Ignite Creation Date:
2024-05-05 @ 11:19 AM
Last Modification Date:
2024-10-26 @ 9:02 AM
Study NCT ID:
NCT00001213
Status:
COMPLETED
Last Update Posted:
2014-07-22
First Post:
1999-11-03
Brief Title:
Cysteamine Eye Drops to Treat Corneal Crystals in Cystinosis
Sponsor:
National Eye Institute NEI
Organization:
National Institutes of Health Clinical Center CC
Study Overview
Official Title:
Trial of Topical Cysteamine in the Treatment of Corneal Cystine Crystal Accumulation in Cystinosis
Status:
COMPLETED
Status Verified Date:
2014-06
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Cystinosis is an inherited disease that results in poor growth and kidney disease among other things The damage to the kidneys and other organs is thought to be due to accumulation of cystine inside the cells of various body tissues This chemical also accumulates in the cornea-the covering of the eye over the pupil and iris After 10 to 20 years the corneas of some patients become so packed with crystals that the surfaces may become irregular occasionally causing small painful breaks
Patients enrolled in a NIH study on cystinosis are receiving the drug cysteamine Taken by mouth this drug reduces cystine in some tissues but not in the cornea This study began in 1986 to test whether cysteamine eye drops could prevent or reduce corneal cystine crystals in these patients The drops have been very effective in removing crystals and reducing pain in patients who take the medication as directed Patients who do not take the medication as prescribed do not benefit
After the effectiveness of the drops was proven the main purpose was modified to continue to evaluate the long-term safety and effectiveness of cysteamine eye drops for treating cystine crystals in the corneas of patients with cystinosis until the drops are approved by the Food and Drug Administration FDA When the New Drug Application NDA for the Sigma-Tau standard formulation is granted this protocol will be terminated
Patients enrolled in a NIH study on cystinosis are receiving the drug cysteamine Taken by mouth this drug reduces cystine in some tissues but not in the cornea This study began in 1986 to test whether cysteamine eye drops could prevent or reduce corneal cystine crystals in these patients The drops have been very effective in removing crystals and reducing pain in patients who take the medication as directed Patients who do not take the medication as prescribed do not benefit
After the effectiveness of the drops was proven the main purpose was modified to continue to evaluate the long-term safety and effectiveness of cysteamine eye drops for treating cystine crystals in the corneas of patients with cystinosis until the drops are approved by the Food and Drug Administration FDA When the New Drug Application NDA for the Sigma-Tau standard formulation is granted this protocol will be terminated
Detailed Description:
Protocol 86-EI-0062 began as a randomized double-masked placebo controlled study to evaluate the efficacy and safety of 05 topical cysteamine but was subsequently amended as a natural history protocol Additional protocols conducted at the National Eye Institute NEI at the National Institutes of Health NIH began after this protocol and tested various formulations of cysteamine topical solution for efficacy and safety in patients with cystinosis Subjects from these NIH protocols testing various formulations were ultimately transferred to this natural history protocol for open-label treatment once it was established that the formulation within this study was the most effective All subjects enrolled in this protocol received the most effective cysteamine topical solution formulation in both eyes The control was defined as the natural course of corneal crystal accumulation in patients with cystinosis The efficacy data were obtained from all of the studies conducted at NIH evaluating various cysteamine ophthalmic solution formulations from 1986 until 2005 The safety data were collected from 1986 until the termination of this protocol in July 2013
OBJECTIVE
The free thiol cysteamine depletes cystinotic leukocytes and other cells of cystine whose accumulation is considered the cause of organ damage in cystinosis This organ damage involves most tissues of the body Cysteamine therapy improved growth and stabilized renal function in pre-renal transplant cystinosis without substantial toxicity but there was no noticeable effect on cystine crystal accumulation in the cornea most likely because of inadequate local cysteamine concentration in the cornea Previous studies have shown the safety of cysteamine 05 topical solution in benzalkonium chloride and its efficacy in resolving the cystine corneal crystals The main purpose of this protocol is to maintain topical cysteamine treatment in patients with nephropathic cystinosis until the drops are approved by the FDA When the NDA for the Sigma-Tau standard formulation is granted the present protocol 86-EI-0062 will be terminated
STUDY POPULATION
Up to 350 adults and children over two years old who have a confirmed diagnosis of cystinosis will be enrolled
STUDY DESIGN
This is an open label treatment protocol Eligible subjects will receive drops of cysteamine 05 topical solution in benzalkonium chloride hourly while awake in both eyes They will undergo an eye examination at their baseline visit They will take cysteamine eye drops in both eyes every hour during waking hours They will return to the NIH Clinical Center for a follow-up safety eye examination one year after the baseline visit and then every two years thereafter until the drug is available commercially
OUTCOME MEASURES
The initial pre-specified primary outcome measure was the reduction of cystine corneal crystals The post-hoc primary outcome measure after the protocol was modified was the collection of safety data
OBJECTIVE
The free thiol cysteamine depletes cystinotic leukocytes and other cells of cystine whose accumulation is considered the cause of organ damage in cystinosis This organ damage involves most tissues of the body Cysteamine therapy improved growth and stabilized renal function in pre-renal transplant cystinosis without substantial toxicity but there was no noticeable effect on cystine crystal accumulation in the cornea most likely because of inadequate local cysteamine concentration in the cornea Previous studies have shown the safety of cysteamine 05 topical solution in benzalkonium chloride and its efficacy in resolving the cystine corneal crystals The main purpose of this protocol is to maintain topical cysteamine treatment in patients with nephropathic cystinosis until the drops are approved by the FDA When the NDA for the Sigma-Tau standard formulation is granted the present protocol 86-EI-0062 will be terminated
STUDY POPULATION
Up to 350 adults and children over two years old who have a confirmed diagnosis of cystinosis will be enrolled
STUDY DESIGN
This is an open label treatment protocol Eligible subjects will receive drops of cysteamine 05 topical solution in benzalkonium chloride hourly while awake in both eyes They will undergo an eye examination at their baseline visit They will take cysteamine eye drops in both eyes every hour during waking hours They will return to the NIH Clinical Center for a follow-up safety eye examination one year after the baseline visit and then every two years thereafter until the drug is available commercially
OUTCOME MEASURES
The initial pre-specified primary outcome measure was the reduction of cystine corneal crystals The post-hoc primary outcome measure after the protocol was modified was the collection of safety data
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 86-EI-0062 | None | None | None |