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The main objective of this study is to evaluate the efficacy and safety of the PRO-232 formulation manufactured by Laboratorios Sophia S.A. de C.V. on the ocular surface of postoperative cataract patients versus a concomitant administration of ophthalmic moxifloxacin and dexamethasone.
This is a multicenter, randomized, double-blind, parallel-group, controlled clinical study designed to evaluate the efficacy and safety of PRO-232 ophthalmic solution in postoperative cataract patients. Participants will receive study treatment for 14 days.
The primary efficacy endpoint is to evaluate PRO-232 ophthalmic solution applied to the ocular surface of postoperative cataract patients, compared with concomitant administration of ophthalmic moxifloxacin and dexamethasone, by the proportion of patients with a grade 0 cellularity after 14 days of treatment.
Secondary outcomes include assessment of anterior chamber cellularity, ocular inflammation, eye pain using the Wong-Baker Faces® Visual Analog Scale, incidence of treatment-releated unexpected adverse events, best-corrected visual acuity (BCVA), and changes in intraocular pressure (IOP).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PRO-232 | Experimental | Two eyedroppers: one for PRO-232 and another for Placebo. Both will be administrated as follows: 1 drop four times a day (QID) with a minimum of four hours between applications, in the study eye for 14 days; with the exception of day 1 (the same day of the baseline visit), where a reduction in the interval between applications to a minimum of 3 hours per day will be allowed. A period of minimum 5 minutes between eyedropper administration will be required. |
|
| Moxifloxacin / Dexamethasone | Active Comparator | Two eyedroppers: one for moxifloxacin and another for dexamethasone. Both will be administrated as follows: 1 drop four times a day (QID) with a minimum of four hours between applications, in the study eye for 14 days; with the exception of day 1 (the same day of the baseline visit), where a reduction in the interval between applications to a minimum of 3 hours per day will be allowed. A period of minimum 5 minutes between eyedropper administration will be required. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Moxifloxacin / Dexamethasone Ophthalmic Solution | Drug | Moxifloxacin 0.5% / Dexamethasone phosphate 0.1% Ophthalmic solution |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with grade 0 cellularity among interventions | Using a slit lamp, a detailed assessment of cellularity in the anterior chamber of the eye will be performed. Using a 0.5 X 8.0mm beam of light directed obliquely the degree of cellularity will be measured. The grade of cellularity in the anterior chamber will be reported acording to the following scale: Grade Number of cells Grade 0 (≤ 5 cells), grade 1+ (5-10 cells [mild]), grade 2+ (11-20 [moderate]), grade 3+ (21-50 [marked]), grade 4+ (over 50 [severe]). The evaluated population for this outcome measure will be the PP population (subjects who finished the study without presenting any mayor deviations to protocol). | Day 1, 3, 8 and 15. |
| Proportion of patients presenting unexpected adverse events (AE) related between interventions | The manifested adverse events during the conduction of this trial will be obtained during trial visits and reported in the electronic CRF, where the clinical team of the center included the information from source documents. These will be previously checked by the monitor team, pharmacovigilance specialist, and the medical specialist part of the sponsor's crew to verify concordance with what was stipulated in the protocol. The classification as unexpected and/or related will be based in previously reported AE for the ingredients of the investigational products and comparators. This outcome measure considered the Intention-To-Treat (ITT) population, all participants who were randomized and exposed to treatment, regardless of whether they finished the study. | Day 1, 3, 8, 15 and 20. |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of cellularity in the anterior chamber between interventions | Using a slit lamp, a detailed assessment of cellularity in the anterior chamber of the eye will be performed. Using a 0.5 X 8.0mm beam of light directed obliquely the degree of cellularity will be measured. The grade of cellularity in the anterior chamber will be reported acording to the following scale: Grade Number of cells Grade 0 (≤ 5 cells), grade 1+ (5-10 cells [mild]), grade 2+ (11-20 [moderate]), grade 3+ (21-50 [marked]), grade 4+ (over 50 [severe]). A higher score is a worse outcome. This outcome measure considered the Intention-To-Treat (ITT) population, all participants who were randomized and exposed to treatment, regardless of whether they finished the study. |
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Inclusion Criteria:
To have the ability to voluntarily grant their signed informed consent (FCI).
