Clobetasol Propionate Ophthalmic Nanoemulsion 0.05% for the Treatment of Inflammation and Pain Associated With Cataract Surgery (CLOSE-1)

Last updated: November 30, 2022
Sponsor: Salvat
Overall Status: Completed

Phase

3

Condition

Eye Disorders/infections

Eye Disease

Vision Loss

Treatment

N/A

Clinical Study ID

NCT04246801
CLOBOF3-16IA01
  • Ages > 18
  • All Genders

Study Summary

Cataract surgery is one of the most common surgical procedures performed worldwide. In fact, in 2017, 3.8 million cataracts procedures were performed in the US.

Despite of surgical advances, pain and inflammation after ophthalmic surgery continues to be a burden on both patients and physicians. The treatment of postoperative pain is essential for hospitalized patients, but it is even more important for patients who are treated on an outpatient basis.

This study will compare the efficacy and safety of clobetasol propionate ophthalmic nanoemulsion 0.05% to placebo, when administering one drop four times a day during 14 days after routine unilateral cataract surgery. Participants will undergo routine cataract surgery according to the ophthalmologist's normal procedures.

Overall, 210 participants are planned to take part in the study. They will be screened across 20 centers in the US. Participants who experience postoperative inflammation on the first day following routine cataract surgery and who meet all other eligibility criteria will be randomly assigned by chance to one of two study groups in a 2:1 ratio to receive either clobetasol propionate ophthalmic nanoemulsion 0.05 % (N=140) or placebo (N=70) for the treatment of inflammation and pain associated with cataract surgery.

Six (6) study visits are planned: Visit -1 (Screening), Visit 1 (Baseline; 24h after the surgery), Visit 2 (Day 3), Visit 3 (Day 8), Visit 4 (Day 15), and Visit 5 (Day 29).

The ophthalmologist will administer the first dose of the study medication 24 hours after the surgery, at the end of the Baseline visit, at the study center. Study medication will be then dispensed to participants for self-administration during the study at a dosage of one drop four times a day, during 14 days. Direct instillation is the most efficient method for delivery to the ocular surface and is an accepted and widely used method for topical application to the eye.

This study will examine effect and tolerability for 14 days of clobetasol propionate ophthalmic nanoemulsion 0.05% dosed four times a day.

This study is being conducted to support an application for approval to market clobetasol propionate ophthalmic nanoemulsion 0.05% in the US for the indication of inflammation and pain after ocular surgery. The reference (comparator) product in this study, the vehicle, is expected to provide a lower efficacy rate when compared to clobetasol 0.05%.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Male or female, age 18 years or older on day of consent
  2. Participants with routine unilateral cataract surgery on the day prior to studyrandomization
  3. Participants with at least 5 cells in anterior chamber on the first day after surgery (at Baseline visit)
  4. Willing and able to understand and provide written informed consent form (ICF) (atScreening visit)
  5. Women who satisfy one of the following:
  6. Are of child-bearing potential who are not pregnant or lactating and who areeither abstinent or sexually active on an acceptable method of birth control (methods that can achieve a failure rate of less than 1% per year when usedconsistently and correctly, like hormonal contraception (oral pills, implantabledevice, or skin patch), intrauterine device, bilateral tubal occlusion, or doublebarrier) for at least 4 weeks prior to Baseline visit and throughout the study (i.e., until Day 29), OR
  7. Are post-menopausal (have had no menstrual cycle for at least one year prior toScreening visit) or have undergone a sterilization procedure (bilateral tuballigation, hysterectomy, hysterectomy with unilateral or bilateral oophorectomy orbilateral oophorectomy) at least 6 months prior to Screening visit

Exclusion

Exclusion Criteria:

  1. Systemic administration of any corticosteroid or immunosuppressant drugs in theprevious 2 weeks prior to the first instillation of the investigational medicalproduct (IMP)
  2. Periocular injection in the study eye of any corticosteroid solution within 4 weeksprior to the first instillation of the IMP, or of any corticosteroid depot within 2months prior to the first instillation of the investigational medical product (Ozurdex® [dexamethasone]: within prior 6 months; Iluvien® [fluocinolone]: withinprior 36 months)
  3. Instillation of any topical ocular corticosteroid, non-steroidal antiinflammatory drug (NSAID), mast cells stabilizers, antihistamines or decongestants within 2 weeks priorto the first instillation of the IMP, except pre-surgical and/or surgicaladministration of 1 drop of a topical NSAID or corticosteroid, at the investigatordiscretion
  4. Prescription of any topical ocular medication, except preservative-free antibioticsfor prophylactic purposes
  5. Any history of glaucoma or ocular hypertension in the study eye
  6. History or presence of endogenous uveitis
  7. Any current corneal abrasion or ulceration
  8. Any confirmed or suspected active viral, bacterial, or fungal keratoconjunctivaldisease
  9. Known hypersensitivity or contraindication to the study drug or any of its components
  10. History of steroid-related intraocular pressure (IOP) increase
  11. Previous surgery in the last 4 weeks prior to the Screening visit or new surgeryscheduled to be performed before the end of the study period on the contralateral eye
  12. Presence of ocular hemorrhage which interferes with the evaluation of post-surgeryinflammation
  13. Presence of intraoperative complications during the cataract surgical procedure thatmay increase post-operative inflammation; this includes, in particular, participantswith ocular hemorrhage, floppy iris syndrome, increased IOP (≥24 mmHg), posteriorcapsule rupture and injections of gas into the vitreous body
  14. Increased cumulative dissipated energy value during phacoemulsification (increasedenergy used for phacoemulsification exert additional stress on iris and other anteriorchamber structures and may generate excessive inflammation)
  15. Presence of zonular dialysis (rupture of zonular fibers that attach lens to the ciliarbody which may lead to partial luxation of the lens / lens capsule and is a seriouscomplication of cataract surgery)
  16. Presence of Fuchs´ endothelial dystrophy (loss of endothelial cells that may result inchronic corneal edema after cataract surgery especially if high energy was used duringphacoemulsification)
  17. Presence of cornea guttata
  18. Pupil dilation lower than 4.5 mm
  19. Presence of lower lacrimal duct obstruction and/or history of infectiousdacryocystitis
  20. Presence of IOP ≥24 mmHg at Baseline visit
  21. Participation in any study of an investigational topical or systemic new drug ordevice within 30 days prior to the Screening visit, or at any time during the study
  22. Prior participation in the study described in this protocol, unless participant wasnot randomized
  23. In the opinion of the investigator or study coordinator, be unwilling or unable tocomply with study protocol or unable to successfully instill eye drops
  24. Disease, condition (including monocular participants), or disorder that in thejudgement of investigator could confound study assessments or limit compliance tostudy protocol

Study Design

Total Participants: 250
Study Start date:
June 10, 2020
Estimated Completion Date:
May 19, 2021

Connect with a study center

  • Arizona Eye Center

    Chandler, Arizona 85224
    United States

    Site Not Available

  • Beverly Hills Institute of Ophthalmology

    Beverly Hills, California 90210
    United States

    Site Not Available

  • Mark B. Kislinger, MD, Inc.

    Glendora, California 95670
    United States

    Site Not Available

  • LoBue Laseer & Eye Medical Center

    Murrieta, California 92562
    United States

    Site Not Available

  • Pasedena Eye Medical Group

    Pasadena, California 91105
    United States

    Site Not Available

  • Martel Medical Eye Group

    Rancho Cordova, California 95670
    United States

    Site Not Available

  • Santa Barbara Eyecare

    Santa Barbara, California 93105
    United States

    Site Not Available

  • Wolston & Goldberg Eye Associates

    Torrance, California 90505
    United States

    Site Not Available

  • Arus Research at Cape Coral Eye Center

    Cape Coral, Florida 33904
    United States

    Site Not Available

  • Dixon Eye Care

    Albany, Georgia 31701
    United States

    Site Not Available

  • Eye Care Centers Management, Inc. (Clayton Eye Center)

    Morrow, Georgia 30260
    United States

    Site Not Available

  • Coastal Research Associates

    Roswell, Georgia 30076
    United States

    Site Not Available

  • Chicago Eye Specialists

    Chicago, Illinois 60619
    United States

    Site Not Available

  • Chicago Cornea Consultants Ltd

    Hoffman Estates, Illinois 60169
    United States

    Site Not Available

  • Huron Ophthalmology P.C.

    Ypsilanti, Michigan 48197-1102
    United States

    Site Not Available

  • Silverstein Eye Centers

    Kansas City, Missouri 64133
    United States

    Site Not Available

  • Wellish Vision Institute

    Las Vegas, Nevada 89119
    United States

    Site Not Available

  • Fifth Avenue Eye Associates

    New York, New York 10028
    United States

    Site Not Available

  • Apex Eye

    Mason, Ohio 45014
    United States

    Site Not Available

  • Black Hills Regional Eye Institute

    Rapid City, South Dakota 57701
    United States

    Site Not Available

  • Texan Eye, PA / Keystone Research Ltd.

    Austin, Texas 78731
    United States

    Site Not Available

  • Houston Eye Associates

    Houston, Texas 77025
    United States

    Site Not Available

  • Medical Center Ophthalmology Associates

    San Antonio, Texas 78240
    United States

    Site Not Available

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