Multicenter, Randomized, Controlled Study of the Effect of Lotemax on Initiation of Dry Eye Treatment With Restasis

• ClinicalTrials.gov Identifier: NCT00407043
• Recruitment Status: Completed
• First Posted: December 4, 2006
• Last Update Posted: July 21, 2011
• Sponsor: Ophthalmic Consultants of Long Island
• Collaborator: Bausch & Lomb Incorporated
• Information provided by: Ophthalmic Consultants of Long Island

Study Description

Brief Summary:

To evaluate the impact of Lotemax on the initiation of Restasis therapy in patients with dry eye.

It is hypothesized that the anti-inflammatory activity of Lotemax may help mitigate the stinging with cyclosporine administration and the dry eye signs and symptoms experienced during the initiation of therapy.

Condition or disease	Intervention/treatment	Phase
Dry Eye Disease; Keratoconjunctivitis Sicca	Drug: Lotemax; Drug: Restasis	Phase 4

Detailed Description:

Dry eye is an ocular surface disease that produces discomfort and irritation. Estimated prevalence ranges from 20 million people in the US being affected with mild to moderate dry eye, to as many as one out of every five Americans.

A growing body of evidence has associated ocular inflammation with the signs and symptoms of dry eye.

Restasis is indicated to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with a condition called keratoconjunctivitis sicca. The relief of dry eye signs and symptoms with Restasis therapy is often delayed by 1 to 6 months from the initiation of therapy. Stinging on installation, particularly when initiating therapy, has been reported.

Lotemax, an ophthalmic corticosteroid, targets inflammation with a unique, site-active mechanism of action.Structural modifications associated with an ester ophthalmic steroid make Lotemax highly lipid soluble, enhancing penetration into cells and enabling Lotemax to exert anti-inflammatory activity within the eye. Lotemax is indicated for the treatment of steroid responsive inflammatory conditions associated with the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 5 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double
• Primary Purpose: Treatment
• Official Title: A Prospective, Multicenter, Randomized Controlled Study of the Effect of Lotepredol Etabonate on The Initiation of Dry Eye Treatment With Topical Cyclosporine
• Study Start Date: November 2006
• Actual Primary Completion Date: September 2007
• Actual Study Completion Date: September 2007

Arms and Interventions

Outcome Measures

Primary Outcome Measures :

1. Ocular Surface Disease Questionnnaire Results
2. Lissamine green staining
3. Fluorescein Staining
4. Schirmer testing

Eligibility Criteria

• Ages Eligible for Study: 30 Years to 80 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• Between the ages of 30 and 80 inclusive.
• Has not worn contact lenses for at least 1 month prior to the study and agrees to not wear contact lenses during study.
• Oral medications stable 1 month prior to study.
• Oral medications anticipated to be stable during 60 day study.
• Patient is in generally good & stable overall health.
• Patient likely to comply with eye drop regimen, study guidelines & study visits.
• Corneal stain > 1+ or Conjunctival stain > 1+ or OSDI equal or > 5 or using regular artificial tears at least on average twice daily.
• Informed consent signed.

Exclusion Criteria:

• History of Stevens-Johnson Syndrome or Ocular Pemphigoid.
• Punctal plugs inserted or punctal cautery in the past 3 months.
• Intra-ocular surgery within 6 months or ocular laser surgery within 3 months.
• History of liver disease.
• Pregnant or lactating women.
• Severe clinical vitamin deficiencies or history of vitamin overdose.
• Highly variable vitamin intake.
• Unstable use of systemic or topical medications known to create dry eye.
• Corneal pathology, which could, of itself, cause an ocular surface disorder.
• Use of glaucoma medications, topical or oral.
• Unstable diabetes mellitus.
• Allergy or sensitivity to Lotemax, Restasis or the OTC Tear Supplement.
• Use of topical steroids or Restasis within the past 1 month.
• Use of other topical ocular agents other than tear replacements within the past 1 week.

Contacts and Locations

Locations

United States, New York

Ophthalmic Consultants of Long Island

Lynbrook, New York, United States, 11563

Sponsors and Collaborators

Ophthalmic Consultants of Long Island

Bausch & Lomb Incorporated

Investigators

• Study Director: Maria Howard; Ophthalmic Consultants of Long Island

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Sheppard JD, Donnenfeld ED, Holland EJ, Slonim CB, Solomon R, Solomon KD, McDonald MB, Perry HD, Lane SS, Pflugfelder SC, Samudre SS. Effect of loteprednol etabonate 0.5% on initiation of dry eye treatment with topical cyclosporine 0.05%. Eye Contact Lens. 2014 Sep;40(5):289-96. doi: 10.1097/ICL.0000000000000049.

• Responsible Party: Dr. Eric Donnenfeld, OCLI
• ClinicalTrials.gov Identifier: NCT00407043
• Other Study ID Numbers: Donnenfeld Review 1
• First Posted: December 4, 2006
• Last Update Posted: July 21, 2011
• Last Verified: July 2011

Keywords provided by Ophthalmic Consultants of Long Island:

Dry Eye Disease; Lotemax; Restasis; Loteprednol; Cyclosporine

Additional relevant MeSH terms:

Dry Eye Syndromes; Keratoconjunctivitis Sicca; Eye Diseases; Keratoconjunctivitis; Lacrimal Apparatus Diseases; Conjunctivitis; Conjunctival Diseases; Keratitis; Corneal Diseases; Loteprednol Etabonate; Anti-Allergic Agents