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Acute Autoimmune Inflammatory Optic NeuritisACSONNCT03862313

Repetitive Transorbital Alternating Current Stimulation in Acute Autoimmune Optic Neuritis

A study testing active-rtACS treatment in people with Acute Autoimmune Inflammatory Optic Neuritis, run by University of Zurich at 1 site in Switzerland.

Terminated

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

Official record
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Trial summary

Optic neuritis (ON) is an acute inflammatory, demyelinating attack of the optic nerve that triggers neurodegeneration in the entire visual pathway; translating into visual dysfunction. Currently, no neuroprotective therapy with satisfying evidence can be offered to patients. Read more about this study

Who is it for?
Ages 18 to 50 years
What is being tested?
active-rtACS treatment
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
2 participants
Where
1 siteSwitzerland
Study dates
14 Oct 2019to 27 Dec 2019
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 to 50 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Participants fulfilling all of the following inclusion criteria are eligible for the study:
  • Informed Consent as documented by signature
  • Participants are capable of giving informed consent
  • Participant who have a good knowledge of German (patient information and consent must be understood)
  • Patients, presenting with typical signs and symptoms suggestive of a first-ever episode of unilateral acute autoimmune, inflammatory, demyelinating ON, including idiopathic ON and ON suggestive of multiple sclerosis (MS) (typical clinically isolated syndrome, or with an established diagnosis of relapsing-remitting MS according to latest panel criteria and no better explanation)
  • Patients with high-contrast visual acuity of ≤ 0.63 (decimal system) corresponding to a LogMAR value of ≥ 0.2 on the affected eye (assessed using a Snellen chart during clinical routine)
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  • Patients presenting in clinics within 14 days of symptom onset
  • In principle 18-50 year old female and male patients may be recruited. However, since the randomization of patients will be controlled for gender and participants will be enrolled one at a time on a continuous basis, the gender might become relevant late in the study (e.g. if the female block has already been fully recruited and only males might still be enrolled).
  • Patients are receiving standard-of-care treatment for ON (cortisone therapy)

Who cannot join

  • The presence of any one of the following exclusion criteria will lead to exclusion of the participant:
  • Patient without legal capacity who is unable to understand the nature, significance and consequences of the trial
  • Women who are pregnant or have the intention to become pregnant during the course of the study (For women who can get pregnant, pregnancy will be omitted using a pregnancy test when checking for inclusion and exclusion criteria. Patients will be informed that they must use contraception during the study)
  • Patients with a previous clinical history of ON in the respective eye
  • Patients with obvious retinal pathology other than that associated with ON
  • Patients who are unable to perform the study assessments (e.g. OCT examination) because of a severe nystagmus (repetitive, uncontrolled eye movements causing unsteady fixation)
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  • Patients with a recent eye surgery
  • Patients with known anti-aquaporin-4- or myelin oligodendrocyte glycoprotein- antibody seropositivity
  • Patients with contraindications to the class of device under study (for rtACS): implanted electronic devices, metallic artefacts in the head (excluding dentition), epilepsy, brain cancer, pregnancy, breastfeeding, increased intraocular pressure without appropriate treatment, arterial hypertension without appropriate treatment, skin irritations at intended positions of electrodes, cognitive deficits (unable to provide written informed consent or follow the instructions)
  • Known or suspected non-compliance, drug or alcohol abuse
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant
  • Participation in another study with investigational drug/device within the 30 days preceding and during the present study
  • Previous enrolment into the current study
  • Enrolment of the investigator, his/her family members, employees and other dependent persons

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • Department of Neurology and Department of Ophthalmology, University Hospital Zurich

    Zurich, 8091

Other trials in Switzerland

About this study

Official title: Assessing Repetitive Transorbital Alternating Current Stimulation in Acute Autoimmune Inflammatory Optic Neuritis Using the NextWave® 1.1 System: A Prospective, Randomized, Patient-blinded, Sham-controlled Pilot Study

Optic neuritis (ON) is an acute inflammatory, demyelinating attack of the optic nerve that triggers neurodegeneration in the entire visual pathway; translating into visual dysfunction. Currently, no neuroprotective therapy with satisfying evidence can be offered to patients. Repetitive transorbital alternating current stimulation (rtACS) is a methodology applied to electrically stimulate the retina and the optic nerve and is considered having neuroprotective- and restorative potential. The goal of this pilot study is to assess safety, tolerability and preliminary efficacy of rtACS as a treatment to improve visual functional as well as structural retinal outcomes in patients with a first-ever episode of autoimmune acute ON.

Being tested
active-rtACS treatment, sham-rtACS treatment
Keywords
optic neuritis, multiple sclerosis, repetitive transorbital alternating current stimulation, optical coherence tomography, low-contrast visual acuity
Medical subject headings
Optic Neuritis, Multiple Sclerosis

What participants receive

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

  • active-rtACS treatmentDevice

    Also called NextWave® 1.1 system, EBS Technologies GmbH, Germany

    For the active-rtACS treatment arm, a CE-certificated proprietary class IIa medical device will be used to apply transorbital symmetrical rectangular current pulses in bursts (NextWave® 1.1 system; EBS Technologies GmbH, Germany). The stimulation protocol will be patient-individualized, with a stimulation current strength of 125% of the phosphene threshold recorded during 5Hz stimulation and stimulation frequencies between the individual's EEG alpha frequency and their flicker fusion frequency.

  • sham-rtACS treatmentDevice

    Also called NextWave® 1.1 system, EBS Technologies GmbH, Germany

    For the sham-rtACS treatment arm, exactly the same medical device, setup, time schedule, etc. will be used as for the patients of the active-rtACS arm. However, sham-treated patients will receive no actual current stimulation during the therapy sessions.

