Ignite Creation Date:
2025-12-25 @ 4:05 AM
Ignite Modification Date:
2025-12-26 @ 3:01 AM
Study NCT ID:
NCT06658002
Status:
RECRUITING
Last Update Posted:
2025-10-06
First Post:
2024-10-23
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Fungal Ulcer Treatment Augmented With Natamycin and Cyclosporine A
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D003320', 'term': 'Corneal Ulcer'}], 'ancestors': [{'id': 'D015817', 'term': 'Eye Infections'}, {'id': 'D007239', 'term': 'Infections'}, {'id': 'D007634', 'term': 'Keratitis'}, {'id': 'D003316', 'term': 'Corneal Diseases'}, {'id': 'D005128', 'term': 'Eye Diseases'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D016572', 'term': 'Cyclosporine'}], 'ancestors': [{'id': 'D003524', 'term': 'Cyclosporins'}, {'id': 'D010456', 'term': 'Peptides, Cyclic'}, {'id': 'D047028', 'term': 'Macrocyclic Compounds'}, {'id': 'D011083', 'term': 'Polycyclic Compounds'}, {'id': 'D010455', 'term': 'Peptides'}, {'id': 'D000602', 'term': 'Amino Acids, Peptides, and Proteins'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'QUADRUPLE', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR'], 'maskingDescription': 'The treating and examining doctors and all participants will be masked to the identity of the medication in each group. The study drug will be labeled A, B ,C D, E, F with two letters to each treatment group. The only people who will not be masked is the pharmacist at Pondicherry who relabels the medications with the study drug code and maintains the master key of which drug belongs to which study label, the data analyst responsible for generating the randomization code, and a United States study coordinator who is responsible for relabeling protocol and training. The study coordinator at Aravind will not be informed of the master key but will be aware of the study drug allocation name as he/she will be dispensing study drug to the participant. The study coordinator at Aravind will review the drops with the patient each visit. The participants will be informed to not show the examining doctor any of the medications. The study doctors will not ask to see the study medications.'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'FACTORIAL', 'interventionModelDescription': 'This is a randomized controlled trial in which participants with smear or culture proven fungal keratitis are treated for a minimum of 48 hours with topical natamycin and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1% or CsA 2% or placebo for 4 weeks. In cases of bilateral fungal keratitis, if both eyes fit inclusion criteria, the eye with worse acuity will be randomized.\n\nThe primary outcome is Best Corrected Visual Acuity (BCVA) at 3 months.'}, 'enrollmentInfo': {'type': 'ESTIMATED', 'count': 150}}, 'statusModule': {'overallStatus': 'RECRUITING', 'startDateStruct': {'date': '2025-09-01', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-10', 'completionDateStruct': {'date': '2027-09-01', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-10-02', 'studyFirstSubmitDate': '2024-10-23', 'studyFirstSubmitQcDate': '2024-10-23', 'lastUpdatePostDateStruct': {'date': '2025-10-06', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2024-10-26', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2027-09-01', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Best Corrected Visual Acuity (BCVA)', 'timeFrame': '3 months (12 weeks)'}]}, 'oversightModule': {'isUsExport': False, 'oversightHasDmc': True, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Corneal Ulcer', 'Cyclosporine A', 'Fungal Keratitis', 'Fungal Corneal Ulcer'], 'conditions': ['Fungal Keratitis', 'Corneal Ulcer']}, 'referencesModule': {'references': [{'pmid': '34483271', 'type': 'BACKGROUND', 'citation': 'Chatterjee S, Agrawal D. Use of Topical Cyclosporine 0.1% in Therapeutic Penetrating Keratoplasty for Fungal Keratitis. Cornea. 