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Leukemia (Both ALL and AML)Phase 4IkervisNCT04636918

Ikervis for DED Due to GVHD Post Allo-HSCT

A Phase 4 study testing Cyclosporine Ophthalmic in people with Leukemia (Both ALL and AML) and MDS-EB-1, run by Singapore Eye Research Institute at 1 site in Singapore.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Dry eye disease (DED) is a common sequelae of graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Since Ikervis is reported to be a safe and efficacious treatment of DED associated with chronic GVHD, our study would like to study the efficacy of prophlactic Ikervis in… Read more about this study

Who is it for?
Ages 13 to 95 years
Conditions the study is for
Leukemia (Both ALL and AML), MDS-EB-1
What is being tested?
Cyclosporine Ophthalmic
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteSingapore
Study dates
28 Nov 2019to 30 Dec 2022
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 13 to 95 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Age 13 and above
  • Able to give informed consent

Who cannot join

  • Presence of concurrent disease
  • Unable to complete the follow up

Trial locations and contacts

1 site in 1 country.

Singapore1 site, 1 recruiting
  • Singapore Eye Research Institute

    Singapore

    Li Lim, 63224500, lim.li@singhealth.com.sg

    Recruiting

Other trials in Singapore

About this study

Official title: Ikervis for Prophylaxis of Dry Eye Disease Due to Graft vs Host Disease Post Allogeneic Haemtopoietic Stem Cell Transplant

Dry eye disease (DED) is a common sequelae of graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Since Ikervis is reported to be a safe and efficacious treatment of DED associated with chronic GVHD, our study would like to study the efficacy of prophlactic Ikervis in preventing ocular GVHD development.

Read the detailed description

This is a prospective single arm interventional study.

The recruitment period will be over 12-18 months to enroll all suitable patients. The total duration of prophylaxis will be for 1 year. After completion of the period of prophylaxis, the patients will be followed up as a non-study patient as clinically indicated.

Forty subjects, undergoing allo-HSCT, will be recruited from the Singapore National Eye Centre upon referral from the Department of Hematology, Singapore General Hospital and followed up at least 5 times over a period of 12 months at the Singapore Eye Research Institute.

The images of the subject eyes will be recorded and stored electronically. These images (corneal fluorescein staining score, Lipiview, meibography, conjunctival redness, tear stability assessment) will be used in the analysis of outcome measures. The Lipiview result is in video format.

Being tested
Cyclosporine Ophthalmic
Medical subject headings
Leukemia, Leukemia, Myeloid, Acute

What participants receive

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

  • Cyclosporine OphthalmicDrug

    Also called Ikervis

    Prospective interventional study (single arm)

Study groups in NCT04636918
Study groupRoleWhat they receive
Single armOtherIkervis (cyclosporine 0.1%), emulsion, one drop into both eyes, once at night.
Receives: Drug: Cyclosporine Ophthalmic

What is being measured

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

  1. To assess change in basline visual acuity using LogMAR chart with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Visual acuity will be assessed using LogMAR chart at baseline screening and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 months, 6 months and 1 year post-HSCT follow up

  2. To assess change in baseline intraocular pressure using non-contact tonometry with 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Intraocular pressure (mmHg) will be assessed using non-contact tonometry at baseline screening and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 months, 6 months and 1 year post-HSCT follow up

  3. To assess change in baseline anterior ocular health using slit lamp examination with 12 months post Haematopoietic Stem Cell Transplant.

    Slit lamp examination will be performed at baseline screening and 12 months post-HSCT after prophylactic Ikervis. Clinical findings such as macroerosions or chemosis on cornea, or cataract will be recorded.

    Measured: Baseline screening and 1 year post-HSCT follow up

  4. To assess change in baseline posterior ocular health using fundus examination with 12 months post Haematopoietic Stem Cell Transplant.

    Fundus examination will be performed at baseline screening and 12 months post-HSCT after prophylactic Ikervis. Clinical findings such as cup disc ratio will be graded from 0.0 to 1.0 (greater value means larger cup), hemorrhage, edema of the retina/macular will be recorded.

    Measured: Baseline screening and 1 year post-HSCT follow up

  5. To assess change of baseline dry eye symptoms with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Dry eye symptoms will be assessed using SPEED questionnaire (in score 0-28). A higher score means worse dry eye symptom. The change of dry eye symptoms will be assess from baseline before prophylactic Ikervis, 3 to 5 weeks from baseline (Pre-HSCT), and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  6. To assess change of baseline non-invasive tear break up time with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Non-invasive tear break up time (in seconds) will be assessed using Oculus Keratography K5M. The change of NITBUT will be assessed from baseline before prophylactic Ikervis, pre-HSCT, and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  7. To assess change of baseline conjunctival redness with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Conjunctival Redness (in grading 0-4) will be assessed using Oculus Keratography K5M. A higher grading means conjunctiva is more red. The change of conjunctival redness will be assessed from baseline before prophylactic Ikervis, pre-HSCT, and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  8. To assess change of baseline tear lipid thickness with prophylactic Ikervis 12 months post Haematopoietic Stem Cell Transplant.

