- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03085290
Allogeneic Versus Autologous Serum Eye Drops (AVAnS)
Allogeneic Versus Autologous Serum Eye Drops: a Double-blind Randomized Cross Over Trial
Serum eye drops (SEDs) are used to treat patients with extreme dry eyes and other corneal defects. Serum is used in severe ophthalmic cases where conventional eye drops (artificial tears) have insufficient effect. The use of SEDs in dry eye patients usually has a rapid effect. Most patients claim the effect to be instantaneous, and all symptoms improve within 48 hours.
There is evidence suggesting that substances in serum may help in the healing of epithelial defects, such as epidermal growth factor, fibroblast growth factor, fibronectin, and/or vitamin A. However, the precise serum factor responsible for alleviating the patient's complaints is currently not known. Commonly, autologous SEDs are used, but they are replaced more and more by allogeneic SEDs prepared from donor serum.
Allogeneic SED are derived from healthy voluntary, non-remunerated male donors with blood group AB. The use of allogeneic SED could provide blood bank controlled quality, a safer product in larger quantities that is quickly available for each patient.
No double-blind randomized trials are known to exist to detect a difference in result between the effect of allogeneic SED or autologous SED. This pilot study is intended to obtain insight in the ability of autologous and allogeneic SEDs to improve patient dry eye sensation. Our hypothesis is that autologous SEDs (in a 1:1 dilution with saline) result in an improvement of the patient dry eye sensation, while allogeneic SEDs (in a 1:1 dilution with saline) do not.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Serum eye drops (SEDs) are used to treat patients with dry eyes and other diseases, like corneal defects. SEDs are used in ophthalmic cases where conventional eye drops have insufficient effect. The use of SEDs in dry eye patients usually has a rapid effect. Most patients claim the effect to be instantaneous and all symptoms improve by 48 hours [1].
There is evidence suggesting that serum may enhance corneal epithelial healing [2]. Some biologically active substances are thought to contribute to the positive effects, like epidermal growth factor, fibroblast growth factor, fibronectin, and vitamin A.
Autologous SEDs are used internationally on a regular basis, and allogeneic SEDs are becoming increasingly popular. In the Netherlands, only autologous SEDs are in use.
Obtaining autologous SED is an organizational burden. Patient-related problems are old age, travelling, or travelling with low vision and sometimes immobility due to other diseases. Sometimes venipuncture is impossible due to poor access. Medical conditions such as inability to donate large amounts of whole blood due to previous cerebrovascular accidents or cardiovascular disease, anemia, or use of certain medication may prevent collection of blood for SEDs. Patients affected with hematological diseases, bacterial, viral or fungal infections are also unsuitable for production of autologous SEDs. In 2.3% of donors for preparing autologous SEDs, a systemic infection can be detected [3]. In the UK, use of autologous SED is restricted largely due to cost [4]. Logistically, it is a problem that it takes time as well as joint effort of several departments in the hospital to prepare the SEDs, causing considerable waiting time for the patient. Further, the use of allogeneic drops allows immediate access to SEDs in case time is limited to prevent corneal scars, ulcers, infiltrates or even transplants, epithelial defects or low vision due to epithelial surface disease.
Allogeneic SEDs are derived from healthy donors and are produced by a blood bank facility. Blood banks are experienced and equipped to produce blood products in a good manufacturing practice (GMP) environment. They can perform quality control, and are able to produce larger quantities that are quickly available. For our study, donors with blood group AB will be selected to ensure ABO compatibility. Donors are further selected to be males that never had a blood transfusion to minimize anti-HLA titers.
