Safety and Efficacy of Pro-ocular™ 1% in Daily Scleral Lens Wearing Patients With Ocular Graft-versus-Host Disease
Primary Purpose
Ocular Graft-versus-host Disease
Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Pro-ocular™ Topical Gel 1%
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Ocular Graft-versus-host Disease focused on measuring scleral lens, scleral lenses, scleral lens wear
Eligibility Criteria
Inclusion Criteria:
- Male or female of any race, at least 18 years of age at Visit 1.
- Has had the diagnosis of ocular GvHD (oGvHD) for at least 3 months prior to Visit 1.
- Use of scleral lenses daily in both eyes for at least two months prior to Visit 1 for treatment of oGvHD with planned continuation for use of the same scleral lenses throughout this study.
- Excluding final scleral lens removal of the day, after successful daily insertion, patient feels need to remove or does remove one or both scleral lenses at least once per day due to physical discomfort or visual acuity issues (lenses have debris or deposit build up or vision is foggy, cloudy or blurry).
- Has staining score in central corneal region of ≥ 2 out of 10 in either eye at Visit 1.
- Has Modified SANDE Frequency score of ≥ 35 out of 100 in either eye for both Modified SANDE daytime questionnaire with lenses and Modified SANDE nighttime questionnaire without lenses.
- Has provided verbal and written informed consent.
- Be able and willing to follow oral and written instructions provided in English, with or without assistance and participate in all assessments and visits.
- Has access to telephone necessary for evaluations.
- Had an ophthalmological exam within past year prior to Visit 1.
Exclusion Criteria:
- Has tested positive from COVID-19 within twenty-eight days prior to Screening.
- Active trigeminal neuritis, trigeminal neuralgia, ocular herpes zoster, facial herpes zoster, ocular herpes simplex, or neurotrophic keratitis at Visit 1.
- History of ocular herpes zoster, facial herpes zoster, ocular herpes simplex, or neurotrophic keratitis within the last 5 years that is not being medically managed including oral antivirals. Patients with a history of herpes simplex virus must be receiving appropriate antiviral therapy.
- History of breast cancer in patient or immediate biological family (parents, siblings and children).
- Eyelid surgery or ocular surgery within the last 12 weeks prior to screening that in the judgment of the clinical investigator will interfere with study assessments.
- Comorbidity with other severe, acute or chronic systemic or ocular condition that in the judgment of the investigator will interfere with study assessments, study participant safety, or study compliance such as active COVID-19 infection.
- Significant change (e.g. discontinuation) in oral corticosteroid dose or corticosteroid-containing eye drops or gels, cyclosporine ophthalmic emulsion or lifitegrast ophthalmic solution within 7 days prior to screening.
- Wears any type of lenses overnight (e.g. scleral lenses, bandage contact lenses).
- Women of childbearing potential who are pregnant, nursing an infant, planning a pregnancy, not receiving an adequate method of birth control, or have a positive urine pregnancy test at Screening. Women of childbearing potential must be willing to use contraception throughout this study.
- Has a known adverse reaction and/or sensitivity to the study drug.
- Prior or current use of Pro-ocular™.
- Unwilling to cease the use of sunscreen on the forehead or eye area.
- Currently using more than one preserved topical medication for glaucoma.
- Currently enrolled in an investigational drug or device study exclusively for ocular GvHD.
Sites / Locations
- BostonSight
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
Vehicle
Pro-ocular™ Topical Gel 1%
Arm Description
Outcomes
Primary Outcome Measures
Change in Modified Symptom Assessment in Dry Eye Questionnaire, Global Score for nighttime without scleral lenses.
0-100 visual analog scale, lower score is a better outcome than a higher score
Secondary Outcome Measures
Change in Central Corneal Staining
0-10 scale, lower score is a better outcome than a higher score
Change in Blurred or Cloudy Vision in Glia Ocular Surface Disease Symptoms Questionnaire.
