ROCK: A Prospective Study to Assess the Hypotensive Efficacy of Rho-Kinase Inhibitor AR-12286 Ophthalmic Solution 0.5% and 0.7% in Patients With Exfoliation Syndrome and Ocular Hypertension or Glaucoma

Sponsor
Robert Ritch, MD, LLC. (Other)
Overall Status
Completed
CT.gov ID
NCT01936389
Collaborator
(none)
10
1
2
13
0.8

Study Details

Study Description

Brief Summary

Glaucoma is the world's the second leading cause of irreversible blindness. The World Health Organization (WHO) estimated the incidence of blindness due to glaucoma to be 4.4 million people worldwide in 2002. Intraocular pressure (IOP) is the sole proven modifiable risk factor for the development and progression of glaucomatous optic neuropathy. Medical therapy is aimed at lowering IOP in order to prevent or slow progression.

Exfoliation syndrome (XFS) is the most common identifiable cause of open-angle glaucoma, affecting an estimated 60 to 70 million people worldwide. Approximately two-thirds of patients have disease in only one eye on clinical examination; however, XFS is detectable in the other eye with conjunctival biopsy. XFS is also a systemic disease, with effects on the cardiovascular and cerebrovascular systems.

Patients with XFS are twice as likely to convert from ocular hypertension to glaucoma. Glaucoma in XFS is more severe than primary open angle glaucoma. There is greater diurnal IOP fluctuation, greater visual field loss and optic nerve head damage at the time of diagnosis, poorer response to medications, more rapid visual field progression and more frequent need for surgery.

Because you meet eligibility criteria for our study, we ask for your consent to participate in the study described below. In brief, you will be taking an investigational drug (AR-12286, rho-kinase Inhibitor) at either 0.5% or 0.7% once a day for 6 months. This drug is currently being tested in patients with primary open-angle glaucoma, but not yet in glaucoma in exfoliation syndrome. Because of the mechanism of glaucoma in XFS and the mechanism of action of rho-kinase inhibitors, there is reason to think it would be more effective in eyes with XFS and glaucoma than in primary open-angle glaucoma (ordinary glaucoma). There will be a baseline and study day 1 visit, week 1 visit, month 1 and 3 visit, week 13 visit, month 6 visit and a week 25 visit; for a total of 7 office visits.

Condition or Disease Intervention/Treatment Phase
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
10 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Participant, Investigator)
Primary Purpose:
Treatment
Official Title:
A Prospective Study to Assess the Hypotensive Efficacy of Rho-Kinase Inhibitor AR-12286 Ophthalmic Solution 0.5% and 0.7% in Patients With Exfoliation Syndrome and Ocular Hypertension or Glaucoma
Study Start Date :
Sep 1, 2013
Actual Primary Completion Date :
Oct 1, 2014
Actual Study Completion Date :
Oct 1, 2014

Arms and Interventions

Arm Intervention/Treatment
Experimental: 0.5%

0.5% Rho-Kinase Inhibitor

Drug: AR-12286
Other Names:
  • Rho-Kinase Inhibitor
  • Experimental: 0.7%

    0.7% Rho-Kinase Inhibitor

    Drug: AR-12286
    Other Names:
  • Rho-Kinase Inhibitor
  • Outcome Measures

    Primary Outcome Measures

    1. Evaluate the Ocular Hypotensive Efficacy of Rho Kinase Inhibitor (AR-12286 0.5% and 0.7%) [6 months]

      Goldmann Aplanation Tonometry (IOP mmHg) will be used to measure the ocular hypotensive efficacy.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    50 Years to 85 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • 50-85 y.o.

    • Male and Female

    • Exfoliation Syndrome and ocular hypertension or mild or moderate exfoliative glaucoma

    • IOP ≥22 mmHg prior to initiation of treatment in one or both eyes with two measurements taken two hours apart

    • No previous intraocular surgery except clear cornea phacoemulsification

    • Corrected visual acuity in both eyes ≥20/50 in the eligible eye

    • Not more than 6 diopters spherical equivalent on the study eye

    • Not more than 3 diopters cylinder equivalent on the study eye

    • Have given written informed consent, prior to any investigational procedures

    • Ability to attend for the 6-month duration of the study

    Exclusion Criteria:
    • Open angle glaucoma other than exfoliative glaucoma

    • Closed angle glaucoma (primary or secondary)

