Comparing Effect of Topical Tacrolimus 0.03% Versus Cyclosporine 0.05% in Dry Eyes of Secondary Sjogren Syndrome

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-30

Study Completion Date

2019-04-30

Brief Summary

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Evaluation of the effect of topical application of Tacrolimus 0.03% (FK506) eye drops versus Cyclosporine 0.05% eye drops in treatment of dry eye in Secondary Sjogren Syndrome.

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Detailed Description

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Sjogren syndrome is a chronic autoimmune disorder characterized by immune cell infiltration of exocrine glands (exocrinopathy or epitheliitis) and systemic complications due to autoantibody production, immune complex deposition and lymphocytic infiltration of many organs .The loss of aqueous tear flow in Sjogren syndrome is a result of inflammatory cell infiltration of the lacrimal glands.The principal ocular manifestation of which is decreased tear production leading to chronic irritation and damage to the corneal and conjunctival epithelium. Dry eye associated with Sjogren syndrome (SS dry eye) is often more severe than non-Sjogren dry eye (non-SS dry eye). Rose bengal staining, fluorescein staining, impression cytology, and brush cytology show greater changes in SS dry eye owing to a lack of both basic tearing and reflex tearing resulting from lacrimal gland destruction, which is the hallmark of deteriorating clinical conditions.

The initial tear film ocular surface society dry eye workshop report noted the importance of ocular surface inflammation not only in the development of, but as a downstream effect and propagator of dry eye disease , and reviewed a range of therapies that function, at least in part, by anti-inflammatory mechanisms of action. Thus understanding the link between inflammation and dry eye validates the utilization of anti-inflammatory therapy in everyday practice.

Cyclosporine is understood to be an immunomodulatory drug with anti-inflammatory properties, as well as having other actions relevant to managing dry eye disease . Topical cyclosporine was approved by the FDA for the treatment of moderate-to-severe dry eye disease in 2003, based on an improvement in tear production.

Tacrolimus, a macrolide produced by Streptomyces tsukubaensis,was discovered in 1984 in Japan while searching for new immunosuppressive and cancer chemotherapeutic agents. The use of tacrolimus is of special interest in ophthalmology because it is indicated to be effective in the treatment of immune-mediated diseases Thus, the investigators performed this study to evaluate the effect of two different immunomodulatory eye drops on the ocular surface which are topical application of Tacrolimus 0.03% (FK506) eye drops versus Cyclosporine 0.05% eye drops in treatment of dry eye in Secondary Sjogren Syndrome.

Conditions

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Dry Eye Sjogren Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Evaluation of the effect of topical application of Tacrolimus 0.03% (FK506) eye drops versus Cyclosporine 0.05% eye drops in treatment of dry eye in Secondary Sjogren Syndrome.

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Cyclosporins 0.05 % treated eyes

Topical Cyclosporins 0.05% eye drops twice in one eye for 3 months

Group Type ACTIVE_COMPARATOR

Cyclosporins

Intervention Type DRUG

Cyclosporins eye drops to be administered in dry eyes

Tacrolimus 0.03% treated eyes

Topical Tacrolimus 0.03% eye drops twice in one eye for 3 months

Group Type ACTIVE_COMPARATOR

Tacrolimus

Intervention Type DRUG

Tacrolimus eye drops to be administered in dry eyes

Interventions

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Cyclosporins

Cyclosporins eye drops to be administered in dry eyes

Intervention Type DRUG

Tacrolimus

Tacrolimus eye drops to be administered in dry eyes

Intervention Type DRUG

Other Intervention Names

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Restasis FK506

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed as Secondary Sjogren syndrome according to the 2002 American European consensus group (AECG) criteria, which require the presence of well defined major connective tissue disease (such as rheumatoid arthritis and systemic lupus erythematosus.
* All patients show chronic symptoms of burning, foreign body sensation, itching in both eyes, abnormal Schirmer test \<5 mm wetting of the paper after 5 minutes, and abnormal tear breakup time (TBUT) \< 10 seconds.
* Wash out period of 30 days before start of the immunomodulatory eye drops included in the investigator's study

Exclusion Criteria

1. Any inflammation or active structural changes in the iris or anterior chamber.
2. Patients receiving or who had received systemic cyclosporine or tacrolimus.
3. Patients receiving any systemic drug that can cause dry eye as some antidepressants , antihistaminic drugs , hormonal therapy…etc
4. Glaucoma.
5. Previous ocular surgery.
6. Use of any topical medication other than artificial tears.
7. Contact lens wearers.
8. Presence of any corneal infection.
9. Any corneal diseases (ulcer, opacity, scar, bullous keratopathy, symblepharon or tumors).
10. Deforming structural lid or conjunctival abnormality.
11. Pregnancy.
12. Prior diagnosis of any of the following conditions would exclude participation in AECG study :

Past head and neck radiation treatment Hepatitis C infection Acquired immunodeficiency disease (AIDS) Pre-existing lymphoma Sarcoidosis Graft versus host disease

Minimum Eligible Age

20 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No