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Dry EyePhase 4NCT02752763

Comparison of Autologous Serum Versus Preservative Free Artificial Tear

A Phase 4 study testing %40 diluted Autologous serum and Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop) in people with Dry Eye, run by Niğde State Hospital at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Dry eye is a significant adverse effect of isotretinoin causing patients to use ophthalmic medications. For this reason, many patients using isotretinoin are referred to ophthalmology clinic because of discomfort symptoms. Read more about this study

Who is it for?
Ages 18 to 35 years
Conditions the study is for
Dry Eye
What is being tested?
%40 diluted Autologous serum and Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteTurkey (Türkiye)
Study dates
Oct 2015to Mar 2016
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • isotretinoin use for any reason

Who cannot join

  • corneal pathologies such as dry eye illness before isotretinoin treatment
  • previous cornea surgery, injury or keratitis
  • active ocular infection
  • meibomian gland dysfunction
  • excessive allergic reaction that may be associated with dry eye
  • glaucoma therapy use
Show all 9Show fewer
  • severe anemia
  • previously use of PFAT or AS for any reason
  • (Hb<10 g/dL) and elevated hepatic function tests requiring withdrawal of therapy

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Niğde State Hospital

    Niğde, Niğde Province, 51100

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of Autologous Serum Versus Preservative Free Artificial Tear in Patients With Dry Eye Due to Systemic Isotretinoin Therapy

Dry eye is a significant adverse effect of isotretinoin causing patients to use ophthalmic medications. For this reason, many patients using isotretinoin are referred to ophthalmology clinic because of discomfort symptoms. In the literature, there are studies suggesting superiority of Autologous serum drops regarding effects on ocular surface when compared to artificial tear. In addition, Autologous serum was also used in several corneal pathologies with successful outcomes. No data regarding use in the ocular adverse effects of isotretinoin was found in the literature; however, investigators think that it may be an effective alternative in the treatment of dry eye developed during isotretinoin use due to positive effects on ocular surface, epithelial regeneration and anti-inflammatory effect. Autologous serum can be a choice of ophthalmologists in routine practice by increasing number of comprehensive studies investigating effectiveness, safety and long-terms effects of Autologous serum therapy.In this study, it was aimed to investigate dry eye development in the patients receiving systemic retinoic acid therapy and to compare effectiveness of Autologous serum and Preservative free artificial tear in the patients with dry eye disease.

Read the detailed description

This prospective, cross-sectional, double blind study was conducted by Ophthalmology Clinic on patients who have drye eye due to systemic isotretinoin treatment for several reasons in Niğde State Hospital between October, 2015 and March 2016. Patients determined as having drye eye during systemic isotretinoin treatment were included to our study. At baseline, 1.and 2. month of study, detailed ocular examination, best corrected visual acuity measurement, intraocular pressure measurement, Tear Break-Up time(TBUT)(5 µL of fluorescein sodium 2 % eye drops was used per each measurement using a pipette for standardization, and the mean value of two readings per patient was recorded) and Schirmer Test I (ST I) without topical anesthesia were performed. Effect on daily life was assessed by using Ocular Surface Disease Index (OSDI) score. TBUT<10 seconds, ST I <10 mm without local anesthesia, corneal and conjunctival staining was interpreted in favor of dry eye. In the follow-up period, investigators investigated the efficacy of autologous serum eye drops for the patients having dry eye illness during isotretinoin treatment. After informed consent, peripheral venous blood (14-20 ml) was drawn from antecubital vein of patients to prepare AS. Blood sample was left at room temperature over 2 hours for clotting. Serum was obtained after centrifugation at 4000 revolutions per minute (rpm) for 10 minutes at 4 °C using a centrifugal device(Nuve NF1200R). Next, in a laminar flow cabinet under sterile conditions, approximately 10 mL of supernatant was collected and diluted to 40 % with isotonic (0.9 % NaCl) saline solution and then 25 mL of preparation was aliquoted into 1.5-mL Eppendorf vials, each of which was wrapped with aluminum foil by the other specialist(Erkut Küçük) for protection against ultraviolet light (to prevent vitamin A degradation), and blinding the patients to the treatment. PFAT eye drops were also placed into different 1.5-ml Eppendorf vials and likewise wrapped with aluminum foil by the other specialist(Erkut Küçük) for blinding the patients. The droppers were also wrapped with aluminum foil for further blinding the patient while applying the eye drops. Patients were randomised via assigned laterality numbers and sealed regime envelopes by the other specialist(Erkut Küçük). Preservative-free isotonic saline was used for washout for 2 weeks prior to beginning of the study.

After the first treatment period (1 month) all patients underwent a 2-week washout period with isotonic saline (0.9 % NaCl) eye drops. Ten a new set of vials (AS or PFAT) was assigned to each patient by the other specialist(Erkut Küçük) for the second treatment period.

After the first 1-month treatment period, patients who had conventional PFAT treatment were switched to AS treatment and the patients who had AS treatment in the first 1-month treatment period were switched to conventional PFAT treat- ment in the second 1-month treatment period, according to the study's crossover nature. The examining ophthalmologist (Uğur Yılmaz) that performed tear function and ocular surface evaluations was blinded to the type of eye drops given to each patient. In addition, the patients were blinded to which treatment they were receiving.

Only the Other specialist (Erkut Küçük), who was not responsible for patient evaluation, knew which patient received which treatment during study periods. All patients were instructed to keep the vials (containing either AS or PFAT) in a refrigerator at 4 °C. All patients were advised to change the vial every other day during the treatment period. TBUT and ST I were administered by the same ophthalmologist (Uğur Yılmaz).

