimental
Arm Description
In treatment arm 2, the dose of the study drug will be 5 mg/kg/day. The daily dose will not exceed 400 mg. In both groups, the dose will be rounded down to 100, 200, 300, or 400 mg/day.
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine lower dose
Other Intervention Name(s)
plaquenil
Intervention Description
The participants weight will be measured and converted to kilograms. The participants will receive 4 mg/kg/day. At the first follow-up visit (4 months) weight will be re-measured and the study drug dosing will be adjusted accordingly if the dosing has changed. Participants receiving 100 mg daily will be instructed to ingest one 200 mg tablet every other day. Participants receiving 200 mg daily will be instructed to ingest one 200 mg tablet daily. Participants receiving 300 mg daily will be instructed to alternate days ingesting two 200 mg tablets and one 200 mg tablet. Participants receiving 400 mg daily will be instructed to ingest two 200 mg tablets daily.
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine higher dose
Other Intervention Name(s)
plaquenil
Intervention Description
The start of intervention for treatment arm 2 of the study will be delayed until preliminary safety of the drug is established with the 6 patients in treatment arm 1 at the first follow-up visit (4 months). The participants in this group will receive 5 mg/kg/day. At the first follow-up visit (4 months) weight will be re-measured and the study drug dosing will be adjusted accordingly if the dosing has changed. Participants receiving 100 mg daily will be instructed to ingest one 200 mg tablet every other day. Participants receiving 200 mg daily will be instructed to ingest one 200 mg tablet daily. Participants receiving 300 mg daily will be instructed to alternate days ingesting two 200 mg tablets and one 200 mg tablet. Participants receiving 400 mg daily will be instructed to ingest two 200 mg tablets daily.
Primary Outcome Measure Information:
Title
Change in Ellipsoid zone area measured by Spectral-Domain Optical Coherence Tomography (SD-OCT)
Description
These will be performed at: screening, baseline, 4 months, 12 months, and 18 months
Time Frame
screening up to 18 months
Title
Change in Retinal sensitivity (decibels) measured by scotopic and mesopic microperimetry
Description
These will be performed at: screening, baseline, 4 months, 12 months, and 18 months
Time Frame
screening up to 18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Stated willingness to comply with all study procedures and availability for the duration of the study Signed and dated informed consent form Early Treatment Diabetic Retinopathy Study Best Corrected Visual Acuity (ETDRS BCVA) of 20 letters (approximately 20/400 Snellen) or better in at least one eye Clinical diagnosis of autosomal dominant retinitis pigmentosa Confirmed to have one copy of the P23H-RHO pathogenic variant by genetic testing at a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory Clarity of ocular media and adequate pupillary dilation to allow for adequate clinical ocular examination and retinal imaging Ability to perform testing required by the study as determined by the investigator Ability to take oral medication (medication tablets must be swallowed whole) and be willing to adhere to the daily medication regimen For females of reproductive potential: use of highly effective contraception beginning no later than 1 week after the first screening visit, and agreement to use such a method during study participation and through the end of the washout period (6 months after the end of HCQ administration) Agreement to adhere to Lifestyle Considerations throughout study duration (take the study drug with meals, avoid taking over-the-counter antacids or kaolin-containing products 4 hours before or after taking the study drug) Exclusion Criteria: Use of any other drugs which are known to prolong the QT interval Concurrent use of any of the following drugs, if the drug cannot be discontinued or substituted: digoxin, antiepileptic medications, cimetidine, methotrexate, cyclosporine, praziquantel, ampicillin Current or previous use of tamoxifen Pregnancy or lactation Known allergy or hypersensitivity to hydroxychloroquine or any other 4-aminoquinoline drugs (chloroquine, amodiaquine, mefloquine, quinacrine, etc.), or known history of glucose-6-phosphate dehydrogenase deficiency Treatment with another investigational medical intervention for retinitis pigmentosa within 3 months, or any ever previous treatment with an investigational surgical intervention Any pre-existing cardiac, renal, hepatic, or hematologic disease, any prior history of psoriasis or porphyria, or any alcoholism Abnormal screening laboratory values including aspartate transaminase (AST) or alanine transaminase (ALT) > 2.0 x upper limit of normal, subnormal glomerular filtration rate (< 90 mL/min/1.73m2) or abnormal complete blood count attributable to underlying hematologic disease such as malignancy, aplastic anemia, agranulocytosis, leukopenia, or thrombocytopenia.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Callie Gordon
Phone
734-615-8560
Email
callieg@umich.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Yu Cheng MD Zhao, MD
Phone
734-232-8262
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Zacks, MD
Organizational Affiliation
University of Michigan
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Callie Gordon
Phone
734-615-8560
Email
callieg@umich.edu

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified, individual participant data that underlie reported results will be shared.
IPD Sharing Time Frame
Data be available beginning 9 months after publication and ending 36 months after publication.
IPD Sharing Access Criteria
Researchers who provide a methodologically sound proposal can access the data. Types of analyses: to achieve proposed aims. Proposals should be directed to the study Principal Investigator. To gain access, data requestors will need to sign a data access agreement.

Learn more about this trial

Oral Hydroxychloroquine (HCQ) for Retinitis Pigmentosa Caused by P23H- Rhodopsin (RHO)

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