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| Name | Class |
|---|---|
| United States Department of Defense | FED |
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The objectives of this study are to evaluate the efficacy of Valproic Acid (VPA) to both slow the progression of visual function loss and/or to restore visual function in patients with Autosomal Dominant Retinitis Pigmentosa (RP) and to collect safety and tolerability information.
Retinitis Pigmentosa (RP) is an incurable and untreatable group of heterogeneous retinal degenerative diseases that cause severe visual loss. There is currently no therapeutic that substantially slows the progression of this disease, and certainly none that can restore vision in RP patients. The Valproic Acid (VPA) study is designed as a six-site, interventional, prospective, randomized, placebo controlled, double-blinded study of 90 participants to evaluate the efficacy of oral Valproic Acid to both slow the progression of visual function loss and/or to restore visual function in patients with an Autosomal Dominant RP genetic mutation and to collect safety and tolerability information. Patients that participate in the study will be randomized to either placebo or VPA in a 1:1 ratio.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Valproic Acid | Active Comparator | Subjects who receive valproic acid |
|
| Placebo | Placebo Comparator | Subjects who receive placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Valproic Acid | Drug | One to four 250mg softgels by mouth daily (dose determined by body weight) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change in Visual Field Area From Baseline to 52 Weeks--III4e Isopter | Mean change in visual field area from baseline to 52 weeks. Visual field area is measured with semi-automated kinetic perimetry (SKP) using the Octopus 900 (Haag-Streit) with the III4e target size for each eye and done at least twice to ensure reliable sessions; the visual field area measurements are averaged over the two sessions. Analysis performed with linear mixed model | baseline to week 52 |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change in Visual Field Area From Baseline to 52 Weeks--I4e Isopter | Mean change in visual field area from baseline to 52 weeks. Visual field area is measured with semi-automated kinetic perimetry (SKP) using the Octopus 900 (Haag-Streit) with the I4e target size for each eye and done at least twice to ensure reliable sessions; the visual field area measurements are averaged over the two sessions. Analysis performed with linear mixed model |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Patricia Zilliox, PhD | Foundation Fighting Blindness | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Miami, Bascom Palmer Eye Institute | Miami | Florida | 33136 | United States | ||
| University of Michigan, Ann Arbor |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12202526 | Background | Berson EL, Rosner B, Weigel-DiFranco C, Dryja TP, Sandberg MA. Disease progression in patients with dominant retinitis pigmentosa and rhodopsin mutations. Invest Ophthalmol Vis Sci. 2002 Sep;43(9):3027-36. | |
| 8614514 | Background | Bryant AE 3rd, Dreifuss FE. Valproic acid hepatic fatalities. III. U.S. experience since 1986. Neurology. 1996 Feb;46(2):465-9. doi: 10.1212/wnl.46.2.465. |
| Label | URL |
|---|---|
| Click here for more information about this study: Clinical Trial page of the Foundation Fighting Blindness Website. | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Valproic Acid | Subjects who receive valproic acid Valproic Acid: One to four 250mg softgels by mouth daily (dose determined by body weight) |
| FG001 | Placebo | Subjects who receive placebo Placebo: Dosage per subject weight- same schedule as the active comparator |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Subjects who receive placebo Placebo: Dosage per subject weight- same schedule as the active comparator |
| BG001 | Valproic Acid | Subjects who receive valproic acid Valproic Acid: One to four 250mg softgels by mouth daily (dose determined by body weight) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Mean Change in Visual Field Area From Baseline to 52 Weeks--III4e Isopter | Mean change in visual field area from baseline to 52 weeks. Visual field area is measured with semi-automated kinetic perimetry (SKP) using the Octopus 900 (Haag-Streit) with the III4e target size for each eye and done at least twice to ensure reliable sessions; the visual field area measurements are averaged over the two sessions. Analysis performed with linear mixed model | The analysis followed the intent-to-treat principle in that all randomized participants were included and analyzed according to their treatment assignment regardless of amount or type of treatment received. Only observed data were analyzed. | Posted | Mean | Standard Deviation | Visual field area (degrees squared) | baseline to week 52 | eyes | eyes |
|
Treatment emergent adverse events are defined as those that occur between the first dose of study drug and the last dose of study drug plus 7 days.
