Safety and Efficacy Study of Erythropoietin as add-on Therapy of Methylprednisolone to Treat Acute Optic Neuritis
What it found
A paper reports the results; we have not read it yet. See Papers below.
What was tested
Treatment tested
- Erythropoietin
What it measured
Main measures
nerve fiber loss in the optical nerve head determined by optical coherence tomography at weeks 4,8 and 16 compared to baseline. Measurements at baseline and week 16 are used to calculate estimates for changes and differences between the groups.
4 months
Retina scans (OCT)
Other measures (1)
Visual acuity and visual field perception determined at weeks 1, 4, 8, 16 compared to baseline (week 0). MRI measurements of optic nerve atrophy performed at weeks 4, 8 and 16 compared to baseline (week 0)
4 months
MRI lesionsBrain volume lossVision
Who could take part
Optic neuritis · 18 to 50
Inclusion Criteria: To be eligible to participate in this study, candidates must meet the following eligibility criteria at the time of randomization: * Must give written informed consent and authorize the release and use of protected health information (PHI). * Must be 18 to 50 years old, inclusive, at the time of informed consent. * Must have acute unilateral optic neuritis with or without prior diagnosis of MS (according to McDonald criteria). * Symptoms related to optic neuritis must exist for no longer than 10 days prior to inclusion. * Must have had normal visual acuity on both eyes before and no history of optic neuritis. * Must have a decreased visual acuity on the affected eye to 0.5 or less at screening. Exclusion Criteria: Candidates will be excluded from study if any of the following exclusion criteria exist at the time of randomization: Medical history: * Abnormal laboratory results or clinical signs indicative of any significant cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, gastrointestinal, dermatologic, psychiatric, renal, neurological (other than MS), and/or other major disease. * History of prior optic neuritis on the affected or non-affected eye. * History of squint or amblyopia on either side. * Hyperopia > 3dptr on either side. * Myopia \< -5dptr on either side. * Astigmatism > 2dptr on either side. * Horizontal cup disc ratio > 0.5 on either side. * Retinal nerve fiber layer thickness outside normal values (with respect to the OCT data base). * Ocular diseases effecting visual acuity or visual fields (cataract, glaucoma, maculadegeneration, diabetic retinopathy, retinal heredodegeneration or others). * History of elevated blood pressure. * Systolic blood pressure of > 159 mmHg, diastolic blood pressure > 99 mmHg at screening examination. * History of thromboembolic events. * Frequent thromboembolic events in 1st grade family members. * Significant surgery within the 4 weeks prior to randomization. * History of severe allergic or anaphylactic reactions after administration of Epo. * History of malignancy. * History of seizures. * Tuberculosis with ongoing or unknown activity. * Acute gastrointestinal ulceration within the last three months. * Acute virus, bacterial or fungus infection. * Infection with HIV, HBV, or HCV. * History of colitis ulcerosa, diverticulitis, or acute enteroanastomosis. * Severe osteoporosis. * Active immunization within 2 weeks prior to inclusion. * Diagnosis of phenylketonuria. * Implanted cardiac pacemaker or other non MRI-compatible metallic body implants. * History of drug or alcohol abuse (as defined by the investigator) within 2 years prior to randomization. * Any of the following abnormal blood tests at screening: alanine transaminase/serum glutamate-pyruvate transaminase (AST/SGPT), or aspartate transaminase/serum glutamicoxaloacetic transaminase (AST/SGOT), gamma-glutamyl-transferase (GGT), or serum creatinine > 2 times the upper limit of normal; hematocrit > the upper limit of normal. Treatment history * Prior treatment with cyclosporine, mitoxantrone, methotrexate, cyclophosphamide or other immunosuppressive agents. * Treatment with corticosteroids or Epo within 30 days prior to randomization. Miscellaneous * Female subjects considering becoming pregnant while in the study. * Female subjects who are currently pregnant or breast-feeding. * Previous participation in this study or any other investigational drug study within the last four weeks. * Current enrollment in any other investigational drug study. * Unwillingness or inability to comply with the requirements of the protocol including the presence of any condition (physical, mental, or social) that is likely to affect the subject's ability to comply with the protocol. * Any other reasons that, in the opinion of the investigator, the subject is determined to be unsuitable for enrollment in this study.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The purpose of this study is to determine the safety and efficacy of erythropoietin as an add-on therapy to methylprednisolone in subjects with acute autoimmune optic neuritis.
Papers
Results
Disease Activity and Conversion into Multiple Sclerosis after Optic Neuritis Is Treated with Erythropoietin.Int J Mol Sci · 2016
Results
Treatment of optic neuritis with erythropoietin (TONE): a randomised, double-blind, placebo-controlled trial-study protocol.BMJ Open · 2016
Results
A randomized, double-blind, phase 2 study of erythropoietin in optic neuritis.Ann Neurol · 2012
Background
Maier K, Rau CR, Storch MK, Sattler MB, Demmer I, Weissert R, Taheri N, Kuhnert AV, Bahr M, Diem R. Ciliary neurotrophic factor protects retinal ganglion cells from secondary cell death during acute autoimmune optic neuritis in rats. Brain Pathol. 2004 Oct;14(4):378-87. doi: 10.1111/j.1750-3639.2004.tb00081.x.
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History
Started
Aug 2006
Main results due
Feb 2011
Finished
Jul 2011
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