Being able and willing to comply with scheduled visits in the treatment plan and other study procedures.
Being 18 years of age or older.
Male or female.
Women within childbearing age who do not have a history of bilateral tubaric obstruction, hysterectomy, or bilateral oophorectomy should ensure continued use (initiated ≥ 30 days prior to signing the ICF) of a hormonal contraceptive method or intrauterine device (IUD) during the study period.
Having a postoperative diagnosis (unilateral, single eye) of cataract extraction by phacoemulsification with uncomplicated intraocular lens (IOL) placement** on the day prior to inclusion.
Having an intraocular pressure ≥ 8 and ≤ 21 mmHg.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Oscar Olvera-Montaño, MD | Contact | 3330004200 | oscar.olvera@sophia.com.mx | |
| Alejandra Sánchez-Ríos, MD | Contact | 3330004200 | 1190 | alejandra.sanchez@sophia.com.mx |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Retina Center | Recruiting | Tijuana | Estado de Baja California | 22010 | Mexico | |
| RGH Integra |
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| ID | Term |
|---|---|
| D000077266 | Moxifloxacin |
| D014785 | Vision, Ocular |
| C004180 | dexamethasone 21-phosphate |
| ID | Term |
|---|---|
| D024841 | Fluoroquinolones |
| D042462 | 4-Quinolones |
| D015363 | Quinolones |
| D011804 | Quinolines |
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Phase III, parallel, controlled, comparative, double-blind, multicenter clinical study
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| Placebo | Drug | Same excipients as PRO-232, without active principles (moxifloxacin and dexamethasone) |
|
| Moxifloxacin Hydrochloride, Ophthalmic | Drug | Moxifloxacin 0.5% Ophthalmic solution |
|
| Dexamethasone phosphate | Drug | Dexamethasone phosphate 0.1% Ophthalmic solution |
|
| Day 1, 3, 8 and 15. |
| Pain level score between interventions. | The patient's level of eye pain will be assessed using a visual analog scale (Wong-Baker FACES® Visual Analog Scale). The scoring system will be as follows: Severity: (0) Doesn't hurt, (2) Hurts a little, (4) Hurts a little more, (6) Hurts a lot, (8) Hurts too much, (10) Unbearable pain. A higher score is a worse outcome. This outcome measure considered the Intention-To-Treat (ITT) population, all participants who were randomized and exposed to treatment, regardless of whether they finished the study. | Day 1, 3, 8 and 15. |
| Changes in best corrected visual acuity (BCVA) measurement between interventions | The patient will be evaluated using his/her best refractive correction. BCVA is a test of visual function. It will be evaluated with the Snellen chart. The Snellen chart is the standard tool used to evaluate visual acuity. It was located in a place with adequate lighting, natural or artificial and at a distance of 3 meters from the subject to be evaluated. The contralateral eye to which it will be evaluated is covered, then the examiner detects until the line can clearly see the letters given he or she a score, the normal score for a VA is 20/20.This score can be expressed in fraction (i.e. 20/20) decimal (i.e. 1.0), or LogMAR (i.e. 0) formats. In this study, BCVA wiil be expressed in fraction and LogMAR formats. In fraction format and in LogMAR, a higher denominator number or number (respectively) is a worse outcome. | Day 1, 3, 8 and 15. |
| Proportion of patients who present an increase in intraocular pressure (IOP) ≥10 mmHg compared to baseline. | The IOP will be measured through Goldmann tonometer in milligrams of mercury (mmHg). After instillation of topical anesthetic (tetracaine 0.5%) and fluorescein stain, IOP will be evaluated. Normal values are considered between 10 and 21 mmHg. | Day 1, 3, 8 and 15. |
| Recruiting |
| Puebla City |
| Puebla |
| 72180 |
| Mexico |
| D006574 |
| Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D055537 | Light Signal Transduction |
| D015398 | Signal Transduction |
| D001669 | Biochemical Phenomena |
| D055598 | Chemical Phenomena |
| D002468 | Cell Physiological Phenomena |
| D012677 | Sensation |
| D009424 | Nervous System Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D009799 | Ocular Physiological Phenomena |