Use of 5.0% Lifitegrast Ophthalmic Solution for the Treatment of Dry Eye Disease in Contact Lens Wearers

October 23, 2018 updated by: Jason Nichols, University of Alabama at Birmingham
Discomfort with contact lens wear is the biggest reason why people stop wearing contact lenses. The investigators believe that inflammation is one of the causes of discomfort, and by blocking the inflammation using lifitegrast, the investigators may be able to relieve some of that discomfort. This study will enroll 50 subjects with contact lens discomfort and will receive lifitegrast to use over a period of approximately 3 months.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

The most common reason for contact lens drop out is ocular discomfort, with patients identifying dryness as the major reason. Currently, many patients with contact lens dry eye (CLDE) utilize rewetting drops to relieve their symptoms. The problem with rewetting drops is that they fail as they are transient, and do not address the inflammatory component of contact lens discomfort. Lifitegrast 5.0% ophthalmic solution was approved and is now marketed as Xiidra, for the treatment of signs and symptoms of dry eye disease. Lifitegrast works by reducing inflammation, which suggests that it may be effective in patients with contact lens dry eye. More specifically, lifitegrast may work by blocking the interaction between ICAM-1 and LFA-1, which leads to a decrease in the activation and recruitment of T-cells, and a decrease in pro-inflammatory cytokines.

The safety and efficacy of Xiidra has been studied in four, 12 week clinical trials involving over 2,100 patients. Each study assessed the effects of Xiidra on symptoms using an Eye Dryness Score (EDS), which is a visual analogue ranging from 0 (no discomfort) to 100 (maximal discomfort). In two of those studies, lifitegrast was shown to improve symptom relief at weeks 2, 6, and 12 compared to the placebo (https://www.xiidra-ecp.com/efficacy-symptom-improvement).

Each of the four clinical trials mentioned above also assessed clinical signs of dry eye disease, with a particular focus on inferior corneal staining graded on 0.5 unit increments on a 0 (no staining) to 4 scale (coalescent). In three of the four clinical trials, lifitegrast reduced inferior corneal staining by week 12, compared to placebo (https://www.xiidra-ecp.com/efficacy-treating-signs).

Contact lens dry eye is mediated by significant symptoms of ocular surface dryness, in addition to similar clinical signs of dry eye disease such as corneal staining and inflammation. Thus, the purpose of this interventional study is to examine the effect of lifitegrast ophthalmic solution in subjects with contact lens dry eye.

Study Type

Interventional

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Alabama
      • Birmingham, Alabama, United States, 35294
        • University of Alabama at Birmingham

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

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:

  • Has provided informed consent.
  • Age ≥ 18 years.
  • Have a diagnosis of CLDE based on Contact Lens Dry Eye Questionnaire (CLDEQ) results:

Answer to question #10 of "Yes" and score >-0.13, or Answer to Question #10 of "No" and score > 1.27, or Answer to #10 of "Unsure" and score > 1.44

  • Have a score of ≥ 2 on the Ocular Dryness Assessment at Visit 1.
  • Are willing and able to follow instructions and can be present for the required study visits for the duration of the study.
  • Are willing to avoid restricted medications for the time frames indicated during the study.
  • Wears soft contact lenses at least 4 days a week for at least 5 hours per day using the same brand of contact lenses for at least the last 30 days.

Exclusion Criteria:

  • Have a history of significant adverse reaction to lifitegrast or other components of the drug product, or contraindication to the use of lifitegrast or other components of the drug product.
  • Have changed the brand or material or design of soft contact lenses or care solutions within 30 days prior to screening or anticipates the need to change current type/brand of contact lenses or care solutions throughout the 84-day study.
  • Use contact lenses overnight.
  • Use rigid gas permeable contact lenses or hybrid lenses.
  • Have any uncontrolled systemic diseases that in the investigator's opinion could be expected to interfere with the study.
  • Have had cauterization of the punctum or have had punctal plugs (silicone or collagen) inserted or removed within the 90 days prior to the screening.
  • Have any active ongoing ocular infection, ocular disease or condition that would require treatment with topical ophthalmic medications.
  • Require any topically delivered ophthalmic medication for any condition during the study. This includes any preserved or unpreserved rewetting drops or artificial tears. The subject must not have used ophthalmic prescription medications for at least 30 continuous days prior to Visit 1, and must not have used rewetting drops or artificial tears for at least 5 continuous days prior to Visit 1.
  • Have recently started taking omega-3 fatty acids supplements within the past 2 months.
  • Are taking Omega-3 fatty acids supplements but unable to maintain consistent dosage for the duration of the study.
  • Are unwilling or unable to comply with the protocol.
  • Have been exposed to any investigational drug within the preceding 30 days.
  • Are an employee of the site that is directly involved in the management, administration, or support of this study or be an immediate family member of the same.
  • If female, participant must be non-pregnant and non-lactating, and those of childbearing potential must be using an acceptable method of birth control (i.e. an Intrauterine Contraceptive Device with failure rate of <1%, hormonal contraceptives, or a barrier method.) If a female subject is abstinent, she must agree to use one of the acceptable contraceptive methods if she becomes sexually active.
  • Have a clinically significant ophthalmic abnormality, infection, or disease noted by subject history or examination that would otherwise contraindicate contact lens wear and/or the use of lifitegrast (i.e., ≤ grade 3 giant papillary conjunctivitis, active ocular allergies, conjunctivitis, keratitis, uveitis).
  • Have had a history of corneal surgery (corneal transplants, LASIK, PRK).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Treatment
lifitegrast ophthalmic solution 5.0%, to be instilled 1 drop in each eye, twice a day
Drug: Lifitegrast
Eye drop
Other Names:
  • Xiidra

