Intravitreal Sirolimus as Therapeutic Approach to Uveitis

• Status: Recruiting
• Trial end date: 2022-12-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to find out about the safety and effectiveness of two different doses the study drug, sirolimus, administered intravitreally in patients with uveitis. The potential effectiveness of sirolimus can be utilized to control inflammation in uveitis and yet avoid the potential complications that are usually associated with the systemic use of the drug and other immunomodulatory therapies. In this study, the investigators will administer sirolimus inside the eye (intravitreally) in one of two doses (440mcg/mcL or 880mcg/mcL). Local administration of sirolimus to the eye is not expected to have effects on the rest of the body. Therefore, it may offer a safer way than the current methods used to control the inflammation caused by non-infectious uveitis.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Johns Hopkins University; Stanford University
• Collaborator: Santen Inc.
• Treatments: Everolimus; Sirolimus

Criteria

Inclusion Criteria:

1. Males and females greater than or equal to 12 years of age.

2. Able to give informed consent and attend all study visits.

3. Have diagnosis of uveitis determined by the Investigator to be non-infectious based on the patient's medical history, history of present illness, ocular examination, review of systems, physical examination, and any pertinent laboratory evaluations.

4. Meet the following criteria:

• Have active uveitis, defined as having at least 1+ Vitreous Haze and/or at least 1+ Vitreous Cell Count (SUN scale), and:

• are receiving no treatment; or

• are receiving:

• prednisone ≥ 10 mg/day (or equivalent dose of another corticosteroid), or

• at least 1 systemic immunosuppressant other than corticosteroids, or

• combination of prednisone ≥ 10 mg/day (or equivalent dose of another corticosteroid) and other systemic immunosuppressant.

• Have inactive disease, defined as having 0.5+ Vitreous Haze or less and 0.5+ or less Vitreous Cell Count (SUN scale), and:

• are receiving:

• prednisone <10 mg/day (or equivalent dose of another corticosteroid), or

• at least 1 systemic immunosuppressant other than corticosteroids, or

• combination of prednisone <10 mg/day (or equivalent dose of another corticosteroid) and other systemic immunosuppressant.

• Have posterior, intermediate, or panuveitis; for panuveitis, if an anterior component is present, it must be less than the posterior component.

• Sufficient inflammation to require systemic treatment and, based on the Investigator's decision, warrants intravitreal treatment.

• Best-corrected ETDRS visual acuity of 20/400 or better (approximately 20 letters) in the study eye.

• Best-corrected ETDRS visual acuity of 20/400 or better in the fellow eye (approximately 20 letters).

Exclusion Criteria:

1. Patients with bilateral uveitis who are receiving systemic immunosuppressive therapy (e.g., methotrexate, cyclosporine, cyclophosphamide, chlorambucil, mycophenolate mofetil, tacrolimus, or azathioprine) other than prednisone or other corticosteroids for the treatment of uveitis and the uveitis in the fellow eye, in the opinion of the Investigator, cannot be controlled with standard local therapies alone;

2. Any significant ocular disease that could compromise the visual outcome in the study eye.

3. Intravitreal injections (including but not limited to anti-vascular endothelial growth factors 60 days prior to the baseline;

4. Posterior subtenon's or intravitreal injection of steroids 90 days prior to Baseline;

5. Intraocular surgery within 90 days prior to Day 0 in the study eye;

6. Capsulotomy within 30 days prior to Day 0 in the study eye;

7. History of vitreoretinal surgery or scleral buckling within 90 days prior to Day 0 in the study eye;

8. Any ocular surgery (including cataract extraction or capsulotomy) of the study eye anticipated within the first 180 days following Day 0;

9. Intraocular pressure ≥25 mmHg in the study eye (glaucoma patients maintained on no more than 2 topical medications with IOP <25 mmHg are allowed to participate);

10. Pupillary dilation inadequate for quality fundus photography in the study eye;

11. Media opacity that would limit clinical visualization, intravenous fluorescein angiography (IVFA), or OCT evaluation in the study eye;

12. Presence of any form of ocular malignancy in the study eye, including choroidal melanoma;

13. History of herpetic infection in the study eye or adnexa;

14. Presence of known active or inactive toxoplasmosis in either eye;

15. Ocular or periocular infection in either eye;

16. Participation in other investigational drug or device clinical trials within 30 days prior to Day 0, or planning to participate in other investigational drug or device clinical trials within 180 days following Day 0. This includes both ocular and non-ocular clinical trials.