Comparison Between Continuous and Pulsed Oral Doxycycline Treatment Protocols for Refractory Meibomian Gland Dysfunction
- Conditions
- Meibomian Gland DysfunctionBlepharitisDoxycycline Adverse Reaction
- Interventions
- Registration Number
- NCT06520007
- Lead Sponsor
- University of Milan
- Brief Summary
The goal of this observational study (spontaneous, non-randomised, prospective cohort, phase IV) is to compare the efficacy and safety of two different oral doxycycline treatment protocols (LCP - Low dose continuous protocol \& FPP - Full dose pulsed protocol) for meibomian gland dysfunction (MGD) in patients with refractory MGD (OSDI \> 13 after at least 2 months treatment with warm compresses and lacrimal substitutes - first-line therapy). Systemic doxycycline doesn't have a standardized treatment protocol and this is why those patients are treated as in normal clinical practice. The main questions it aims to answer are:
Which treatment protocol has a greater impact on patient symptoms during the follow-up (OSDI score reduction)? Which treatment protocol has a greater impact on patient signs during the follow-up (TBUT and corneal staining variations)? Which treatment protocol is safer (in terms of adverse events rate)?
Participants will be visited every 3 months (V0-V1-V2-V3) with signs and symptoms assessment (TBUT, corneal staining, OSDI score) after being treated for 3 months with the assigned doxycycline treatment protocol (LCP or FPP).
- Detailed Description
This spontaneous, prospective, non-randomized, parallel-group, phase IV study was conducted in compliance with the tenets of the Declaration of Helsinki.
All study participants were fully consented, and written informed consent was obtained.
This study included patients with refractory MGD. Refractory MGD is defined as symptomatic MGC (OSDI \> 13 points) despite 2 months of first-line treatment with lacrimal substitutes 3 times per day and meibomian gland expression with warm compresses twice per day.
The study will consist of 3 visits: Baseline (day 0), Visit 2 (day 90 ± 5 - 3rd month), Visit 3 (day 180 ± 5 - 6 month). At each visit, patients will receive an OSDI questionnaire, NIBUT, type I Schirmer test and AS assessment, including TBUT, corneal staining (Oxford scale) At baseline, eligible patients will be enrolled and treated with the assigned protocol. The investigators will assign the protocol (non-randomized) in a 1:1 ratio.
At Visit 2, NIBUT, TBUT, Oxford scale and OSDI improvement will be evaluated compared with Visit 1. Patients will be carefully asked about their compliance with the treatment. Patients who interrupted the treatment for adverse events or low compliance (\<75% of the protocol adherence) will exit the study and be excluded from the analysis.
At Visit 3, the study population will be evaluated as done in Visit 2
The protocols in the study are the following:
LCD (low-dose continuous protocol) - 50 mg of doxycycline for three months FPP ( Full-dose pulsed protocol) - 100 mg of doxycycline for the first 15 days of the month for three months.
The enrollment period will last about 6 months. Therefore, the study will end about 6 months after the last patient enrols.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 65
Not provided
Not provided
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description LCP - Low dose continuous protocol Doxycyclin Assumption of 50 mg of oral doxycycline per day for 3 months FPP - Full dose pulsed protocol Doxycyclin Assumption of 100 mg of oral doxycycline per day for 15 days per month (with a subsequent 15 days of washout) for 3 months
- Primary Outcome Measures
Name Time Method OSDI score Baseline - 3 months (90 days ± 5 days) - 6 months (180 days ± 5 days) Ocular Surface Disease Index
- Secondary Outcome Measures
Name Time Method Adverse events From baseline up to the 3rd month Number of dropouts due to drug toxicity
TBUT Baseline - 3 months (90 days ± 5 days) - 6 months (180 days ± 5 days) Tear break-up time
Corneal staining Baseline - 3 months (90 days ± 5 days) - 6 months (180 days ± 5 days) Oxford scale has been use to assess corneal staining
Trial Locations
- Locations (1)
ASST Santi Paolo e Carlo - Ospedale San Paolo
🇮🇹Milano, MI, Italy