Efficacy and Safety of Adalimumab in Subjects With Active Uveitis



Status:Completed
Conditions:Cervical Cancer, Ocular
Therapuetic Areas:Oncology, Ophthalmology
Healthy:No
Age Range:18 - Any
Updated:4/12/2016
Start Date:August 2010
End Date:August 2014

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A Multicenter Study of the Efficacy and Safety of the Human Anti-TNF Monoclonal Antibody Adalimumab as Maintenance Therapy in Subjects Requiring High Dose Corticosteroids for Active Non-infectious Intermediate-, Posterior-, or Pan-uveitis

A study comparing the safety and efficacy of Adalimumab vs. Placebo in subjects with active
uveitis.


Inclusion Criteria:

- Subject is at least 18 years of age.

- Subject is diagnosed with non-infectious intermediate-, posterior-, or pan-uveitis.

- Subject must have active disease at the Baseline visit as defined by the presence of
at least 1 of the following parameters in at least one eye despite at least 2 weeks
of maintenance therapy with oral prednisone >/= 10 mg/day to corticosteroid equivalent):

- Active, inflammatory, chorioretinal and/or inflammatory retinal vascular lesion

- >/= 2+ anterior chamber cells (Standardization of Uveitis Nomenclature [SUN]
criteria)

- >/= 2+ vitreous haze (National Eye Institute [NEI]/SUN criteria)

- Subject is on oral prednisone >/= 10 mg/day to equivalent) for at least 2 weeks prior to Screening and remains on the same dose from
Screening to Baseline visit.

- Subject with documented prior adequate response to oral corticosteroids (equivalent
of oral prednisone up to 1 mg/kg/day).

- Subjects who do not have previous, active or latent TB. Only one TB test is required
to allow the subject in the study. Subjects with either negative PPD (< 5 mm of
induration) or negative QuantiFERON®-TB Gold test (or IGRA equivalent) are eligible.
Subjects with a repeat indeterminate QuantiFERON®-TB Gold test (or IGRA equivalent)
result are not eligible. Note, that only one TB screening test is allowed and
required. A repeat QuantiFERON® TB Gold test (or IGRA equivalent) is not permitted if
the PPD skin test is positive. The TB screening tests are diagnostic tests. In the
event of a negative TB screening test, the results are to be interpreted in the
context of the patient's epidemiology, history, exam findings, etc. and it is the
responsibility of the investigator to determine if a patient has previous, active or
latent tuberculosis or not. Under no circumstances can a patient with a positive PPD
result or positive QuantiFERON®-TB Gold test (or IGRA equivalent) enter the study.

Exclusion Criteria:

- Subject with isolated anterior uveitis.

- Subject with prior inadequate response to high-dose oral corticosteroids

- Subject with confirmed or suspected infectious uveitis, including but not limited to
infectious uveitis due to TB, cytomegalovirus ( CMV ), Human T-Lymphotropic Virus
Type 1 (HTLV-1), Whipple's disease, Herpes Zoster virus (HZV), Lyme disease,
toxoplasmosis and herpes simplex virus (HSV).

- Subject with serpiginous choroidopathy.

- Subject with corneal or lens opacity that precludes visualization of the fundus or
that likely requires cataract surgery during the duration of the trial.

- Subject with intraocular pressure of >/= 25 mmHg and on >/= 2 glaucoma medications or
evidence of glaucomatous optic nerve injury.

- Subject with Best Corrected Visual Acuity (BCVA) less than 20 letters (Early
Treatment Diabetic Retinopathy Study) in at least one eye at the Baseline Visit.

- Subject with intermediate uveitis or panuveitis that has signs of intermediate
uveitis (e.g.presence or history of snowbanking or snowballs) and symptoms and/or
Magnetic Resonance Imaging (MRI) findings suggestive of a demyelinating disease such
as multiple sclerosis. All subjects with intermediate uveitis or panuveitis that have
signs of intermediate uveitis (e.g., presence or history of snowbanking or snowballs)
must have had a brain MRI within 90 days prior to the Baseline Visit.

- Subject has previous exposure to anti-TNF therapy or any biologic therapy (except
intravitreal anti-Vascular endothelial growth factor [VEGF] therapy) with a potential
therapeutic impact on non-infectious uveitis.

- If entering the study on 1 concomitant immunosuppressive therapy, dose has been
increased within the last 28 days prior to Baseline visit or is not within the
following allowable doses at the Baseline visit:

- Methotrexate (MTX)
- Cyclosporine
- Mycophenolate mofetil mofetil (e.g.mycophenolic acid) at an equivalent dose approved by the Medical
Monitor.

- Azathioprine
- Tacrolimus (oral formulation)
- Subject has received Retisert® (glucocorticosteroids implant) within 3 years prior to
the Baseline visit or that has had complications related to the device. Subject has
had Retisert® (glucocorticosteroids implant) removed within 90 days prior to the
Baseline visit or has had complications related to the removal of the device.

- Subject has received intraocular or periocular corticosteroids within 30 days prior
to Baseline visit.

- Subject with proliferative or severe non-proliferative diabetic retinopathy or
clinically significant macular edema due to diabetic retinopathy.

- Subject with neovascular/wet age-related macular degeneration

- Subject with abnormality of vitreo-retinal interface (i.e., vitreomacular traction,
epiretinal membranes, etc.) with the potential for macular structural damage
independent of the inflammatory process.

- Subject with severe vitreous haze that precludes visualization of the fundus at the
Baseline visit.

- Subject has received Ozurdex® (dexamethasone implant) within 6 months prior to the
Baseline visit.

- Subject has received intravitreal anti-VEGF therapy within 45 days of the Baseline
visit for Lucentis® (ranibizumab) or Avastin® (bevacizumab) or within 60 days of the
Baseline visit for anti-VEGF Trap (aflibercept).

- Subject has received intravitreal methotrexate within 90 days prior to the Baseline
visit

- Subject on systemic carbonic anhydrase inhibitor within 1 week prior to Screening
visit.

- Subject with macular edema as the only sign of uveitis.

- Subject with a history of scleritis.

- Subject with intolerance to high-dose oral corticosteroids (equivalent of oral
prednisone 1 mg/kg/day or 60 to 80 mg/day).

- Subject on cyclophosphamide within 30 days prior to the Baseline visit.
We found this trial at
32
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