    Tear lipid thickness will be measured using LipiView. The change of tear lipid thickness will be only be assessed from baseline before prophylactic Ikervis and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline and 1 year post-HSCT follow up

  9. To assess change of baseline Meibomian gland status with prophylactic Ikervis 12 months post Haematopoietic Stem Cell Transplant.

    Meibomian gland (in grade 0-3) will be assessed using Infra-red Meibography. We will grade the Meibomian gland disease as: 0, no loss of meibomian glands; 1, lost area was less than one third of the total area of meibomian glands; 2, lost area was between one third and two thirds of the total area of meibomian glands; 3, lost area was over two thirds of the total area of meibomian glands. The change of meibomian gland will be assessed from baseline before prophylactic Ikervis pre-HSCT and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline and 1 year post-HSCT follow up

  10. To assess change of baseline tear cytokines with prophylactic Ikervis after 3 to 5 weeks after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Tear cytokine will be analysed with tears extracted from Schirmers test. The change of tear cytokines will be assess from baseline before prophylactic Ikervis, 3 to 5 weeks from baseline (Pre-HSCT), and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  11. To assess change of conjunctival impression cytology 3 to 5 weeks after prophylactic Ikervis with 12 months post Haematopoietic Stem Cell Transplant.

    Conjunctival impression cytology will be performed using EyePrim. The change of conjunctival impression cytology only will be assessed 3 to 5 weeks from baseline (Pre-HSCT) and 12 months post-HSCT after prophylactic Ikervis.

    Measured: 3 to 5 weeks from baseline (Pre-HSCT) and 1 year post-HSCT follow up

  12. To assess change of baseline corneal fluorescein staining score with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Corneal fluorescein staining (in grade 0-4) will be imaged by Oculus Keratograph K5M. A greater number indicating more intense or greater area of staining. The change of corneal fluorescein staining will be assess from baseline before prophylactic Ikervis, 3 to 5 weeks from baseline (Pre-HSCT), and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  13. To assess change of baseline Meibomian gland expressibility with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant.

    Meibomian gland expressibility will be assessed using Meibomian gland evaluator. Texture of expressed secretion will be graded as liquid or viscous. The number of expressible glands will be recorded. The change of meibomian gland expressibility will be assess from baseline before prophylactic Ikervis, 3 to 5 weeks from baseline (Pre-HSCT), and 3, 6, and 12 months post-HSCT after prophylactic Ikervis.

    Measured: Baseline, 3 to 5 weeks from baseline (Pre-HSCT), 3 months, 6 months and 1 year post-HSCT follow up

  14. To assess Quality of Life Questionnaire at 12 months post Haematopoietic Stem Cell Transplant.

    Quality of Life (in score 0, 1, 2, 3, 8) will be assessed using Impact of Vision Impairment Profile questionnaire at the end of the prophylactic Ikervis, 12 months post-HSCT. The score in 0 means a lot of the time, 1 means a fair amount of the time, 2 means a little of the time, 3 means not at all, 8 means do not do this for other reasons.

    Measured: 1 year post-HSCT follow up

Timeline

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

  1. First posted19 Nov 2020
  2. Study start28 Nov 2019
  3. Primary completion22 Aug 2022 (estimated)
  4. Study completion30 Dec 2022 (estimated)

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
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04636918
Sponsor's protocol ID
R1641/38/2019
Acronym
Ikervis
Status last verified
Nov 2020
First submitted
9 Mar 2020
Last updated
19 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Tong L, Lim EWL, Yeo SWJ, Hou A, Linn YC, Ho A, Than H, Quek JKS, Hwang WYK, Lim FLWI, Lim L. Conjunctival T Cell Profile in Allogeneic Hematopoietic Stem Cell Transplant Patients after Instilling Topical Cyclosporine-A 0.1% Cationic Emulsion. Ophthalmol Ther. 2023 Jun;12(3):1547-1567. doi: 10.1007/s40123-023-00686-0. Epub 2023 Mar 1.

    PubMed 36856978

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Cyclosporine Ophthalmic in people with Leukemia (Both ALL and AML) and MDS-EB-1, run by Singapore Eye Research Institute at 1 site in Singapore.

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 2 inclusion and 2 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: status not confirmed, as of the sponsor's last update on 19 Nov 2020. 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 Singapore. 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?

Results are not available in the source record.

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

Contact Li Lim (63224500, lim.li@singhealth.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To assess change in basline visual acuity using LogMAR chart with prophylactic Ikervis after 3 to 5 weeks before Haematopoietic Stem Cell Transplant and 3 months, 6 months and 12 months post Haematopoietic Stem Cell Transplant. (time frame: Baseline, 3 months, 6 months and 1 year post-HSCT follow up). The study lists 14 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 NCT04636918, 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 19 Nov 2020.

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