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Study Title: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial

Primary Purpose

Treatment of Ocular Inflammation Associated With Cataract Surgery

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Bromfenac
Nepafenac
Sponsored by
Silverstein Eye Centers
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Treatment of Ocular Inflammation Associated With Cataract Surgery focused on measuring Post-Ocular Inflammation, Cataract Surgery

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All Sexes

Inclusion Criteria:

  1. Are male or female at least 18 years of age who are scheduled for unilateral cataract surgery VIA phacoemulsification with posterior chamber intraocular lens implantation and for whom no other ophthalmic surgical procedures (e.g., relaxing incisions, iridectomy, conjunctival excisions, etc) are to be conducted during the cataract surgery.
  2. Agree not to have any other ocular surgical procedures in the study or fellow (non study) eye within 15 days prior to the initiation of dosing with the test article or throughout the duration of the study.
  3. Have a Best Corrected Visual Acuity of 20/200 or better in either eye.
  4. Are willing/able to return for all required study visits.
  5. Are willing/able to follow instructions from the study investigator and his/her staff.
  6. Are able to self administer test article (or have a caregiver available to instill all doses of test article).
  7. If a woman capable of becoming pregnant, agree to have urine pregnancy testing performed at screening (must be negative) and agree to use a medically acceptable form of birth control throughout the study duration and for at least one week prior to and after completion of the study. Women considered capable of becoming pregnant include all females who have experienced menarche and who have not experienced menopause (as defined by amenorrhea for greater than 12 consecutive months) or have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy).
  8. Have signed informed consent approved by Institutional Review Board or Independent Ethics Committee.
  9. Have IOP ≥ 5 mmHg and ≤ 22 mmHg (in study eye) without anti glaucoma therapy at the pre operative screening visit (if >22 mmHg, adjust following pachymetry)

Exclusion Criteria:

  1. Have known hypersensitivity to bromfenac or nepafenac or to any component of the test article (including "procedural" medications such as anesthetic and/or fluorescein drops, dilating drops, etc.).
  2. Have a known hypersensitivity to salicylates (i.e., aspirin) or to other non steroidal anti inflammatory drugs (NSAIDs).
  3. Have intraocular inflammation (i.e., cells or flare in the anterior chamber as measured on slit lamp examination) in the study eye at the screening visit.
  4. Have a known blood dyscrasia or bone marrow suppression, a diagnosis of uncontrolled/unstable peptic ulcer disease, inflammatory bowel disease, or ulcerative colitis, or any uncontrolled/unstable pulmonary, cardiac, vascular, autoimmune, hepatic, renal, or central nervous system disease.
  5. Have used ocular, topical, or systemic NSAIDs or ocular, topical, or systemic gentamicin, or cyclosporine ophthalmic emulsion within 7 days prior to initiation of dosing with the test article or throughout the duration of the study.
  6. Have used any ocular prostaglandins within 30 days prior to initiation of dosing with the test article or throughout the duration of the study.
  7. Have active corneal pathology noted in the study eye at the screening visit. Active corneal pathology is defined as corneal pathology that is non stable, or greater than mild, or will compromise assessment of the safety or efficacy of treatment. Superficial punctate keratitis in the study eye is a criterion for exclusion.
  8. Have any extraocular/intraocular inflammation in the study eye noted at the screening visit (blepharitis allowed if mild only, and no concurrent conjunctivitis or lid erythema/edema) or ongoing, unresolved uveitis.
  9. Have used topical, ocular, inhaled or systemic steroids within 14 days prior to screening.
  10. Have had radial keratotomy, corneal transplant, or corneal refractive surgery in the study eye within the last two years.
  11. Have a history of abuse of alcohol/drugs within six months prior to the screening visit.
  12. Are pregnant or nursing/lactating.
  13. Have participated in any other study of an investigational drug or device within 30 days prior to randomization.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Active Comparator

    Arm Label

    Prolensa (Bromfenac Ophthalmic Solution) 0.07%

    Ilevro® (nepafenac ophthalmic suspension ) 0.3%

    Arm Description

    Bausch and Lomb, Rochester, NJ Dose: Subjects will instill one drop into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one days prior to surgery (Day 1), continue on the day of surgery plus 1 hour before surgery and for 14 days after surgery.

    Alcon Laboratories, Inc., Fort Worth, TX Dose: Subjects will instill one drop of test article into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one day prior to surgery (Day 1), continue on the day of surgery plus1 hour before surgery and for 14 days after surgery.

