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CompletedNCT03308448TONTT-2Updated Mar 8, 2024

Traumatic Optic Neuropathy Treatment Trial 2

A Phase 3 interventional study of Recombinant human erythropoietin in Traumatic Optic Neuropathy, sponsored by Iran University of Medical Sciences. Completed at 3 sites in Iran, Islamic Republic of. Open to participants aged 7 Years and older. Per ClinicalTrials.gov, last updated 2024-03-08.

Sponsored by Iran University of Medical Sciences · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
93
Allocation
Randomized
Ages
7 Years and older
Sex
All
01

Study summary

After introducing intravenous erythropoietin (EPO) as an option for treatment of patients with indirect traumatic optic neuropathy in 2011 and publishing non inferiority trial in Oct.2017), TONTT2 is aiming to find out the best dose and timing of EPO administration in this group of patients.

Read the detailed description

Patients with TON will be visited. After being eligible to enter the study and obtaining informed consent, they will be randomly assigned into 3 groups of different total dose of intravenous administration of EPO to which patients and outcome assessors will be masked. They will be assessed at different follow up time periods with the last follow up of at least 3 months.

02

Conditions studied

  • Traumatic Optic Neuropathy

Keywords

  • Traumatic optic neuropathy
  • Erythropoietin
  • EPO
  • Eprex
03

Who can participate

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

Inclusion criteria

  1. Having indirect traumatic optic neuropathy(with normal eye and fundus exam)
  2. Trauma to treatment interval of 3 weeks and less
  3. Age of 7 years and more

Exclusion criteria

Exclusion Criteria:

  1. Direct optic neuropathy,
  2. Glaucoma,
  3. Any retinopathy
  4. Globe laceration
  5. Age under 7
  6. Hypertension,
  7. Polycythemia,
  8. Creatinin more than 3 mg/dl,
  9. Sensitivity to EPO
  10. Patients who have received any other form of treatment for their traumatic optic neuropathy
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
93 participants (actual)

Study arms

  • Active comparator
    Group 1

    Intervention is Intra-Venous injection of Eprex or EPO \[recombinant human erythropoietin, Pooyesh Darou Biopharmaceuticals CO., Tehran, Iran, 4000 unit/ml solution in prefilled syringe\], 300 units/kg/day for three consecutive days (total:900/kg in 3 days)

    Drug: Recombinant human erythropoietin

  • Active comparator
    Group 2

    Intervention is Intra-Venous injection of Eprex or EPO \[recombinant human erythropoietin, Pooyesh Darou Biopharmaceuticals CO., Tehran, Iran, 4000 unit/ml solution in prefilled syringe\], 600 units/kg/day for three consecutive days (total:1800/kg in 3 days)

    Drug: Recombinant human erythropoietin

  • Active comparator
    Group 3

    Intervention is Intra-Venous injection of Eprex or EPO \[recombinant human erythropoietin, Pooyesh Darou Biopharmaceuticals CO., Tehran, Iran, 4000 unit/ml solution in prefilled syringe\], 600 units/kg/day for three consecutive days then repetition of the same treatment in month 1 (Total: 3600/kg in 2 set of 3-day treatment, 1 month apart)

    Drug: Recombinant human erythropoietin

Interventions

  • DrugRecombinant human erythropoietin

    Intravenous administration of recombinant human erythropoietin (4000 u/vial) with different dosage for each group

    Also known as: EPO, Eprex

05

What researchers measure

Primary outcomes

  1. Change in Mean LogMAR Best corrected visual acuity (BCVA) from 20/20 to no light perception (NLP) as assessed by Snellen visual acuity chart and analyzed based on mean LogMAR change.