The study was approved Institutional Review Board of Erciyes University, Medicine School. The study was conducted in accordance to Helsinki Declaration. All patients gave written informed consent.

Conditions
Dry Eye
Being tested
%40 diluted Autologous serum, Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop)
Keywords
Dry eye, isotretinoin, AS, Autologous serum
Medical subject headings
Dry Eye Syndromes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • %40 diluted Autologous serumDrug

    Serum that obtained after centrifugation of blood sample

  • Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop)Drug

    Also called Tears naturale free(hydroxypropyl methylcellulose), Refresh single dose(polyvinyl Alcohol + Povidone)

    Preservative free artificial tears is a group naming for drops commonly used for drye disease

Study groups in NCT02752763
Study groupRoleWhat they receive
preservative free artificial tear dropExperimentalpreservative free artificial tears drop is a drop group declaring different kind of active agent like hydroxypropyl methylcellulose, carboxymethyl cellulose etc commonly used in dry eye treatment. Preservative free artificial tear( carboxymethyl cellulose, hydroxypropyl methylcellulose) was used as four times one drop daily. In our study, we prescribed to patients preservative free artificial tears drop(hydroxypropyl methylcellulose or carboxymethyl cellulose) four times one drop daily.
Receives: Drug: Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop)
%40 Autologous serum(AS)Experimentalperipheral venous blood (14-20 ml) that drawn from antecubital vein of patients to prepare Autologous Serum. Blood sample was left at room temperature over 2 hours for clotting. Serum was obtained after centrifugation at 4000 revolutions per minute (rpm) for 10 minutes at 4 °C using a Nuve NF1200R. Next, in a laminar flow cabinet under sterile conditions, approximately 10 mL of supernatant was collected and diluted to 40 % with isotonic saline solution. It is recommended for dry eye diseases, too. %40 diluted Autologous Serum used as four times one drop daily.
Receives: Drug: %40 diluted Autologous serum

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Schirmer Test I in Patients with Dry Eye due to isotretinoin use after autologous serum or preservative free artificial tears treatment

    Schirmer Test I is used for Dry Eye evaluation before and after autologous serum or preservative free artificial tears treatment. Schirmer test is used to measure tear secretion. Schirmer strips are used for this test. Wetting of the paper is recorded in millimeter

    Measured: up to 3 Months monthly measurements were done

  2. Change in Break up Time in Patients with Dry Eye due to isotretinoin use after autologous serum or preservative free artificial tears treatment

    fluorescein sodium eye drops was used for measurement of Break up Time. Value of Break up Time for per eye is recorded as seconds

    Measured: up to 3 Months monthly measurements were done

  3. Change in Ocular surface Disease Index in Patients with Dry Eye due to isotretinoin use after autologous serum or preservative free artificial tears treatment

    OSDI score is a reliable and feasible test which is commonly used for dry eye patients to grade either dry eye symptom severity and its effect on vision-related function. In this index, people are asked to indicate whether they experienced any of the symptoms or problems due to drye eye, if so, how often. Every question asked to patients is scored from one to four according to the frequency of symptoms. The scores were collected from all the questions.

    Measured: up to 3 Months monthly measurements were done

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Apr 2016 (estimated)
  2. Study startOct 2015
  3. Primary completionMar 2016
  4. Study completionMar 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02752763
Sponsor's protocol ID
NSH 333
Status last verified
Apr 2016
First submitted
31 Mar 2016
Last updated
27 Apr 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
Undecided

Publications

  • Oner AF, Ferahbas A, Karakucuk S, Utas S, Karaman B, Kutlugun C et al. Ocular side effects associated with systemic isotretinoin. Cutan Ocul Toxicol. 2005;23:189-195.

  • Egger SF, Huber-Spitzy V, Bohler K, Scholda C. [Isotretinoin administration in treatment of acne vulgaris. A prospective study of the kind and extent of ocular complications]. Ophthalmologe. 1995 Feb;92(1):17-20. German.

    PubMed 7719068
  • Tananuvat N, Daniell M, Sullivan LJ, Yi Q, McKelvie P, McCarty DJ, Taylor HR. Controlled study of the use of autologous serum in dry eye patients. Cornea. 2001 Nov;20(8):802-6. doi: 10.1097/00003226-200111000-00005.

    PubMed 11685055
  • Kojima T, Ishida R, Dogru M, Goto E, Matsumoto Y, Kaido M, Tsubota K. The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case-control study. Am J Ophthalmol. 2005 Feb;139(2):242-6. doi: 10.1016/j.ajo.2004.08.040.

    PubMed 15733983
  • Urzua CA, Vasquez DH, Huidobro A, Hernandez H, Alfaro J. Randomized double-blind clinical trial of autologous serum versus artificial tears in dry eye syndrome. Curr Eye Res. 2012 Aug;37(8):684-8. doi: 10.3109/02713683.2012.674609. Epub 2012 Jun 6.

    PubMed 22670856

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing %40 diluted Autologous serum and Preservative free artificial tears(Tears naturale free, Refresh single dose eye drop) in people with Dry Eye, run by Niğde State Hospital at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Apr 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Schirmer Test I in Patients with Dry Eye due to isotretinoin use after autologous serum or preservative free artificial tears treatment (time frame: up to 3 Months monthly measurements were done). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02752763, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2016.

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