    Outcomes

    Primary Outcome Measures

    Outcome Change measured by Summed Ocular Inflammation Score (SOIS)
    50 Subjects are planned, 25 per treatment group who are undergoing planned cataract extraction with posterior chamber intraocular lens implantation to evaluate the non-inferiority of Prolensa and Ilevro when administering a pulse dose in each arm 1 hour prior to surgery. Outcome measure is defined as SIOS score of zero (no cell or flare) on day 15 (day one being the day prior to surgery, and for 14 days following surgery

    Secondary Outcome Measures

    Adverse Events
    Adverse Events reported, elicited, and observed
    Slit Lamp Biomicroscopy
    Slit Lamp Biomicroscopy evaluated and observed within normal limits
    Intraocular Pressure
    Intraocular Pressure evaluated and observed within normal limits
    Funduscopic Examination (Dilated)
    Funduscopic Examination (Dilated) evaluated and observed within normal limits

    Full Information

    First Posted
    March 18, 2019
    Last Updated
    March 28, 2019
    Sponsor
    Silverstein Eye Centers
    Collaborators
    Bausch & Lomb Incorporated, Churchhill Communications, Statistics & Data Corporation
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03886779
    Brief Title
    Study Title: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial
    Official Title
    Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2019
    Overall Recruitment Status
    Completed
    Study Start Date
    October 30, 2013 (Actual)
    Primary Completion Date
    February 15, 2017 (Actual)
    Study Completion Date
    March 2019 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Silverstein Eye Centers
    Collaborators
    Bausch & Lomb Incorporated, Churchhill Communications, Statistics & Data Corporation

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    Yes
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (nepafenac Ophthalmic Suspension) 0.3% QD with extra (pulse) dose on day of surgery for Treatment of Ocular Inflammation Associated with Cataract Surgery
    Detailed Description
    Name of Finished Product: Prolensa (Bromfenac Ophthalmic Solution) 0.07% Bausch and Lomb, Rochester, NJ Dose: Subjects will instill one drop into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one days prior to surgery (Day 1), continue on the day of surgery plus 1 hour before surgery and for 14 days after surgery. 2) Ilevro® (nepafenac ophthalmic suspension ) 0.3% This is a single-center, randomized, investigator and subject-masked, parallel group, and active-comparator controlled study. Subjects will be screened for this study between 1 and 21 days prior to the initiation of dosing with the test article. Subjects who sign the informed consent form and meet all inclusion/exclusion criteria will be randomized to receive either Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD or Ilevro (nepafenac Ophthalmic Suspension) 0.3% (1:1) for 14 days after cataract extraction.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Treatment of Ocular Inflammation Associated With Cataract Surgery
    Keywords
    Post-Ocular Inflammation, Cataract Surgery

