Eye DiseasesPhase 2HLA-A29NCT03871361
Abatacept in Patients With Birdshot HLA A29 Uveitis
A Phase 2 study testing Abatacept 125 MG/ML Prefilled Syringe in people with Eye Diseases and Uveitis, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.
Trial summary
To assess the efficacy and safety of Abatacept as an immunosuppressive treatment in Birdshot uveitis. The primary objective is to test the efficacy to suppress inflammation in active Birdshot uveitis patients, using quantitative and qualitative measurements of visual function. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Eye Diseases, Uveitis
- What is being tested?
- Abatacept 125 MG/ML Prefilled Syringe
- Type of treatment
- Vaccines, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 15 participants
- Where
- 1 siteBelgium
- Study dates
- 1 Apr 2019to 1 Dec 2023
- Phase
- Phase 2
- 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
- Subject is at least 18 years of age.
- Subject is diagnosed with Birdshot uveitis, HLA A 29+
- Subject must have active disease at the Baseline visit as defined by the presence of at least 1 of the following parameters in at least one eye :
- -Active, inflammatory, chorioretinal and/or inflammatory retinal vascular lesions
- -≥ 1+ vitreous haze (National Eye Institute [NEI]/SUN criteria)
- Subjects who do not have previous, active or latent tuberculosis (TB). Subjects with negative QuantiFERON®-TB Gold test (or interferon-gamma release assay (IGRA) equivalent) are eligible. Subjects with a repeat indeterminate QuantiFERON®-TB Gold test (or IGRA equivalent) result are not eligible. The TB screening tests are diagnostic tests. In the event of a negative TB screening test, the results are to be interpreted in the context of the patient's epidemiology, history, exam findings, etc. and it is the responsibility of the investigator to determine if a patient has previous, active or latent tuberculosis or not. Under no circumstances can a patient with a positive QuantiFERON®-TB Gold test (or IGRA equivalent) enter the study.
Who cannot join
- Subject with prior inadequate response to high-dose oral corticosteroids (>30 mg of prednisolone or equivalent)
- Subject with confirmed or suspected infectious uveitis, including but not limited to infectious uveitis due to TB, cytomegalovirus (CMV), Human T-Lymphotropic Virus Type 1 (HTLV-1), Whipple's disease, Herpes Zoster virus (HZV), Lyme disease, toxoplasmosis and herpes simplex virus (HSV).
- Subject with corneal or lens opacity that precludes visualization of the fundus or that likely requires cataract surgery during the duration of the trial.
- Subject with intraocular pressure of ≥ 25 mmHg and on ≥ 2 glaucoma medications or evidence of glaucomatous optic nerve injury.
- Subject with Best Corrected Visual Acuity (BCVA) less than 20 letters (Early Treatment Diabetic Retinopathy Study) in at least one eye at the Baseline Visit.
- Subject with intermediate uveitis or panuveitis that has signs of intermediate uveitis (e.g.presence or history of snowbanking or snowballs) and symptoms and/or magnetic resonance imaging (MRI) findings suggestive of a demyelinating disease such as multiple sclerosis. All subjects with intermediate uveitis or panuveitis that have signs of intermediate uveitis (e.g., presence or history of snowbanking or snowballs) must have had a brain MRI within 90 days prior to the Baseline Visit.
Show all 23Show fewer
- Subject has had previous exposure to anti-tumor necrosis factor (TNF) therapy or any biologic therapy (except intravitreal anti-vascular endothelial growth factor [VEGF] therapy) with a potential therapeutic impact on non-infectious uveitis
- Subject with exposure to classic immunosuppressive therapy, in which the dose has been increased within the last 28 days prior to Baseline visit or is within the following doses at the screening visit: Methotrexate (MTX) >25 mg per week Cyclosporine > 4 mg/kg per day Mycophenolate mofetil >2 grams per day or an equivalent drug to mycophenolate mofetil (e.g. mycophenolic acid) at an equivalent dose approved by the Medical Monitor. Azathioprine > 175 mg per day Tacrolimus (oral formulation) >8 mg per day.