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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 | Placebo | Subjects who receive placebo Placebo: Dosage per subject weight- same schedule as the active comparator |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Osteoarthritis | Musculoskeletal and connective tissue disorders | MedDRA (19.0) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | MedDRA (19.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Chief Drug Development Officer | Foundation Fighting Blindness Clinical Research Institute | 410 423 0581 | pzilliox@blindness.org |
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| ID | Term |
|---|---|
| D012174 | Retinitis Pigmentosa |
| ID | Term |
|---|---|
| D015785 | Eye Diseases, Hereditary |
| D005128 | Eye Diseases |
| D058499 | Retinal Dystrophies |
| D012162 | Retinal Degeneration |
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| ID | Term |
|---|---|
| D014635 | Valproic Acid |
| ID | Term |
|---|---|
| D010421 | Pentanoic Acids |
| D014631 | Valerates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
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| Placebo | Drug | Dosage per subject weight- same schedule as the active comparator |
|
| baseline to week 52 |
| Static Perimetry by Treatment Arm--Full Field Hill of Vision | Mean change from baseline at week 52 for Full field Hill of Vision (Static perimetry) | baseline to week 52 |
| Static Perimetry Volume--30 Degree Hill of Vision | Mean Change from baseline to week 52 for Static Perimetry Volume --30 Degree Hill of Vision. Full field static perimetry protocol was followed using the Octopus 900 (Haag-Streit) for a single session for each eye. | baseline to week 52 |
| Mean Change From Baseline in Best Corrected Visual Acuity | Mean change in best corrected visual acuity as assessed by ETDRS (Early Treatment Diabetic Retinopathy Study) method from baseline to week 52 | baseline to week 52 |
| Ann Arbor |
| Michigan |
| 48105 |
| United States |
| Oregon Health & Science University | Portland | Oregon | 97239 | United States |
| University of Tennessee, Hamilton Eye Institute | Memphis | Tennessee | 38163 | United States |
| Retina Foundation of the Southwest | Dallas | Texas | 75231 | United States |
| University of Utah School of Medicine, Moran Eye Center | Salt Lake City | Utah | 84132 | United States |
| 3976802 | Background | Berson EL, Sandberg MA, Rosner B, Birch DG, Hanson AH. Natural course of retinitis pigmentosa over a three-year interval. Am J Ophthalmol. 1985 Mar 15;99(3):240-51. doi: 10.1016/0002-9394(85)90351-4. |
| 17850978 | Background | Chen PS, Wang CC, Bortner CD, Peng GS, Wu X, Pang H, Lu RB, Gean PW, Chuang DM, Hong JS. Valproic acid and other histone deacetylase inhibitors induce microglial apoptosis and attenuate lipopolysaccharide-induced dopaminergic neurotoxicity. Neuroscience. 2007 Oct 12;149(1):203-12. doi: 10.1016/j.neuroscience.2007.06.053. Epub 2007 Jul 28. |
| 15145530 | Background | Delyfer MN, Leveillard T, Mohand-Said S, Hicks D, Picaud S, Sahel JA. Inherited retinal degenerations: therapeutic prospects. Biol Cell. 2004 May;96(4):261-9. doi: 10.1016/j.biolcel.2004.01.006. |
| 16600518 | Background | Dragunow M, Greenwood JM, Cameron RE, Narayan PJ, O'Carroll SJ, Pearson AG, Gibbons HM. Valproic acid induces caspase 3-mediated apoptosis in microglial cells. Neuroscience. 2006 Jul 21;140(4):1149-56. doi: 10.1016/j.neuroscience.2006.02.065. |
| 18950246 | Background | Gaby AR. Nutritional therapies for ocular disorders: Part Three. Altern Med Rev. 2008 Sep;13(3):191-204. |
| 11742974 | Background | Gottlicher M, Minucci S, Zhu P, Kramer OH, Schimpf A, Giavara S, Sleeman JP, Lo Coco F, Nervi C, Pelicci PG, Heinzel T. Valproic acid defines a novel class of HDAC inhibitors inducing differentiation of transformed cells. EMBO J. 2001 Dec 17;20(24):6969-78. doi: 10.1093/emboj/20.24.6969. |
| 17113430 | Background | Hartong DT, Berson EL, Dryja TP. Retinitis pigmentosa. Lancet. 2006 Nov 18;368(9549):1795-809. doi: 10.1016/S0140-6736(06)69740-7. |
| 14624229 | Background | Henry TR. The history of valproate in clinical neuroscience. Psychopharmacol Bull. 2003;37 Suppl 2:5-16. |
