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Dry Eye SyndromeNCT03803722

To Demonstrate the Non-inferiority of Eyestil Protection® Compared to Vismed® in Terms of Clinical Performance

A study testing Eyestil Protection® unidose in people with Dry Eye Syndrome, run by SIFI SpA at 11 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a national, prospective, multicenter, comparative, randomized, single-blinded non-inferiority study performed in two parallel groups. 3 months (plus a run in period of 15 days prior inclusion) Patients with moderate to severe dry eye syndrome. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Dry Eye Syndrome
What is being tested?
Eyestil Protection® unidose
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
21 participants
Where
11 sitesin 2 countries
Study dates
8 Jul 2019to 30 Jun 2020
Phase
Interventional
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients, male or female, of at least 18 years of age at the screening visit
  • Patients understanding the study, willing to follow the instructions and providing their written Informed Consent Form to participate
  • Patients with moderate up severe dry eye with keratoconjunctivitis sicca diagnosed at least 4 weeks before the screening visit
  • Patients using artificial tears at least once a day for at least 4 weeks before the screening visit
  • Patients with corneal/conjunctival lesions consistent with a diagnosis of keratoconjunctivitis measured by tests of staining: i.e. the overall score of the corneal staining test must be ≥ 3 and ≤ 9 on the 15-point Oxford scale
  • And at least one of the following element: Tear volume decreased: must be either present a Schirmer test ≥ 3 mm and ≤ 9 mm / 5 minutes or the sum of 3 consecutive measurements of the tear film break-up time (TBUT) ≤ 30s for at least one eye;
  • OSDI score ≥18
  • Covered by healthcare insurance.

Who cannot join

  • Patients with medical history of herpetic keratitis, peripheral ulcerative keratitis, sclerites, diabetic retinopathy
  • Any systemic disease that is not well controlled for at least 2 months (e.g. lupus, rheumatoid arthritis, thyroiditis…) according to clinical judgment
  • Patients using any topical therapies such as non-steroidal anti-inflammatory drugs, cortisone, cyclosporine, vasoconstrictor
  • Patients with at least one of the following concomitant ocular inflammatory disease: Stevens Johnson Disease, Atopic Keratoconjunctivitis; Scarlet Eye Pemphigoid
  • Patients with anomalies of the eyelid, sucking, infectious conjunctivitis, pterygia, and/or a glaucoma treated with eyedrops
  • Presence of graft versus host disease (GVHD)
Show all 14Show fewer
  • Patients who have undergone surgery in the eye, within three months before the study enrolment
  • Patients who have undergone corneal transplantation or refractive surgery or plan to undergo any eye surgery in the next four months
  • Patients with known or suspected eye allergy
  • Patients with a condition or history that, in the opinion of the investigator, may interfere significantly with the subject's participation in the study
  • Female pregnant, planning a pregnancy during the study period and nursing an infant
  • Patients who are participating or have participated in other clinical trial with investigational drug or device within 30 days prior to screening
  • Patients unable to be compliant with the study procedures and requirements, according to the opinion of the investigator
  • Patient deprived of liberty by a judicial or administrative decision, or who is under a measure of legal protection (e.g. guardianship or curatorship)

Trial locations and contacts

11 sites in 2 countries.

11 sites in 2 countries

France10 sites
  • CHU d'Amiens

    Amiens

  • Centre Rétine Anjou

    Angers, 49000

  • Cabinet d'ophtalmologie Fosh

    Bordeaux

  • Hopital Saint Vincent de Paul

    Lille

  • Hopital Edouard Herriot

    Lyon

  • Hôpital Saint Joseph

    Marseille

  • Chu Kremlin-Bicetre

    Paris, 94270

  • APHP - Hôpital Cochin

    Paris

  • Centre Hospitalier Universitaire de Rennes

    Rennes

  • CHU Strasbourg

    Strasbourg

Other trials in France

Spain1 site
  • Hospital Universitario Miguel Servet

    Zaragoza

Other trials in Spain

About this study

Official title: A Prospective Multicenter, Comparative, Randomized, Single-blind, Non-inferiority Study of Eyestil Protection® Unidose Versus Vismed® Unidose in Patients With Moderate to Severe Dry Eye Syndrome

This is a national, prospective, multicenter, comparative, randomized, single-blinded non-inferiority study performed in two parallel groups.

3 months (plus a run in period of 15 days prior inclusion) Patients with moderate to severe dry eye syndrome.

Read the detailed description

Public hospitals and private practices specialized in ophthalmology Approximately 10 sites France Approximately 80 patients globally: 40 per arm with a 1:1 ratio including an expected dropout rate of 15%.

Dry eye has been defined as a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms, in which the tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.

However, prevalence estimates for dry eye vary dramatically from 5% to 50% due to the various operational definitions of dry eye used and the characteristics of the population studied.

