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KeratitisPhase 2/3NCT05255016

Safety and Effectiveness of the PXL Platinum 330 System With Riboflavin Solution for Refractory Corneal Ulcers

A Phase 2/3 study testing PXL Platinum 330 system + Riboflavin 0.25% TE Solution in people with Keratitis and Corneal Ulcer, run by Peschke GmbH at 12 sites in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study is being conducted to evaluate the safety and effectiveness of using the PXL Platinum 330 System with riboflavin solution for performing corneal collagen crosslinking (CXL) for the treatment of refractory corneal ulcers. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Keratitis, Corneal Ulcer
What is being tested?
PXL Platinum 330 system + Riboflavin 0.25% TE Solution
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
488 participants
Where
12 sitesUnited States
Study dates
14 Mar 2022to 24 Feb 2024
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years of age or older
  • Central corneal ulcer or hypopyon, and/or failure to improve within 24 hours of initiating conventional antibiotic eyedrops (eg, quinolone, polymyxin/trimethoprim, erythromycin, or other non-fortified antibiotics) or failure to completely re-epithelialisation within 1 week of initiating conventional antibiotic drops
  • Consent to a corneal culture for bacterial keratitis (suspected keratitis is defined as a corneal epithelial defect of any size with an infiltration of the underlying stroma)
  • Signed written informed consent
  • Willingness and ability to comply with schedule for follow-up visits
  • Minimum corneal thickness >300 μm

Who cannot join

  • Presence of a perforated corneal ulcer
  • Presence of a corneal ulcer that has produced a descemetocele
  • Presence of a corneal ulcer deeper than 50% depth or 275 μm in the cornea
  • Any active ocular infection other than the central corneal ulcer or hypopyon to be treated
  • Suspicion of amoebic or viral keratitis requiring treatment with topical anti- amoebic or topical antiviral ophthalmic medications
  • Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye(s) for future complications. This may include history of or active corneal disease (eg, herpes simplex, herpes zoster keratitis, recurrent erosion syndrome, acanthamoeba, etc.)
Show all 9Show fewer
  • Uncontrolled systemic disease, especially a collagen-vascular or rheumatologic condition that could contribute to the corneal condition
  • Pregnancy (or plan to become pregnant) or lactation during the course of the study
  • A known sensitivity to study medications

Trial locations and contacts

12 sites in 1 country.

Patricia Huezo-Diaz Curtis, PhD contact

0041 (0) 787 422151

Patricia.Huezo-Diaz@confinis.com

12 sites in 1 country

United States12 sites, 12 recruiting
  • SightMD

    Babylon, New York, 11702

    Eric Rosenberg, MD

    Recruiting
  • Woolfson Eye

    Chattanooga, Tennessee, 37421

    Jonathan Woolfson, MD

    Recruiting
  • Prisma Health Opthalmology

    Columbia, South Carolina, 29203

    Shawn Iverson, MD

    Recruiting
  • Gorovoy M.D Eye Specialists

    Fort Myers, Florida, 33907

    Mark Gorovoy, MD

    Recruiting
  • Houston Eye Associates

    Houston, Texas, 77008

    John Goosey, MD

    Recruiting
  • Price Vision Group

    Indianapolis, Indiana, 46260

    Francis Price, MD

    Recruiting
  • San Antonio Eye Center

    Lackland Air Force Base, Texas, 78236

    Vasudha Panday, MD

    Recruiting
  • Colorado Eye Consultants

    Littleton, Colorado, 80120

    Lance Forstot, MD

    Recruiting
  • Milwaukee Eye Surgeons

    Milwaukee, Wisconsin, 53203

    Ken Weinlander

    Recruiting
  • Valley Eye

    Oshkosh, Wisconsin, 54901

    Michael Vrabec, MD

    Recruiting
  • Bay Area Eye Institute

    Tampa, Florida, 33613

    Craig Berger, MD

    Recruiting
  • The cornea & Laser Eye Institute-NJ

    Teaneck, New Jersey, 07666

    Peter Hersh, MD

    Recruiting

Other trials in United States

About this study

This study is being conducted to evaluate the safety and effectiveness of using the PXL Platinum 330 System with riboflavin solution for performing corneal collagen crosslinking (CXL) for the treatment of refractory corneal ulcers. The PXL Platinum 330 System is a combination product consisting of an ultraviolet-A (UV-A) 365 nm wavelength light source (PXL Platinum 330 Illumination System) and riboflavin (Peschke Riboflavin 0.25% Transepithelial Solution) administered in conjunction with the UV-A light as a photosensitizer.

