INtravitreal and Aqueous Dexamethasone Levels After DEXtenza

NCT ID: NCT04529512

Last Updated: 2021-01-29

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-31

Study Completion Date

2021-03-31

Brief Summary

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A prospective, open-label, interventional study to determine intraocular concentration levels of dexamethasone following use of the DEXTENZA® implant.

Detailed Description

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On December 3rd, 2018, DEXTENZA® was approved by the FDA for the treatment of ocular pain following ophthalmic surgery. On June 21st, 2019, the FDA approved a Supplemental New Drug Application (sNDA) for DEXTENZA® to include the treatment of ocular inflammation following ophthalmic surgery as an additional indication.

DEXTENZA® is a corticosteroid implant indicated for the treatment of ocular pain following ophthalmic surgery. DEXTENZA® is inserted into the lower lacrimal punctum into the canaliculus by the physician following ophthalmic surgery. A single DEXTENZA® releases a 0.4 mg dose of dexamethasone for up to 30 days following insertion. DEXTENZA® is preservative free, resorbable and does not require removal. Saline irrigation or manual expression can be performed to remove the insert, if necessary.

In the two phase III trials, patients were given DEXTENZA® or its vehicle immediately after cataract surgery. In the first study, 80 percent of DEXTENZA®-treated patients (n=164) were pain-free at the eighth day compared to 43 percent of vehicle-treated patients (n=83) (p\<0.0001). In the second trial, 77 percent of patients on active drug (n=161) were pain-free at the eighth day vs. 59 percent of those on the vehicle.1

Safety was assessed from the three Phase 3 clinical trials and a Phase 2 clinical trial.1,2 Overall, 567 subjects were exposed to DEXTENZA®. The most common ocular adverse reactions in subjects treated with DEXTENZA® were: anterior chamber inflammation including iritis and iridocyclitis (10%), increased intraocular pressure (6%), reduced visual acuity (2%), cystoid macular edema (1%), corneal edema (1%), eye pain (1%), and conjunctival hyperemia (1%). The most common non-ocular adverse event was headache (1%).

Though DEXTENZA has been found to be safe and effective, it is a relatively new therapy and a randomized prospective study looking at dexamethasone and pain levels following retinal surgery has not yet been done. The purpose of this study is to provide real-world intraocular dexamethasone concentration levels in subjects implanted with DEXTENZA as well as to confirm the reduction of pain in patients undergoing retinal surgery is the same as subjects who underwent cataract surgery in the phase III studies.

Conditions

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Ocular Disease Requiring Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Receiving DEXTENZA® 1-3 days prior to surgery

Participants to receive DEXTENZA® 1-3 days prior to surgery

Group Type EXPERIMENTAL

DEXTENZA®

Intervention Type DRUG

DEXTENZA® is a corticosteroid implant indicated for the treatment of ocular pain following ophthalmic surgery. DEXTENZA® is inserted into the lower lacrimal punctum into the canaliculus by the physician following ophthalmic surgery. A single DEXTENZA® releases a 0.4 mg dose of dexamethasone for up to 30 days following insertion. DEXTENZA® is preservative free, resorbable and does not require removal. Saline irrigation or manual expression can be performed to remove the insert, if necessary.

Receiving DEXTENZA® 1-2 weeks prior to surgery

Participants to receive DEXTENZA® 1-2 weeks prior to surgery

Group Type EXPERIMENTAL

DEXTENZA®

Intervention Type DRUG

DEXTENZA® is a corticosteroid implant indicated for the treatment of ocular pain following ophthalmic surgery. DEXTENZA® is inserted into the lower lacrimal punctum into the canaliculus by the physician following ophthalmic surgery. A single DEXTENZA® releases a 0.4 mg dose of dexamethasone for up to 30 days following insertion. DEXTENZA® is preservative free, resorbable and does not require removal. Saline irrigation or manual expression can be performed to remove the insert, if necessary.

