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CompletedNCT01647217DBTSUpdated Jul 26, 2017Results posted

Demodex Blepharitis Treatment Study

A Phase 1 interventional study of Terpinen-4-ol and Placebo in Chronic Blepharitis, sponsored by BioTissue Holdings, Inc. Completed at 1 site in United States. Open to participants aged 15 Years to 80 Years. Per ClinicalTrials.gov, last updated 2017-07-26.

Sponsored by BioTissue Holdings, Inc · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
15 Years to 80 Years
Sex
All
01

Study summary

This is a randomized clinical trial to determine the safety and efficacy of terpinen-4-ol (T4O), the most active ingredient of tea tree oil (TTO), in eradicating ocular demodicosis (reducing ocular demodex counts and achieving the clinical improvement with minimal or no irritation).

Read the detailed description

Demodex blepharitis is one of the most common causes of chronic blepharitis. The investigators preliminary clinical study showed that lid scrub with TTO was effective in resolving chronic blepharoconjunctivitis; however, it was not convenient for self-administration and caused irritation in some patients. Preclinical safety studies have verified that T4O is less irritant. In this study, the investigators will determine the optimal regimen of T4O Pads.

02

Conditions studied

  • Chronic Blepharitis

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Keywords

  • Blepharitis
  • Demodex
  • Mites
  • Tea Tree oil
  • Terpinen
03

In context

Blepharitis

70 studies on the registry are indexed under Blepharitis; 5 are open to participants now.

This study's enrollment of 17 is below the median of 60 across 62 interventional studies indexed under Blepharitis.

Browse Blepharitis studies →

Lead sponsor

BioTissue Holdings, Inc is the lead sponsor of 14 studies on the registry; none are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

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

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Who can participate

Ages eligible
15 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with symptomatic Demodex blepharitis for duration of at least 3 months.
  • Age range: 15-80 years old.
  • Both genders and all ethnic groups comparable with the local community.
  • Able to understand and willing to sign a written informed consent
  • Able and willing to cooperate with the investigational plan.
  • Able and willing to complete all mandatory follow-up visits.

Exclusion criteria

Exclusion Criteria:

  • Patients who are currently engaged in another clinical trial, unwilling or unable to give consent, to accept randomization, or to return for scheduled visits.
  • Children under 15.
  • Pregnant women or expecting to be pregnant during the study.
  • Systemic immune deficient conditions such as AIDS or under systemic immunosuppressant.
  • Concomitant use of ophthalmic topical medications (excluding non-preserved tear substitutes).
  • Concomitant use of systemic antibiotics or steroids.
  • Contact lens wear (unless discontinued for ≥ 30 days before randomization)
  • Active ocular infection or allergy
  • Unable to close eyes or uncontrolled blinking
  • Presence of aqueous tear deficient dry eye defined by the Fluorescein Clearance Test as less than 3 mm wetting in 1-minute Schirmer test with anesthesia.
  • Previous allergic reaction to TTO-containing products or cosmetic fragrance.
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Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    Terpinen-4-ol Treatment Arm

    8 patients will be randomized into the Study Group and will be subdivided into 2 subgroups (3 / 5 patients) according to the treatment regimen (once or twice per day). Changes in the mite counts will be correlated with changes in symptoms and signs.

    Drug: Terpinen-4-ol

  • Placebo comparator
    Placepo Pads Contol Arm

    9 patients will be randomized into the control group and will be treated with placebo pads. They will be divided into 2 subgroups (5 / 4 patients) according to the frequency (once or twice per day). Changes in the mite counts will be correlated with changes in symptoms and signs.

    Other: Placebo

Interventions

  • DrugTerpinen-4-ol

    Lid scrub once or twice per day for one month.

    Also known as: T4O

  • OtherPlacebo

    Lid scrub once or twice per day for one month

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What researchers measure

Primary outcomes

  1. Change in the Number of Demodex Mites

    Change in mites count after treatment compared to the baseline data. If the mites' count remains zero during the last two visits, it is considered "complete eradication". Patients without achieving complete eradication will be categorized as "incomplete eradication".

    Time frame: 6 weeks

Secondary outcomes

  1. Change in Lid Margin Redness and Bulbar Conjunctival Hyperemia

    Lid margin redness and bulbar conjunctival hyperemia were each assessed using an ordered categorical value ranging from 0 (None) to 3 (Severe). The two scores were summed to obtain the final score, which ranges from 0 (None) to 6 (Severe).

    Time frame: Baseline and 6 weeks

07

Results

Posted Jul 26, 2017

Participant flow

Participant flow — Overall Study
MilestoneTerpinen-4-ol Treatment ArmPlacepo Pads Contol Arm
Started89
Completed78
Not completed11

Outcome measures

PrimaryChange in the Number of Demodex Mites

Change in mites count after treatment compared to the baseline data. If the mites' count remains zero during the last two visits, it is considered "complete eradication". Patients without achieving complete eradication will be categorized as "incomplete eradication".

