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CompletedNCT00908466SAVEUpdated Aug 20, 2018Results posted

Sirolimus as Therapeutic Approach to Uveitis

A Phase 1 interventional study of Sirolimus (rapamycin) and Sirolimus (rapamycin) in Uveitis, Intermediate Uveitis and Posterior Uveitis, sponsored by Johns Hopkins University. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-08-20.

Sponsored by Johns Hopkins University · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to find out about the safety and effectiveness of the study drug, sirolimus, in patients with uveitis and to utilize the potential effectiveness of sirolimus, and yet to avoid the potential complications of systemic use of the drug. In this study, the investigators will administer sirolimus either around (subconjunctival injection) or inside the eye (intravitreal injection). Local administration of sirolimus to the eye is not expected to have effects on the rest of the body. Therefore, it may offer a safer way than the current methods used to control the inflammation caused by non-infectious uveitis.

Read the detailed description

Uveitis is a condition in which certain parts of your eye become inflamed. The inflammation is usually recurrent. If the inflammation is not treated adequately, permanent damage to the eye and to the vision may occur. The inflammation can be caused by infectious or non infectious causes. The current research is being done to determine the safety and the usefulness of treatment of non-infectious uveitis using a drug called sirolimus.

Current treatment options for uveitis include oral corticosteroids and drugs that weaken the immune system of the body (i.e., immunosuppressant drugs). Treatment using oral corticosteroids, especially for long periods, may cause many undesirable side effects and complications such as high blood sugar, high blood pressure, bone weakness, obesity, stomach ulcers, abnormal hair growth, and increased risks of infection. In addition to that, in some cases, the disease cannot be controlled even with the highest dose of steroids.

Injection of steroids around and inside the eye can be used to control uveitis. However, the inflammation does not always respond to such kind of treatment. The eyes may develop high pressure and cataract with injections of steroids into the eyes or around the eyes.

On the other hand, despite their potential effectiveness, treatment with drugs that weaken the immune system may cause severe side effects. Increased risk of infection is a common side effect of all the immunosuppressant drugs. The immune system protects the body from infections. When the immune system is suppressed, infections are more likely to happen. Some of these infections are potentially dangerous. Because the immune system protects the body against some forms of cancer, immunosuppressant drugs are also associated with a slightly increased risk of cancer. For example, long-term use of immunosuppressant drugs may carry an increased risk of developing skin cancer as a result of the combination of the drugs and exposure to sunlight. The immunosuppressive drugs are very powerful and can cause serious side effects such as high blood pressure, kidney problems, and liver problems. Some side effects may not show up until years after the medicine is used.

02

Conditions studied

  • Uveitis
  • Intermediate Uveitis
  • Posterior Uveitis
  • Panuveitis

Keywords

  • Non-infectious
  • Uveitis
  • Panuveitis
03

In context

Uveitis

299 studies on the registry are indexed under Uveitis; 32 are open to participants now.

This study's enrollment of 30 is close to the median of 30 across 175 interventional studies indexed under Uveitis.

Browse Uveitis studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Males and females greater than or equal to 18 years of age;
  2. Able to give and attend all study visits;
  3. Have diagnosis of uveitis determined by the Investigator to be non infectious;

    • Have active uveitis, defined as having at least 1+ Vitreous Haze and/or at least 1+ Vitreous Cell Count (SUN scale), and:

      • are receiving no other treatment; or,
      • are receiving prednisone ≥10 mg/day (or equivalent dose of another ) and/or at least 1 other systemic ; or, b. Have inactive disease, defined as having 0.5+ Vitreous Haze or less and a grade of 0.5+ Vitreous Cell Count or less (SUN scale), and:
      • are receiving prednisone \<10 mg/day (or equivalent dose of another corticosteroid) and/or at least 1 other systemic immunosuppressant.
  4. Have posterior, intermediate, or panuveitis; for panuveitis, if an anterior component is present, it must be less than the posterior component;
  5. Sufficient inflammation to require systemic treatment and, based on the Investigator's decision, warrants intravitreal or subconjunctival treatment;
  6. Best-corrected (ETDRS) visual acuity of 20/40 to 20/400 (approximately 70 to 20 letters) in the study eye;
  7. Best- corrected ETDRS visual acuity of 20/400 or better in the fellow eye (approximately 20 letters).

Exclusion criteria

Exclusion Criteria:

  1. Patients with bilateral uveitis who are receiving systemic therapy (e.g., methotrexate, cyclosporine, cyclophosphamide, chlorambucil, mycophenolate mofetil, tacrolimus, or azathioprine) other than prednisone or other for the treatment of the uveitis, and the uveitis in the fellow eyes, in the opinion of the investigator, cannot be controlled with standard local therapies alone;
  2. Any significant ocular disease that could compromise vision in the study eye. These include, but are not limited to:

    • Diabetic retinopathy: proliferative diabetic retinopathy (PDR) or non-proliferative diabetic retinopathy (NPDR) that compromise the vision.
    • Age-related macular degeneration;
    • Myopic degeneration with active subfoveal choroidal neovascularization.
  3. Any of the following treatments within 90 days prior to Day 0 or anticipated use of any of the following treatments to the study eye:

    • Intravitreal injections (including but not limited to steroids or anti-vascular endothelial growth factors);
    • Posterior subtenon's steroids.
  4. Intraocular surgery within 90 days prior to Day 0 in the study eye;
  5. Capsulotomy within 30 days prior to Day 0 in the study eye;
  6. If the patient has had glaucoma surgery (trabeculectomy or aqueous shunt device), there must be adequate conjunctiva
  7. History of vitreoretinal surgery or scleral buckling
  8. Any ocular surgery (including cataract extraction or capsulotomy) of the study eye anticipated within the first 180 days following Day 0;
  9. Intraocular pressure ≥25 mmHg in the study eye (glaucoma patients maintained on no more than 2 topical medications with intraocular pressure (IOP) \<25 mmHg are allowed to participate);
  10. Pupillary dilation inadequate for quality stereoscopic fundus photography in the study eye;
  11. Media opacity that would limit clinical visualization;
  12. Presence of any form of ocular in the study eye, including choroidal melanoma;
  13. History of herpetic infection in the study eye or adnexa;
  14. Presence of known active or inactive toxoplasmosis in either eye;
  15. Ocular or periocular infection in either eye;
  16. Participation in other drug or device clinical trials within 30 days prior to Day 0, or planning to participate in other investigational drug or device clinical trials within 180 days following Day 0. This includes both ocular and non-ocular clinical trials.
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    Intravitreal Injection

    Will receive intravitreal injections of sirolimus 352 µg in study eye on Days 0, 60, and 120.

    Drug: Sirolimus (rapamycin)

  • Experimental
    Subconjunctival Injection

    Will receive subconjunctival injections of sirolimus 1320 µg in the study eye on Days 0, 60, and 120.

    Drug: Sirolimus (rapamycin)

Interventions

  • Will receive intravitreal injections of sirolimus (rapamycin) 352 µg in study eye on Days 0, 60, and 120.

    Also known as: Rapamycin, Rapamune, Sirolimus

  • Will receive subconjunctival injections of sirolimus 1320 µg in the study eye on Days 0, 60, and 120.

    Also known as: Rapamycin, Rapamune, Sirolimus

06

What researchers measure

Primary outcomes

  1. Number of Participants With at Least 2-step Decrease in Vitreous Haze (VH)

    Vitreous Haze is calculated using a 9 step photographic haze in uveitis patients using fundus photograph

    Time frame: 6 months

Secondary outcomes

  1. Change From Baseline VA by ETDRS

    Time frame: 6 and 12 months

07

Results

Posted Aug 20, 2018

Participant flow

Participant flow — Overall Study
MilestoneIntravitreal InjectionSubconjunctival Injection
Started1515
Completed1414
Not completed11

Outcome measures

PrimaryNumber of Participants With at Least 2-step Decrease in Vitreous Haze (VH)

Vitreous Haze is calculated using a 9 step photographic haze in uveitis patients using fundus photograph

Time frame:
6 months
Reported as:
Number · participants
Number of Participants With at Least 2-step Decrease in Vitreous Haze (VH)
participantsIntravitreal InjectionSubconjunctival Injection
Number of Participants With at Least 2-step Decrease in Vitreous Haze (VH)44
SecondaryChange From Baseline VA by ETDRS
Time frame:
6 and 12 months

Results for this outcome have not been posted.

Adverse events

Collected over 6 Months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Intravitreal Injection—1/15 (6.7%)0/15 (0%)
Subconjunctival Injection—0/15 (0%)6/15 (40%)
Most frequent serious events
Most frequent serious events
EventIntravitreal InjectionSubconjunctival Injection
Serious Ocular Adverse EventEye disorders1/150/15
Most frequent other events
Most frequent other events
EventIntravitreal InjectionSubconjunctival Injection
Inflammation at the injection siteEye disorders0/156/15

Baseline characteristics

Age, Continuous
Age, Continuous(years)Intravitreal InjectionSubconjunctival InjectionTotal
Mean45 ± 19.848 ± 18.247 ± 18.8
Sex: Female, Male
Sex: Female, Male(Participants)Intravitreal InjectionSubconjunctival InjectionTotal
Female6915
Male9615
Race/Ethnicity, Customized
Race/Ethnicity, Customized(participants)Intravitreal InjectionSubconjunctival InjectionTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American336
White111122
More than one race000
Unknown or Not Reported112
08

Study locations

1 site
  • Wilmer Eye Institute at Johns Hopkins University
    Baltimore, Maryland 21287, United States
09

References and documents

Publications

  • Vigil EM, Sepah YJ, Watters AL, Sadiq MA, Ansari M, Bittencourt MG, Ibrahim MA, Do DV, Nguyen QD. Assessment of changes in quality of life among patients in the SAVE Study - Sirolimus as therapeutic Approach to uVEitis: a randomized study to assess the safety and bioactivity of intravitreal and subconjunctival injections of sirolimus in patients with non-infectious uveitis. J Ophthalmic Inflamm Infect. 2015 Apr 18;5:13. doi: 10.1186/s12348-015-0044-1. eCollection 2015. PubMed 25918559 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 20, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00908466
Collaborators
MacuSight, Inc.
Responsible party
Sponsor
First posted
May 25, 2009
Start date
Jul 2009
Primary completion
Jul 2012
Completion
Feb 2013
Results posted
Aug 20, 2018
Last update
Aug 20, 2018

Study contacts

Quan D Nguyen, MD, MSc
principal investigator · Johns Hopkins University

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Dec 2017. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Sirolimus

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