| 15059710 | Background | Hoffman DR, Locke KG, Wheaton DH, Fish GE, Spencer R, Birch DG. A randomized, placebo-controlled clinical trial of docosahexaenoic acid supplementation for X-linked retinitis pigmentosa. Am J Ophthalmol. 2004 Apr;137(4):704-18. doi: 10.1016/j.ajo.2003.10.045. |
| 9804150 | Background | Jacobson SG, Cideciyan AV, Huang Y, Hanna DB, Freund CL, Affatigato LM, Carr RE, Zack DJ, Stone EM, McInnes RR. Retinal degenerations with truncation mutations in the cone-rod homeobox (CRX) gene. Invest Ophthalmol Vis Sci. 1998 Nov;39(12):2417-26. |
| 17371805 | Background | Kim HJ, Rowe M, Ren M, Hong JS, Chen PS, Chuang DM. Histone deacetylase inhibitors exhibit anti-inflammatory and neuroprotective effects in a rat permanent ischemic model of stroke: multiple mechanisms of action. J Pharmacol Exp Ther. 2007 Jun;321(3):892-901. doi: 10.1124/jpet.107.120188. Epub 2007 Mar 19. |
| 11448327 | Background | Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD; National Eye Institute Visual Function Questionnaire Field Test Investigators. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7):1050-8. doi: 10.1001/archopht.119.7.1050. |
| 18378578 | Background | Noorwez SM, Ostrov DA, McDowell JH, Krebs MP, Kaushal S. A high-throughput screening method for small-molecule pharmacologic chaperones of misfolded rhodopsin. Invest Ophthalmol Vis Sci. 2008 Jul;49(7):3224-30. doi: 10.1167/iovs.07-1539. Epub 2008 Mar 31. |
| 15996734 | Background | Nowomiejska K, Vonthein R, Paetzold J, Zagorski Z, Kardon R, Schiefer U. Comparison between semiautomated kinetic perimetry and conventional Goldmann manual kinetic perimetry in advanced visual field loss. Ophthalmology. 2005 Aug;112(8):1343-54. doi: 10.1016/j.ophtha.2004.12.047. |
| 19094165 | Background | Nowomiejska K, Vonthein R, Paetzold J, Zagorski Z, Kardon R, Schiefer U. Reaction time during semi-automated kinetic perimetry (SKP) in patients with advanced visual field loss. Acta Ophthalmol. 2010 Feb;88(1):65-9. doi: 10.1111/j.1755-3768.2008.01407.x. Epub 2009 Dec 16. |
| 16164485 | Background | Peterson GM, Naunton M. Valproate: a simple chemical with so much to offer. J Clin Pharm Ther. 2005 Oct;30(5):417-21. doi: 10.1111/j.1365-2710.2005.00671.x. No abstract available. |
| 18706104 | Background | Wong R, Khan J, Adewoyin T, Sivaprasad S, Arden GB, Chong V. The ChromaTest, a digital color contrast sensitivity analyzer, for diabetic maculopathy: a pilot study. BMC Ophthalmol. 2008 Aug 17;8:15. doi: 10.1186/1471-2415-8-15. |
| 29879277 | Derived | Birch DG, Bernstein PS, Iannacone A, Pennesi ME, Lam BL, Heckenlively J, Csaky K, Hartnett ME, Winthrop KL, Jayasundera T, Hughbanks-Wheaton DK, Warner J, Yang P, Fish GE, Teske MP, Sklaver NL, Erker L, Chegarnov E, Smith T, Wahle A, VanVeldhuisen PC, McCormack J, Lindblad R, Bramer S, Rose S, Zilliox P, Francis PJ, Weleber RG. Effect of Oral Valproic Acid vs Placebo for Vision Loss in Patients With Autosomal Dominant Retinitis Pigmentosa: A Randomized Phase 2 Multicenter Placebo-Controlled Clinical Trial. JAMA Ophthalmol. 2018 Aug 1;136(8):849-856. doi: 10.1001/jamaophthalmol.2018.1171. |
| Adverse Event |
|
| Withdrawal by Subject |
|
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Genetic Mutations | Summary of participants' gene mutation or combination of mutations identified and thought to be responsible for autosomal dominant retinitis pigmentosa | Count of Participants | Participants |
|
| OG001 | Placebo--Left Eye | Left eye of Placebo-treated patients |
| OG002 | Valproic Acid--Right Eye | Right eye of Valproic acid-treated patients |
| OG003 | Valproic Acid--Left Eye | Left eye of Valproic acid-treated patients |
|
|
|
| Secondary | Mean Change in Visual Field Area From Baseline to 52 Weeks--I4e Isopter | Mean change in visual field area from baseline to 52 weeks. Visual field area is measured with semi-automated kinetic perimetry (SKP) using the Octopus 900 (Haag-Streit) with the I4e target size for each eye and done at least twice to ensure reliable sessions; the visual field area measurements are averaged over the two sessions. Analysis performed with linear mixed model | The analysis followed the intent-to-treat principle in that all randomized participants were included and analyzed according to their treatment assignment regardless of amount or type of treatment received. Only observed data were analyzed. | Posted | Mean | Standard Deviation | Visual field area (degrees squared) | baseline to week 52 | eyes | eyes |
