The Role of Loteprednol in Reducing Post-Intravitreal Injection Related Pain
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Paul K Varghese
- Phone Number: 7033999886
- Email: paulv@vt.edu
Study Locations
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-
Virginia
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Roanoke, Virginia, United States, 24019
- Vistar Eye Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All patients must have age-related macular degeneration and be undergoing intravitreal injections for treatment as defined by a retina specialist.
Exclusion Criteria:
- Dementia
- Report baseline eye pain
- Use topical NSAIDs or steroids
- Patient under 18 years old
- History of corticosteroid responsive elevation in intraocular pressure
- Allergy to Loteprednol or Nepafenac
- Pre-existing chronic pain disorders
- Advanced Glaucoma
- Herpes zoster
- Allergy to local anesthetic or penicillin
- Patients unable to consent on own behalf
- Patients unable to communicate pain
- Pregnancy
- Incarceration
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Loteprednol
1 drop of Loteprednol is administered immediately after the intravitreal injection in this treatment arm.
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Loteprednol (ophthalmic corticosteroid) will be stored in the clinic according to the instructions on the package.
The vial will be stored upright between 15°-25°C (59°-77°F).
In the clinic, the vial will be opened by the retina surgeon according to sterile procedure and administered (1 drop) by the surgeon immediately after the intravitreal injection.
|
|
Placebo Comparator: Artificial tears
1 drop of artificial tears is administered immediately after the intravitreal injection in this treatment arm.
This arm acts as a negative control.
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REFRESH® Brand Lubricant Eye Drops are artificial tears.
In the clinic, the vial will be opened by the retina surgeon according to sterile procedure and administered (1 drop) by the surgeon immediately after the intravitreal injection.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Post-Intravitreal Injection Pain
Time Frame: 2-hour Post-Intravitreal Injection
|
11-point Numerical Rating Scale (0-10, 0 being the lowest level of pain and 10 being highest level of pain)
|
2-hour Post-Intravitreal Injection
|
|
Post-Intravitreal Injection Pain
Time Frame: 1-day Post-Intravitreal Injection
|
11-point Numerical Rating Scale (0-10, 0 being the lowest level of pain and 10 being highest level of pain)
|
1-day Post-Intravitreal Injection
|
|
Post-Intravitreal Injection Pain
Time Frame: 1-week Post-Intravitreal Injection
|
11-point Numerical Rating Scale (0-10, 0 being the lowest level of pain and 10 being highest level of pain)
|
1-week Post-Intravitreal Injection
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Analgesic Medication Use
Time Frame: 2-hour Post-Intravitreal Injection
|
Pill count
|
2-hour Post-Intravitreal Injection
|
|
Analgesic Medication Use
Time Frame: 1-day Post-Intravitreal Injection
|
Pill count
|
1-day Post-Intravitreal Injection
|
|
Analgesic Medication Use
Time Frame: 1-week Post-Intravitreal Injection
|
Pill count
|
1-week Post-Intravitreal Injection
|
|
Artificial Tear Use
Time Frame: 2-hour Post-Intravitreal Injection
|
Artificial Tear Drop Count
|
2-hour Post-Intravitreal Injection
|
|
Artificial Tear Use
Time Frame: 1-day Post-Intravitreal Injection
|
Artificial Tear Drop Count
|
1-day Post-Intravitreal Injection
|
|
Artificial Tear Use
Time Frame: 1-week Post-Intravitreal Injection
|
Artificial Tear Drop Count
|
1-week Post-Intravitreal Injection
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Vishak John, MD, Vistar Eye Center
- Principal Investigator: Romulo Albuquerque, M.D., Ph.D., Vistar Eye Center
Publications and helpful links
General Publications
- Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005 Aug;14(7):798-804. doi: 10.1111/j.1365-2702.2005.01121.x.
- El-Harazi SM, Feldman RM. Control of intra-ocular inflammation associated with cataract surgery. Curr Opin Ophthalmol. 2001 Feb;12(1):4-8. doi: 10.1097/00055735-200102000-00002.
- Ambati J, Fowler BJ. Mechanisms of age-related macular degeneration. Neuron. 2012 Jul 12;75(1):26-39. doi: 10.1016/j.neuron.2012.06.018.
- Amon M, Busin M. Loteprednol etabonate ophthalmic suspension 0.5 %: efficacy and safety for postoperative anti-inflammatory use. Int Ophthalmol. 2012 Oct;32(5):507-17. doi: 10.1007/s10792-012-9589-2. Epub 2012 Jun 16.
- DeCroos FC, Afshari NA. Perioperative antibiotics and anti-inflammatory agents in cataract surgery. Curr Opin Ophthalmol. 2008 Jan;19(1):22-6. doi: 10.1097/ICU.0b013e3282f30577.
- Fong R, Cavet ME, DeCory HH, Vittitow JL. Loteprednol etabonate (submicron) ophthalmic gel 0.38% dosed three times daily following cataract surgery: integrated analysis of two Phase III clinical studies. Clin Ophthalmol. 2019 Aug 1;13:1427-1438. doi: 10.2147/OPTH.S210597. eCollection 2019.
