Effect of Traditional Chinese Medicine on Basic Tear Secretion and Tear Cytokines in Patients With Dry Eye Disease

Sponsor
China Medical University Hospital (Other)
Overall Status
Recruiting
CT.gov ID
NCT04785261
Collaborator
(none)
60
1
2
14.5
4.1

Study Details

Study Description

Brief Summary

This is a single center, randomized, single-blind, controlled pilot study of CJDHW plus JWXYS as a complementary therapy to treat dry eye disease during a 12-week period. The investigators intend to enroll 60 subjects aged between 20 and 75 years old (treatment group(N=30); controlled group(N=30)). Treatment group will be treated with artificial tears combined with TCM, while control group will use artificial tears only. The aim of this study is to explore the efficacy of TCM for dry eye disease.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

Dry eye disease (DED) is a chronic inflammatory disease. In severe cases, it may cause corneal ulcers, blurred vision, and even blindness. The prevalence of DED is about 30% in Taiwan. With the popularity of technological products and prolonged average life expectancy, the incidence of dry eye disease is increasing at a rate of 10% per year in Taiwan. However, treatment of DED mainly focuses on symptom relief in modern medicine. It is a difficult problem to improve the pathological state of patients with DED. Hence, there is an urgent need for a more effective and safe method of treating this disease.

Chi-Ju-Di-Huang-Wan (CJDHW) is commonly used in traditional Chinese medicine (TCM) for eye diseases. However, current research shows that use CJDHW alone to treat dry eye is less effective for tear secretion, which may be related to the unimproved inflammation state. Ligustilide and ferulic acid, which own significant anti-inflammatory effects, are the effective ingredients of Jia-Wei-Xiao-Yao-San (JWXYS). Many studies have demonstrated that JWXYS can reduce serum TNF-α and IFN-γ levels in patients with DED. Therefore, the investigators choose to use CJDHW plus JWXYS for treatment in this study.

This is a single center, randomized, single-blind, controlled pilot study of CJDHW plus JWXYS as a complementary therapy to treat dry eye disease during a 12-week period. The investigators intend to enroll 60 subjects aged between 20 and 75 years old (treatment group(N=30); controlled group(N=30)). Treatment group will be treated with artificial tears combined with TCM, while control group will use artificial tears only. The evaluation will be conducted on 1st, 4th, 8th,12th week. Primary endpoints include Schirmer's test and non-invasive tear film breakup time(NiBUT); secondary endpoints include tear meniscus height, meibomian gland loss rate, tear cytokines and matrix metalloproteinases (MMPs) levels and Ocular Surface Disease Index (OSDI).

The aim of this study is to explore the efficacy and possible mechanism of TCM for DED.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
60 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Single (Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Pilot Study on The Effect of Traditional Chinese Medicine on Basic Tear Secretion and Tear Cytokines in Patients With Dry Eye Disease
Actual Study Start Date :
Mar 16, 2021
Anticipated Primary Completion Date :
May 31, 2022
Anticipated Study Completion Date :
May 31, 2022

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: conventional treatment

Patients in this group will be given conventional treatment including Artelac® Eye Drops (1-2 drips each time, every 4 hours) and Vidisic® Gel (1 drip each time, at bedtime) for 12 weeks.

Drug: Methylhydroxypropylcellulose
1-2 drips each time, every 4 hours, for 12 weeks.
Other Names:
  • Artelac® Eye Drops
  • Drug: Carbomer
    1 drip each time, at bedtime, for 12 weeks.
    Other Names:
  • Vidisic® Gel
  • Experimental: conventional treatment + TCM

    Patients in this group will be given conventional treatment and traditional Chinese medicine (6.0g twice daily) for 12 weeks.

    Drug: Methylhydroxypropylcellulose
    1-2 drips each time, every 4 hours, for 12 weeks.
    Other Names:
  • Artelac® Eye Drops
  • Drug: Carbomer
    1 drip each time, at bedtime, for 12 weeks.
    Other Names:
  • Vidisic® Gel
  • Drug: TCM Formula
    6.0g Chi-Ju-Di-Huang-Wan plus 6.0g Jia-Wei-Xiao-Yao-San, 6.0g twice daily for 12 weeks.

    Outcome Measures

    Primary Outcome Measures

    1. Schirmer's Test [Change from baseline Schirmer's Test at week 4, week 8 and week 12]

      Uses paper strips inserted into the eye for 5 minutes to measure the production of tears. Both eyes are tested at the same time.

    2. Non-invasive Tear Film Break-up Time (NiBUT) [Change from baseline NiBUT at week 4, week 8 and week 12]

      Measured by Antares Corneal Topography.

    Secondary Outcome Measures

    1. Tear Meniscus Height [Change from baseline Tear meniscus height at week 4, week 8 and week 12]

      Measured by Antares Corneal Topography.

    2. Meibomian Gland Loss Rate [Change from baseline Meibomian gland loss rate at week 4, week 8 and week 12]

      Measured by Antares Corneal Topography.

    3. Tear Cytokines [Change from baseline Tear cytokines at week 4, week 8 and week 12]

    4. Ocular Surface Disease Index (OSDI) [Change from baseline OSDI at week 4, week 8 and week 12]

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    20 Years to 75 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Age between 20 and 75 years.

    • A confirmed diagnosis of DED by ophthalmologists.

    • Willing to sign informed consent form.

    Exclusion Criteria:
    • With autoimmune diseases.

    • Pregnant or lactating.

    • Underwent transplant surgery and got graft-versus-host disease in the past.

    • With eye infection, inflammation, trauma, or underwent eye surgery in the past three months.

    • Underwent dry eye intense pulse light treatment in the past three months.

    • Underwent other treatments including TCM drugs or acupuncture in the past month or during the trial.

    • Persistent in taking diuretics, antidepressant, antihistamines and anticholinergics.

    • Combined treatment with autologous serum, cyclosporine or steroid eye drops during the trial.

    • Took fish oil or vitamin D during the trial.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 China Medical University Hospital Taichung Taiwan 404332

    Sponsors and Collaborators

    • China Medical University Hospital

    Investigators

    • Principal Investigator: Hui-Ju Lin, PhD, China Medical University Hospital

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    China Medical University Hospital
    ClinicalTrials.gov Identifier:
    NCT04785261
    Other Study ID Numbers:
    • CMUH109-REC2-169
    First Posted:
    Mar 5, 2021
    Last Update Posted:
    Dec 6, 2021
    Last Verified:
    Dec 1, 2021
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Dec 6, 2021