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The purpose of this study is to look at the safety and effectiveness of CNTF implants on vision in persons with retinitis pigmentosa, Usher type II & III, and Choroideremia. This research is being done because there are no effective therapies for people with these retinal degenerations. They are genetic disorders that affect one's ability to see at night, and later cause tunnel vision and loss of central vision. Retinal degenerations affect the retina, a light sensitive layer of cells in the back of the eye. Slowly over time, these cells die and cause permanent loss of vision.
The implant is a small capsule that contains human retinal pigment epithelium cells. These cells have been given the ability to make CNTF and release it through the capsule membrane into the surrounding fluid. In this study, two different CNTF dose levels will be used: a high dose and a low dose in one eye, as well as a sham (or placebo) surgery in the other eye.
This study will involve about 18 visits over 2½ years for specific tests of the participant's vision and health. These visits may include visual exams, blood draw for laboratory testing, brief medical history and exam, and occasionally a questionnaire (survey), in addition to the visit for the surgical procedures. The primary effectiveness outcome for this study will be a visual field score one year after the implant surgery. There will be about 12 centers participating in this study, and up to 60 people enrolled, across the US. Each participant joining the study who has completed initial screening will then be scheduled to have a brief surgical procedure performed on each eye, one of which will include a very small cell-filled implant. Follow-up visits for repeat assessments will be required regularly to determine if the implant being tested is safe and effective for use to treat retinitis pigmentosa (RP).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low Dose | Experimental | NT-501 Low Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Implant in Fellow Eye |
|
| High Dose | Experimental | NT-501 High Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Implant in Fellow Eye |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NT-501 | Drug | Low Dose |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Change in Humphrey Visual Fields - Total Sensitivity | The primary efficacy endpoint was the change in Humphrey VFS from baseline to month 12 (Visit 10) as determined by the HVF 30-2 test, comprised of 76 points. The measure was the sum of actual thresholds for all 76 locations. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Mean Humphrey Visual Fields Sensitivity | Baseline compared to 6, 12, 18, 24 and 30 months | |
| Mean Humphrey Visual Fields Sensitivity | Change in Humphrey Visual Field Sensitivity over time |
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Study inclusion / exclusion criteria:
Criteria for patients to qualify for the study include, but are not limited to:
The following criteria will exclude patients from the study:
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| Name | Affiliation | Role |
|---|---|---|
| David Birch, MD, PhD | Retina Foundation of the Southwest | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Retina-Vitreous Associates Medical Group | Beverly Hills | California | 90211 | United States | ||
| University of Califoria, Davis |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23668681 | Derived | Birch DG, Weleber RG, Duncan JL, Jaffe GJ, Tao W; Ciliary Neurotrophic Factor Retinitis Pigmentosa Study Groups. Randomized trial of ciliary neurotrophic factor delivered by encapsulated cell intraocular implants for retinitis pigmentosa. Am J Ophthalmol. 2013 Aug;156(2):283-292.e1. doi: 10.1016/j.ajo.2013.03.021. Epub 2013 May 10. | |
| 23049090 |
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A total of 90 participants were screened and 73 were randomized to dose groups. 17 of 90 patients were screen failures and not associated (randomized) to either arm. Of the 73 randomized participants, 5 participants, 2 in the high dose and 3 in the low dose arms were randomized but did not receive surgery and did not take part in the study. 68 participants had surgery.
For participants randomized to treatment dose, one eye was randomized to surgery and the fellow eye was randomized to sham.