2022 Sep 1;41(9):1116-1121. doi: 10.1097/ICO.0000000000002827. Epub 2021 Sep 3.'}, {'pmid': '26371985', 'type': 'BACKGROUND', 'citation': 'Kauss Hornecker M, Charles Weber S, Brandely Piat ML, Darrodes M, Jomaa K, Chast F. [Cyclosporine eye drops: A 4-year retrospective study (2009-2013)]. J Fr Ophtalmol. 2015 Oct;38(8):700-8. doi: 10.1016/j.jfo.2015.02.008. Epub 2015 Sep 11. French.'}, {'pmid': '10336034', 'type': 'BACKGROUND', 'citation': 'Bell NP, Karp CL, Alfonso EC, Schiffman J, Miller D. Effects of methylprednisolone and cyclosporine A on fungal growth in vitro. Cornea. 1999 May;18(3):306-13. doi: 10.1097/00003226-199905000-00012.'}, {'pmid': '11862086', 'type': 'BACKGROUND', 'citation': 'Perry HD, Doshi SJ, Donnenfeld ED, Bai GS. Topical cyclosporin A in the management of therapeutic keratoplasty for mycotic keratitis. Cornea. 2002 Mar;21(2):161-3. doi: 10.1097/00003226-200203000-00006.'}, {'pmid': '24722799', 'type': 'BACKGROUND', 'citation': 'Cordeiro RA, Macedo RB, Teixeira CEC, Marques FJF, Bandeira TJPG, Moreira JLB, Brilhante RSN, Rocha MFG, Sidrim JJC. The calcineurin inhibitor cyclosporin A exhibits synergism with antifungals against Candida parapsilosis species complex. J Med Microbiol. 2014 Jul;63(Pt 7):936-944. doi: 10.1099/jmm.0.073478-0. Epub 2014 Apr 10.'}, {'pmid': '21447377', 'type': 'BACKGROUND', 'citation': 'Survase SA, Kagliwal LD, Annapure US, Singhal RS. Cyclosporin A--a review on fermentative production, downstream processing and pharmacological applications. Biotechnol Adv. 2011 Jul-Aug;29(4):418-35. doi: 10.1016/j.biotechadv.2011.03.004. Epub 2011 Apr 5.'}]}, 'descriptionModule': {'briefSummary': 'The goal of this clinical trial is to learn if adjunctive topical Cyclosporine A eye drops combined with standard of care topical Natamycin treatment improves vision outcomes in patients with fungal keratitis.', 'detailedDescription': 'This is a randomized, masked, clinical trial of patients with documented fungal infections of the cornea. In this trial participants are treated with (standard of care) topical natamycin for a minimum of 48 hours and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1%, or CsA 2%, or placebo for 4 weeks. Natamycin will be continued until the corneal ulcer has resolved. The primary outcome of this pilot trial is best corrected visual acuity (BCVA) at 3 months. The specific aims of this trial are to:\n\n* to determine if early use of topical cyclosporine A is a beneficial adjuvant to natamycin in the treatment of mild to moderate fungal keratitis.\n* to determine if adjunctive 2% cyclosporine A demonstrates greater efficacy than 0.1% cyclosporine A in the treatment of fungal keratitis.\n* to determine which ulcer characteristics, predict the most benefit from the addition of early topical cyclosporine.\n\nIn this study the investigators will partner with their cornea colleagues at the Aravind Eye Hospital. This is because the incidence of fungal corneal ulcers is among the highest in the world in this location.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Inclusion is based on presenting acuity, not ulcer size.\n* Inclusion of 20/40 = 6/12 = 0.3 Log MAR and 20/400 = 3/60 = +1.3 Log MAR.\n* Smear or culture positive for fungal keratitis, any length.\n* Age 18 years.\n* Willing to participate in study.\n\nExclusion Criteria:\n\n* Co-infection with bacterial or viral keratitis.\n* Corneal perforation.\n* Requiring therapeutic keratoplasty for fungal keratitis.\n* Unwilling or unable to follow up (e.g., living too far from hospital).\n* Presenting acuity better than 20/40 = 6/12 = 0.3 Log MAR or worse than 20/400 = 3/60 = +1.3 Log MAR.