Use of Simvastatin as a Steroid Sparing Agent for Uveitis Patients
Can Simvastatin Significantly Reduce the Amount of Immunosuppressive Medication Required by Patients With Sight Threatening Uveitis? A Phase 2b, Single Site, Randomized, Placebo Controlled, Double Blinded Trial.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
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.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
-
-
-
London, United Kingdom, EC1V 2PD
- Moorfields Eye Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients must be >18 years and under 80 years.
- Both sexes may participate, but, because of possible teratogenicity of simvastatin women may do so only following counselling about the need for adequate contraception.
- Women of child bearing potential will have to have a negative pregnancy test prior to enrolment.
- Patients must have been previously diagnosed with intermediate, posterior or panuveitis (as defined by the standardization of uveitis nomenclature group).14
- Patients must be taking systemic prednisolone 10mg once daily or more.
- Patients may be treated with or without a second line agent.
- Patients must be willing and able to provide informed consent
Exclusion Criteria:
- No associated underlying systemic disease causing the uveitis.
- 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.
- Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for trial treatment.
- Females must not be breastfeeding.
- 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.
- Patients will be advised not to drink grapefruit juice during the study.
- Family history of hereditary muscle disorders.
- Active Liver disease
- Severe renal insufficiency.
- Persistently elevated serum transaminases.
- Allergies to excipients of simvastatin and placebo
- Lactose intolerance
- Involvement in other clinical trials
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Simvastatine
Group of patients receiving simvastatin 80mg once daily in addition to standard care
|
Simvastatin 80mg once daily
|
|
Placebo Comparator: Placebo
Group of patients receiving placebo once daily in addition to standard care
|
Placebo tablets once daily
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
1. Change in dose (mg) of prednisolone after 12 months of treatment
Time Frame: 12 months
|
To determine whether the mean reduction in prednisolone dosage achieved at 12 months is greater in the simvastatin group compared to the placebo treated group?
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The mean reduction in prednisolone achieved at 24 months.
Time Frame: 24 months
|
24 months
|
|
The chnage in the number of 2nd-line immunosuppressive drugs at 24 months
Time Frame: 24 months
|
24 months
|
|
The number of disease relapses by 24 months
Time Frame: 24 months
|
24 months
|
|
Blood cholesterol and lipid levels at 24 months as compared to baseline
Time Frame: 24 months
|
24 months
|
|
Change in visual acuity at 12 and 24 months as compared to baseline
Time Frame: 12 and 24 months
|
12 and 24 months
|
|
Treg and Th17 levels at 12 and 24 months as compared to baseline
Time Frame: 12 and 24 months
|
12 and 24 months
|
|
Number of patients with adverse events.
Time Frame: 24 months
|
24 months
|
|
The change in dose (mg) of 2nd-line immunosuppressive drugs at 24months
Time Frame: 24 months
|
24 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Oren Tomkins-Netzer, MD, PhD, University College, London
- Study Chair: Sue Lightman, PhD,FRCOphth, University College, London
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 14/0172 (Other Grant/Funding Number: The Moulton Trust)
- 2014-003119-13 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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