No prospective double blind randomized cross-over trials are known to exist to detect a difference in result between the effect of allogeneic SED or autologous SED for ocular surface disease. This pilot study is intended to obtain insight in the ability of autologous and allogeneic SEDs to improve patient dry eye sensation. Our hypothesis is that autologous SEDs (in a 1:1 dilution with saline) result in an improvement of the patient dry eye sensation, while allogeneic SEDs (in a 1:1 dilution with saline) do not.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Nijmegen, Netherlands
- Radboudumc
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- chronic dry eye syndrome
- age 18 or higher
- expected to benefit from SEDs
- can donate sufficient blood to prepare autologous SEDs
- meet the donor guidelines of Sanquin (except for age, donation frequency and hemoglobin concentration)
Exclusion Criteria:
- has corneal lesions more than punctates
- has a history of unstable Herpes simplex virus (HSV) keratitis or is treated for HSV keratitis
- currently already uses SEDs
- pregnancy, lactating, or intending the become pregnant in the next 3 months
- unable or unwilling to give informed consent
- active (systemic) microbial infection
- immuno-deficiency
- poor venous access
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Group A
Subjects assigned to this arm will receive autologous serum eye drops first, followed by a washout period and then allogeneic serum eye drops.
|
Autologous serum eye drop doses will be 6 times daily in each eye
Allogeneic serum eye drop doses will be 6 times daily in each eye
|
Experimental: Group B
Subjects assigned to this arm will receive allogeneic serum eye drops first, followed by a washout period and then autologous serum eye drops.
|
Autologous serum eye drop doses will be 6 times daily in each eye
Allogeneic serum eye drop doses will be 6 times daily in each eye
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Ocular Surface Disease Index (OSDI)
Time Frame: One month after starting with serum eye drops
|
Normalized OSDI score
|
One month after starting with serum eye drops
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Tear production (Schirmer's test)
Time Frame: One month after starting with serum eye drops
|
Millimeter
|
One month after starting with serum eye drops
|
Tear break up time
Time Frame: One month after starting with serum eye drops
|
Number of seconds before a dry spot appears in the tear film
|
One month after starting with serum eye drops
|
Corneal punctates
Time Frame: One month after starting with serum eye drops
|
Number
|
One month after starting with serum eye drops
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Pieter F van der Meer, PhD, Senior Scientist
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NL53068.091.15
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Dry Eye Syndrome
-
Olympic Ophthalmics, Inc.RecruitingMicroBlepharoexfoliation, NuLids, iTEAR100, iLIDS100, Blepharitis, Dry Eye SyndromeUnited States
-
Fidia Farmaceutici s.p.a.RecruitingDry Eye Syndrome (DES)Italy
-
Instituto Universitario de Oftalmobiología Aplicada...Completed
-
Santen SASCompletedModerate to Severe Dry Eye SyndromeFrance
-
AllerganCompletedDry Eye Syndrome | Dry Eye DiseaseUnited States
-
Applied Science & Performance InstituteTrue Eye Experts - New Tampa; True Eye Experts - Lutz; True Eye Experts - South...CompletedDry Eye | Dry Eye SyndromesUnited States
-
Senju Pharmaceutical Co., Ltd.CompletedDry Eye Syndrome | Dry Eye DiseaseUnited States
-
ReGenTree, LLCCompletedDry Eye | Dry Eye SyndromesUnited States
-
LantibioRiver Plate Biotechnology, Inc.; Rx Development Resources, LLCCompletedSafety and Efficacy Assessment of Vismed® (Sodium Hyaluronate) for the Treatment of Dry Eye SyndromeDry Eye DiseaseUnited States
-
OphRx Ltd.CompletedDry Eye SyndromesIsrael
Clinical Trials on Autologous serum eye drops
-
E-DA HospitalCompletedCorneal DiseasesTaiwan
-
Hospital Nacional Profesor Alejandro PosadasCompletedDry Eye Syndromes | Sjogren Syndrome With KeratoconjunctivitisArgentina
-
Sanquin Research & Blood Bank DivisionsRadboud University Medical Center; Maastricht University Medical Center; UMC... and other collaboratorsUnknown
-
Assiut UniversityNot yet recruitingDry Eye | Persistent Corneal Epithelial Defects
-
Hai Yen Eye CareBrien Holden Vision InstituteCompleted
-
Zhaoke (Guangzhou) Ophthalmology Pharmaceutical...Recruiting
-
University Health Network, TorontoNot yet recruitingDry Eye Syndromes | Ocular Surface DiseaseCanada
-
Medical University of ViennaCompleted
-
Alcon ResearchCompleted