- Subject is still on immunosuppressive therapy ( Corticosteroids, Methotrexate, Cyclosporine, Mycophenolate Mofetil, Azathioprine, Tacrolimus, Sirolimus) at the baseline visit.
- Subject has received Iluvien® (glucocorticosteroids implant) within 3 years prior to the Baseline visit or that has had complications related to the device. Subject has had Iluvien® (glucocorticosteroids implant) removed within 90 days prior to the Baseline visit or has had complications related to the removal of the device.
- Subject has received intraocular or periocular corticosteroids within 30 days prior to Baseline visit.
- Subject with proliferative or severe non-proliferative diabetic retinopathy or clinically significant macular edema due to diabetic retinopathy. Subject with neovascular/wet age-related macular degeneration Subject with abnormality of vitreo-retinal interface (i.e., vitreomacular traction, epiretinal membranes, etc.) with the potential for macular structural damage independent of the inflammatory process. Subject with severe vitreous haze that precludes visualization of the fundus at the Baseline visit.
- Subject has received Ozurdex® (dexamethasone implant) within 6 months prior to the Baseline visit. Subject has received intravitreal anti-VEGF therapy within 45 days of the Baseline visit for Lucentis® (ranibizumab) or Avastin® (bevacizumab) or within 60 days of the Baseline visit for anti-VEGF Trap (aflibercept).
- Subject has received intravitreal methotrexate within 90 days prior to the Baseline visit
- Subject on systemic carbonic anhydrase inhibitor within 1 week prior to Screening visit.
- Subject with macular edema as the only sign of uveitis.
- Subject with a history of scleritis.
- Subject on cyclophosphamide within 30 days prior to the Baseline visit.
- Subjects with a known HIV, HepB/C infection.
- Subjects with an active or recent acute infection.
- Subjects with a history of chronic or recurrent bacterial, viral or systemic fungal infections.
- Subjects with malignancies.
- Subjects who have received any live vaccines within 3 months of the start of the study drug.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Abatacept in Patients With Birdshot HLA A29 Uveitis: A Phase II Prospective 0pen Label Interventional Proof-of-Concept Study
To assess the efficacy and safety of Abatacept as an immunosuppressive treatment in Birdshot uveitis. The primary objective is to test the efficacy to suppress inflammation in active Birdshot uveitis patients, using quantitative and qualitative measurements of visual function.
Read the detailed description
To assess the efficacy and safety of Abatacept as an immunosuppressive treatment in Birdshot uveitis. The primary objective is to assess the efficacy to suppress active uveitis in Birdshot uveitis and to induce inflammatory remission during the 1 year treatment and after 2 years of treatment. Treatment efficacy will be assessed, using quantitative and qualitative measurements of visual function. In this trial we will also assess the utility of quantitative outcome measures in detecting disease activity.
- Conditions
- Eye Diseases, Uveitis
- Being tested
- Abatacept 125 MG/ML Prefilled Syringe
- Keywords
- Birdshot Uveitis, HLA A29, Abatacept
- Medical subject headings
- Eye Diseases, Uveitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Abatacept 125 MG/ML Prefilled SyringeDrug
Also called Orencia
Abatacept 125 MG/ML Prefilled Syringe [Orencia] weekly
| Study group | Role | What they receive |
|---|---|---|
| Abatacept 125 MG/ML Prefilled Syringe | Experimental | Participants will inject the drug at home on a weekly basis. Participants will receive the syringes on the visit dates, supplying them for the period until the next visit. At baseline, participants will be explained and shown how to inject the drug themselves.
Subject will have to stop all concomitant immunosuppressive drugs at baseline, e.g. Corticosteroids, Methotrexate, Mofetil Mycophenolate, Azathioprine, Tacrolimus, Sirolimus or Cyclosporin. Other drugs can be continued. In case of recurrence in the abatacept group, the study will end for that subject.
Patients treated with abatacept (ORENCIA) may receive concurrent vaccinations, except for live vaccines. Live vaccines should not be given concurrently with abatacept or within 3 months of its discontinuation. Receives: Drug: Abatacept 125 MG/ML Prefilled Syringe |
What is being measured
The primary outcome is the main question the study is designed to answer.
time to recurrence in ≥1 eye
Patients are assessed for recurrence, if at least 1 of the following criteria are fulfilled in at least 1 eye.