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| ID | Title | Description |
|---|---|---|
| FG000 | Participants That Received Low Dose NT-501 Implant Surgery and Sham Surgery in Fellow Eye | NT-501 Low Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Surgery in Fellow Eye |
| FG001 | Sham Treatment in Fellow Eye for Low Dose Arm |
| Title | Milestones | Reasons Not Completed | ||||
|---|---|---|---|---|---|---|
| Overall Study |
|
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| NT-501 |
| Drug |
High Dose |
|
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| Baseline compared to 6, 12, 18, 24 and 30 months |
| Sacramento |
| California |
| 95817 |
| United States |
| University of California, San Francisco | San Francisco | California | 94143-0730 | United States |
| Bascom Palmer Eye Insitute | Miami | Florida | 33101 | United States |
| Kellogg Eye Center | Ann Arbor | Michigan | 48105 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455-0501 | United States |
| NY University Medical Center | New York | New York | 10016 | United States |
| Casey Eye Institue | Portland | Oregon | 97239-4197 | United States |
| The Hamilton Eye Institute | Memphis | Tennessee | 38163 | United States |
| Retina Foundation of Southwest | Dallas | Texas | 75231 | United States |
| University of Utah | Salt Lake City | Utah | 84112 | United States |
| The University of Utah - John A. Moran Eye Center | Salt Lake City | Utah | 84132 | United States |
| Kauper K, McGovern C, Sherman S, Heatherton P, Rapoza R, Stabila P, Dean B, Lee A, Borges S, Bouchard B, Tao W. Two-year intraocular delivery of ciliary neurotrophic factor by encapsulated cell technology implants in patients with chronic retinal degenerative diseases. Invest Ophthalmol Vis Sci. 2012 Nov 1;53(12):7484-91. doi: 10.1167/iovs.12-9970. |
| 21087953 | Derived | Talcott KE, Ratnam K, Sundquist SM, Lucero AS, Lujan BJ, Tao W, Porco TC, Roorda A, Duncan JL. Longitudinal study of cone photoreceptors during retinal degeneration and in response to ciliary neurotrophic factor treatment. Invest Ophthalmol Vis Sci. 2011 Apr 6;52(5):2219-26. doi: 10.1167/iovs.10-6479. |
Sham Surgery in Fellow Eye for NT-501 Low Dose Implant Arm |
| FG002 | Participants That Received High Dose NT-501 Implant Surgery and Sham Surgery in Fellow Eye | NT-501 High Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Surgery in Fellow Eye |
| FG003 | Sham Treatment in Fellow Eye for High Dose Implant Arm | Sham Surgery in Fellow Eye for NT-501 Low Dose Implant Arm |
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| NT-501 Surgery Completed |
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| COMPLETED | Study completion |
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| NOT COMPLETED |
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The baseline analysis population includes all 73 participants who were randomized to a treatment arm including the 3 participants from low dose arm and the 2 participants from the high dose arm who discontinued prior to surgery, and study start.
| ID | Title | Description |
|---|---|---|
| BG000 | Low Dose - Implant | NT-501 Low Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina |
| BG001 | Low Dose - Sham | Sham Implant in Fellow Eye (Low Dose Arm) |
| BG002 | High Dose - Implant | NT-501 High Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina |
| BG003 | High Dose - Sham | Sham Implant in Fellow Eye (High Dose Arm) |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Eyes |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years | Participants |
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| Sex: Female, Male | Count of Participants | Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants | Participants |
| |||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants | Participants |
| |||||||||||||||||||
| Ocular History - Years Since RP Diagnosis | Mean | Standard Deviation | years | Participants |
| ||||||||||||||||||
| Type of Ocular History | Number | Eyes | Eyes |
| |||||||||||||||||||
| Humphrey Visual Fields - Total Sensitivity (MITT Population) | Humphrey Visual Field Sensitivity (VFS) is based on the HVF 30-2 test, consisting of 76 points; response measure was the sum of actual thresholds for all 76 locations, in dB (decibels). Foveal sensitivity was not used in assessing total. | MITT Population who received an implant | Mean | Standard Deviation | dB | Participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Humphrey Visual Fields - Total Sensitivity | The primary efficacy endpoint was the change in Humphrey VFS from baseline to month 12 (Visit 10) as determined by the HVF 30-2 test, comprised of 76 points. The measure was the sum of actual thresholds for all 76 locations. | MITT Population excluding 1 participant from the high dose arm who did not complete any visits subsequent to surgery. | Posted | Mean | Standard Deviation | dB | 12 months |
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| ||||||||||||||||||||||||||||||||||
| Secondary | Change in Mean Humphrey Visual Fields Sensitivity | MITT Population excluding 1 participant from the high dose arm who did not complete any visits subsequent to surgery. | Posted | Mean | Standard Deviation | dB | Baseline compared to 6, 12, 18, 24 and 30 months |
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| ||||||||||||||||||||||||||||||||||||
| Secondary | Mean Humphrey Visual Fields Sensitivity | Change in Humphrey Visual Field Sensitivity over time | MITT Population | Posted | Mean | Standard Deviation | dB | Baseline compared to 6, 12, 18, 24 and 30 months |