- Grzybowski A, Told R, Sacu S, Bandello F, Moisseiev E, Loewenstein A, Schmidt-Erfurth U; Euretina Board. 2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations. Ophthalmologica. 2018;239(4):181-193. doi: 10.1159/000486145. Epub 2018 Feb 1.
- Gundogan FC, Yolcu U, Akay F, Ilhan A, Ozge G, Uzun S. Diabetic Macular Edema. Pak J Med Sci. 2016 Mar-Apr;32(2):505-10. doi: 10.12669/pjms.322.8496.
- Kaplan RI, Drinkwater OJ, Lee RH, Chod RB, Barash A, Giovinazzo JV, Gologorsky D, Jansen ME, Rosen RB, Gentile RC. Pain Control after Intravitreal Injection Using Topical Nepafenac 0.3% or Pressure Patching: A Randomized, Placebo-Controlled Trial. Ophthalmol Retina. 2019 Oct;3(10):860-866. doi: 10.1016/j.oret.2019.04.022. Epub 2019 Apr 26.
- Kaplan RI, Rosen RB, Gentile RC. Optimizing the Patient Experience and Satisfaction: The Role of Topical NSAIDs with Intravitreal Injections. Ophthalmol Retina. 2020 May;4(5):459-460. doi: 10.1016/j.oret.2020.03.004. No abstract available.
- Karia N. Retinal vein occlusion: pathophysiology and treatment options. Clin Ophthalmol. 2010 Jul 30;4:809-16. doi: 10.2147/opth.s7631.
- Oztas Z, Akkin C, Afrashi F, Nalcaci S. The short-needle intravitreal injection technique. Int J Ophthalmol. 2016 Jun 18;9(6):929-30. doi: 10.18240/ijo.2016.06.24. eCollection 2016. No abstract available.
- Popovic MM, Muni RH, Nichani P, Kertes PJ. Topical Nonsteroidal Anti-inflammatory Drugs for Pain Resulting from Intravitreal Injections: A Meta-Analysis. Ophthalmol Retina. 2020 May;4(5):461-470. doi: 10.1016/j.oret.2020.01.024. Epub 2020 Feb 13.
- Rifkin L, Schaal S. Shortening ocular pain duration following intravitreal injections. Eur J Ophthalmol. 2012 Nov-Dec;22(6):1008-12. doi: 10.5301/ejo.5000147. Epub 2012 Apr 24.
- Shin SH, Park SP, Kim YK. Factors Associated with Pain Following Intravitreal Injections. Korean J Ophthalmol. 2018 Jun;32(3):196-203. doi: 10.3341/kjo.2017.0081. Epub 2018 May 15.
- Tan HY, Agarwal A, Lee CS, Chhablani J, Gupta V, Khatri M, Nirmal J, Pavesio C, Agrawal R. Management of noninfectious posterior uveitis with intravitreal drug therapy. Clin Ophthalmol. 2016 Oct 13;10:1983-2020. doi: 10.2147/OPTH.S89341. eCollection 2016.
- Toslak D, Thapa D, Chen Y, Erol MK, Paul Chan RV, Yao X. Wide-field fundus imaging with trans-palpebral illumination. Proc SPIE Int Soc Opt Eng. 2017 Jan 28;10045:100451X. doi: 10.1117/12.2252491. Epub 2017 Feb 8.
- Yahalomi T, Hecht I, Lagstein O, Nemet A, Pe'er L, Hadad F, Keren-Yaar A, Kassem R, Burgansky-Eliash Z, Bar A, Achiron A. REDUCTION OF POSTINTRAVITREAL INJECTION PAIN USING ICE: An Open-Label Interventional Randomized Controlled Trial. Retina. 2020 Jul;40(7):1434-1438. doi: 10.1097/IAE.0000000000002608.
- Chou R, McDonagh MS, Nakamoto E, Griffin J. Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Oct. Report No.: 11(12)-EHC076-EF. Available from http://www.ncbi.nlm.nih.gov/books/NBK65646/
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
Keywords
- Eye Diseases
- Glucocorticoids
- Immunologic Factors
- Retinal Diseases
- Immunosuppressive Agents
- Anti-Inflammatory Agents
- Intravitreal Injection
- Molecular Mechanisms of Pharmacological Action
- vascular endothelial growth factor
- Loteprednol
- Loteprednol Etabonate Ophthalmic Suspension
- Post-Intravitreal Injection Pain
Additional Relevant MeSH Terms
- Retinal Degeneration
- Retinal Diseases
- Eye Diseases
- Macular Degeneration
- Ophthalmic Solutions
- Pharmaceutical Solutions
- Pharmaceutical Preparations
- Pharmacologic Actions
- Chemical Actions and Uses
- Therapeutic Uses
- Polycyclic Compounds
- Steroids
- Fused-Ring Compounds
- Solutions
- Specialty Uses of Chemicals
- Androstadienes
- Androstenes
- Androstanes
- Lubricants
- Loteprednol Etabonate
- Lubricant Eye Drops
Other Study ID Numbers
Other Study ID Numbers
- 22-514
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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