Clinical Trial: A Placebo Controlled Comparison of Topical Zirgan Versus Genteal Gel for the Treatment of Adenovirus Conjunctivitis

Study Status: Completed
Recruit Status: Unknown status
Study Type: Interventional

Official Title: A Prospective, Double-masked, Placebo Controlled Comparison of Topical 0.15% Ganciclovir Gel (Zirgan®) Versus 0.3% Hypromellose Gel (Genteal Gel®; Placebo) for the Treatment of The investigators are conducting this study because the patient have an eye infection which is called adenoviral conjunctivitis, and is the most common cause of "pink eye". There is currently no treatment for this condition. However, the researchers associated with this study want to understand if using a product called Zirgan, which is a topical ointment that is already FDA-approved for other types of eye infections, will help with the type of infection that the patient currently have. Zirgan is not FDA-approved to treat your type of eye infection. Your participation in this study is expected to last 21 days but the patient will only apply the topical ointment for 14 of those days. During the study, the patient will be asked to come into this clinic 8 times.

The purpose of this study is to determine whether topical Zirgan can reduce days that the patient suffers from the eye infection, and also to see if it can prevent the infection from spreading to your second eye and to also see if it can prevent the spreading of the infection to people that the patient come in close contact with.

Zirgan will be compared to Genteal Gel in this trial. Genteal Gel is a non-prescription eye lubricant gel and is commonly used for treatment of dry eye.

The patient will be asked to apply a topical ointment (either Zirgan or Genteal gel 5 times a day for the first 7 days and then 3 times a day for the following 7 days. The patient will be asked to return to the clinic 21 days after the patient starts the study for a final check-up.

It is planned that about 80 people with Adenovirus Conjunctivitis will be enrolled in this study between 8-12 sites across the United States.

The patient wi

Detailed Summary:

Study Objectives To evaluate the safety and efficacy of 0.15% ganciclovir gel (Zirgan®) in patients with adenoviral keratoconjunctivitis in comparison with 0.3% hypromellose gel (Genteal gel®) as placebo.

Background Adenoviruses are the most common cause of ocular viral infection worldwide. Conjunctivitis and keratoconjunctivitis caused by adenoviruses are highly contagious. Adenovirus is a non-enveloped, double-stranded DNA virus comprised of 53 serotypes. Unlike many enveloped viruses which can be more easily inactivated, adenoviruses are resilient to disinfection and are long lasting on fomites. The ocular infection generally begins unilaterally and, in many cases, spreads to both eyes. It may cause epidemics and endemics, being most commonly spread in the summer or winter. Epidemics are common in day care centers, schools and the military and have been spread in the offices of eye care professionals. Patients may have painful conjunctival membranes and palpable preauricular adenopathy. Subsequent subepithelial corneal infiltrates can cause light sensitivity, reduced vision and lead to irregular astigmatism. The differential diagnosis includes herpes simplex, Chlamydia and enteroviral infection.

There are 3 major presentations of ocular adenovirus infection: Follicular conjunctivitis (predominantly serotypes 3, 4,7a); epidemic keratoconjunctivitis (EKC; predominantly serotypes 8, 19, 37, 53); and pharyngealconjunctival fever (mostly serotypes 3, 4, 7a, 11).

There is supporting laboratory and clinical data to warrant a clinical trial of topical ganciclovir for the treatment of adenoviral keratoconjunctivitis. Several studies has shown that ganciclovir (GCV) is active in vitro against adenovirus.

Primary Outcome T
Sponsor: Lifelong Vision Foundation

Current Primary Outcome: Time to Viral Eradication [ Time Frame: 14 days ]

Time to viral eradication from the ocular surface, as determined by quantitative viral isolation in A549 cell tissue culture (performed on Day 0, 2, 4, 6, 8, 10, and 14)


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Development of sub-epithelial infiltrates [ Time Frame: 21 days ]
    Development of sub-epithelial infiltrates (SEIs)-incidence for the study duration and severity at each follow-up visit (based on scale of mild, moderate and severe) in those eyes which develop SEIs
  • Degree of Bulbar conjunctival Injection [ Time Frame: 21 days ]
    Degree of bulbar conjunctival injection (redness of the eye) (as determined by the Efron scale) at each follow-up visit
  • Second eye involvment [ Time Frame: 14 days ]
    Second eye involvement - incidence for the study duration and severity at each visit up to Day 14(measured as degree of bulbar injection using Efron scale) in the baseline culture negative fellow eyes, which turned culture positive during the study up to Day 14


Original Secondary Outcome: Same as current

Information By: Lifelong Vision Foundation

Dates:
Date Received: January 31, 2012
Date Started: January 2012
Date Completion: April 2016
Last Updated: March 30, 2015
Last Verified: March 2015