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of hours related to comfort in wearing contact lenses.
Time Frame: Baseline to Week 12.
The amount of comfortable lens wear time averaged over the 12th week of lens wear as reported with participant diary.
Baseline to Week 12.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of hours related to comfort in wearing contact lenses.
Time Frame: Baseline to Week 2.
The amount of comfortable lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Baseline to Week 2.
Number of hours related to comfort in wearing contact lenses.
Time Frame: Baseline to Week 6.
The amount of comfortable lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Baseline to Week 6.
Number of hours related to total contact lens wear.
Time Frame: Baseline to Week 2.
The amount of total lens wear time averaged over the 2nd week of lens wear as reported with participant diary.
Baseline to Week 2.
Number of hours related to total contact lens wear.
Time Frame: Baseline to Week 6.
The amount of total lens wear time averaged over the 6th week of lens wear as reported with participant diary.
Baseline to Week 6.
Number of hours related to total contact lens wear
Time Frame: Baseline to Week 12
The amount of total lens wear time averaged over the 12th week of lens wear as reported with participant diary.
Baseline to Week 12
Number of hours of overall eye dryness in the morning.
Time Frame: Baseline to Week 2.
The amount of overall eye dryness experienced in the morning, averaged over the 2nd week of lens wear as reported with participant diary.
Baseline to Week 2.
Number of hours of overall eye dryness in the morning.
Time Frame: Baseline to Week 6th.
The amount of overall eye dryness experienced in the morning, averaged over the 6th week of lens wear as reported with participant diary.
Baseline to Week 6th.
Number of hours of overall eye dryness in the morning.
Time Frame: Baseline to Week 12th.
The amount of overall eye dryness experienced in the morning, averaged over the 12th week of lens wear as reported with participant diary.
Baseline to Week 12th.
Number of hours of overall eye dryness in the evening.
Time Frame: Baseline to Week 2.
The amount of overall eye dryness experienced in the evening, averaged over the 2nd week of lens wear as reported with participant diary.
Baseline to Week 2.
Number of hours of overall eye dryness in the evening
Time Frame: Baseline to Week 6
The amount of overall eye dryness experienced in the evening, averaged over the 6th week of lens wear as reported with participant diary
Baseline to Week 6
Number of hours of overall eye dryness in the evening.
Time Frame: Baseline to Week 12.
The amount of overall eye dryness experienced in the evening, averaged over the 12th week of lens wear as reported with participant diary.
Baseline to Week 12.
Change in Contact Lens Dry Eye diagnosis.
Time Frame: Baseline to Week 2.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 2.
Baseline to Week 2.
Change in Contact Lens Dry Eye diagnosis.
Time Frame: Baseline to Week 6.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 6.
Baseline to Week 6.
Change in Contact Lens Dry Eye diagnosis.
Time Frame: Baseline to Week 12.
The participant diagnosis is made using the Contact Lens Dry Eye Questionnaire at Week 12.
Baseline to Week 12.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Alabama at Birmingham

Collaborators

Shire

Investigators

  • Principal Investigator: Jason J Nichols, OD PhD MPH, University of Alabama at Birmingham

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

November 1, 2018

Primary Completion (Anticipated)

December 31, 2018

Study Completion (Anticipated)

December 31, 2019

Study Registration Dates

First Submitted

February 6, 2018

First Submitted That Met QC Criteria

February 6, 2018

First Posted (Actual)

February 13, 2018

Study Record Updates

Last Update Posted (Actual)

October 25, 2018

Last Update Submitted That Met QC Criteria

October 23, 2018

Last Verified

October 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • F49384759

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

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 Contact Lens Dry Eye

Clinical Trials on Lifitegrast

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in New Zealand

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe