A clinical study to follow the implantation of Holoclar on the cornea in patients with occular burns
- Conditions
- Treatment of corneal lesions with associated moderate (at least two corneal quadrants, central corneal involvement resulting in severe visual impairment) to severe limbal stem cell deficiency due to ocular burnsMedDRA version: 20.0Level: LLTClassification code 10011012Term: Corneal epithelium opacitySystem Organ Class: 100000004853Therapeutic area: Diseases [C] - Eye Diseases [C11]
- Registration Number
- EUCTR2014-002845-23-IT
- Lead Sponsor
- CHIESI FARMACEUTICI S.P.A.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Recruiting
- Sex
- All
- Target Recruitment
- 80
1.Written informed consent prior to any study-related procedures. Informed consent will also include the possibility of a second transplantation and of the rolling over to the long-term extension study HOLOCORE-FU. In case the patient will be judged by the investigator as eligible to a second transplantation, an additional written addendum to the first informed consent form will have to be obtained to proceed with the second ACLSCT;
2.Adult male and female patients (=18 years old);
Five Paediatric patients aged 2 to 17 years will be also enrolled for safety purposes only.
3.LSCD secondary to unilateral or bilateral physical or chemical ocular burns, with at least 1-2 mm2 of undamaged limbus to harvest stem cells for expansion in culture. LSCD will be considered for inclusion in presence of superficial neo-vascularization invading at least two corneal quadrants with central corneal involvement (including corneal neo-vascularization or corneal opacity) according to the independent assessors;
4.Stability of LSCD, defined by a duration of disease of at least 24 months (12 months for minors) at the time of the Screening Visit and presence of continuum epithelium as per fluorescein staining scored as none or trace.
5.Presence of severe impairment in visual acuity defined by a score after best correction (i.e. Best Corrected Visual Acuity) equal or below 1/10th (or 20/200) at the Snellen chart (legal blindness) ;
6.Absence of other clinical contraindications to ACLSC transplantation based upon investigator’s judgment;
7.A cooperative attitude to follow up the study procedures (Caregivers in case of minors).
Are the trial subjects under 18? yes
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 73
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 14
1. LSCD of mild degree (i.e. below 2 quadrants of neo-vessel invasion ), due to a recent burn (less than 24 months before screening for adults and 12 months for minors), or secondary to medical conditions other than burns (i.e.radiotherapy);
2. Severe ocular inflammation according to the Efron Grading Scale for Contact Lens Complications. Patient can be re-screened after appropriate
treatment;
3. Presence of eyelids malposition;
4. Conjunctival scarring with fornix shortening;
5. Tear secretion deficiency, determined by Schirmer's test (<5 mm/ 5 min);
6. Corneal anaesthesia and conjunctival anaesthesia or severe hypoesthesia;
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To demonstrate the efficacy of Holoclar® at one year after the first treatment in patients suffering from moderate (vascularization in two-three corneal quadrants with central corneal involvement) to severe (vascularization in four corneal quadrants with central corneal involvement) LSCD with severe visual impairment and secondary to ocular burns, in terms of percentage of patients with a success of transplantation at approximately 12 months from the first Holoclar® treatment.;Secondary Objective: To evaluate the efficacy of one or two treatments with Holoclar at one year after the last treatment.;Primary end point(s): - Percentage of patients with a success of transplantation (success is defined on the basis of the degree of superficial corneal neovascularization and epithelial defects);Timepoint(s) of evaluation of this end point: 12 months from the first Holoclar treatment
- Secondary Outcome Measures
Name Time Method Secondary end point(s): Percentage of patients with clinical success after one or two ACLSCTs<br>(same definition of success as primary endpoint);Timepoint(s) of evaluation of this end point: 12 months after the last treatment with Holoclar