Study groups in NCT03862313
Study groupRoleWhat they receive
active-rtACS armExperimentalActive rtACS on 10 consecutive working days, in addition to standard-of-care corticosteroid treatment.
Receives: Device: active-rtACS treatment
sham-rtACS armSham comparatorSham rtACS on 10 consecutive working days, in addition to standard-of-care corticosteroid treatment.
Receives: Device: sham-rtACS treatment

What is being measured

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

  1. The primary functional outcome measure will be low-contrast visual acuity [LogMAR] at 16 weeks (3 month follow-up) in ON eyes.

    Measured: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  2. The primary structural outcome measure will be the mean change in macular ganglion cell and inner plexiform layer thickness [µm] of the affected ON eye at 16 weeks in comparison to baseline of the unaffected contralateral NON eye (pre-treatment).

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  3. The primary safety outcome measure will be the total number of adverse events during the entire study period

    Measured: up to 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

Secondary outcomes (15)
  1. Low-contrast visual acuity [LogMAR] at 4 (post-treatment) weeks in ON eyes.

    Measured: post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  2. The mean change in macular ganglion cell and inner plexiform layer thickness [µm] of the affected ON eye at 4 weeks in comparison to baseline of the unaffected contralateral NON eye (pre-treatment).

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  3. High-contrast visual acuity [LogMAR] at 16 weeks (3 month follow-up) in ON eyes.

    Measured: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  4. High-contrast visual acuity [LogMAR] at 4 weeks (post-treatment) in ON eyes.

    Measured: post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  5. Colour vision [tritan] at 16 weeks (3 month follow-up) in ON eyes.

    Measured: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  6. Colour vision [tritan] at 4 weeks (post-treatment) in ON eyes.

    Measured: post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  7. Visual field testing [dB] at 16 weeks (3 month follow-up) in ON eyes.

    Measured: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  8. Visual field testing [dB] at 4 weeks (post-treatment) in ON eyes.

    Measured: post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  9. Recovery of pattern-reversal visual evoked potential conduction velocity of the affected optic nerve [ms] compared to the intra-individual baseline of the unaffected optic nerve at 16 weeks (3 month follow-up).

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  10. Patient-reported vision-related quality of life assessed by the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) at 16 weeks (3 month follow-up).

    The questionnaire contains the following 12 sub-scales: general health, general vision, ocular pain, near activities, distance activities, vision-specific social functioning, vision-specific mental health, vision-specific role difficulties, vision-specific dependency, driving, colour vision and peripheral vision. The mean VFQ-25 composite score (calculated as an unweighted average of responses to all items except for the general health sub-scale) and selected sub-scale scores will be analysed. Each sub-scale, and also the composite score, will be quantified with values between 0-100, with zero being the worst and 100 being the best.

    Measured: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  11. Patient-reported vision-related quality of life assessed by the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) at 4 weeks (post-treatment).

    The questionnaire contains the following 12 sub-scales: general health, general vision, ocular pain, near activities, distance activities, vision-specific social functioning, vision-specific mental health, vision-specific role difficulties, vision-specific dependency, driving, colour vision and peripheral vision. The mean VFQ-25 composite score (calculated as an unweighted average of responses to all items except for the general health sub-scale) and selected sub-scale scores will be analysed. Each sub-scale, and also the composite score, will be quantified with values between 0-100, with zero being the worst and 100 being the best.

    Measured: post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  12. The mean change in peripapillary retinal nerve fibre layer (pRNFL) thickness [µm] of the affected ON eye at 16 weeks (3 month follow-up) in comparison to baseline of the contralateral NON eye.

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  13. The mean change in peripapillary retinal nerve fibre layer (pRNFL) thickness [µm] of the affected ON eye at 4 weeks (post-treatment) in comparison to baseline of the contralateral NON eye.

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

  14. The mean change in macular inner nuclear layer (INL) thickness [µm] of the affected ON eye at 16 weeks (3 month follow-up) in comparison to baseline of the contralateral NON eye.

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)

  15. The mean change in macular inner nuclear layer (INL) thickness [µm] of the affected ON eye at 4 (post-treatment) weeks in comparison to baseline of the contralateral NON eye.

    Measured: Baseline (pre-treatment, i.e. 1 week after recruitment), post-treatment (4 weeks after recruitment, i.e. one week after the last treatment day)

Timeline

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

  1. First posted5 Mar 2019
  2. Study start14 Oct 2019
  3. Primary completion27 Dec 2019
  4. Study completion27 Dec 2019

Why it stopped: Primarily due to insufficient recruitment (n = 2 instead of n = 30), the study was prematurely discontinued for feasibility reasons. Neither any meaningful results on safety nor on efficacy can be reported.

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03862313
Sponsor's protocol ID
201802353
Acronym
ACSON
Status last verified
Mar 2021
First submitted
14 Feb 2019
Last updated
30 Mar 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing active-rtACS treatment in people with Acute Autoimmune Inflammatory Optic Neuritis, run by University of Zurich at 1 site in Switzerland.

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 9 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 30 Mar 2021. 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 Switzerland. 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. Some participants in this study may receive a placebo. 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: Primarily due to insufficient recruitment (n = 2 instead of n = 30), the study was prematurely discontinued for feasibility reasons. Neither any meaningful results on safety nor on efficacy can be reported.). 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?

The primary functional outcome measure will be low-contrast visual acuity [LogMAR] at 16 weeks (3 month follow-up) in ON eyes. (time frame: 3 month follow-up (16 weeks after recruitment, i.e. 3 months after the last treatment day)). 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?
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 30 Mar 2021.

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