\n* Subjects taking cyclosporine at any concentration on presentation.\n* Acuity worse than 20/200 = 6/60 = +1.0 Log MAR in unaffected eye.\n* Pregnant women.\n* Penetrating Keratoplasty.\n* Presents with a 0-7 day history of topical steroid.'}, 'identificationModule': {'nctId': 'NCT06658002', 'acronym': 'FANCY', 'briefTitle': 'Fungal Ulcer Treatment Augmented With Natamycin and Cyclosporine A', 'organization': {'class': 'OTHER', 'fullName': 'University of California, San Francisco'}, 'officialTitle': 'Fungal Ulcer Treatment Augmented With Natamycin and Cyclosporine A', 'orgStudyIdInfo': {'id': '24-41971'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Cyclosporine A (CsA) 0.1%', 'description': 'After one week of hourly natamycin eye drops the participants in this arm will use this drop four times a day for one month then twice a day for one month.', 'interventionNames': ['Drug: Cyclosporine A']}, {'type': 'EXPERIMENTAL', 'label': 'Cyclosporine A (CsA) 2%', 'description': 'After one week of hourly natamycin eye drops the participants in this arm will use this drop four times a day for one month then twice a day for one month.', 'interventionNames': ['Drug: Cyclosporine A']}, {'type': 'PLACEBO_COMPARATOR', 'label': 'Placebo', 'description': 'After one week of hourly natamycin eye drops the participants in this arm will use this drop four times a day for one month then twice a day for one month.', 'interventionNames': ['Other: Placebo Comparator: Placebo']}], 'interventions': [{'name': 'Cyclosporine A', 'type': 'DRUG', 'description': 'Participants with smear or culture proven fungal keratitis are treated for a minimum of 48 hours with topical natamycin and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1%, 2% or placebo for 4 weeks. Natamycin is continued until the ulcer has healed.', 'armGroupLabels': ['Cyclosporine A (CsA) 0.1%', 'Cyclosporine A (CsA) 2%']}, {'name': 'Placebo Comparator: Placebo', 'type': 'OTHER', 'description': 'Participants with smear or culture proven fungal keratitis are treated for a minimum of 48 hours with topical natamycin and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1%, 2% or placebo for 4 weeks. Natamycin is continued until the ulcer has healed.', 'armGroupLabels': ['Placebo']}]}, 'contactsLocationsModule': {'locations': [{'zip': '94143', 'city': 'San Francisco', 'state': 'California', 'status': 'NOT_YET_RECRUITING', 'country': 'United States', 'contacts': [{'name': 'Gerami D Seitzman, MD', 'role': 'CONTACT', 'email': 'gerami.seitzman@ucsf.edu', 'phone': '415-476-1442'}, {'name': 'Brianna K Colado, BA', 'role': 'CONTACT', 'email': 'brianna.colado@ucsf.edu', 'phone': '5593492629'}], 'facility': 'University of California, San Farncisco', 'geoPoint': {'lat': 37.77493, 'lon': -122.41942}}, {'zip': '605 007', 'city': 'Pondicherry', 'state': 'Tamil Nadu', 'status': 'RECRUITING', 'country': 'India', 'contacts': [{'name': 'Josephine Christy, MD', 'role': 'CONTACT', 'email': 'josephine@aravind.org'}, {'name': 'Kunal Mandlik, MD', 'role': 'CONTACT'}], 'facility': 'Aravind Eye Institute'}], 'centralContacts': [{'name': 'Gerami D Seitzman, MD', 'role': 'CONTACT', 'email': 'gerami.seitzman@ucsf.edu', 'phone': '4154761442'}, {'name': 'Thomas Lietman, MD', 'role': 'CONTACT', 'email': 'tom.lietman@ucsf.edu'}], 'overallOfficials': [{'name': 'Gerami D Seitzman, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'UCSF Proctor Foundation'}]}, 'ipdSharingStatementModule': {'ipdSharing': 'NO'}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'University of California, San Francisco', 'class': 'OTHER'}, 'collaborators': [{'name': 'Aravind Eye Hospitals, India', 'class': 'OTHER'}, {'name': 'Aravind Eye Care System', 'class': 'OTHER'}], 'responsibleParty': {'type': 'SPONSOR'}}}}