Treatment of Graves' Orbitopathy (Thyroid Eye Disease) to Reduce Proptosis With Teprotumumab Infusions in a Randomized, Placebo-Controlled, Clinical Study (OPTIC)
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|ClinicalTrials.gov Identifier: NCT03298867|
Recruitment Status : Completed
First Posted : October 2, 2017
Results First Posted : March 10, 2020
Last Update Posted : April 8, 2021
|Condition or disease||Intervention/treatment||Phase|
|Thyroid Eye Disease Graves' Orbitopathy||Biological: Teprotumumab Other: Placebo||Phase 3|
This is a randomized, double-masked, placebo-controlled, parallel-group, multicenter study. Approximately 76 participants (38/group) who meet the study eligibility criteria will be randomized on Day 1 in a 1:1 ratio (stratified by tobacco use status) to receive 8 infusions of teprotumumab or placebo q3W. All participants will enter a 24-week double-masked Treatment Period, during which study drug will be infused on Day 1 (Baseline), and Weeks 3, 6, 9, 12, 15, 18, and 21 (with a final visit at Week 24). All study drug dosing will be performed at the clinic under the supervision of clinic staff. On each dosing day, scheduled assessments (except for adverse event [AE] and concomitant medication use monitoring, which will be monitored throughout the clinic visit) will be completed prior to study drug dosing.
At the end of the double-masked Treatment Period (Week 24), participants who are proptosis non-responders (study eye has < 2 mm decrease in proptosis) will be eligible to enter an open-label extension study in which participants receive 8 infusions of teprotumumab in an open-label fashion.
At Week 24, proptosis responders, as well as non-responders who choose not to enroll in the open-label extension study, will enter a 48-week Follow-Up Period, during which study drug will not be administered and clinic visits are scheduled for Weeks 28, 36, 48, 60, and 72. Participants who are considered responders at Week 24 but who meet criteria for re-treatment due to relapse during the Follow-Up Period may enroll in the open-label extension study.
Participants who complete the Week 72 Visit will be contacted 6 and 12 months later via phone or email by research staff to enquire if any treatment for TED has been received since last study contact.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||83 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Official Title:||A Phase 3, Randomized, Double-Masked, Placebo-Controlled, Parallel-Group, Multicenter Study Evaluating Teprotumumab (HZN-001) Treatment in Subjects With Active Thyroid Eye Disease|
|Actual Study Start Date :||October 24, 2017|
|Actual Primary Completion Date :||February 13, 2019|
|Actual Study Completion Date :||November 13, 2020|
Active Comparator: Teprotumumab 20 mg/kg
Approximately 38 participants will receive 8 infusions of teprotumumab q3W for a total of 21 weeks. Teprotumumab 10 mg/kg will be administered on Day 1 and teprotumumab 20 mg/kg will be administered q3W for the remaining 7 infusions.
Teprotumumab is a fully human anti-IGF-1R mAb. Teprotumumab will be provided in single-dose 20 mL glass vials as a freeze-dried powder. Each vial of teprotumumab must be reconstituted with 10 mL of water for injection. Reconstituted teprotumumab solution must be further diluted in 0.9% (w/v) sodium chloride (NaCl) solution prior to administration. Teprotumumab will be administered in 100 mL or 250 mL infusion bags (100 mL infusion bags for doses up to 1800 mg and 250 mL infusion bags for doses > 1800 mg).
Other Name: HZN-001
Placebo Comparator: Placebo
Approximately 38 participants will receive 8 infusions of placebo q3W for a total of 21 weeks.
Placebo will consist of normal saline (0.9% NaCl) solution and will be administered in 100 mL or 250 mL infusion bags, as would be appropriate, per weight-based dosing volumes (100 mL infusion bags for doses up to 1800 mg and 250 mL infusion bags for doses > 1800 mg).
Other Name: Saline solution
- Percentage of Participants Who Were Proptosis Responders at Week 24 [ Time Frame: Week 24 ]Proptosis responders were defined as participants with a ≥2 mm reduction from Baseline in proptosis in the study eye, without deterioration (≥2 mm increase) of proptosis in the fellow eye at Week 24.