- worsening of BCVA (Best Corrected Visual Acuity measured by ETDRS chart) by >15 letters relative to baseline
- 30% increase of central retinal thickness on OCT (Optical Coherence Tomography) relative to baseline
- 2-step increase in VH (Vitreous Haze) grade relative to baseline
- new active, inflammatory choroidal (detected on ICG Angiography) and/or inflammatory retinal vascular lesions relative to baseline (detected on FA: fluorescein angiography).
Measured: 1 year and 2 years
Secondary outcomes (8)
Change in Vitreous Haze (VH) Grade in Each Eye From Baseline to the Final/Early Termination Visit
Vitreous haze is measured using dilated indirect ophthalmoscopy (DIO) and assessed by the Investigator according to National Eye Institute (NEI) and SUN criteria:
Grade 0: No evident vitreous haze Grade 0.5+: Slight blurring of the optic disc margin because of the haze; normal striations and reflex of the nerve fiber layer cannot be visualized; Grade 1+: Permits a better definition of both the optic nerve head and the retinal vessels (compared to higher grades); Grade 2+: Permits better visualization of the retinal vessels (compared to higher grades); Grade 3+: Permits the observer to see the optic nerve head, but the borders are quite blurry; Grade 4+: Optic nerve head is obscured.
Measured: 1 year and 2 years
Change In Logarithm of the Minimum Angle of Resolution (LogMAR) Best Corrected Visual Acuity (BCVA) In Each Eye From Baseline to the Final/Early Termination Visit
Using corrective lenses based on that visit's refraction testing, participant's best corrected visual acuity is measured using an Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart.
Measured: 1 year and 2 years
Time to Optical Coherence Tomography (OCT) Evidence of Macular Edema in At Least 1 Eye On or After Baseline
Optical coherence tomography is performed at every visit using the Zeiss Cirrus OCT. Images are evaluated by a central reader (PI). Macular edema is defined as cystoid macular edema. OCT evidence of macular edema on or after Baseline is to be counted as an event. Dropouts due to reasons other than OCT evidence of macular edema are to be considered as censored observations at the time of dropping out.
Optical Coherence Tomography will be measured using the Zeiss Cirrus OCT. For each eye a macular cube slab 512x128 and 2 HD 5 lines rasters (1 on 180° and 1 on 90°) will be taken, centered on the fovea.
Measured: 1 year and 2 years
Percent Change in Central Retinal Thickness in Each Eye From Baseline to the Final/Early Termination Visit
Optical coherence tomography is performed at every visit using the Zeiss Cirrus OCT.Retinal thickness will be measured on the macular cube slab centered on the fovea. This will be measured by a central reader (PI).
Measured: 1 year and 2 years
Percent Change in Choroidal Thickness in Each Eye From Best State Achieved Prior to week 6 to the Final/Early Termination Visit
Choroidal thickness will be measured using the EDI mode of the Zeiss Cirrus OCT (HD 5 lines raster) and will be measured by a central reader (PI).
Measured: 1 year and 2 years
Change in Visual Functioning Questionnaire 25 (VFQ-25) Composite Score From Baseline to the Final/Early Termination Visit
The National Eye Institute VFQ-25 is an ocular disease-specific survey that measures the influence of visual disability and visual symptoms on generic health domains such as emotional well-being and social functioning, in addition to task-oriented domains related to daily visual functioning
Measured: 1 year and 2 years
Change in scoring of Dual Fluorescein and ICG (Indocyanine Green) angiography from best state achieved
Change in scoring of Dual Fluorescein and ICG (Indocyanine Green) angiography from best state achieved, as defined by the Angiography Scoring for Uveitis Working group using the Heidelberg Scanning LASER fluorescein and ICG angiography
Measured: 1 year and 2 years
Change in Full Field ElectroRetinoGraphy (ERG) using the ISCEV standard protocols from baseline until the Final Visit
Quantitative values, such as 30 Hz implicit time, amplitude in a and b wave and latency will be recorded
Measured: 1 year and 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Mar 2019
- Study start1 Apr 2019
- Primary completion1 Jan 2022
- Study completion1 Dec 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Eye DiseasesStudies of the same condition, open and under way.