0-10 scale, lower score is a better outcome than a higher score
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04769648
Brief Title
Safety and Efficacy of Pro-ocular™ 1% in Daily Scleral Lens Wearing Patients With Ocular Graft-versus-Host Disease
Official Title
A Phase II/III Trial of Safety and Efficacy of Pro-ocular™ 1% in Daily Scleral Lens Wearing Patients With Ocular Graft-versus-Host Disease
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 15, 2021 (Actual)
Primary Completion Date
August 15, 2023 (Anticipated)
Study Completion Date
October 15, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Glia, LLC
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This clinical study seeks to evaluate the safety and efficacy of Pro-ocular™1% topical gel in patients with ocular Graft-versus-Host Disease who wear scleral lenses daily. This vehicle-controlled trial will evaluate the investigational drug's effect on signs and symptoms of ocular Graft-versus-Host Disease and on the hours of daily comfortable and serviceable scleral lens wear.
Detailed Description
This Phase 2/3 placebo-controlled clinical study of Safety and Efficacy of Pro-ocular™ 1% in Daily Scleral Lens Wearing Patients with Ocular Graft-versus-Host Disease (oGvHD) will evaluate the the investigational drug's effect on signs and symptoms of oGvHD and subject-reported hours of duration of comfortable and serviceable scleral lens wear time.
The study will enroll 38 subjects. In the first 12 weeks, subjects will be randomized 1:1 active to placebo. At week 12, placebo subjects will cross-over to active drug treatment. At week 24, all subjects can opt into an open label phase.
In clinic visits will occur at weeks 0, 12 and 24 with remote telephone assessments at weeks 6 and 18. For subjects who opt into the open-label phase, in-clinic visits will occur at weeks 36 and 52.
Safety monitoring for adverse events will be performed at all onsite and remote visits.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ocular Graft-versus-host Disease
Keywords
scleral lens, scleral lenses, scleral lens wear
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
12 weeks randomized 1:1 active to placebo. At 12 weeks, placebo group crosses over to active drug. At week 24, all subjects can opt in to an open-label phase.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Subjects randomized for week 0 - week 12; subjects, investigators and study staff will be masked through week 24.
Allocation
Randomized
Enrollment
44 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Vehicle
Arm Type
Placebo Comparator
Arm Title
Pro-ocular™ Topical Gel 1%
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Pro-ocular™ Topical Gel 1%
Intervention Description
Pro-ocular™ is a topical gel applied dermally to forehead twice-daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo is a vehicle topical gel without active ingredient applied dermally to forehead twice-daily
Primary Outcome Measure Information:
Title
Change in Modified Symptom Assessment in Dry Eye Questionnaire, Global Score for nighttime without scleral lenses.
Description
0-100 visual analog scale, lower score is a better outcome than a higher score
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change in Central Corneal Staining
Description
0-10 scale, lower score is a better outcome than a higher score
Time Frame
12 weeks
Title
Change in Blurred or Cloudy Vision in Glia Ocular Surface Disease Symptoms Questionnaire.
Description
0-10 scale, lower score is a better outcome than a higher score
Time Frame
12 weeks
Other Pre-specified Outcome Measures:
Title
Change in Corneal fluorescein staining using modified NEI scoring.
Description
0-10 scale, lower score is a better outcome than a higher score
Time Frame
12 weeks
Title
Change in Conjunctival lissamine staining using NEI scoring.
Description
0-10 scale, lower score is a better outcome than a higher score
Time Frame
12 weeks
Title
Change in Eyelid evaluation using Efron scale with 0.5 steps (with and without scleral lenses).
Description
0-4 scale with 0.5 steps, lower score is a better outcome than a higher score
Time Frame
12 weeks
Title
Change in Conjunctival redness using Efron scale with 0.5 steps (with and without scleral lenses).
Description
0-4 scale with 0.5 steps, lower score is a better outcome than a higher score
Time Frame
12 weeks
Title
Change in Tear break-up time using fluorescein and slit lamp.
Description
0-10 scale, higher score is a better outcome than a lower score
Time Frame
12 weeks
Title
Change in Eye redness using redness scan by keratograph.
Time Frame
12 weeks
Title
Change in Modified Glia Ocular Surface Disease Symptoms Questionnaire using VAS.
Description
patient-reported ocular discomfort, dryness, conjunctival redness, photophobia, blurred or cloudy vision, difficulty blinking and level of sleep disturbance; 0-10 visual analog scale, lower score is a better outcome than a higher score
Time Frame
6 weeks, 12 weeks
Title
Change in Scleral Lens Wear Glia Questionnaire
Description
total hours daily scleral lens wear, daily hours of comfort wear, daily hours of serviceable wear, number of instances of lens removal for cleaning and re-insertion.
Time Frame
6 weeks, 12 weeks
Title
Change in Modified Symptom Assessment in Dry Eye Questionnaire in daytime with scleral lenses and at nighttime without scleral lenses.
Description
0-100 scale, lower score is a better outcome than a higher score
Time Frame
6 weeks, 12 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female of any race, at least 18 years of age at Visit 1.
Has had the diagnosis of ocular GvHD (oGvHD) for at least 3 months prior to Visit 1.
Use of scleral lenses daily in both eyes for at least two months prior to Visit 1 for treatment of oGvHD with planned continuation for use of the same scleral lenses throughout this study.
Excluding final scleral lens removal of the day, after successful daily insertion, patient feels need to remove or does remove one or both scleral lenses at least once per day due to physical discomfort or visual acuity issues (lenses have debris or deposit build up or vision is foggy, cloudy or blurry).
Has staining score in central corneal region of ≥ 2 out of 10 in either eye at Visit 1.
Has Modified SANDE Frequency score of ≥ 35 out of 100 in either eye for both Modified SANDE daytime questionnaire with lenses and Modified SANDE nighttime questionnaire without lenses.
Has provided verbal and written informed consent.
Be able and willing to follow oral and written instructions provided in English, with or without assistance and participate in all assessments and visits.
Has access to telephone necessary for evaluations.
Had an ophthalmological exam within past year prior to Visit 1.
Exclusion Criteria:
Has tested positive from COVID-19 within twenty-eight days prior to Screening.
Active trigeminal neuritis, trigeminal neuralgia, ocular herpes zoster, facial herpes zoster, ocular herpes simplex, or neurotrophic keratitis at Visit 1.
History of ocular herpes zoster, facial herpes zoster, ocular herpes simplex, or neurotrophic keratitis within the last 5 years that is not being medically managed including oral antivirals. Patients with a history of herpes simplex virus must be receiving appropriate antiviral therapy.
History of breast cancer in patient or immediate biological family (parents, siblings and children).
Eyelid surgery or ocular surgery within the last 12 weeks prior to screening that in the judgment of the clinical investigator will interfere with study assessments.
Comorbidity with other severe, acute or chronic systemic or ocular condition that in the judgment of the investigator will interfere with study assessments, study participant safety, or study compliance such as active COVID-19 infection.
Significant change (e.g. discontinuation) in oral corticosteroid dose or corticosteroid-containing eye drops or gels, cyclosporine ophthalmic emulsion or lifitegrast ophthalmic solution within 7 days prior to screening.
Wears any type of lenses overnight (e.g. scleral lenses, bandage contact lenses).
Women of childbearing potential who are pregnant, nursing an infant, planning a pregnancy, not receiving an adequate method of birth control, or have a positive urine pregnancy test at Screening. Women of childbearing potential must be willing to use contraception throughout this study.
Has a known adverse reaction and/or sensitivity to the study drug.
Prior or current use of Pro-ocular™.
Unwilling to cease the use of sunscreen on the forehead or eye area.
Currently using more than one preserved topical medication for glaucoma.
Currently enrolled in an investigational drug or device study exclusively for ocular GvHD.
Facility Information:
Facility Name
BostonSight
City
Needham
State/Province
Massachusetts
ZIP/Postal Code
02494
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Safety and Efficacy of Pro-ocular™ 1% in Daily Scleral Lens Wearing Patients With Ocular Graft-versus-Host Disease
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