Optic Neuritis
Conditions
Keywords
Optic neuritis, Multiple Sclerosis, Clinically isolated syndrome, Erythropoietin
Brief summary
This clinical trial aims at preventing visual dysfunction and optic nerve degeneration associated with autoimmune optic neuritis by systemic i.v. administration of 33.000 IU erythropoietin over 3 days. The primary objective is to determine the efficacy of erythropoietin compared to placebo given as add-on to methylprednisolone as assessed by measurements of retinal nerve fibre layer thickness and low contrast visual acuity 6 months after acute optic neuritis.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
Patients eligible for inclusion in this trial must meet all of the following criteria: 1. Written informed consent obtained according to international guidelines and local laws 2. Male and female patients aged ≥ 18 to ≤ 50 years 3. Patients with ON 4. First symptoms of ON ≤ 10 days prior to the first administration of investigational product 5. High contrast visual acuity (HCVA) of ≤ 0.5 (decimal system) 6. Adequate OCT measurements available Patients eligible for this trial must not meet any of the following criteria: 1. Patient without legal capacity who is unable to understand the nature, significance and consequences of the trial 2. Simultaneous participation in another interventional trial which could interfere with this trial and/or participation in a clinical trial within the last 3 months before enrolment in this trial 3. Refractive anomalies: Hyperopia \> 5 dpt, myopia \< -7 dpt, astigmatism \> 3 dpt 4. Media opacity 5. Severe papillitis 6. Previous ON 7. Any other optic nerve and retinal disease 8. Pre-existing MS or any other neurological disease 9. Congenital diseases: * thrombophilia * phenylketonuria 10. Acquired diseases: * autoimmune diseases, * cardiovascular diseases, * diabetes mellitus, * uncontrolled hypertension (with blood pressure \> 140 / 90 mm Hg (cf. chapter 7.7.5)), * any malignancy, * epilepsy, * known tuberculosis with ongoing or unknown activity, * acute gastrointestinal ulceration within the last 3 months prior to randomisation, * acute viral, bacterial or fungal infection, * known infection with Human Immunodeficiency Virus (HIV), Hepatitis B Virus, or Hepatitis C Virus, * history of colitis ulcerosa, diverticulitis, or acute enteroanastomosis, * known osteoporosis, * history of thromboembolic events, * elevated haemoglobin level (\>17 g/dl in men or \>15 g/dl in women) * polycythaemia * any other significant illness potentially interfering with any trial assessment or trial treatment 11. Performing semi-professional or professional sporting activities or physical training 12. Pre-treatment with corticosteroids in the last 30 days prior to the onset of optic neuritis 13. Pre-treatment with EPO 14. Known or persistent abuse of medication, drugs or alcohol 15. Active immunization within 2 weeks prior to randomisation 16. Significant surgery within 4 weeks prior to randomisation 17. Blood donation or bloodletting within 4 weeks prior to screening 18. Pre-treatment with immunosuppressive or immunomodulatory agents 19. Persons who are in a relationship of dependence/employment with the sponsor or the investigator This section concerns only female patients who are able to have a child: 20. Current or planned pregnancy; nursing period within 3 months from investigational product administration 21. Unwillingness to use one of the following safe combination methods of contraception within 3 months from investigational product administration to achieve a PEARL index of \<1: female condom, diaphragm or coil, each used in combination with a spermicide; hormonal intra-uterine device or hormonal contraception in combination with a mechanical method of contraception
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Global retinal nerve fibre layer thickness (RNFLT-G) | 6 months | Determination of the efficacy of erythropoietin compared to placebo given as add-on to methylprednisolone (standard of care) as assessed by measurement of global retinal nerve fibre layer thickness (RNFLT-G) in the affected eye 6 months after randomisation. |
| Low contrast visual acuity (LCVA) | 6 months | Determination of the efficacy of erythropoietin compared to placebo given as add-on to methylprednisolone (standard of care) as assessed by measurement of low contrast visual acuity (LCVA) in the affected eye 6 months after randomisation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Retinal nerve fibre layer thickness in the temporal quadrant | 6 months | — |
| Total macular volume | 6 months | — |
| Visual acuity | 6 months | — |
| Contrast sensitivity | 6 months | — |
| Absolute values of the global retinal nerve fibre layer thickness | 6 months | — |
| Latency [ms] and amplitude [µV] of visual evoked potentials (VEP) | 6 months | — |
| Expanded Disability Status Scale (EDSS) score | 6 months | — |
| Quality of life | 6 months | Determined by NEI-VFQ-25 |
| Safety | Screening until end of study | Assessment of AEs / SAEs |
| Mean visual field defect | 6 months | — |
| Retinal nerve fibre layer thickness in the papillomacular bundle | 6 months | — |
Countries
Germany