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Stage 1: Single Ascending Dose, Safety, Tolerability and Pharmacokinetics (n=24)
Stage 2: Multiple Dose, Safety and Efficacy Study with 28-day Dosing and 5 months Followup (n=51)
Stage 1: Single Ascending Dose, Safety, Tolerability and Pharmacokinetics (n=24)
Objectives are to evaluate ocular safety and tolerability by biomicroscopy, ophthalmoscopy, intraocular pressure and visual acuity, and to assess general safety by physical exams, vital signs, clinical laboratory tests and adverse events reporting and to evaluate systemic CBT-001 exposure by Cmax, Tmax and an estimation of the area under the curve (AUC).
Three dose cohorts will be planned with a dose ascending strategy to guide dose concentrations (n=8 per Cohort x 3 cohorts = 24). Primary pterygium patients will be selected in this phase because the main goal is to assess the safety and tolerability of CBT-001 and primary pterygium patients are much easier to recruit. The ~8 primary pterygium patients from each Cohort will be administered a single ocular drug dose at Day 1 in the eye with primary pterygium; the unaffected eye will be dosed with vehicle. Examinations will be performed at both screening day (Day 0) and Day 1. Blood samples at pre-dose, 0.25, 0.5, 1, 2, 4 and 8 hours post dose will be taken at Day 1 to assess systemic pharmacokinetics (PK). The data will be reviewed by Data Review Committee (DRC) to determine whether to initiate enrollment for the next Cohort.
Cohort 1 will begin at the lowest CBT-001 concentration of 0.02%, followed by an increasing dose to 0.05% for Cohort 2 and then to 0.2% for Cohort 3. If no safety issues are found at all doses, the highest dose of 0.2% will be used for the next phase study.
Stage 2: Multiple Dose, Safety and Efficacy Study with 28-day Dosing and 5 months Followup (n=51)
Objectives are to evaluate ocular and systemic safety of CBT-001 in primary or recurrent patients that have moderate to severe pterygium vascularity and to assess whether CBT-001 is efficacious in reducing pterygium vascularity and pterygium lesion growth. The dosing will be 4 weeks. The followup period will be 5 months.
Study Population Characteristics: Approximately 50 (30 primary pterygium and 20 recurrent) patients will be enrolled at up to 3 centers to have an estimated 40 patients complete the study based on an anticipated dropout rate of 20%. Although we have no evidence to suggest attrition due to Adverse Effects (AEs), the dropout rate is most conservative based on industry experience in comparable clinical studies. Patients will be randomized in a 1:1 treatment allocation to receive either CBT-001 0.2% or Vehicle.
Dosage/Dose regimen: One drop of the assigned study medication will be administered in the study eye TID for 4 weeks. The study eye is defined as the qualified eye (i.e., the eye meeting the inclusion criterion for primary or recurrent pterygium). If both eyes are qualified, then the eye with the more severe vascularity grade on the Pterygium Hyperemia Grading Scale at the baseline (Day 1) visit will be the study eye. If both eyes meet the criterion and have the same severity, the right eye will be the study eye. Patients with bilateral pterygium will administer study medication only in the study eye. The fellow eyes in all study subjects will be untreated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CBT-001 Ophthalmic Solution Single dose | Experimental | One drop in the study administered one time only for one day |
|
| Vehicle | Placebo Comparator | One drop in the study administered three times daily (TID) for 4 weeks |
|
| CBT-001 Ophthalmic Solution Multidose | Experimental | One drop in the study administered three times daily (TID) for 4 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBT-001 single dose | Drug | One drop in the study administered one time |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pterygium Vascularity Change Assessed Using the Pterygium Hyperemia Grading Scale | The primary efficacy variable is the change from baseline (Day 1) in severity grade of pterygium vascularity at Week 4. Pterygium vascularity intensity is based on color coordinates as measured by digital image analysis of pterygium photographs. The quantitative analysis of photographs using a 5-point Pterygium Hyperemia Grading Scale (0 = absent, 1 = trace, 2 = mild, 3 = moderate, 4 = severe) will be conducted at an independent image reading center. | Change from baseline at 4 weeks |
| Ocular and General Safety and Tolerability | The ocular safety and tolerability are measured by biomicroscopy, ophthalmoscopy, intraocular pressure and visual acuity, and to assess general safety by physical exams, vital signs, clinical laboratory tests and adverse events reporting | One day |
| Measure | Description | Time Frame |
|---|---|---|
