Retinitis Pigmentosa Clinical Trial
Official title:
Effects of Lutein in Retinitis Pigmentosa
Phase I/II double-masked, randomized, placebo-controlled, cross-over trial to determine effects of lutein on vision in retinitis pigmentosa, including safety and effective dosage assessment
Retinitis pigmentosa (RP) is a group of congenital retinal degenerations affecting over
100,000 individuals in the US, characterized by nightblindness, gradual loss of peripheral
vision, and eventually total vision loss. Despite surgical and medical efforts it has not
been possible to slow down, let alone reverse, the process of photoreceptor degeneration in
RP. However, a recent patient-initiated pilot study demonstrated that RP patients may
respond to a nutrition supplement (lutein) with a modest, but statistically significant gain
in visual acuity and central visual field area; demonstration of these effects relied
critically on frequent home vision tests using a letter chart on the screen of a personal
computer and a wall chart to measure the central visual field. Supporting the reliability of
the data was a highly significant correlation between eye color and vision changes; eye
color has earlier been shown to influence macular pigment changes following lutein
supplementation.
At this state, a study of long-term lutein benefits would be costly and, without
placebo-controlled pilot data, premature. We are proposing to prepare for a long-term
clinical trial through an exploratory study, investigating the effects of lutein and
creating PC-based home vision tests. In the initial 6 months of the study, we will develop
and adapt standard clinical vision tests for use on a personal computer, and recruit two
study groups: 1) 42 RP patients to study the effects of lutein on vision, using placebo and
20 dosages in a randomized, double-masked crossover design (Latin Square, 2x16 weeks),
testing for possible adverse effects through serum hepatic panels every 4-6 weeks, and
measuring compliance through baseline and end-value serum carotenoid tests and frequent
macular pigment density tests; 2) 31 other volunteers (10 normally signed, 21 RP patients)
who, along with the first group, will monitor their vision every 1-2 weeks at home using the
PC-based tests. Results will be validated against those obtained with standards tests during
multiple visits to our center.
The results and tools produced by this study will enable a long-term lutein supplementation
trial with vision as its principal outcome measure, and the study can serve as a model for
other supplement trials. Moreover, by virtue of the PC-based home vision tests developed as
part of this study, such future trials may, under proper safeguards, enroll remote
participants who would download test software, perform frequent outcome tests at home,
submit test results via e-mail, and be examined periodically by local physicians to detect
potential adverse effects.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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