    • Intraocular pressure >30 mm Hg

    • Severe exfoliation glaucoma

    • Known hypersensitivity to any component of the formulation (benzalkonium chloride, etc.), or to topical anesthetics

    • Previous intraocular surgery except clear cornea phacoemulsification

    • Clinically significant ocular disease (e.g. corneal edema, uveitis, severe keratoconjunctivitis sicca) which might interfere with the study

    • Ocular medication of any kind within 30 days of base-line visit, with the exception of ocular hypotensive medications and/or lubricating drops for dry eye (which may be used throughout the study)

    • Any abnormality preventing reliable applanation tonometry of either eye

    • Clinically significant systemic disease (e.g., uncontrolled diabetes, myasthenia gravis, hepatic, renal, endocrine or cardiovascular disorders) which might interfere with the study

    • Changes of systemic medication that could have a substantial effect on IOP anticipated during the study

    • Participation in any investigational study within the past 30 days

    • Inability to perform reliable VF testing

    • Unwilling to sign the consent form approved by the Institutional Review Board (IRB) of the New York Eye and Ear Infirmary

    • Self-reported poor compliance to treatment

    • Reluctance to return for scheduled follow-up visits

    • Patients not able to understand the nature of the study

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Glaucoma Associates of New York New York New York United States 10003

    Sponsors and Collaborators

    • Robert Ritch, MD, LLC.

    Investigators

    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Robert Ritch, MD, LLC.
    ClinicalTrials.gov Identifier:
    NCT01936389
    Other Study ID Numbers:
    • 12286
    First Posted:
    Sep 6, 2013
    Last Update Posted:
    Nov 16, 2018
    Last Verified:
    Apr 1, 2015

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title 0.5% 0.7%
    Arm/Group Description 0.5% Rho-Kinase Inhibitor AR-12286 0.7% Rho-Kinase Inhibitor AR-12286
    Period Title: Overall Study
    STARTED 5 5
    COMPLETED 4 5
    NOT COMPLETED 1 0

    Baseline Characteristics

    Arm/Group Title 0.5% 0.7% Total
    Arm/Group Description 0.5% Rho-Kinase Inhibitor AR-12286 0.7% Rho-Kinase Inhibitor AR-12286 Total of all reporting groups
    Overall Participants 5 5 10
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    2
    40%
    0
    0%
    2
    20%
    >=65 years
    3
    60%
    5
    100%
    8
    80%
    Sex: Female, Male (Count of Participants)
    Female
    2
    40%
    2
    40%
    4
    40%
    Male
    3
    60%
    3
    60%
    6
    60%

    Outcome Measures

    1. Primary Outcome
    Title Evaluate the Ocular Hypotensive Efficacy of Rho Kinase Inhibitor (AR-12286 0.5% and 0.7%)
    Description Goldmann Aplanation Tonometry (IOP mmHg) will be used to measure the ocular hypotensive efficacy.
    Time Frame 6 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title 0.5% 0.7%
    Arm/Group Description 0.5% Rho-Kinase Inhibitor AR-12286 0.7% Rho-Kinase Inhibitor AR-12286
    Measure Participants 5 5
    Mean (Standard Deviation) [mmHg]
    24.2
    (2.4)
    25.8
    (2.4)

    Adverse Events

    Time Frame
    Adverse Event Reporting Description
    Arm/Group Title 0.5% 0.7%
    Arm/Group Description 0.5% Rho-Kinase Inhibitor AR-12286 0.7% Rho-Kinase Inhibitor AR-12286
    All Cause Mortality
    0.5% 0.7%
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN)
    Serious Adverse Events
    0.5% 0.7%
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/5 (0%) 0/5 (0%)
    Other (Not Including Serious) Adverse Events
    0.5% 0.7%
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 1/5 (20%) 0/5 (0%)
    Eye disorders
    Conjunctivitis 1/5 (20%) 1 0/5 (0%) 0

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Jessica Jasien, MEn
    Organization NYGRI
    Phone 2124777540 ext 371
    Email jjasien.ganyresearch@gmail.com
    Responsible Party:
    Robert Ritch, MD, LLC.
    ClinicalTrials.gov Identifier:
    NCT01936389
    Other Study ID Numbers:
    • 12286
    First Posted:
    Sep 6, 2013
    Last Update Posted:
    Nov 16, 2018
    Last Verified:
    Apr 1, 2015