| Corneal Pterygium Lesion Length Change From Baseline | The Corneal Pterygium Lesion Length is measured from digital images of the eye by an independent image reading center. | 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John Hovanesian, M.D. | Harvard Eye Associates | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Harvard Eye Associates | Laguna Beach | California | 92651 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | CBT-001 Ophthalmic Solution Single Dose | CBT-001 Ophthalmic Solution Single dose in one day |
| FG001 | Vehicle Multi-dose | One drop in the study administered three times daily (TID) for 4 weeks |
| FG002 | CBT-001 Ophthalmic Solution Multi-dose | One drop in the study administered three times daily (TID) for 4 weeks |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | CBT-001 Ophthalmic Solution Single Dose | One drop in the study administered one time CBT-001: One drop in the study administered one time |
| BG001 | Vehicle Multi-dose | One drop in the study administered three times daily (TID) for 4 weeks Vehicle: One drop in the study administered three times daily (TID) for 4 weeks |
| Units | Counts |
|---|---|
| Participants |
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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 |
| 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 | Pterygium Vascularity Change Assessed Using the Pterygium Hyperemia Grading Scale | The primary efficacy variable is the change from baseline (Day 1) in severity grade of pterygium vascularity at Week 4. Pterygium vascularity intensity is based on color coordinates as measured by digital image analysis of pterygium photographs. The quantitative analysis of photographs using a 5-point Pterygium Hyperemia Grading Scale (0 = absent, 1 = trace, 2 = mild, 3 = moderate, 4 = severe) will be conducted at an independent image reading center. | Modified Intent-to-Treat Population | Posted | Mean | Standard Deviation | grade | Change from baseline at 4 weeks |
|
6 months
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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 | CBT-001 Ophthalmic Solution Single Dose | One drop in the study administered one time One drop in the study administered one time in one day |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Transient ischaemic attack | Blood and lymphatic system disorders | Systematic Assessment | not treatment related |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Conjunctival Discoloration | Eye disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr, Jinsong Ni | Cloudbreak Therapeutics, LLC | 9496789752 | Ni-Jinsong@cloudbreaktherapeutics.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 12, 2017 | Jan 28, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D011625 | Pterygium |
| ID | Term |
|---|---|
| D003229 | Conjunctival Diseases |
| D005128 | Eye Diseases |
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| Vehicle | Drug | One drop in the study administered three times daily (TID) for 4 weeks |
|
| CBT-001 Multi-dose | Drug | One drop in the study administered three times daily (TID) for 4 weeks |
|
| BG002 | CBT-001 Ophthalmic Solution Multi-dose | One drop in the study administered three times daily (TID) for 4 weeks CBT-001: One drop in the study administered three times daily (TID) for 4 weeks |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 |
| CBT-001 Ophthalmic Solution Multi-dose |
One drop in the study administered three times daily (TID) CBT-001: One drop in the study administered three times daily (TID) for 4 weeks |
|
|
|
| Primary | Ocular and General Safety and Tolerability | The ocular safety and tolerability are measured by biomicroscopy, ophthalmoscopy, intraocular pressure and visual acuity, and to assess general safety by physical exams, vital signs, clinical laboratory tests and adverse events reporting | mITT | Posted | Number | participants | One day |
|
|
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| Secondary | Corneal Pterygium Lesion Length Change From Baseline | The Corneal Pterygium Lesion Length is measured from digital images of the eye by an independent image reading center. | Modified Intent-to-Treat Population | Posted | Mean | Standard Deviation | mm | 4 weeks |
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| 0 |
| 24 |
| 0 |
| 24 |
| 4 |
| 24 |
| EG001 | Vehicle Multi-dose | One drop in the study administered three times daily (TID) Vehicle: One drop in the study administered three times daily (TID) for 4 weeks | 0 | 25 | 1 | 25 | 2 | 25 |
| EG002 | CBT-001 Ophthalmic Solution Multi-dose | One drop in the study administered three times daily (TID) CBT-001: One drop in the study administered three times daily (TID) for 4 weeks | 0 | 26 | 0 | 26 | 20 | 26 |
|
| Foreign Body Sensation in Eyes | Eye disorders | Systematic Assessment |
|
| Lacrimation Increased | Eye disorders | Systematic Assessment |
|
| Dysgeusia | General disorders | Systematic Assessment |
|
| Influenza A infection | Infections and infestations | Systematic Assessment |
|
| Eye irritation | Eye disorders | Systematic Assessment | Mild eye irritation |
|
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