|
|
|
|
| Secondary | Static Perimetry by Treatment Arm--Full Field Hill of Vision | Mean change from baseline at week 52 for Full field Hill of Vision (Static perimetry) | The analysis followed the intent-to-treat principle in that all randomized participants were included and analyzed according to their treatment assignment regardless of amount or type of treatment received. Only observed data were analyzed. | Posted | Mean | Standard Deviation | db-steridians | baseline to week 52 | eyes | eyes |
|
|
|
|
| Secondary | Static Perimetry Volume--30 Degree Hill of Vision | Mean Change from baseline to week 52 for Static Perimetry Volume --30 Degree Hill of Vision. Full field static perimetry protocol was followed using the Octopus 900 (Haag-Streit) for a single session for each eye. | The analysis followed the intent-to-treat principle in that all randomized participants were included and analyzed according to their treatment assignment regardless of amount or type of treatment received. Only observed data were analyzed. | Posted | Mean | Standard Deviation | db-steridans | baseline to week 52 | eyes | eyes |
|
|
|
|
| Secondary | Mean Change From Baseline in Best Corrected Visual Acuity | Mean change in best corrected visual acuity as assessed by ETDRS (Early Treatment Diabetic Retinopathy Study) method from baseline to week 52 | The analysis followed the intent-to-treat principle in that all randomized participants were included and analyzed according to their treatment assignment regardless of amount or type of treatment received. Only observed data were analyzed. | Posted | Mean | Standard Deviation | letters read correctly | baseline to week 52 |
|
|
|
| 0 |
| 44 |
| 2 |
| 44 |
| 41 |
| 44 |
| EG001 | Valproic Acid | Subjects who receive valproic acid Valproic Acid: One to four 250mg softgels by mouth daily (dose determined by body weight) | 1 | 46 | 3 | 46 | 45 | 46 |
| Road Traffic Accidents | Injury, poisoning and procedural complications | MedDRA (19.0) | Non-systematic Assessment | Motorcycle crash |
|
| Immunodeficiency common variable | Immune system disorders | MedDRA (19.0) | Systematic Assessment | Common Variable Immune Deficiency |
|
| Lens Dislocation | Eye disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Atrial Fibrilation | Cardiac disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Sinusitis | Infections and infestations | MedDRA (19.0) | Non-systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA (19.0) | Non-systematic Assessment |
|
| Bronchitis | Infections and infestations | MedDRA (19.0) | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Abdominal Pain Upper | Gastrointestinal disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Gastroesophageal Reflux Disease | Gastrointestinal disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Vision Blurred | Eye disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Cystoid Macular Oedema | Eye disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Ammonia Increased | Investigations | MedDRA (19.0) | Systematic Assessment |
|
| Alanine Aminotransferase Increased | Investigations | MedDRA (19.0) | Systematic Assessment |
|
| Aspartate Aminotransferase Increased | Investigations | MedDRA (19.0) | Systematic Assessment |
|
| Weight Increased | Investigations | MedDRA (19.0) | Non-systematic Assessment |
|
| Hepatic Enzyme Increased | Investigations | MedDRA (19.0) | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Tremor | Nervous system disorders | MedDRA (19.0) | Non-systematic Assessment |
|
| Fatigue | General disorders | MedDRA (19.0) | Non-systematic Assessment |
|
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| D012164 |
| Retinal Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D009930 |
| Organic Chemicals |
| D005232 | Fatty Acids, Volatile |
| D005227 | Fatty Acids |
| D008055 | Lipids |
| eyes |
|
|
| eyes |
|