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Clinical Trial Results:
Double blind, randomized, multicenter, placebo-controlled, parallel-group design clinical trial of the efficacy and tolerability of cloriclomene hydrochloride capsules 100 mg TID in diabetic patients with mild to moderate non-proliferative retinopathy

Summary
EudraCT number
2004-002249-11
Trial protocol
IT  
Global end of trial date
08 May 2009

Results information
Results version number
v1(current)
This version publication date
28 Aug 2020
First version publication date
28 Aug 2020
Other versions

Trial information

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Trial identification
Sponsor protocol code
BLQ01-003-04
Additional study identifiers
ISRCTN number
-
US NCT number
-
WHO universal trial number (UTN)
-
Sponsors
Sponsor organisation name
Bausch & Lomb Incorporated
Sponsor organisation address
1400 North Goodman Street, Rochester, United States, 14609
Public contact
Study Manager, Bausch&Lomb Dr Gerhard Mann chem.-Fabrik GmbH, natasa.orlic-pleyer@bausch.com
Scientific contact
Study Manager, Bausch&Lomb Dr Gerhard Mann chem.-Fabrik GmbH, Raphaele.SiouMermet@bausch.com
Paediatric regulatory details
Is trial part of an agreed paediatric investigation plan (PIP)
No
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Results analysis stage
Analysis stage
Final
Date of interim/final analysis
08 May 2009
Is this the analysis of the primary completion data?
Yes
Primary completion date
08 May 2009
Global end of trial reached?
Yes
Global end of trial date
08 May 2009
Was the trial ended prematurely?
Yes
General information about the trial
Main objective of the trial
To demonstrate that the oral therapy with Cloricromene hydrochloride (Proendotel ®) capsules 100m admistered 3 time daily via oral route for 24 months, is superior to placebo in the arrest of progression of non-proliferative retinopathy in patients with diabetes of type I and II (insulin or non-insulin dependent)
Protection of trial subjects
The protocol complied with the ethical principles for medical research and recommendations adopted by the 18th World Medical Assembly (Helsinki, 1964) and its amendments (52nd WMA General Assembly, Edinburgh, Scotland, October 2000, and clarifications by the WMA General Assembly, Washington 2002). The protocol also complied with the laws and regulations applicable in Italy. This study was conducted according to globally accepted standards of good clinical practice ed in the ICH E6 Guideline for Good Clinical Practice, 1 May 1996.
Background therapy
-
Evidence for comparator
-
Actual start date of recruitment
21 Apr 2005
Long term follow-up planned
No
Independent data monitoring committee (IDMC) involvement?
No
Population of trial subjects
Number of subjects enrolled per country
Country: Number of subjects enrolled
Italy: 127
Worldwide total number of subjects
127
EEA total number of subjects
127
Number of subjects enrolled per age group
In utero
0
Preterm newborn - gestational age
0
Newborns (0-27 days)
0
Infants and toddlers (28 days-23 months)
0
Children (2-11 years)
0
Adolescents (12-17 years)
0
Adults (18-64 years)
93
From 65 to 84 years
34
85 years and over
0

Subject disposition

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Recruitment
Recruitment details
-

Pre-assignment
Screening details
Patients underwent an initial screening visit in which candidate patients for the study were selected, a 2- to 7-day run-in period, where patients had any non-permitted medications withdrawn prior to study entry and study entry criteria were checked, and a 24-month treatment period with the assigned study drug (active treatment).

Period 1
Period 1 title
Treatment Phase (overall period)
Is this the baseline period?
Yes
Allocation method
Randomised - controlled
Blinding used
Double blind
Roles blinded
Subject, Investigator

Arms
Are arms mutually exclusive
Yes

Arm title
ProEndotel
Arm description
-
Arm type
Experimental

Investigational medicinal product name
Cloricromene hydrochloride
Investigational medicinal product code
Other name
Pharmaceutical forms
Capsule
Routes of administration
Oral use
Dosage and administration details
100 mg via oral route. One capsule TID.

Arm title
Placebo
Arm description
-
Arm type
Placebo

Investigational medicinal product name
Matched placebo
Investigational medicinal product code
Other name
Pharmaceutical forms
Capsule
Routes of administration
Oral use
Dosage and administration details
Matched placebo capsules via oral route. One capsule TID.

Number of subjects in period 1
ProEndotel Placebo
Started
62
65
Completed
30
31
Not completed
32
34
     Study Terminated by Sponsor
12
16
     Protocol deviation
7
4
     Other
3
2
     Physician decision
1
-
     Adverse event, non-fatal
6
4
     Consent withdrawn by subject
2
3
     Lost to follow-up
1
5

Baseline characteristics

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Baseline characteristics reporting groups
Reporting group title
Treatment Phase
Reporting group description
ITT

Reporting group values
Treatment Phase Total
Number of subjects
127 127
Age categorical
Units: Subjects
    In utero
0 0
    Preterm newborn infants (gestational age < 37 wks)
0 0
    Newborns (0-27 days)
0 0
    Infants and toddlers (28 days-23 months)
0 0
    Children (2-11 years)
0 0
    Adolescents (12-17 years)
0 0
    Adults (18-64 years)
93 93
    From 65-84 years
34 34
    85 years and over
0 0
Age continuous
Units: years
    arithmetic mean (standard deviation)
52.0 ± 9.3 -
Gender categorical
Units: Subjects
    Female
48 48
    Male
79 79

End points

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End points reporting groups
Reporting group title
ProEndotel
Reporting group description
-

Reporting group title
Placebo
Reporting group description
-

Primary: Patients with progression of retinopathy

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End point title
Patients with progression of retinopathy [1]
End point description
End point type
Primary
End point timeframe
24 months
Notes
[1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
Justification: Due to the low sample size reached and consequently the lack of statistical power, the statistical methods were modified to descriptive analysis for all endpoints and safety data.
End point values
ProEndotel Placebo
Number of subjects analysed
45
39
Units: Patients
0
1
No statistical analyses for this end point

Secondary: Change from baseline in Best Corrected Visual Acuity (right eye)

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End point title
Change from baseline in Best Corrected Visual Acuity (right eye)
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
35
32
Units: units
    least squares mean (standard error)
-0.009 ± 0.019
-0.003 ± 0.021
No statistical analyses for this end point

Secondary: Change from baseline in Best Corrected Visual Acuity (left)

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End point title
Change from baseline in Best Corrected Visual Acuity (left)
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
30
31
Units: units
    least squares mean (standard error)
-0.009 ± 0.023
0.005 ± 0.025
No statistical analyses for this end point

Secondary: Frequency of patients with 3-line visual loss

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End point title
Frequency of patients with 3-line visual loss
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
45
39
Units: Patients
0
2
No statistical analyses for this end point

Secondary: Presence of Macular Edema

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End point title
Presence of Macular Edema
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
39
37
Units: Patients
10
15
No statistical analyses for this end point

Secondary: Change from baseline in mean Retinal Thickness (right eye)

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End point title
Change from baseline in mean Retinal Thickness (right eye)
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
33
32
Units: units
    least squares mean (standard error)
8.217 ± 15.622
20.101 ± 18.001
No statistical analyses for this end point

Secondary: Change from baseline in mean Retinal Thickness (left eye)

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End point title
Change from baseline in mean Retinal Thickness (left eye)
End point description
End point type
Secondary
End point timeframe
24 months
End point values
ProEndotel Placebo
Number of subjects analysed
27
31
Units: units
    least squares mean (standard error)
7.598 ± 10.138
28.430 ± 11.057
No statistical analyses for this end point

Adverse events

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Adverse events information
Timeframe for reporting adverse events
24 months
Assessment type
Non-systematic
Dictionary used for adverse event reporting
Dictionary name
MedDRA
Dictionary version
12.1
Reporting groups
Reporting group title
ProEndotel
Reporting group description
-

Reporting group title
Placebo
Reporting group description
-

Serious adverse events
ProEndotel Placebo
Total subjects affected by serious adverse events
     subjects affected / exposed
7 / 62 (11.29%)
2 / 65 (3.08%)
     number of deaths (all causes)
1
0
     number of deaths resulting from adverse events
1
0
Injury, poisoning and procedural complications
Cervical vertebral fracture
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Investigations
Arteriogram coronary
     subjects affected / exposed
0 / 62 (0.00%)
1 / 65 (1.54%)
     occurrences causally related to treatment / all
0 / 0
0 / 1
     deaths causally related to treatment / all
0 / 0
0 / 0
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Endometrial cancer
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Hepatic neoplasm malignant
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Cardiac disorders
Tachycardia
     subjects affected / exposed
0 / 62 (0.00%)
1 / 65 (1.54%)
     occurrences causally related to treatment / all
0 / 0
0 / 1
     deaths causally related to treatment / all
0 / 0
0 / 0
Nervous system disorders
Cerebrovascular accident
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 1
0 / 0
Ear and labyrinth disorders
Otosalpingitis
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Gastrointestinal disorders
Anal fissure
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Haemorrhoids
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Rectal prolapse
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Hepatobiliary disorders
Cholelithiasis
     subjects affected / exposed
0 / 62 (0.00%)
1 / 65 (1.54%)
     occurrences causally related to treatment / all
0 / 0
0 / 1
     deaths causally related to treatment / all
0 / 0
0 / 0
Hepatic cirrhosis
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Metabolism and nutrition disorders
Metabolic disorder
     subjects affected / exposed
0 / 62 (0.00%)
1 / 65 (1.54%)
     occurrences causally related to treatment / all
0 / 0
0 / 1
     deaths causally related to treatment / all
0 / 0
0 / 0
Infections and infestations
Labyrinthitis
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Streptococcal sepsis
     subjects affected / exposed
1 / 62 (1.61%)
0 / 65 (0.00%)
     occurrences causally related to treatment / all
0 / 1
0 / 0
     deaths causally related to treatment / all
0 / 0
0 / 0
Frequency threshold for reporting non-serious adverse events: 3%
Non-serious adverse events
ProEndotel Placebo
Total subjects affected by non serious adverse events
     subjects affected / exposed
6 / 62 (9.68%)
5 / 65 (7.69%)
Nervous system disorders
Neuropathy peripheral
     subjects affected / exposed
0 / 62 (0.00%)
2 / 65 (3.08%)
     occurrences all number
0
2
Gastrointestinal disorders
Diarrhoea
     subjects affected / exposed
2 / 62 (3.23%)
1 / 65 (1.54%)
     occurrences all number
2
1
Vomiting
     subjects affected / exposed
2 / 62 (3.23%)
0 / 65 (0.00%)
     occurrences all number
2
0
Nausea
     subjects affected / exposed
2 / 62 (3.23%)
0 / 65 (0.00%)
     occurrences all number
2
0
Metabolism and nutrition disorders
Hyperglycaemia
     subjects affected / exposed
0 / 62 (0.00%)
3 / 65 (4.62%)
     occurrences all number
0
3

More information

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Substantial protocol amendments (globally)

Were there any global substantial amendments to the protocol? Yes
Date
Amendment
02 Nov 2004
Deletion of fluorescein angiography at visit 3 (month 6); Fluorescein angiography to be performed only in the most seriously affected eye, in case of bilateral affection; Centralized reading of fundus color photography, fluorescein angiography and OCT at AIBILI (Association for Innovation and Biomedical research on Light and Image) – Coimbra (Portugal); Best corrected visual acuity measured in both eyes at visit 1, and only in the affected eye in case of monolateral affection; demographic data to be collected in the run-in period Carton boxes were provided containing 40 blisters with 15 capsules each, instead of 60 blisters with 10 capsules each Specification that the interim analysis would be done “to assess consistency of progression rates in the Chloricromene and placebo groups with planned estimations”
27 Sep 2007
Change in selection criteria, to facilitate patients’ enrolment: exclusion criterion “history of focal photocoagulation for diabetic macular edema in the study eye” modified as follows: “history of photocoagulation for diabetic macular edema in the study eye except focal photocoagulation at least 6 months before”. This change had no impact on the primary end-point “progression of retinopathy”; Prolongation of the study timelines with study end postponed until December 2010, due to slow enrolment rate
30 Nov 2008
Anticipation of closure in study activities, due to slow enrolment rate, with study end established in May 2009.

Interruptions (globally)

Were there any global interruptions to the trial? No

Limitations and caveats

Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
Due to the low sample size reached and consequently the lack of statistical power, the statistical methods were modified to descriptive analysis for all endpoints and safety data.
3
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