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Model Description
    This is a single center, randomized, investigator masked, parallel group, and active-comparator controlled study to evaluate the clinical outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% for the treatment of ocular inflammation associated with cataract surgery
    Masking
    Investigator
    Masking Description
    The study is investigator-masked to treatment group assignment for the duration of the study. Should the masking need to be broken, the study staff may reveal the treatment to the Investigator. The date, time, and reason for the unmasking must be documented as soon as
    Allocation
    Randomized
    Enrollment
    57 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Prolensa (Bromfenac Ophthalmic Solution) 0.07%
    Arm Type
    Active Comparator
    Arm Description
    Bausch and Lomb, Rochester, NJ Dose: Subjects will instill one drop into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one days prior to surgery (Day 1), continue on the day of surgery plus 1 hour before surgery and for 14 days after surgery.
    Arm Title
    Ilevro® (nepafenac ophthalmic suspension ) 0.3%
    Arm Type
    Active Comparator
    Arm Description
    Alcon Laboratories, Inc., Fort Worth, TX Dose: Subjects will instill one drop of test article into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one day prior to surgery (Day 1), continue on the day of surgery plus1 hour before surgery and for 14 days after surgery.
    Intervention Type
    Drug
    Intervention Name(s)
    Bromfenac
    Intervention Description
    0.7 MG/ML [Prolensa]
    Intervention Type
    Drug
    Intervention Name(s)
    Nepafenac
    Intervention Description
    3 MG/ML [Ilevro]
    Primary Outcome Measure Information:
    Title
    Outcome Change measured by Summed Ocular Inflammation Score (SOIS)
    Description
    50 Subjects are planned, 25 per treatment group who are undergoing planned cataract extraction with posterior chamber intraocular lens implantation to evaluate the non-inferiority of Prolensa and Ilevro when administering a pulse dose in each arm 1 hour prior to surgery. Outcome measure is defined as SIOS score of zero (no cell or flare) on day 15 (day one being the day prior to surgery, and for 14 days following surgery
    Time Frame
    Day 1 through Day 15
    Secondary Outcome Measure Information:
    Title
    Adverse Events
    Description
    Adverse Events reported, elicited, and observed
    Time Frame
    42 Days
    Title
    Slit Lamp Biomicroscopy
    Description
    Slit Lamp Biomicroscopy evaluated and observed within normal limits
    Time Frame
    42 Days
    Title
    Intraocular Pressure
    Description
    Intraocular Pressure evaluated and observed within normal limits
    Time Frame
    42 Days
    Title
    Funduscopic Examination (Dilated)
    Description
    Funduscopic Examination (Dilated) evaluated and observed within normal limits
    Time Frame
    42 Days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Eligibility Criteria
    Inclusion Criteria: Are male or female at least 18 years of age who are scheduled for unilateral cataract surgery VIA phacoemulsification with posterior chamber intraocular lens implantation and for whom no other ophthalmic surgical procedures (e.g., relaxing incisions, iridectomy, conjunctival excisions, etc) are to be conducted during the cataract surgery. Agree not to have any other ocular surgical procedures in the study or fellow (non study) eye within 15 days prior to the initiation of dosing with the test article or throughout the duration of the study. Have a Best Corrected Visual Acuity of 20/200 or better in either eye. Are willing/able to return for all required study visits. Are willing/able to follow instructions from the study investigator and his/her staff. Are able to self administer test article (or have a caregiver available to instill all doses of test article). If a woman capable of becoming pregnant, agree to have urine pregnancy testing performed at screening (must be negative) and agree to use a medically acceptable form of birth control throughout the study duration and for at least one week prior to and after completion of the study. Women considered capable of becoming pregnant include all females who have experienced menarche and who have not experienced menopause (as defined by amenorrhea for greater than 12 consecutive months) or have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy). Have signed informed consent approved by Institutional Review Board or Independent Ethics Committee. Have IOP ≥ 5 mmHg and ≤ 22 mmHg (in study eye) without anti glaucoma therapy at the pre operative screening visit (if >22 mmHg, adjust following pachymetry) Exclusion Criteria: Have known hypersensitivity to bromfenac or nepafenac or to any component of the test article (including "procedural" medications such as anesthetic and/or fluorescein drops, dilating drops, etc.). Have a known hypersensitivity to salicylates (i.e., aspirin) or to other non steroidal anti inflammatory drugs (NSAIDs). Have intraocular inflammation (i.e., cells or flare in the anterior chamber as measured on slit lamp examination) in the study eye at the screening visit. Have a known blood dyscrasia or bone marrow suppression, a diagnosis of uncontrolled/unstable peptic ulcer disease, inflammatory bowel disease, or ulcerative colitis, or any uncontrolled/unstable pulmonary, cardiac, vascular, autoimmune, hepatic, renal, or central nervous system disease. Have used ocular, topical, or systemic NSAIDs or ocular, topical, or systemic gentamicin, or cyclosporine ophthalmic emulsion within 7 days prior to initiation of dosing with the test article or throughout the duration of the study. Have used any ocular prostaglandins within 30 days prior to initiation of dosing with the test article or throughout the duration of the study. Have active corneal pathology noted in the study eye at the screening visit. Active corneal pathology is defined as corneal pathology that is non stable, or greater than mild, or will compromise assessment of the safety or efficacy of treatment. Superficial punctate keratitis in the study eye is a criterion for exclusion. Have any extraocular/intraocular inflammation in the study eye noted at the screening visit (blepharitis allowed if mild only, and no concurrent conjunctivitis or lid erythema/edema) or ongoing, unresolved uveitis. Have used topical, ocular, inhaled or systemic steroids within 14 days prior to screening. Have had radial keratotomy, corneal transplant, or corneal refractive surgery in the study eye within the last two years. Have a history of abuse of alcohol/drugs within six months prior to the screening visit. Are pregnant or nursing/lactating. Have participated in any other study of an investigational drug or device within 30 days prior to randomization.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Steven M Silverstein, MD
    Organizational Affiliation
    Silverstein Eye Centers
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    De-identified individual participant data for all primary and secondary outcome measures will be made available
    IPD Sharing Time Frame
    To Be Determined
    Citations:
    PubMed Identifier
    31552543
    Citation
    Silverstein SM. Bromfenac Ophthalmic Solution 0.07% Versus Nepafenac Ophthalmic Suspension 0.3% for Post-Cataract Surgery Inflammation: A Pilot Study of Identical Dosing Regimens with Pre-Surgical "Pulse" Dose. Ophthalmol Ther. 2019 Dec;8(4):577-587. doi: 10.1007/s40123-019-00215-y. Epub 2019 Sep 24.
    Results Reference
    derived

    Learn more about this trial

    Study Title: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial

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