The PXL Platinum 330 System is intended to induce corneal collagen CXL to improve the biomechanical properties of the cornea by strengthening the corneal tissue in the anterior stroma. Corneal collagen CXL is performed by pretreating the cornea with riboflavin 0.25% ophthalmic solution beginning 40 min before UV-A light exposure to saturate the corneal tissue with the riboflavin photosensitizer. The cornea is then irradiated with UV-A light (365 nm) at an irradiance of 18 mW/cm2 (5 seconds on, 5 seconds off) for 10 min. Exposure of the cornea to this UV-A light regimen after topical administration of riboflavin (0.25%) has been shown to induce CXL of the corneal collagen fibrils, with a resultant increase in tensile strength and diameter of the collagen fibrils. Clinically, CXL has been shown to stabilize the corneal curvature in eyes with progressive keratoconus, with no significant change in the refractive index of the cornea. Numerous reports and a few clinical trials have also shown benefit in aiding resolution of infective corneal ulcers.

Read the detailed description

This is a prospective, 2-arm parallel-group, single-blind, randomized multicenter study to determine the safety and effectiveness of the PXL Platinum 330 System for performing CXL in eyes with refractory corneal ulcers. Subjects with a history of non-resolving infective corneal ulcers will be evaluated initially for suitability as a candidate for CXL. Subjects who are candidates for CXL will be asked to participate in this study and will undergo the required screening procedures to determine study eligibility. Informed consent will be obtained from each subject before performance of any required study procedures that are not part of the investigator's routine examination. After completing screening procedures, the diagnosis for each eligible eye will be confirmed. Subjects will be randomized to 1 of 2 groups:

  1. Group 1: Standard-of-care therapy (anti fungal drops if there is clinical suspicion for fungus, fortified antibiotics if corneal culture is positive for a specific organism sensitive to a fortified antibiotic, and empiric antibiotic drops based on community prevalence if corneal culture is negative and there is no clinical suspicion for fungus)
  2. Group 2: Standard-of-care therapy + CXL

Eyes undergoing CXL will have topical anesthetic administered and then have topical riboflavin instilled onto the cornea every 2 min (or longer as needed to assure adequate corneal penetration), after which the cornea will be exposed to UV-A pulsed light 18 mW/cm2 for 10 min. Riboflavin instillation will continue every 2 min during CXL. The CXL procedures will be performed on an outpatient basis using the PXL Platinum 330 System (UV-A light source and riboflavin solution). All use of the PXL Platinum 330 System will be in accordance with this protocol and the general instructions provided by the manufacturer (PESCHKE) in the PXL Platinum 330 Illumination System Operator's Manual. All subjects will be evaluated at Screening/Baseline, Day 0 (Randomization/Treatment), Day 1, Day 3 ( +/- 1 day), Week 1 ( +/- 2 days), Week 2 ( +/- 2 days), Week 4 ( +/- 3 days), and Week 6 ( +/- 4 days) after treatment. Efficacy monitoring throughout the study will include observations at appropriate times for re-epithelialization, size of infection, and corneal culture results. Safety monitoring throughout the study will include observations at appropriate times for pain, IOP, BSCVA, corneal scar size, AEs, clinically significant findings on ophthalmic examination, dilated fundus examination, and slit lamp examination. After treatment, subjects will be followed at the treating physician's discretion.

Being tested
PXL Platinum 330 system + Riboflavin 0.25% TE Solution, Sham CXL + Artificial Tears
Medical subject headings
Keratitis, Corneal Ulcer

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PXL Platinum 330 system + Riboflavin 0.25% TE SolutionCombination product

    Standard-of-care therapy (antifungal drops or fortified antibiotics and empiric antibiotic drops). In addition CXL + Riboflavin 0.25% TE solution.

