DHA and X-Linked Retinitis Pigmentosa

NCT ID: NCT00100230

Last Updated: 2015-03-17

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-09-30

Study Completion Date

2014-08-31

Brief Summary

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Purpose:

Retinitis pigmentosa (RP) is characterized by progressive loss of visual function due to specific genetic mutations. This trial is focused on patients with one of the most severe forms of the disease, X-linked inherited RP (XLRP). This disease is characterized by early onset (typically loss of night vision as a child) followed by loss of peripheral vision as a teenager and young adult. There is no male-to-male transmission of the disease in the family.

There is no cure for RP and treatment options are limited. Two clinical trials have not found a benefit from nutritional supplementation with the long-chain polyunsaturated fatty acid, docosahexaenoic acid (DHA), at low daily doses although there is evidence that it slows disease progression in certain instances. In this clinical trial, we propose that a high dose nutritional DHA supplement will slow the loss of visual function and preserve usable vision in patients with XLRP.

This study is a 4-year placebo-controlled randomized clinical trial meaning that patients have a 50-50 chance of receiving placebo or experimental treatment. A total of 66 patients will be enrolled; 33 will receive placebo and 33 will receive the treatment. Entry criteria include diagnosis of XLRP by an ophthalmologist, age 7 to 32 years, male, sufficient visual function such that disease progression can be followed for the entire duration of the trial, and a willingness to visit the testing site (Dallas, TX) once a year.

Annual visual function testing includes ETDRS visual acuity, full-field and multifocal electroretinography (ERG), static peripheral visual fields, and fundus photography. Cone ERG function is the primary outcome measure.

Funding Source - FDA, Foundation Fighting Blindness, DSM Nutritionals

Detailed Description

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Location \& Contact Information:

Retina Foundation of the Southwest, 9600 N. Central Expressway, Suite 200, Dallas, TX 75231 Contact: Dr. D. Hoffman ([email protected]) or Dr. D. Birch ([email protected]).

Conditions

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Retinitis Pigmentosa X-linked Genetic Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1.

Oral Docosahexaenoic acid, dosage based on body weight

Group Type EXPERIMENTAL

docosahexaenoic acid OR corn/soy oil placebo

Intervention Type DRUG

daily intake of DHA based on body weight or corn/soy oil placebo(oil not containing DHA; 4 year trial

2

corn/soy oil placebo; oil not containing DHA...dosage based on body weight

Group Type PLACEBO_COMPARATOR

docosahexaenoic acid OR corn/soy oil placebo

Intervention Type DRUG

daily intake of DHA based on body weight or corn/soy oil placebo(oil not containing DHA; 4 year trial

Interventions

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docosahexaenoic acid OR corn/soy oil placebo

daily intake of DHA based on body weight or corn/soy oil placebo(oil not containing DHA; 4 year trial

Intervention Type DRUG

Other Intervention Names

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DHA; omega-3 fatty acid OR RANDOMIZED TO corn/soy oil placebo

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of RP by a retinal specialist
* Clinical diagnosis consistent with X-linked inheritance
* Enrolling minors and young adults (early onset of X-linked disease; ages 7 to 32)
* Measurable cone ERG responses --patients with less than 0.64 microvolt response to 31-Hz flicker will be excluded as they are more likely to become undetectable during the study
* Both eyes must meet entry criteria as both will be tested (i.e., no cataracts requiring surgery or retinal detachments).
* Media clarity sufficient for fundus photography
* Able to return to study site at yearly intervals
* Willing to supply blood samples at 6-month intervals
* Judiciously take the placebo or DHA supplement for the 4-year study duration
* Patient/parent/guardian understands and signs consent form.

Exclusion Criteria

* Excessive fish consumption (e.g., cold water fish such as salmon, tuna, sardines) and/or fish oil supplementation (or other oil containing DHA)
* Baseline RBC-DHA levels showing evidence of supplementation (a typical level of RBC-DHA in normals is about 3.8%)
* Chronic metabolic disease that may interfere with fatty acid metabolism or require anti-coagulant medication

No ethnic or racial groups will be excluded.
Minimum Eligible Age

7 Years

Maximum Eligible Age

32 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Foundation Fighting Blindness

OTHER

Sponsor Role collaborator

DSM Nutritional Products, Inc.

INDUSTRY

Sponsor Role collaborator

Retina Foundation of the Southwest

OTHER

Sponsor Role lead

Responsible Party

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Dennis Hoffman

Senior Research Scientist (Retina Foundation of the Southwest)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dennis R. Hoffman, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Retina Foundation of the Southwest

Locations

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Retina Foundation of the Southwest

Dallas, Texas, United States

Site Status

Countries

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United States

References

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Hoffman DR, Hughbanks-Wheaton DK, Pearson NS, Fish GE, Spencer R, Takacs A, Klein M, Locke KG, Birch DG. Four-year placebo-controlled trial of docosahexaenoic acid in X-linked retinitis pigmentosa (DHAX trial): a randomized clinical trial. JAMA Ophthalmol. 2014 Jul;132(7):866-73. doi: 10.1001/jamaophthalmol.2014.1634.

Reference Type RESULT
PMID: 24805262 (View on PubMed)

Hughbanks-Wheaton DK, Birch DG, Fish GE, Spencer R, Pearson NS, Takacs A, Hoffman DR. Safety assessment of docosahexaenoic acid in X-linked retinitis pigmentosa: the 4-year DHAX trial. Invest Ophthalmol Vis Sci. 2014 Jul 11;55(8):4958-66. doi: 10.1167/iovs.14-14437.

Reference Type RESULT
PMID: 25015354 (View on PubMed)

Hoffman DR, Hughbanks-Wheaton DK, Spencer R, Fish GE, Pearson NS, Wang YZ, Klein M, Takacs A, Locke KG, Birch DG. Docosahexaenoic Acid Slows Visual Field Progression in X-Linked Retinitis Pigmentosa: Ancillary Outcomes of the DHAX Trial. Invest Ophthalmol Vis Sci. 2015 Oct;56(11):6646-53. doi: 10.1167/iovs.15-17786.

Reference Type DERIVED
PMID: 26469750 (View on PubMed)

Cai CX, Locke KG, Ramachandran R, Birch DG, Hood DC. A comparison of progressive loss of the ellipsoid zone (EZ) band in autosomal dominant and x-linked retinitis pigmentosa. Invest Ophthalmol Vis Sci. 2014 Oct 23;55(11):7417-22. doi: 10.1167/iovs.14-15013.

Reference Type DERIVED
PMID: 25342618 (View on PubMed)

Birch DG, Locke KG, Wen Y, Locke KI, Hoffman DR, Hood DC. Spectral-domain optical coherence tomography measures of outer segment layer progression in patients with X-linked retinitis pigmentosa. JAMA Ophthalmol. 2013 Sep;131(9):1143-50. doi: 10.1001/jamaophthalmol.2013.4160.

Reference Type DERIVED
PMID: 23828615 (View on PubMed)

Related Links

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http://www.retinafoundation.org

website for Retina Foundation of the Southwest

Other Identifiers

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FD-R-002543

Identifier Type: -

Identifier Source: secondary_id

5R01FD002543

Identifier Type: FDA

Identifier Source: secondary_id

View Link

C-TX02-0704-0274

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2543

Identifier Type: -

Identifier Source: org_study_id

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