The available evidence suggests also that dry eye has a negative impact on overall quality of life. It causes pain and irritation and affects ocular and general health and well-being, the perception of visual function and visual performance. Reduced quality of life in everyday activities and leisure pursuits is reported by 60% of patients, while 38% of patients complain of reduced efficiency at work.

Therefore, the economic burden and impact of dry eye on vision and quality of life, work productivity, psychological and physical impact of pain are considerable. As a consequence, dry eye represents a public health burden. However, only a handful of therapies are available for dry eye patient and are used according to the disease severity.

In such context, SIFI SpA. has developed Eyestil Protection® (or SF-104 XNT Single dose). It is a sterile preservative-free device (eye drops) for ophthalmic use containing 0.2% xanthan gum, presented in 0.3 ml unidose containers. The main action of Eyestil Protection is to lubricate and moisturize the ocular surface as well as to protect it from oxidative stress thanks to the anti-oxidative properties of the xanthan gum (as demonstrated by in-vitro studies (Amico, Tornetta et al. 2015). It is indicated in all cases of dry-eye related ocular discomfort and to relief ocular discomfort due to the use of contact lenses.

Eyestil Protection® unidose is CE marked but is not available yet in all European countries, notably in France.

Confronted to a European regulatory change on medical devices - from a Directive (Directive 1993/42/EEC) to a Regulation (MDR 2017/745) that now requires clinical evidence of device performance and safety; SIFI SpA decided to implement the present clinical comparative performance study. The choice of Vismed® (unidose) as the comparator has been done since it is the current French standard of care treatment for patients with moderate to severe dry eyes.

Primary objective

  • To demonstrate the non-inferiority of Eyestil Protection® compared to Vismed® in terms of clinical performance as detected by a reduction of keratitis lesions objectified by staining tests after 1 month of treatment, in patients with moderate to severe dry eye syndrome with keratoconjunctivitis.

Secondary objectives Clinical performance

  • To evaluate the tear film stability per group as objectified by the tear break up time (TBUT) test at month 1 and 3;
  • To evaluate the long term clinical performance of Eyestil Protection® compared to Vismed® as detected by a reduction of keratitis lesions objectified by staining tests after 3 months of treatment;
  • To evaluate the tear production per group as objectified by the Schirmer test at month 3.

Patient reported outcomes

  • To compare patients reported outcomes (PRO) measures per group at month 1 and 3, including:
  • Patient's reported symptoms and
  • Patient's quality of life (QoL). Investigator overall satisfaction
  • To assess investigator's overall satisfaction of the treatment's clinical performance at month 1 and 3.

Safety • To describe the safety profile of Eyestil Protection® compared to Vismed® after 3 months of treatment.

Exploratory objectives

  • To compare patient's QoL subscale scores per group at each time point.
Being tested
Eyestil Protection® unidose
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.

  • Eyestil Protection® unidoseDevice

    to demonstrate the non-inferiority of Eyestil Protection® in terms of performance and safety, when compared to Vismed® in treatment of dry eye disease.

Study groups in NCT03803722
Study groupRoleWhat they receive
Arm A Eyestil Protection®ExperimentalNo inferiority of Eyestil Protection® unidose versus Vismed® unidose The intervention consists of Eyestil Protection® : sterile preservative free, medical device, class IIa and CE marked. It contains 0.2% xanthan gum, presented in 0.3 ml unidose containers. It is not available yet on the French Market. dosage: 6 drops a day for three months period.
Receives: Device: Eyestil Protection® unidose
Arm B Vismed®No interventionVismed®: sterile preservative free, medical device class IIb and CE marked. It contains 0.18% sodium hyaluronate, presented in 0.3 ml unidose containers. It is already on the French market. dosage: 6 drops a day for three months period.

What is being measured

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

  1. Primary endpoint/clinical performance by Oxford scale

    Clinical performance of the medical device under investigation: the between-group comparison of the average variation of the global fluorescein corneal and lissamine green conjunctival staining using the Oxford scale (0 to 15). This refers to the average variation between both time points of the Global Ocular Staining Score of the study eye (GOSS).

    0-5 cornea; 0-5 temporal conjuctiva; 0-5 nasal conjunctiva. Max total score: 15

    Measured: between Day 1 and Day 35 ±4.

Secondary outcomes (6)
  1. Secondary endpoint/clinical performance by TBUT test

    The between-group comparisons of the average variation of the time obtained at the tear break up time test (TBUT). This full procedure will be performed 3 times per eye and per time point. Each obtained time will be recorded by the investigator in the eCRF. At screening and at baseline visits, the sum of these 3 times for at least one eye to be eligible must be ≤ 30 seconds.