- Percentage of Participants Who Were Overall Responders at Week 24 [ Time Frame: Week 24 ]
Overall responders were defined as participants with a ≥2 mm reduction in proptosis AND a ≥2 point reduction in Clinical Activity Score (CAS) from Baseline in the study eye, without deterioration (≥2 mm increase in proptosis or ≥2 point increase in CAS) in the fellow eye at Week 24.
The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no clinical activity) to 7 (most clinical activity).
- Percentage of Participants Who Were CAS Categorical Responders at Week 24 [ Time Frame: Week 24 ]
CAS categorical responders were defined as participants with a reduction to a CAS of 0 or 1 (no or minimal inflammatory symptoms).
The CAS is a 7-item description of clinical activity, including: 1. Spontaneous orbital pain; 2. Gaze evoked orbital pain; 3. Eyelid swelling that is considered to be due to active (inflammatory phase) thyroid eye disease/ Graves' Ophthalmopathy or Orbitopathy (TED/GO); 4. Eyelid erythema; 5. Conjunctival redness that is considered to be due to active (inflammatory phase) TED/GO (ignore "equivocal" redness); 6. Chemosis; 7. Inflammation of caruncle or plica. Each item is scored (1=present; 0=absent) and scores for each item are summed for total score of 0 (no inflammatory symptoms) to 7 (most inflammatory symptoms).
- Change From Baseline in Proptosis to Week 24 [ Time Frame: Baseline, up to Week 24 ]
- Percentage of Participants Who Were Diplopia Responders at Week 24 [ Time Frame: Week 24 ]
Diplopia responders were defined as participants with Baseline diplopia Subjective Diplopia Score grade >0 in the study eye who had a reduction of ≥1 grade with no corresponding deterioration (≥1 grade worsening) in the fellow eye at Week 24. Denominator is the number of subjects with diplopia at Baseline.
The Subjective Diplopia Score is a clinical measure of diplopia severity on a grade scale of 0 to 3: 0=no diplopia; 1=intermittent (diplopia in primary position of gaze, when tired or when first awakening); 2=inconstant (diplopia at extremes of gaze); 3=constant (continuous diplopia in primary or reading position).
- Change From Baseline in the Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire Overall Score to Week 24 [ Time Frame: Baseline, up to Week 24 ]The GO-QoL is a 16-item self-administered questionnaire divided into 2 subsets and used to assess the perceived effects of TED by the subjects on (i) their daily physical activity as it relates to visual function, and (ii) psychosocial functioning. The range of the GO-QoL overall transformed scores is 0 to 100, where higher values correspond to better quality of life.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03298867
|United States, California|
|Beverly Hills, California, United States, 90212|
|Cedars-Sinai Medical Center|
|Los Angeles, California, United States, 90078|
|United States, Florida|
|The Lennar Foundation Medical|
|Coral Gables, Florida, United States, 33146|
|Bascom Palmer Eye Institute|
|Miami, Florida, United States, 33136|
|United States, Michigan|
|Kellogg Eye Center at University of Michigan|
|Ann Arbor, Michigan, United States, 48105|
|United States, Oregon|
|Casey Eye Institute at Oregon Health and Science University|
|Portland, Oregon, United States, 97239|
|United States, Tennessee|
|Hamilton Eye Institute at University of Tennessee Health Science Center|
|Memphis, Tennessee, United States, 38163|
|United States, Texas|
|Eye Wellness Center|
|Houston, Texas, United States, 77005|
|United States, Wisconsin|
|Medical College of Wisconsin, The Eye Institute|
|Milwaukee, Wisconsin, United States, 53226|
|University Hospital Essen, Department of Ophthalmology|
|Essen, Germany, 45147|
|Johannes Gutenberg University Medical Center|
|Mainz, Germany, 55131|
|Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico|
|Milan, Italy, 20122|
|University of Pisa, Department of Clinical and Experimental Medicine|
|Pisa, Italy, 56100|
|University of Pisa,Department of Clinical and Experimental Medicine, Endocrinology Unit|
|Pisa, Italy, 56124|
|Principal Investigator:||Raymond Douglas, MD, PhD||Cedars-Sinai Medical Center|
|Principal Investigator:||George Kahaly, MD, PhD||Johannes Gutenberg University Medical Center|