- More trials run by Universitaire Ziekenhuizen KU LeuvenThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Prospective 0pen Label Interventional Proof-of-Concept Study
- Masking
- None (open label)
- Enrolment
- 15 participants (actual)
Sponsor and investigators
- Lead sponsor
- Universitaire Ziekenhuizen KU Leuven
- Sponsor type
- University, hospital or other
- Collaborators
- Ziekenhuis Netwerk Antwerpen (ZNA)
- Responsible party
- Sponsor
- Investigators
- Pieter-Paul FA Schauwvlieghe, MD, Principal investigator, Universitaire Ziekenhuizen KU Leuven
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03871361
- Sponsor's protocol ID
- S62092
- Other IDs
- 2018-003653-16, IM101-794, 2018
- Acronym
- HLA-A29
- Status last verified
- Dec 2023
- First submitted
- 5 Mar 2019
- Last updated
- 4 Dec 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Schauwvlieghe PP, Van Calster J, Herbort CP Jr, Kestelyn PA, de Vlam K. Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial. Br J Ophthalmol. 2024 Jan 29;108(2):244-252. doi: 10.1136/bjo-2022-321585.
PubMed 36585127
Study at a glance
From the registry record, last updated by the sponsor on 4 Dec 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Abatacept in Patients With Birdshot HLA A29 Uveitis: A Phase II Prospective 0pen Label Interventional Proof-of-Concept Study
- ClinicalTrials.gov ID
- NCT03871361
- Acronym / sponsor ID
- HLA-A29 / S62092
- Conditions
- Eye Diseases, Uveitis
- Keywords
- Birdshot Uveitis, HLA A29, Abatacept
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 15 participants (actual)
- Lead sponsor
- Universitaire Ziekenhuizen KU LeuvenUniversity, hospital or other
- Collaborators
- Ziekenhuis Netwerk Antwerpen (ZNA)
- Study start
- 1 Apr 2019 (actual)
- Primary completion
- 1 Jan 2022 (actual)
- Study completion
- 1 Dec 2023 (actual)
- First posted
- 12 Mar 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To assess the efficacy and safety of Abatacept as an immunosuppressive treatment in Birdshot uveitis. The primary objective is to test the efficacy to suppress inflammation in active Birdshot uveitis patients, using quantitative and qualitative measurements of visual function.
Detailed description
To assess the efficacy and safety of Abatacept as an immunosuppressive treatment in Birdshot uveitis. The primary objective is to assess the efficacy to suppress active uveitis in Birdshot uveitis and to induce inflammatory remission during the 1 year treatment and after 2 years of treatment. Treatment efficacy will be assessed, using quantitative and qualitative measurements of visual function. In this trial we will also assess the utility of quantitative outcome measures in detecting disease activity.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Prospective 0pen Label Interventional Proof-of-Concept Study
| Arm | Type | Receives |
|---|---|---|
| Abatacept 125 MG/ML Prefilled Syringe | Experimental | Drug: Abatacept 125 MG/ML Prefilled SyringeParticipants will inject the drug at home on a weekly basis. Participants will receive the syringes on the visit dates, supplying them for the period until the next visit. At baseline, participants will be explained and shown how to inject the drug themselves. Subject will have to stop all concomitant immunosuppressive drugs at baseline, e.g. Corticosteroids, Methotrexate, Mofetil Mycophenolate, Azathioprine, Tacrolimus, Sirolimus or Cyclosporin. Other drugs can be continued. In case of recurrence in the abatacept group, the study will end for that subject. Patients treated with abatacept (ORENCIA) may receive concurrent vaccinations, except for live vaccines. Live vaccines should not be given concurrently with abatacept or within 3 months of its discontinuation. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Subject is at least 18 years of age.
- Subject is diagnosed with Birdshot uveitis, HLA A 29+
- Subject must have active disease at the Baseline visit as defined by the presence of at least 1 of the following parameters in at least one eye :
- -Active, inflammatory, chorioretinal and/or inflammatory retinal vascular lesions
- -≥ 1+ vitreous haze (National Eye Institute [NEI]/SUN criteria)
Key exclusion criteria (23 listed)
- Subject with prior inadequate response to high-dose oral corticosteroids (>30 mg of prednisolone or equivalent)
- Subject with confirmed or suspected infectious uveitis, including but not limited to infectious uveitis due to TB, cytomegalovirus (CMV), Human T-Lymphotropic Virus Type 1 (HTLV-1), Whipple's disease, Herpes Zoster virus (HZV), Lyme disease, toxoplasmosis and herpes simplex virus (HSV).
- Subject with corneal or lens opacity that precludes visualization of the fundus or that likely requires cataract surgery during the duration of the trial.
- Subject with intraocular pressure of ≥ 25 mmHg and on ≥ 2 glaucoma medications or evidence of glaucomatous optic nerve injury.
- Subject with Best Corrected Visual Acuity (BCVA) less than 20 letters (Early Treatment Diabetic Retinopathy Study) in at least one eye at the Baseline Visit.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Abatacept 125 MG/ML Prefilled SyringeAlso: OrenciaAbatacept 125 MG/ML Prefilled Syringe [Orencia] weekly | Drug | Abatacept 125 MG/ML Prefilled Syringe |
Primary outcome
time to recurrence in ≥1 eye
Time frame: 1 year and 2 years
Patients are assessed for recurrence, if at least 1 of the following criteria are fulfilled in at least 1 eye. * worsening of BCVA (Best Corrected Visual Acuity measured by ETDRS chart) by >15 letters relative to baseline * 30% increase of central retinal thickness on OCT (Optical Coherence Tomography) relative to baseline * 2-step increase in VH (Vitreous Haze) grade relative to baseline * new active, inflammatory choroidal (detected on ICG Angiography) and/or inflammatory retinal vascular lesions relative to baseline (detected on FA: fluorescein angiography).
8 secondary outcomes
Change in Vitreous Haze (VH) Grade in Each Eye From Baseline to the Final/Early Termination Visit
Time frame: 1 year and 2 years
Change In Logarithm of the Minimum Angle of Resolution (LogMAR) Best Corrected Visual Acuity (BCVA) In Each Eye From Baseline to the Final/Early Termination Visit
Time frame: 1 year and 2 years
Time to Optical Coherence Tomography (OCT) Evidence of Macular Edema in At Least 1 Eye On or After Baseline
Time frame: 1 year and 2 years
Percent Change in Central Retinal Thickness in Each Eye From Baseline to the Final/Early Termination Visit
Time frame: 1 year and 2 years
Percent Change in Choroidal Thickness in Each Eye From Best State Achieved Prior to week 6 to the Final/Early Termination Visit
Time frame: 1 year and 2 years
Change in Visual Functioning Questionnaire 25 (VFQ-25) Composite Score From Baseline to the Final/Early Termination Visit
Time frame: 1 year and 2 years
Change in scoring of Dual Fluorescein and ICG (Indocyanine Green) angiography from best state achieved
Time frame: 1 year and 2 years
Change in Full Field ElectroRetinoGraphy (ERG) using the ISCEV standard protocols from baseline until the Final Visit
Time frame: 1 year and 2 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Dec 2023.
- Derived from this study: PubMed 36585127Schauwvlieghe PP, Van Calster J, Herbort CP Jr, Kestelyn PA, de Vlam K. Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial. Br J Ophthalmol. 2024 Jan 29;108(2):244-252. doi: 10.1136/bjo-2022-321585.
- Belgian Dataprotection AuthorityLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Pieter-Paul FA Schauwvlieghe, MD principal investigator
Universitaire Ziekenhuizen KU Leuven
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Abatacept 125 MG/ML Prefilled Syringe in people with Eye Diseases and Uveitis, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.
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 6 inclusion and 23 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 4 Dec 2023. 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 Belgium. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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?
time to recurrence in ≥1 eye (time frame: 1 year and 2 years). 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 NCT03871361, which also lists 1 linked publication.
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 4 Dec 2023.