Use of Simvastatin as a Steroid Sparing Agent for Uveitis Patients

NCT ID: NCT02252328

Last Updated: 2017-10-26

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-09-30
• Study Completion Date: 2019-08-31

Brief Summary

The trial will compare the effect on disease control and immunosuppression treatment of adding simvastatin 80mg once daily, over a follow-up and treatment period of 2 years. Patients will be randomised in a 1:1 fashion to standard treatment with placebo or standard treatment with the addition of simvastatin (80mg daily). They will be followed at 3 months intervals for 2 years with a primary end point of mean reduction in corticosteroid dosage at the 12 month follow-up visit.

Detailed Description

This is a non-commercial trial to explore the effect of simvastatin 80mg od on the dose of corticosteroids and immunosuppression in patients with sight-threatening uveitis.

In order to detect a clinical effect the study is designed as a double blinded, parallel group, placebo-controlled, randomised trial. Double blinding will be achieved through the use of a placebo as well as a masked clinical assessor.

Based on the reported effect of simvastatin on brain atrophy among multi[le sclerosis patients after 12 months treatment, patients will receive treatment or placebo and will be treated and followed up for 24 months.

Patients randomised to simvastatin will receive a dose of 80mg od. There will be no dose escalation.

Patients will be reviewed every 3 months and will undergo a complete ophthalmic examination with treatment adjustment accordingly.

Conditions

Uveitis

Keywords

Uveitis; Simvastatin; Visual acuity; Corticosteroids; Immunosuppression

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Simvastatine

Group of patients receiving simvastatin 80mg once daily in addition to standard care

Group Type: EXPERIMENTAL

Simvastatin

Intervention Type: DRUG

Simvastatin 80mg once daily

Placebo

Group of patients receiving placebo once daily in addition to standard care

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

Placebo tablets once daily

Interventions

Simvastatin

Simvastatin 80mg once daily

Intervention Type: DRUG

Placebo

Placebo tablets once daily

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Patients must be >18 years and under 80 years.

2. Both sexes may participate, but, because of possible teratogenicity of simvastatin women may do so only following counselling about the need for adequate contraception.

3. Women of child bearing potential will have to have a negative pregnancy test prior to enrolment.

4. Patients must have been previously diagnosed with intermediate, posterior or panuveitis (as defined by the standardization of uveitis nomenclature group).14

5. Patients must be taking systemic prednisolone 10mg once daily or more.

6. Patients may be treated with or without a second line agent.

7. Patients must be willing and able to provide informed consent

Exclusion Criteria

1. No associated underlying systemic disease causing the uveitis.

2. Females of childbearing potential and males must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 6 weeks after treatment discontinuation.

3. Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for trial treatment.

4. Females must not be breastfeeding.

5. Patients concomitantly taking ciclosporin, fibrates, amiodarone, amlodipine, verapamil, cytochrome P450 3A4 inhibitors (e.g. itraconazole, ketoconazole, posaconazole, voriconazole), HIV protease inhibitors (e.g. nelfinavir), erythromycin, clarithromycin, telithromycin, nefazodone, gemfibrozil, danazol, fusidic acid, diltiazem or anti-coagulants.

6. Patients will be advised not to drink grapefruit juice during the study.

7. Family history of hereditary muscle disorders.

8. Active Liver disease

9. Severe renal insufficiency.

10. Persistently elevated serum transaminases.

11. Allergies to excipients of simvastatin and placebo

12. Lactose intolerance

13. Involvement in other clinical trials

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University College, London

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Oren Tomkins-Netzer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University College, London

Sue Lightman, PhD,FRCOphth

Role: STUDY_CHAIR

University College, London

Locations

Moorfields Eye Hospital

London, , United Kingdom

Countries

United Kingdom

References

Chataway J, Schuerer N, Alsanousi A, Chan D, MacManus D, Hunter K, Anderson V, Bangham CR, Clegg S, Nielsen C, Fox NC, Wilkie D, Nicholas JM, Calder VL, Greenwood J, Frost C, Nicholas R. Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial. Lancet. 2014 Jun 28;383(9936):2213-21. doi: 10.1016/S0140-6736(13)62242-4. Epub 2014 Mar 19.

Reference Type: BACKGROUND

PMID: 24655729 (View on PubMed)

Other Identifiers

2014-003119-13

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

14/0172

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

14/0172

Identifier Type: -

Identifier Source: org_study_id