Uveitis Clinical Trial
Official title:
Prospective Open Label Study of H.P. Acthar Gel Injection in Patients With Active Non-Infectious Uveitis With Associated Glaucoma Thus High Frequency Regional Corticosteroid and Oral Corticosteroids Cause Intolerable Side-Effects
Uveitis represents a heterogeneous group of diseases that results from ocular inflammatory reaction involving ocular tissue and vasculature. The inflammation usually causes pain, redness, photophobia and blurred vision. This inflammation, is typically treated with regional or systemic therapy. The regional therapy typically consists of topical corticosteroids or periocular or regional corticosteroids. Regional therapy can lead to a steroid response glaucoma, which is increased intraocular pressure.This pilot study aims to evaluate the possible effectiveness of H.P. Acthar in patients with active ocular inflammatory disease, and currently on treatment for glaucoma or have a history of glaucoma.
Uveitis represents a heterogeneous group of diseases that results from ocular inflammatory
reaction involving ocular tissue and vasculature. The inflammation usually causes pain,
redness, photophobia and blurred vision.
H.P Acthar Gel stimulate the adrenal cortex to secrete cortisol. Additionally H.P. Acthar gel
is also reported to bind to melanocortin receptors. Melanocortin receptor activation has been
shown to exert marked anti-inflammatory and immune-modulatory effects in animal studies, by
modulating pro inflammatory cytokines, followed by induction of anti- inflammatory mediators
and subsequent leukocyte migration. Specifically melanocortins down regulate Tumor Necrosis
Factor (TNF) alpha, Interleukin (IL) -2, Interferon gamma and T-cell proliferation and
upregulates IL-10 and regulatory T cells. For this reason H.P. Acthar is an approved
treatment for ocular inflammatory disease.
Ocular inflammatory disease is typically treated with regional or systemic therapy. The
regional therapy typically consists of topical corticosteroids or periocular or regional
corticosteroids. Regional therapy can lead to a steroid response glaucoma, which is increased
intraocular pressure.This pilot study aims to evaluate the possible effectiveness of H.P.
Acthar in patients with active ocular inflammatory disease, and currently on treatment for
glaucoma or have a history of glaucoma.
Subjects will be treated with H P Acthar subcutaneous gel, 40 U/ml, given twice weekly x 8
weeks, followed by once weekly x 4 weeks: a total 20 doses with the same cumulative units to
be administered, using the approved route, with the option to do 4 additional doses if
resolution is incomplete.
This will be a prospective open-label, non-randomized pilot study: 12 week treatment for
active non-infectious uveitis, endpoint assessment and safety assessment; additional 12 week
assessment for uveitis activity/quiescence and safety assessment.
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