CO-THEIA (COMBINATION THERAPY WITH METHOTREXATE AND ADALIMUMAB FOR UVEITIS): EFFICACY, SAFETY AND COST-EFFECTIVENESS OF METHOTREXATE, ADALIMUMAB, OR THEIR COMBINATION IN NON INFECTIOUS NON ANTERIOR UVEITIS: A MULTICENTER, RANDOMIZED, PARALLEL 3 ARMS, ACTIVE-CONTROLLED, PHASE 3 OPEN LABEL WITH BLINDED OUTCOME ASSESSMENT STUDY.
- Conditions
- on-infection uveitisTherapeutic area: Diseases [C] - Eye Diseases [C11]
- Registration Number
- CTIS2024-513123-17-00
- Lead Sponsor
- Fundacion Para La Investigacion Biomedica Del Hospital Clinico San Carlos
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 192
Subjects diagnosed with non-infectious intermediate-, posterior-, or pan-uveitis in at least one eye, Adult patients (=18 years), Subjects with at least one flare of active eye inflammation in the previous 180 days before Baseline visit, defined by the presence of at least 1 of the following parameters in either eye: a. Active chorioretinal or retinal vascular lesion, AND/OR b. Presence of macular edema by optical coherence tomography (OCT: thickness >350 µm when measured with spectralis or >340 µm when measured with Cirrus or TopCon, AND cysts or intraretinal fluid), AND/OR c. = 2+ anterior chamber cells (ACC; SUN criteria4) , AND/OR d. = 2+ vitreous haze (National Eye Institute [NEI]113/SUN criteria)., Subjects with active eye inflammation at Baseline visit, defined by the presence of at least 1 of the following parameters in either eye: a. Active chorioretinal or retinal vascular lesion, AND/OR b. Presence of macular edema by OCT (thickness >350 µm when measured with spectralis or >340 µm when measured with Cirrus or TopCon AND cysts or intraretinal fluid), AND/OR c. = 1+ ACC, AND/OR d. = 1+ vitreous haze., Subjects meeting at least ONE of the following criteria: a. Subjects with known chronic condition necessitating GCs-sparing immunosuppressive treatment: multifocal choroiditis with panuveitis, serpiginous choroidopathy, birdshot retinochoroidopathy, diffuse retinal vasculitis, Vogt-Koyanagi-Harada with bullous serous retinal and/or choroidal detachments, sympathetic ophthalmia. No prior therapy is required for these patients. AND/OR b. Intermediate uveitis fulfilling the following characteristics: ? Bilateral disease, AND, ? Low visual acuity (best corrected visual acuity <0.5) OR ? Bilateral macular involvement, defined as presence of macular edema (as defined in Inclusion Criteria 3, subpoint (b)), macular atrophy, and/or macular scarring. No prior therapy is required for these patients. AND/OR c. Subjects with registered local/systemic corticosteroid refractory uveitis in the previous 180 days months before Baseline visit, defined as: ? Presence of active inflammation after 4 weeks of high-dose (1mg/kg prednisone equivalent, see equivalence Table 6) corticosteroid treatment, resulting in an incomplete response (there was an amelioration, but there is still inflammation); AND/OR, ? Presence of active inflammation 4 weeks after a regional corticosteroid injection; AND/OR, ? Treatment with oral corticosteroids resulting in a reduction of inflammation, followed by relapse [increase in =1 grade in ACC or vitreous haze or a change of non-active to active lesions (including chorioretinal or retinal vascular lesion and/or macular edema)] when GCs was tapered; AND/OR, ? Presence of active inflammation after a long-acting corticosteroid intramuscular injection administered between 4 weeks to 180 days before the Baseline visit); AND/OR, ? Active inflammation after treatment with >10mg/day oral prednisone for at least the past 90 days before Baseline., If female, subject is: a. Not of childbearing potential: at least 1 year or more since the final menstrual period or surgically sterile (bilateral tubal ligation, bilateral oophorectomy or hysterectomy); b. Of childbearing potential and willing to use an acceptable method of contraception during the study period (i.e. pharmacologics, devices, barrier methods) or abstinence, and for 150 days after the last dose of study drugs; For the purpose of this clinical trial, woman is considered of chi
Subjects with confirmed or suspected infectious uveitis, including ocular histoplasmosis syndrome, Subjects with a history of prior intraocular surgery within 30 days prior to the Baseline visit, AND/OR any planned eye surgery within the next 52 weeks from Baseline Visit, Subjects with best spectacle-corrected visual acuity (BCVA) worse than 20/400 (ETDRS logMAR > 1.34) in the better eye during the screening or at Baseline visit, Subjects with active malignancy considered by the Site’s Investigator, and confirmed or suspected ocular masquerade syndromes, Subjects with systemic autoimmune disease or ocular condition (besides uveitis) anticipated to dictate treatment course, as considered by the Site’s Investigator, Subjects with infection(s) requiring treatment with intravenous (IV) anti-infectives within 30 days prior to the Baseline visit or oral anti-infectives within 14 days prior to the Baseline visit, Subjects with systemic active or chronic recurring infections, such as active TB (If the subject has a positive PPD test (or equivalent), has had a past ulcerative reaction to PPD placement and/or a CXR consistent with prior tuberculosis (TB) exposure, the subject must initiate, be currently receiving or have documented completion of a course of prophylactic anti-TB therapy (see Study Procedures” section)), syphilis, or hepatitis B or C, at Screening visit or in the previous 90 days before Baseline visit; AND/OR a history of invasive infection (e.g., listeriosis and histoplasmosis), Subjects with history of moderate to severe congestive heart failure (NYHA class III or IV), recent cerebrovascular accident (6 months) and any other condition which, in the opinion of the Site’s Investigator, would put the subject at risk by participation in the study, Subjects with clinically significant abnormal screening laboratory results as evaluated by the Site’s Investigator (at screening/baseline or in the previous 4 weeks)., Central nervous system demyelinating disease: a. Subjects with history of Central nervous system demyelinating disease AND/OR b. Magnetic Resonance Imaging (MRI) findings suggestive of a demyelinating disease: All subjects with intermediate uveitis or panuveitis that have signs of intermediate uveitis (e.g., presence or history of snowbanking or snowballs) must have a brain MRI within 90 days prior to the Baseline visit., Subject diagnosed with or with suspected Behçet’s disease, Subjects with previous intolerability, safety issues according to investigator criteria, AND/OR previous failure to control ocular or other inflammation with MTX, Subjects with previous exposure to any biological therapy at any time (excluding intravitreal anti-vascular endothelial growth factor [anti-VEGF] therapy and denosumab), including those with that have a potential or known association with progressive multifocal leukoencephalopathy (i.e. natalizumab, rituximab or efalizumab);, Subjects with previous exposure to synthetic immunosuppressive therapy (such as mycophenolate or cyclosporine) other than corticosteroids in the past 6 months before Baseline, Subjects with chronic structural eye damage considered by the Site’s Investigator to: a. Interfere with the measurement of any of the study outcomes, AND/OR b. Cause eye damage regardless of the inflammatory process, AND/OR c. Prevent the normalization of the eye structures, Chronic hypotony (IOP < 5 mm Hg for in the last 3 months and/or in the baseline visit) in both eyes, Subjects receiving lo
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method