Receiving DEXTENZA® 1 month prior to surgery

Participants to receive DEXTENZA® 1 month prior to surgery

Group Type EXPERIMENTAL

DEXTENZA®

Intervention Type DRUG

DEXTENZA® is a corticosteroid implant indicated for the treatment of ocular pain following ophthalmic surgery. DEXTENZA® is inserted into the lower lacrimal punctum into the canaliculus by the physician following ophthalmic surgery. A single DEXTENZA® releases a 0.4 mg dose of dexamethasone for up to 30 days following insertion. DEXTENZA® is preservative free, resorbable and does not require removal. Saline irrigation or manual expression can be performed to remove the insert, if necessary.

Not receiving the DEXTENZA® implant

Participants will not receive the DEXTENZA® implant

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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DEXTENZA®

DEXTENZA® is a corticosteroid implant indicated for the treatment of ocular pain following ophthalmic surgery. DEXTENZA® is inserted into the lower lacrimal punctum into the canaliculus by the physician following ophthalmic surgery. A single DEXTENZA® releases a 0.4 mg dose of dexamethasone for up to 30 days following insertion. DEXTENZA® is preservative free, resorbable and does not require removal. Saline irrigation or manual expression can be performed to remove the insert, if necessary.

Intervention Type DRUG

Other Intervention Names

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dexamethasone ophthalmic insert 0.4mg

Eligibility Criteria

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Inclusion Criteria

1. Patients of California Retina Consultants undergoing vitrectomy surgery
2. Must be 18 years old or older
3. Must be able to provide consent

Exclusion Criteria

1. Must not have been treated with DEXTENZA® prior to joining the study.
2. May not have more than one DEXTENZA® implant.
3. May not be currently using an dexamethasone product during the course of the study or within 4 weeks prior to enrolling in the study.
4. Subject has active corneal, conjunctival or canalicular infections, including:

i. Epithelial herpes simplex keratitis (dendritic keratitis)

ii. Vaccini

iii. Varicella

iv. Mycobacterial infections

v. Fungal diseases of the eye

vi. Dacryocystitis
5. Any abnormal lid or punctum anatomy that would preclude or make inappropriate the placement of the insert (e.g., severe ectropion or punctal stenosis).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ocular Therapeutix, Inc.

INDUSTRY

Sponsor Role collaborator

Nathan Steinle

OTHER

Sponsor Role lead

Responsible Party

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Nathan Steinle

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Gabe Gordon, PhD

Role: STUDY_DIRECTOR

Director of Research

Nathan Steinle, MD

Role: PRINCIPAL_INVESTIGATOR

Physician

Locations

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California Retina Consultants

Paso Robles, California, United States

Site Status

California Retina Consultants

San Luis Obispo, California, United States

Site Status

California Retina Consultants

Santa Maria, California, United States

Site Status

Countries

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United States

Central Contacts

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Gabriel Gordon, PhD

Role: CONTACT

Phone: (805) 963-1648

Email: [email protected]

Mary Lopez-Isidro, B.S

Role: CONTACT

Phone: 805-266-7123

Email: [email protected]

Facility Contacts

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Gabe Gordon, PhD

Role: primary

Mary Lopez-Isidro

Role: backup

References

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Tyson SL, Bafna S, Gira JP, Goldberg DF, Jones JJ, Jones MP, Kim JK, Martel JM, Nordlund ML, Piovanetti-Perez IK, Singh IP, Metzinger JL, Mulani D, Sane S, Talamo JH, Goldstein MH; Dextenza Study Group. Multicenter randomized phase 3 study of a sustained-release intracanalicular dexamethasone insert for treatment of ocular inflammation and pain after cataract surgery. J Cataract Refract Surg. 2019 Feb;45(2):204-212. doi: 10.1016/j.jcrs.2018.09.023. Epub 2018 Oct 24.

Reference Type BACKGROUND
PMID: 30367938 (View on PubMed)

Torkildsen G, Abelson MB, Gomes PJ, McLaurin E, Potts SL, Mah FS. Vehicle-Controlled, Phase 2 Clinical Trial of a Sustained-Release Dexamethasone Intracanalicular Insert in a Chronic Allergen Challenge Model. J Ocul Pharmacol Ther. 2017 Mar;33(2):79-90. doi: 10.1089/jop.2016.0154. Epub 2017 Jan 10.

Reference Type BACKGROUND
PMID: 28072552 (View on PubMed)

Other Identifiers

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INDEX

Identifier Type: -

Identifier Source: org_study_id