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Time of consent through Month 30 (study exit)
Adverse events were followed from time of initial consent through 30 Months (study exit).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Low Dose | NT-501 Low Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Implant in Fellow Eye | 0 | 20 | 1 | 20 | 20 | 20 |
| EG001 | High Dose | NT-501 High Dose Implant: encapsulated cell therapy that delivers ciliary neurotrophic factor to the retina Sham Implant in Fellow Eye | 0 | 48 | 4 | 48 | 48 | 48 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cubital tunnel syndrome | Nervous system disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Acute appendicitis | Gastrointestinal disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Ovarian Cyst | Reproductive system and breast disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Hypertrophic medial synovial plica with synovitis | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Non-systematic Assessment | right knee |
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| Non-ischemic cardiomyopathy | Cardiac disorders | MedDRA (9.0) | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anterior Chamber Cell | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Anterior Chamber Flare | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Asthenopia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Cataract Subcapsular | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Conjunctival Haemorrhage | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Conjunctival Hyperaemia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Conjunctival Oedema | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Dellen | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Diplopia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eye Discharge | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eye Inflammation | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eye Irritation | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eye Pain | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eye Pruritis | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Eyelid Oedema | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Foreign Body Sensation in Eyes | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Hypotony of Eye | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Macular Oedema | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Maculopathy | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Miosis | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Ocular Hyperaemia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Photophobia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Photopsia | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Pupils Unequal | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vision Blurred | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Visual Acuity Reduced | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Visual Disturbance | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vitreous Detachment | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vitreous Disorder | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vitreous Floaters | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vitreous Haemorrhage | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Vitreous Opacities | Eye disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Implant Site Reaction | General disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Influenza | Infections and infestations | MedDRA (9.0) | Non-systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (9.0) | Non-systematic Assessment |
| |
| Upper Respiratory Tract Infection | Infections and infestations | MedDRA (9.0) | Non-systematic Assessment |
| |
| Corneal Abrasion | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
| |
| Periorbital Haematoma | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
| |
| Post Procedural Complication | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
| |
| Post Procedural Discomfort | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
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| Procedural Pain | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
| |
| Suture Related Complication | Injury, poisoning and procedural complications | MedDRA (9.0) | Non-systematic Assessment |
| |
| Intraocular Pressure Decreased | Investigations | MedDRA (9.0) | Non-systematic Assessment |
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| Intraocular Pressure Increased | Investigations | MedDRA (9.0) | Non-systematic Assessment |
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| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Non-systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (9.0) | Non-systematic Assessment |
| |
| Depression | Psychiatric disorders | MedDRA (9.0) | Non-systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Patricia Davis, Sr. Director of Clinical Operations | Neurotech USA, Inc. | 401.333.3880 | p.davis@neurotechusa.com |
| ID | Term |
|---|---|
| D012174 | Retinitis Pigmentosa |
| D005128 | Eye Diseases |
| D012164 | Retinal Diseases |
| ID | Term |
|---|---|
| D015785 | Eye Diseases, Hereditary |
| D058499 | Retinal Dystrophies |
| D012162 | Retinal Degeneration |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| ID | Term |
|---|---|
| D020934 | Ciliary Neurotrophic Factor |
| ID | Term |
|---|---|
| D009414 | Nerve Growth Factors |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D009419 | Nerve Tissue Proteins |
| D001685 | Biological Factors |
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