Safety and Efficacy of Iontophoretic Dexamethasone Phosphate Delivery Prior to Implantation of a Posterior Chamber IOL

A Prospective, Multi-Center, Randomized, Double-Masked, Negative-Controlled Clinical Trial Designed to Compare the Safety and Efficacy of EGP-437 (Dexamethasone Phosphate Ophthalmic Solution) Delivered by EyeGate® II Iontophoresis to Placebo in Patients Undergoing Cataract Surgery With Implantation of a Posterior Chamber Intraocular Lens

The purpose of this study is to evaluate the safety and efficacy of ocular iontophoresis with dexamethasone phosphate ophthalmic solution EGP-437 using the EyeGate® II Drug Delivery System (EGDS) compared to placebo in patients undergoing cataract surgery with implantation of a posterior chamber intraocular lens.

Study Overview

• Status: Completed
• Conditions: Cataract
• Intervention / Treatment: Drug: Dexamethasone Phosphate Ophthalmic; Drug: 100 mM Sodium Citrate Buffer

Detailed Description

Phase 2, proof-of-concept (POC) clinical trial designed to evaluate the safety and efficacy of ocular iontophoretic delivery of dexamethasone phosphate ophthalmic solution compared to ocular iontophoresis with a placebo (100 mM citrate buffer of pH 5.7) in patients planning to have cataract surgery with implantation of a posterior chamber intraocular lens (IOL). The population studied was comprised of males and females scheduled for unilateral cataract surgery with implantation of a posterior chamber IOL. Eligible patients were enrolled into the study and were randomized on Day 1 in a 1:1 ratio into one of the following two treatment arms. Treatments were administered on the day prior (Day -1) to cataract surgery (Day 0). Subjects were scheduled to return to the clinic on Days 1, 7, 14, and 28. All subjects were scheduled to exit the study on Day 28. Subjects were asked to complete a daily pain score assessment questionnaire for the first 14 days post-surgery (Days 0 - 14).

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Florida
    • Miami, Florida, United States, 33176
      • Site 501
    • Tamarac, Florida, United States, 33321
      • Site 503
  • Missouri
    • Washington, Missouri, United States, 63090
      • Site 502

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Undergoing unilateral cataract extraction and implantation of a monofocal IOL (at the time of enrollment)
• Male or female 18 years or older
• Receive, understand, and sign a copy of the written informed consent form
• Be able to return for all study visits and willing to comply with all study-related instructions

Exclusion Criteria:

• Subjects not meeting the inclusion criteria
• Subjects being implanted with a multifocal IOL
• Ocular surgery of any kind in the study eye within 6 months prior to baseline visit
• Cataract surgery on the fellow eye within 6 weeks, including 2 weeks without topical ocular medication, prior to baseline visit
• Scheduled for surgery in the fellow eye within the study period
• Have anterior chamber inflammation as measured by slit lamp examination at baseline. Anterior chamber cell and/or flare grade > 0
• Have used any topical ocular medication in either eye, other than tear substitute for dry eye, at least 2 weeks prior to baseline visit
• Have IOP ≥ 25 mmHg at baseline, a history of glaucoma, or require ocular anti-hypertensive medications
• Be known corticosteroid intraocular pressure responder in either eye
• Have used topical corticosteroid or NSAID treatment in either eye ≤ 48 hours prior to baseline visit
• Systemic administration of corticosteroid within the past 14 days prior to baseline visit
• Have received intravitreal, sub-Tenon's, or any periocular corticosteroid treatment in either eye within the past 6 months prior to baseline visit
• Have open wounds/ skin disease on the forehead area where the iontophoresis return electrode will be applied
• Have severe lesions of the eyelids or the ocular surface impeding the application of the iontophoresis applicator
• Have blepharospasm, blepharophimosis, or other eyelid anatomic variations precluding the placement of the iontophoresis applicator
• Have significant Fuch's Corneal Dystrophy
• Have known allergy to dexamethasone or dexamethasone phosphate or any medication to be used in this study
• Have history or diagnosis of ocular herpes, corneal lesion of suspected herpetic origin
• Have optic neuritis of any origin
• Have clinically suspected or confirmed central nervous system or ocular lymphoma
• Have active hyphema, pars planitis, choroiditis, Behçet's disease, clinically significant macular edema, toxoplasmosis scar, or vitreous hemorrhage
• Have severe/serious ocular pathology or medical condition which may preclude study completion
• History of HIV/AIDS
• Have pacemaker and/or any other electrical sensitive support system
• Be pregnant or lactating female, or female of childbearing age and using inadequate birth control method
• Have participated in another investigational device or drug study within 30 days of baseline visit
• Have already participated in this study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dexamethasone Phosphate Ophthalmic; Dexamethasone Phosphate Ophthalmic: (40 mg/mL) solution delivered by ocular iontophoresis consisting of 4.0 mA-min at 1.5 mA on Day -1 (the day before cataract surgery)	Drug: Dexamethasone Phosphate Ophthalmic; Transcleral iontophoresis delivery of EGP-437 (dexamethasone phosphate formulated for ocular iontophoresis); Other Names: Active arm, Arm 1
Placebo Comparator: 100 mM Sodium Citrate Buffer; Placebo (100 mM sodium citrate buffer solution) delivered by ocular iontophoresis consisting of 4.0 mA-min at 1.5 mA on Day -1 (the day before cataract surgery)	Drug: 100 mM Sodium Citrate Buffer; Transcleral iontophoresis delivery of 100 mM sodium citrate buffer solution; Other Names: In-active control arm, Arm 2

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Subjects With AC Cell Count of Zero on Day 7	Percentage of patients with anterior chamber (AC) cell count of zero on Day 7 as compared between the active and placebo groups	At Day 7 (plus or minus two days) following the study treatment

Collaborators and Investigators

• Sponsor: Eyegate Pharmaceuticals, Inc.
• Investigators: Principal Investigator: William Trattler, M.D., Center for Excellence in Eye Care

Study record dates

Study Major Dates

• Study Start: May 1, 2012
• Primary Completion (Actual): October 1, 2012
• Study Completion (Actual): October 1, 2012

Study Registration Dates

• First Submitted: May 16, 2012
• First Submitted That Met QC Criteria: May 16, 2012
• First Posted (Estimate): May 18, 2012

Study Record Updates

• Last Update Posted (Actual): January 29, 2019
• Last Update Submitted That Met QC Criteria: January 10, 2019
• Last Verified: January 1, 2019

More Information

Terms related to this study

• Keywords: Cataract Surgery; Ophthalmology; Iontophoresis; Posterior Chamber Intraocular Lens Implant
• Additional Relevant MeSH Terms: Eye Diseases; Lens Diseases; Cataract; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Autonomic Agents; Peripheral Nervous System Agents; Anti-Inflammatory Agents; Antineoplastic Agents; Antiemetics; Gastrointestinal Agents; Glucocorticoids; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Antineoplastic Agents, Hormonal; Anticoagulants; Chelating Agents; Sequestering Agents; Calcium Chelating Agents; Dexamethasone; Dexamethasone 21-phosphate; Citric Acid; Sodium Citrate
• Other Study ID Numbers: EGP-437-005