    After topical anesthesia, the surgeon or trained designee will apply topical riboflavin (1 drop every 2 min for 40 min with PESCHKE TE solution [0.25%], or longer as needed to assure adequate corneal penetration). At the end of this pre-treatment period, the eye will be examined at the slit lamp with the blue filter for the presence of riboflavin throughout the stroma. When sufficient corneal riboflavin penetration is confirmed, the eye will be aligned under the PXL Platinum 330 light. The correct aperture setting (3 to 12 mm) will be selected for the size of the eye and area needing to be treated (2 mm larger than the maximal ulcer diameter), and the eye will be irradiated at 18 mW/cm2, with pulsed mode (5 seconds on, 5 seconds off) for 10 min, during which time instillation of riboflavin will continue (1 drop every 2 min).

  • Sham CXL + Artificial TearsOther

    Standard-of-care therapy (antifungal drops or fortified antibiotics and empiric antibiotic drops). In addition, for subjects in the sham group, artificial tears (1 drop every 2 min for 40 min) will be administered. after instillation of artificial tears, the eye will be aligned under the PXL Platinum 330 light. The instrument will be kept off and the subject will be kept under the device for 10 min during which time instillation of artificial tears will be performed (1 drop every 2 min) to maintain corneal hydration. The operator will keep track of sham exposure time independently to confirm the actual duration.

Study groups in NCT05255016
Study groupRoleWhat they receive
Standard of care + Sham CXL + Artificial TearsSham comparatorStandard-of-care treatment and Sham CXL and administration of artificial tears.
Receives: Other: Sham CXL + Artificial Tears
Standard of care + CXL + Riboflavin 0.25% TE SolutionExperimentalStandard of care treatment and the experimental combination product. The PXL Platinum 330 Illumination System is a portable electronic medical device. The device's light emitting diode (LED) is used to deliver a metered dose of UV-A light to a targeted treatment area for illuminating the cornea during corneal collagen CXL. The riboflavin solution is an isotonic (0.9%) sodium chloride solution containing 0.25% riboflavin, 1% hydroxypropylmethylcellulose, and 0.007% benzalkonium chloride, adjusted to a pH of 7.0, and packaged in 2 mL sterile syringes for topical ophthalmic use.
Receives: Combination Product: PXL Platinum 330 system + Riboflavin 0.25% TE Solution

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The primary objective of this study is to evaluate the safety and effectiveness of corneal collagen CXL (performed using the PXL-Platinum 330 system with riboflavin solution) for treating refractory corneal ulcers.

    Primary Outcome Measure:

    1. The composite primary endpoint outcome would be the proportion of patients in the treated group, compared to the control group, who achieve all three of the following components:
    • complete re-epithelialization at week 2, defined as absence of corneal fluorescein staining noted with the blue light of the slit lamp by the investigator.
    • no expansion of infiltrate from baseline to week 2. The size of the infiltrate will be reviewed by the investigator using the slit lamp exam and compared to baseline measures to assess expansion of the infiltrate.
    • a negative corneal culture at week 2
    1. Each of the components of this composite endpoints is a binary outcome (yes or no), and are NOT measured as units of measure.

    Measured: Week 2 (#+/- 2 study days).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Feb 2022
  2. Study start14 Mar 2022
  3. Primary completion24 Nov 2023 (estimated)
  4. Study completion24 Feb 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Simple block randomization will be used to assign subjects in a 1:1 ratio to 2 treatment arms. Subjects will be randomized consecutively (not stratified by site) to ensure balance between the treatment arms at any point in the study
Masking
Single blind
Who is masked
Participant
Enrolment
488 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05255016
Sponsor's protocol ID
PXL-330-02A
Status last verified
Oct 2022
First submitted
25 Jan 2022
Last updated
28 Oct 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing PXL Platinum 330 system + Riboflavin 0.25% TE Solution in people with Keratitis and Corneal Ulcer, run by Peschke GmbH at 12 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Patricia Huezo-Diaz Curtis, PhD (0041 (0) 787 422151, Patricia.Huezo-Diaz@confinis.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The primary objective of this study is to evaluate the safety and effectiveness of corneal collagen CXL (performed using the PXL-Platinum 330 system with riboflavin solution) for treating refractory corneal ulcers. (time frame: Week 2 (#+/- 2 study days).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2022.

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