Disulfiram for Treatment of Retinal Degeneration

Inherited Retinal Dystrophy Primarily Involving Sensory Retina Clinical Trial

Official title:

A Cross-over Randomized Control Trial to Evaluate the Retinaldehyde Dehydrogenase Inhibitor, Disulfiram, in Improving Retinal Sensitivity in Eyes Affected by Inherited Retinal Degeneration

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05626920
• Other study ID #: STUDY00015434
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: December 2023
• Est. completion date: September 2024

Study information

• Verified date: November 2023
• Source: University of Washington
• Contact: Debarshi Mustafi, MD, PhD
• Phone: 206-616-9305
• Email: debarshi[@]uw.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Aberrant retinoic acid signaling driven by the degenerating outer retina leads to pathological changes to the inner retina. The resulting hyperactivity of retinal ganglion cells leads to further diminution of the remaining vision in those afflicted with inherited retinal diseases. Inhibition of this pathway has led to improved visual function in murine models of retinal degeneration. This can be accomplished in humans with the FDA-approved irreversible inhibitor of aldehyde dehydrogenases, disulfiram.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 30
• Est. completion date: September 2024
• Est. primary completion date: August 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

Age =18 years Only those with a clinical diagnosis of inherited retinal degeneration. When available, supporting genetic diagnosis form a CLIA approved lab will be further considered for inclusion.

Only one eye per subject should be identified as the study eye. The study eye must meet the following criteria:

• Best corrected ETDRS visual acuity letter score = 70 (i.e., 20/40 or better) within 30 days of enrollment.

• Goldmann visual field exhibiting constriction of visual fields to 10 degrees centrally

• Able and willing to provide informed consent

• Willing and able to abstain from alcohol consumption for the duration of the study and the 2 weeks preceding it and 2 weeks following the study end point

Liver function values that fall in the normal range as specified below:

• Alanine transaminase (ALT): less than 40 IU/L

• Aspartate transaminase (AST): less than 40 IU/L

• Alkaline phosphatase (ALP): less than 300 IU/L

• Albumin (Alb): less than 50 g/L

• Total Protein: less than 80 g/L

• Total Bilirubin: less than 30 umol/L

Exclusion Criteria:

• A condition that, in the opinion of the investigator, would preclude participation in the study, e.g., alcohol dependence, cardiovascular disease, hepatitis.

• Individuals with a history of diabetes mellitus

• Individuals with a history of psychosis

• Individuals with hypothyroidism

• Individuals with hypersensitivity to thiuram derivatives causing rubber contact dermatitis

• Those on anticoagulant therapy or other medications that may be affected by disulfiram.

• An ocular condition, other than inherited retinal degeneration, is present such that, in the opinion of the investigator, visual acuity might be affected (e.g., foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, non-retinal conditions such as epiretinal membrane or vitreo-macular traction, vein occlusion, uveitis or other ocular inflammatory diseases such as neovascular glaucoma, etc).

• History of major ocular surgery within the prior 6 months or major ocular surgery anticipated within the next 6 months following randomization.

• Exam evidence of severe external ocular infection, including conjunctivitis, chalazion, or substantial blepharitis

• Participation in an investigational trial that involves treatment with any drug within 30 days of randomization that has not received regulatory approval at the time of study entry.

Note: study participants cannot receive another investigational drug while participating in this study.

• Known allergy or hypersensitivity to any component of the study drug.

• For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 12 months. Women who are potential study participants should be questioned about the potential for pregnancy. Investigator judgment will be used to determine when a pregnancy test is needed.

• Participants who expect to move out of the area of the clinical center during the 8 months of the study

Related Conditions & MeSH terms

• Inherited Retinal Dystrophy Primarily Involving Sensory Retina
• Retinal Degeneration
• Retinal Dystrophies

Intervention

Drug:
• Disulfiram 250 mg
Disulfiram treatment
• Placebo
Placebo treatment

Locations

Country	Name	City	State
United States	University of Washington-South Lake Union Retina Center	Seattle	Washington

Sponsors (1)

Lead Sponsor	Collaborator
University of Washington

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Assess the effects of disulfiram on retinal sensitivity in eyes afflicted with inherited retinal degenerations	Evaluate change in contrast sensitivity measured by spatial contrast contrast sensitivity testing between disulfiram and placebo arms	Year 1
Secondary	Assess the effects of disulfiram on visual acuity in eyes afflicted with inherited retinal degenerations.	Evaluate change in best corrected visual acuity assessed by ETDRS chart testing between disulfiram and placebo arms	Year 1
Secondary	Assess the effects of disulfiram on photoreceptor functionality in eyes afflicted with inherited retinal degenerations.	Evaluate the change in retinal sensitivity as measured by standard and adaptive optics-scanning laser ophthalmoscopy based microperimetry	Year 1