    Best corrected Visual acuity is measured (Snellen eye chart) and recorded as 20/20-20/25, 20/30, 20/40, 20, 50, 20/70, 20/100, 20/200 and then counting finger (CF), hand motion (HM), light perception (LP), and no light perception (NLP)

    Time frame: Before treatment and on day 1,2,3, 7, 30, and 90 days after the treatment and through study completion, an average of 24 months

Secondary outcomes

  1. Change in Mean Log Unit of Relative afferent pupillary defect (RAPD) from 0.3 to 1.8 log unit as assessed by Neutral density filter

    RAPD will be measured based on six log unit of 0.3, 0.6, 0.9, 1.2, 1.5,and 1.8 in which the higher the number the higher the severity score of RAPD.

    Time frame: Before treatment and on day 1,2,3, 7, 30, and 90 days after the treatment and through study completion, an average of 24 months

  2. Change in Mean number of visible color plates in Color vision test book. It is from 14/14 to 0/14 as assessed by Ishihara 14-plate color test book

    Using Ishihara 14-plate color vision test book, the color vision will be recorded as a fraction of 14 plates; e.g. 10/14. Patients with lower than 20/200 vision will have 0/14 since they can not read the color plates.

    Time frame: Before treatment and on day 1,2,3, 7, 30, and 90 days after the treatment and through study completion, an average of 24 months

  3. Number of patients with treatment related adverse effects as assessed by history taking (change in mood, vertigo, faint), examination (blood pressure) and blood tests (CBC, BUN, Cr., K, Na, PT, PTT, INR, Ca., Ph)

    history taking (change in mood, vertigo, faint), examination (blood pressure) and blood tests (CBC, BUN, Cr., K, Na, PT, PTT, INR, Ca., Ph) will be performed before treatment and on day 1, 2 and 3 after treatment.

    Time frame: before treatment and on day 1, 2 and 3 after treatment.

06

Study locations

3 sites
  • Iran University of Medical Sciences
    Tehrān, Tehran, Iran, Islamic Republic of
  • Mashhad University of Medical Sciences
    Mashhad, Iran, Islamic Republic of
  • Tehran University of Medical Sciences
    Tehran, Iran, Islamic Republic of
07

References and documents

Publications

  • Kashkouli MB, Pakdel F, Sanjari MS, Haghighi A, Nojomi M, Homaee MH, Heirati A. Erythropoietin: a novel treatment for traumatic optic neuropathy-a pilot study. Graefes Arch Clin Exp Ophthalmol. 2011 May;249(5):731-6. doi: 10.1007/s00417-010-1534-3. Epub 2010 Oct 2. PubMed 20890611 ↗
  • Entezari M, Esmaeili M, Yaseri M. A pilot study of the effect of intravenous erythropoetin on improvement of visual function in patients with recent indirect traumatic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2014 Aug;252(8):1309-13. doi: 10.1007/s00417-014-2691-6. Epub 2014 Jul 2. PubMed 24986593 ↗
  • Kashkouli MB, Yousefi S, Nojomi M, Sanjari MS, Pakdel F, Entezari M, Etezad-Razavi M, Razeghinejad MR, Esmaeli M, Shafiee M, Bagheri M. Traumatic optic neuropathy treatment trial (TONTT): open label, phase 3, multicenter, semi-experimental trial. Graefes Arch Clin Exp Ophthalmol. 2018 Jan;256(1):209-218. doi: 10.1007/s00417-017-3816-5. Epub 2017 Oct 6. PubMed 28986670 ↗

Individual participant data

Plan to share: Yes — All IPD information will be available at the end of the study after submitting for publication

Supporting information: Study protocol, Sap, Icf, Csr

08

Registry details

Key details

Study ID
NCT03308448
Lead sponsor
Iran University of Medical Sciences
Collaborators
Mashhad University of Medical Sciences, Tehran University of Medical Sciences
Responsible party
Sponsor
First posted
Oct 12, 2017
Start date
Jan 6, 2018
Primary completion
Aug 6, 2022
Completion
Mar 2, 2023
Last update
Mar 8, 2024

Study contacts

Mohsen B Kashkouli, MD
study chair · Iran University of Medical Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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