    Conventionally TBUT's measures shorter than 10 seconds can be referred to tear film instability and measures shorter than 5 seconds, usually, are undoubtable sign of dry eye. The longer it takes, the more stable the tear film. A short TBUT is a sign of poor tear film. A positive number change from baseline indicates an increase in TBUT (improvement) and a negative number change from baseline indicates a decrease in TBUT (worsening).

    Measured: between Day 1 and Day 35 ±4 and Day 1 and Day 84 ±7

  2. Secondary endpoint/patient reported outcome by DEQS questionnaire

    The between-group comparisons of the average variation of Dry Eye-Related Quality-of-Life (DEQS) general score. It is a validated 15-item scale divided into 2 subscales related to dry eye symptoms and its influence on daily life:

    The frequency is scored on a 5-point Likert scale ranging from 0 (no symptom) to 4 (highest frequency).

    • The degree is scored on a 4-point Likert scale ranging from 1 to 4, a larger number indicates a greater burden.

    The summary score ranges from 0 to 100, higher score indicates higher disability. .

    Measured: between Day 1 and Day 35 ±4 and Day 1 and Day 84 ±7

  3. Secondary endpoint/safety

    The description of all adverse events, related and unrelated to the medical devices, anticipated or unanticipated

    Measured: between Day 1 and Day 84 ±7

  4. Secondary endpoint/clinical performance by Oxford scale

    The between-group comparison of the average variation of the global fluorescein corneal and lissamine green conjunctival staining using the Oxford scale (0-15).This refers to the average variation between both time points of the of the Global Ocular Staining Score of the study eye (GOSS) and the comparison between both treatment groups. -5 cornea; 0-5 temporal conjuctiva; 0-5 nasal conjunctiva. Max total score: 15

    Measured: between Day 1 and Day 84 ±7

  5. Secondary endpoint/clinical performance by Schirmer test

    The between-group comparisons of the average variation of the paper length obtained at the Schirmer Test. The Schirmer test without anesthesia will be here performed to measure the rate of secretion of tears produced by the study eye over 5 minutes.The cut-off value for a severe dry eye in the first one is 6 mm. But the cut-off that will here use will be 9 mm with the following interpretation:

    • Normal = ≥ 10 millimeters (mm) of tears,
    • Dry Eye = ≤ 9 mm of tears A positive number change from baseline indicates an increase in tears (improvement) and a negative number change from baseline indicates a decrease in tears (worsening).

    Measured: between [Day 1 and Day 84 ±7]

  6. Secondary endpoint/patient reported outcome by OSDI score

    The between-group comparisons of the average variation of Ocular Symptoms Disease Index (OSDI) score. The patient's dry eye symptoms will be assessed with the Ocular Surface Disease Index (OSDI). It is a validated 12-questions scale for patients that covers a broad spectrum of ocular surface symptoms, the severity of such symptoms for patients and how these symptoms affect/impact visual function over a 1-week recall period. Its scores range from 0 to 100, with higher scores indicating greater severity of disease.Positive result is considered when the OSDI score is ≥ 18.To be consistent with the IMD indication, patient with moderate to severe dry eye thus with an OSDI ≥ 18 will be selected. If the patient's OSDI score will be strictly below 18 at the screening or baseline visit, s/he will be considered as a screening failure.

    Each item response will be collected in the study database since given separately to patients.

    Measured: between [Day 1 and Day 35 ±4] and [Day 1 and Day 84 ±7]

Timeline

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

  1. First posted15 Jan 2019
  2. Study start8 Jul 2019
  3. Primary completion30 Jun 2020
  4. Study completion30 Jun 2020

Why it stopped: Slow enrolment process and COVID situation worsened the situation. SIFI has developed a new product with probably a better performance. SIFI changed its marketing strategy and decided that Eyestil® Protection will be not marketed anymore

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 N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Approximately 80 patients globally: 40 per arm with a 1:1 ratio including an expected dropout rate of 15%. Single masked. Medical Device
Masking
Single blind
Who is masked
Investigator
Enrolment
21 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03803722
Sponsor's protocol ID
048/SI
Status last verified
May 2022
First submitted
10 Dec 2018
Last updated
9 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Eyestil Protection® unidose in people with Dry Eye Syndrome, run by SIFI SpA at 11 sites in 2 countries.

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 8 inclusion and 14 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: stopped early, as of the sponsor's last update on 9 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in France, Spain. 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.

Are results available for this study?

The study was stopped early (reason given: Slow enrolment process and COVID situation worsened the situation. SIFI has developed a new product with probably a better performance. SIFI changed its marketing strategy and decided that Eyestil® Protection will be not marketed anymore). Results are not available in the source record.

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?

Primary endpoint/clinical performance by Oxford scale (time frame: between Day 1 and Day 35 ±4.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 May 2022.

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