Time frame:
6 weeks
Reported as:
Mean · Mites
Change in the Number of Demodex Mites
MitesTerpinen-4-ol Treatment ArmPlacepo Pads Contol Arm
Change in the Number of Demodex Mites-3 ± 3.1-0.4 ± 3.6
SecondaryChange in Lid Margin Redness and Bulbar Conjunctival Hyperemia

Lid margin redness and bulbar conjunctival hyperemia were each assessed using an ordered categorical value ranging from 0 (None) to 3 (Severe). The two scores were summed to obtain the final score, which ranges from 0 (None) to 6 (Severe).

Time frame:
Baseline and 6 weeks
Reported as:
Mean · units on a scale
Change in Lid Margin Redness and Bulbar Conjunctival Hyperemia
units on a scaleTerpinen-4-ol Treatment ArmPlacepo Pads Contol Arm
Change in Lid Margin Redness and Bulbar Conjunctival Hyperemia-2.3 ± 1.4-3.1 ± 1.9

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Terpinen-4-ol Treatment Arm—0/8 (0%)0/8 (0%)
Placepo Pads Contol Arm—0/9 (0%)0/9 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(Years)Terpinen-4-ol Treatment ArmPlacepo Pads Contol ArmTotal
Mean48.6 ± 21.249 ± 18.548.8 ± 19.1
Sex: Female, Male
Sex: Female, Male(Participants)Terpinen-4-ol Treatment ArmPlacepo Pads Contol ArmTotal
Female4610
Male437
Region of Enrollment
Region of Enrollment(participants)Terpinen-4-ol Treatment ArmPlacepo Pads Contol ArmTotal
United States8917
08

Study locations

1 site
  • Ocular Surface Center
    Miami, Florida 33173, United States
09

References and documents

Publications

  • Gao YY, Di Pascuale MA, Li W, Liu DT, Baradaran-Rafii A, Elizondo A, Kawakita T, Raju VK, Tseng SC. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3089-94. doi: 10.1167/iovs.05-0275. PubMed 16123406 ↗
  • Gao YY, Di Pascuale MA, Li W, Baradaran-Rafii A, Elizondo A, Kuo CL, Raju VK, Tseng SC. In vitro and in vivo killing of ocular Demodex by tea tree oil. Br J Ophthalmol. 2005 Nov;89(11):1468-73. doi: 10.1136/bjo.2005.072363. PubMed 16234455 ↗
  • Gao YY, Di Pascuale MA, Elizondo A, Tseng SC. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007 Feb;26(2):136-43. doi: 10.1097/01.ico.0000244870.62384.79. PubMed 17251800 ↗
  • Kheirkhah A, Casas V, Li W, Raju VK, Tseng SC. Corneal manifestations of ocular demodex infestation. Am J Ophthalmol. 2007 May;143(5):743-749. doi: 10.1016/j.ajo.2007.01.054. Epub 2007 Mar 21. PubMed 17376393 ↗
  • Kheirkhah A, Blanco G, Casas V, Tseng SC. Fluorescein dye improves microscopic evaluation and counting of demodex in blepharitis with cylindrical dandruff. Cornea. 2007 Jul;26(6):697-700. doi: 10.1097/ICO.0b013e31805b7eaf. PubMed 17592319 ↗
  • Li J, O'Reilly N, Sheha H, Katz R, Raju VK, Kavanagh K, Tseng SC. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with Facial rosacea. Ophthalmology. 2010 May;117(5):870-877.e1. doi: 10.1016/j.ophtha.2009.09.057. Epub 2010 Jan 15. PubMed 20079929 ↗
  • Liang L, Safran S, Gao Y, Sheha H, Raju VK, Tseng SC. Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. Cornea. 2010 Dec;29(12):1386-91. doi: 10.1097/ICO.0b013e3181e2eac5. PubMed 20847679 ↗
  • Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010 Oct;10(5):505-10. doi: 10.1097/ACI.0b013e32833df9f4. PubMed 20689407 ↗
  • Gao YY, Xu DL, Huang lJ, Wang R, Tseng SC. Treatment of ocular itching associated with ocular demodicosis by 5% tea tree oil ointment. Cornea. 2012 Jan;31(1):14-7. doi: 10.1097/ICO.0b013e31820ce56c. PubMed 21955627 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 26, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01647217
Lead sponsor
BioTissue Holdings, Inc
Collaborators
National Eye Institute (NEI)
Responsible party
Sponsor
First posted
Jul 23, 2012
Start date
Feb 2014
Primary completion
Jun 2015
Completion
Jul 2015
Results posted
Jul 26, 2017
Last update
Jul 26, 2017

Study contacts

Scheffer CG Tseng, MD, PhD
study chair · BioTissue Holdings, Inc

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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

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