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Completed

NCT Number: NCT03992482

IVIG-eye Drops Treatment for Dry Eye Disease

The main objective of this study is to establish whether patients with Dry Eye Disease are able to safely tolerate receiving Intravenous Immunoglobulin (IVIG) eye drops two times a day for eight weeks (primary 'safety and tolerability' objective). The exploratory objective is to investigate the preliminary efficacy of the use of IVIG eye drops in treating Dry Eye Disease (exploratory efficacy objective) to estimate the effectiveness of the trial intervention and collecting data to inform the design of a future definitive trial.

This will be a Randomized controlled trial, in which a total of 28 subjects will be enrolled at 1 clinical site. Subjects will be randomly assigned to one of two groups (#1, #2), with 14 subjects per group. One group will be given placebo (Normal saline eye drops) and the other group will be given eye drops containing the study drug (IVIG).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

Illinois Eye and Ear Infirmary

Chicago, Illinois, 60612, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Sign and date the informed consent form approved by the Institutional Review Board (IRB)
  • ≥ 18 years of age
  • Demonstrate at least any 2 of the following signs in the same eye or a sign and symptom.
  • Conjunctival staining present ≥ 1 (out of possible score of 6 per eye)
  • Corneal staining present ≥ 2 (out of a possible score of 15 per eye)
  • Tear film break up time (TFBUT) ≤ 7 seconds
  • Schirmer's test ≥ 0 to ≤ 9 mm/5min
  • Superior Limbic Keratoconjunctivitis (SLK) pattern staining ≥ 1
  • Meiboscale grade ≥ 2
  • Validated Bulbar Redness ≥ 40
  • Demonstrate symptoms of dry eye disease Ocular Surface Disease Index (OSDI) score of at least ≥ 13.
  • Demonstrate Symptom Intensity Assessment of ≥ 3.
  • Patient reported dry eye-related ocular symptoms for at least 6 months before the Screening Visit and use or desire to use artificial tears on average 2 times per day in the 2 weeks preceding the screening visit
  • Intraocular pressure (IOP) ≥ 5 mmHg and ≤ 22 mmHg in each eye
  • Women of child-bearing potential must agree to use a reliable method of contraception during study participation and must demonstrate a negative pregnancy test at the Screening Visit
  • Be willing/able to return for all study visits and to follow instructions from the study investigator and his/her staff
  • Ocular Surface Wash Anti-Citrullinated Protein Antibody (ACPA) value of > 4.4 units in either eye at any time in the past.

Exclusion criteria

  • Allergic to IVIG or any similar products, or excipients of IVIG eye drops 4 mg/ml.
  • Use of contact lenses within the last 2-weeks prior to the baseline Visit.
  • Use of Allogenic serum or plasma eye drops within the last 2-weeks prior to the baseline Visit.
  • Unwilling to commit to no use of contact lenses for the duration of the study.
  • Pregnant or nursing/lactating
  • Participation in a study of an investigational drug or device within the 30 days preceding the Screening Visit
  • Current diagnosis of any of the following ocular conditions:

i) Acute allergic conjunctivitis ii) Active infection (e.g. bacterial, viral, protozoan or fungal infection of the cornea, conjunctiva, lacrimal gland, lacrimal sac or eyelids) iii) Active intraocular inflammation (e.g., retinitis, choroiditis, uveitis)

  • A cognitive or psychiatric deficit that precludes informed consent or ability to perform
  • Vulnerable populations, such as neonates, pregnant women, children, prisoners, institutionalized individuals, or others who may be considered vulnerable populations.
  • Have active drug/alcohol dependence or abuse.
  • The corneal epithelial defect is larger than 1 mm2 in either eye.
  • Active ocular infection or ocular allergies.

Treatment and study plan

Intravenous Immune Globulin (IVIG)

Drug

Intravenous Immunoglobulin (IVIG), 4 mg/ml (0.4%) eye drops two times a day for eight weeks

Placebo

Drug

Normal Saline Eye Drops (0.9% NaCl) two times a day for eight weeks

Primary outcomes

  1. Tolerability: The Primary Tolerability Endpoint is the Test Substance Tolerance (Visual Analog Scale) at 8 Weeks (56 Days)

    Time frame: 8 Weeks

    Subjects will assess their tolerance to the administration of the test medication (placebo/ study drug), utilizing a Visual Analog Scale (VAS). The VAS is a 100 mm horizontal line with verbal descriptors at either end. Subjects will place a single slash mark across the horizontal line between the end labeled "completely intolerable" (0 mm) and "easily tolerable" (100mm). The VAS ratings will be completed after administration of the test medication on Day 1 (post-dose), week 4 and week 8.

Other outcomes

  1. The Change in the Ocular Surface Disease Index (OSDI) Which is a Patient's Subjective Rating Scale

    Time frame: Between baseline and at 8 weeks of treatment

    Ocular Surface Disease Index (OSDI), a 12-item questionnaire, assesses symptom of ocular irritation in dry eye disease (DED) and how it affects functioning related to vision in the past week. It has 3 subscales: ocular symptoms, vision-related function, and environmental triggers. Patients rate their responses on 0 to 4 scale with 0 being "none of the time" and 4 being "all of the time." OSDI score range from 0-100 with score 0-12 being normal, 13-22 being mild DED, 23-32 being moderate DED, and >33 being severe DED. OSDI=[(sum of scores for questions answered)×100]/[(total questions answered)×4]

  2. Change in Corneal Staining Score as Measured by Lissamine Dye Staining

    Time frame: Between baseline and at 8 weeks of treatment

    Corneal staining score as measured by Lissamine Green dye staining using National Eye Institute (NEI) grading scale. Dye was applied to each eye and a slit lamp was used to observe corneal staining. NEI scale relies on a chart that divides the cornea into 5 sections and assigns a value from 0 (absent) to 3 (severe) to each section, based on the density of punctate staining, final staining score being the sum of individual section scores with a range of 0 (minimum) -15 (maximum) points. Complete corneal staining clearance with Lissamine dye defined as a score of 0 indicating the best outcome.

Sponsors and collaborators

Lead sponsor

Sandeep Jain, MD

Other

Registry information

Official study title

A Phase I/II Randomized, Placebo-controlled, Double-Blind, Single-Center, Tolerability and Preliminary Efficacy Clinical Trial of Intravenous Immunoglobulin (IVIG) Eye Drops in Patients With Dry Eye Disease

Important dates

Study start
2019
Primary completion
2019
Study completion
2019
First posted
Jun 20, 2019
Registry last updated
Apr 10, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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