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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02834559
Other study ID # uni-koeln-1782
Secondary ID 2015-004731-12
Status Completed
Phase Phase 3
First received
Last updated
Start date October 27, 2016
Est. completion date June 15, 2020

Study information

Verified date April 2022
Source Universitätsklinikum Köln
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study investigates the effectiveness of a simple treatment to prevent proliferative vitreoretinopathy (PVR). Intraoperative intravitreal 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) is used as a prophylactic therapy in high-risk patients with primary rhegmatogenous retinal detachment (RRD). Our major motivation is to reduce the incidence of PVR in the group that receives the trial drug.


Description:

Proliferative vitreoretinopathy (PVR) is a common cause for postoperative failure after vitreoretinal surgery for primary RRD. There is no standard-therapy to prevent PVR. Several attempts using chemotherapeutic agents have been undertaken to prevent this proliferation-process, but none of these was introduced into routine clinical practice. Until recently, it has been challenging to identify patients with high risk for postoperative PVR formation. This is especially important, because in this trial treatment with the trial drug will be restricted to patients at high risk for PVR only. Patients are assigned to the following treatment arms (1:1): (A) Intraoperative adjuvant application of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) via intraocular infusion during routine pars plana vitrectomy (PPV) in high-risk patients for proliferative vitreoretinopathy (PVR) with primary rhegmatogenous retinal detachment (RRD). Versus: (B) Routinely used intraocular infusion with balanced salt solution (BSS) during routine PPV.


Recruitment information / eligibility

Status Completed
Enrollment 326
Est. completion date June 15, 2020
Est. primary completion date June 15, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Primary rhegmatogenous retinal detachment (< 4 weeks) in study eye 2. Scheduled for pars plana vitrectomy for retinal detachment repair without combined cataract surgery in study eye 3. Elevated protein levels in anterior chamber fluid (laser-flare value = 15.0 pc/ms) in study eye 4. Female or male patient = 18 years of age 5. Written informed consent Exclusion Criteria: 1. Retinal detachment lasting > 4 weeks in study eye 2. Traumatic retinal detachment in study eye 3. Giant retinal tears in study eye (size > 3 clock hours) 4. Visual pre-existing PVR grade C in study eye 5. Retinal dystrophies in study eye 6. Scheduled for combined pars plana vitrectomy and cataract surgery for retinal detachment repair in study eye 7. Chronic inflammatory conditions in study eye 8. Active retinal vascular disease in study eye 9. Proliferative diabetic retinopathy in study eye 10. Manifest uveitis in study eye 11. Endophthalmitis in study eye 12. Perforating and non-perforating trauma in study eye 13. Malignant intraocular tumor in study eye 14. Aphakia in study eye 15. Uncontrolled glaucoma or ocular hypertension in study eye (intraocular pressure = 30 mmHg despite IOP lowering therapy) 16. Previous intraocular surgery except uncomplicated cataract surgery with posterior chamber lens implantation in study eye 17. Cataract surgery in study eye = 3 months ago 18. Previous retinal procedures (laserpexy, cryopexy, intravitreal gas-injection, anti-VEGF or corticosteroid-injection) in study eye = 6 months 19. Other uncontrolled ophthalmologic disorders 20. Single eyed patients (BCVA of fellow eye > 1.0 log MAR, < 0.1 decimal, < 1/10 tenth, or < 6/60 Snellen fraction [m]) 21. Evidence or history of alcohol, medication or drug dependency within the last 12 months. 22. Evidence or history (within the last 12 months) of neurotic personality, psychiatric illness that requires or required treatment, epilepsy or suicide risk. 23. Systemic disorders not compatible with adjuvant application of 5-FU and LMWH via intraocular infusion, or not compatible with the local or general anesthesia 24. Any therapy with immunosuppressant or chemotherapy = 3 months and during the trial period 25. Participation in another trial of IMPs or devices parallel to, or less than 3 months before screening, or previous participation in this trial. 26. Known to or suspected of not being able to comply with the protocol. 27. Inability to understand the rationale of this trial or the study aim 28. Any dependency of the patient to the Investigator or the trial site, e.g. employees with direct involvement in the proposed trial or in other trials under the direction of this Investigator or trial site, as well as family members of the employees or the Investigator. 29. Positive urine pregnancy test, pregnancy or breastfeeding mother. 30. Women of child bearing potential without satisfactory contraception, i.e. hormonal contraceptives for at least 14 days before trial enrolment, IUD, double barrier (women of child bearing age must be counselled about the use of adequate contraception).

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
5-fluorouracil and low molecular weight heparin
Intraoperative adjuvant application of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) via intraocular infusion during routine pars plana vitrectomy (PPV).
Placebo
Routinely used intraocular infusion with balanced salt solution (BSS) during routine pars plana vitrectomy (PPV).

Locations

Country Name City State
Germany Augenklinik Uniklinik Bonn Bonn NRW
Germany Universitäts-Augenklinik Düsseldorf Dusseldorf NRW
Germany Augenklinik Uniklinik Freiburg Freiburg BW
Germany Universitätsaugenklinik Göttingen Göttingen
Germany Klinik und Poliklinik für Augenheilkunde Uniklinik Hamburg Eppendorf Hamburg HH
Germany Universitätsaugenklinik Kiel Kiel
Germany Augenklinik der Universität zu Köln Koln NRW
Germany Uniklinik Leipzig Klinik und Poliklinik für Augenheilkunde Leipzig Sachsen
Germany Augenklinik TU München München
Germany Augenärzte am St. Franziskushospital Münster Augenklinik Munster NRW
Germany Universitätsaugenklinik Regensburg Regensburg
Germany Knappschaftskrankenhaus Sulzbach Augenklinik Sulzbach Sulzbach Saarbrücken
Germany STZ eyetrial am Department für Augenheilkunde Tübingen BW

Sponsors (5)

Lead Sponsor Collaborator
Universitätsklinikum Köln German Research Foundation, Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), Pharmacy of the University Hospital Erlangen, The Clinical Trials Centre Cologne

Country where clinical trial is conducted

Germany, 

Outcome

Type Measure Description Time frame Safety issue
Primary Proliferative Vitreoretinopathy (PVR) grade CP (posterior - full thickness retinal folds in clock hours) 1 or higher [yes/no] within 12 weeks
Secondary PVR grade CP 1 or higher [yes/no] within 6 weeks
Secondary PVR grade CA (anterior - full thickness retinal folds in clock hours) 1 or higher [yes/no] within 6 weeks and 12 weeks
Secondary Degree of PVR (PVR grade CA 1-12, PVR grade CP 1-12 (in clock hours)) within 6 weeks and 12 weeks
Secondary Best Corrected Visual Acuity (BCVA) measured by ETDRS charts within 6 weeks and 12 weeks
Secondary Retinal reattachment after primary intervention [yes/no] within 6 weeks and 12 weeks
Secondary Number of retinal re-detachments and if present due to PVR [yes/no] within 6 weeks and 12 weeks
Secondary Number and extent of surgical procedures necessary to achieve retinal reattachment within 12 weeks
Secondary Occurrence of at least one drug-related adverse event that affects the study eye [yes/no] within 12 weeks
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