Anterior Uveitis
Conditions
Keywords
Iontophoresis, Non-Infectious Anterior Segment Uveitis, Ophthalmology
Brief summary
The purpose of this study is to evaluate the safety and efficacy of ocular iontophoresis with dexamethasone phosphate ophthalmic solution EGP-437 using the EyeGate® II Drug Delivery System (EGDS) compared to prednisolone acetate ophthalmic suspension (1%) in patients with non-infectious anterior segment uveitis.
Detailed description
Anterior uveitis is a disorder of the eye associated with intraocular inflammation of the anterior portion of the uvea, particularly the iris and/or ciliary body. It is distinct from other iterations of uveitis such as posterior, diffuse and intermediate uveitis although it is the most common form of uveitis and accounts for approximately 75% of cases. In a Phase 1/2 study (EGP-437-001), the delivery of EGP-437 (40 mg/mL dexamethasone phosphate solution) at four different iontophoresis dose levels was studied in 40 subjects with non-infectious anterior segment uveitis. The study demonstrated that a single EGP-437 treatment: lowered anterior chamber cell (ACC) scores in the majority of patients without requiring additional treatment; produced low short-term systemic exposure to dexamethasone and dexamethasone phosphate; and produced the most beneficial effects in the 1.6 and 4.8 mA-min dose groups; and caused mainly minor AEs and no non-ocular systemic corticosteroid mediated effects were observed. The Phase 3 study is intended to confirm and extend the results from the Phase 2 study. The study is designed to assess the safety and efficacy Ocular Iontophoresis with EGP-437 4.0 mA-min at 1.5 mA and accompanying placebo eyedrops in comparison to Ocular Iontophoresis with sodium citrate buffer solution 4.0 mA-min at 1.5 mA and accompanying prednisolone acetate (1%) eyedrops for the treatment of non-infectious anterior segment uveitis.
Interventions
DRUG40 mg/mL Dexamethasone phosphate ophthalmic solution
Transscleral iontophoresis delivery of EGP-437 (dexamethasone phosphate formulated for ocular iontophoresis)
DRUGPrednisolone Acetate (1%) Eyedrops
Prednisolone acetate (1%) eyedrops
DRUG100 mM sodium citrate buffer solution
Transscleral iontophoresis delivery of 100 mM Sodium citrate buffer solution
DRUGPlacebo Eyedrops
Placebo Eyedrops
Sponsors
Eyegate Pharmaceuticals, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
12 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Male or female, age 12 to 85 years with a diagnosis of non-infectious anterior segment uveitis defined as an anterior chamber cell count of ≥ 11 cells * Receive, understand, and sign a copy of the written informed consent form * Be able to return for all study visits and willing to comply with all study-related instructions
Exclusion criteria
* Have uveitis of infectious etiology * Have active intermediate or posterior uveitis * Known positive HLA-B27 with a severe (4+) fibrinoid reaction * Have previous anterior segment uveitis episode in the study eye ≤ 4 weeks prior to baseline visit * Have used topical corticosteroid treatment in the study eye ≤ 48 hours prior to baseline visit * Have used oral corticosteroid within the past 14 days prior to baseline * Have received intravitreal or sub-Tenon corticosteroid treatment in the study eye within the past 6 months prior to baseline visit * Currently using prescribed nonsteroidal anti-inflammatory agents (i.e., use of over-the-counter dosages is allowable) or prescribed immunosuppressive agents, unless the dose has been stable for the last six weeks and no change in dosing is anticipated for the duration of the study * Have IOP ≥ 25 mmHg at baseline, a history of glaucoma, or require ocular anti-hypertensive medications in the study eye * Be known steroid intraocular pressure responders in either eye * Have open wounds/skin disease on the forehead area where the iontophoresis return electrode will be applied * Have severe lesions of the eyelids or the ocular surface impeding the application of the iontophoresis applicator * Have known allergy to dexamethasone or dexamethasone phosphate or any medication to be used in this study * Have history or diagnosis of ocular herpes, corneal lesion of suspected herpetic origin, or Behçet's disease * Have monocular or BCVA worse than 20/80 in the fellow eye * Have optic neuritis of any origin * Have clinically suspected or confirmed central nervous system or ocular lymphoma * Planning to undergo elective ocular surgery during the study * Have active hyphema, pars planitis, choroiditis, clinically significant macular edema, toxoplasmosis scar, or vitreous hemorrhage * Have severe/serious ocular pathology or medical condition which may preclude study completion * Have pacemaker and/or any other electrical sensitive support system * Be pregnant or lactating female, or female of childbearing age and using inadequate birth control method * Have participated in another investigational device or drug study within 30 days of baseline visit * Have significant Fuch's Corneal Dystrophy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients with with ACC count of zero at Day 14 | At Day 14 (plus or minus two days) following the first study treatment | Proportion of patients with ACC count of zero at Day 14 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients with ACC count of zero at Day 28 | At Day 28 (plus or minus two days) following the first study treatment | Proportion of patients with ACC count of zero at Day 28 |
| Proportion of patients with ACC count of zero at Day 56 | At Day 56 (plus or minus seven days) following the first study treatment | The proportion of patients with ACC count of zero at Day 56 |
| Mean change from baseline in ACC count and score at Day 7 | At Day 7 (plus or minus two days) following the first study treatment | Mean change from baseline in ACC count and score at Day 7 |
| Mean change from baseline in ACC count and score at Day 14 | At Day 14 (plus or minus two days) following the first study treatment | Mean change from baseline in ACC count and score at Day 14 |
| Mean change from baseline in ACC count and score at Day 28 | At Day 28 (plus or minus two days) following the first study treatment | Mean change from baseline in ACC count and score at Day 28 |
| Proportion of patients with ACC count of zero at Day 7 | At Day 7 (plus or minus two days) following the first study treatment | Proportion of patients with ACC count of zero at Day 7 |
| Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 7 | At Day 7 (plus or minus two days) following the first study treatment | Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 7 |
| Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 14 | At Day 14 (plus or minus two days) following the first study treatment | Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 14 |
| Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 28 | At Day 28 (plus or minus two days) following the first study treatment | Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 28 |
| Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 56 | At Day 56 (plus or minus seven days) following the first study treatment | Proportion of subjects with ACC count and score reduction from baseline of one or more units at Day 56 |
| Time to anterior chamber cell count and score of zero | Up to 56 days (plus or minus seven days) following the first study treatment | Time to anterior chamber cell count and score of zero |
| Mean change from baseline in ACC count and score at Day 56 | At Day 56 (plus or minus seven days) following the first study treatment | Mean change from baseline in ACC count and score at Day 56 |
Countries
United States
Outcome results
None listed