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Status unknownNCT05748561Updated Feb 28, 2023

Effect of Intravenous Methylprednisolone and Intravenous Erythropoietin in Toxic Optic Neuropathies: Randomized Clinical Trial.

A Phase 2/3 interventional study of Recombinant human erythropoietin 4,000 UI and 2,000 UI and Methylprednisolone succinate 500 mg in Toxic Optic Neuropathy, Treatment and Methylprednisolone, sponsored by Asociación para Evitar la Ceguera en México. Status unknown at 1 site in Mexico. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2023-02-28.

Sponsored by Asociación para Evitar la Ceguera en México · Phase 2/3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Feb 2023), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 2/3
Study type
Interventional
Enrollment
18
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The goal of this double-blind prospective randomized clinical trial is to determine if the effect of intravenous erythropoietin is superior to the effect of intravenous methylprednisolone in cases of toxic optic neuropathy 4 weeks after therapeutic intervention.

The main question it aims to answer:

  • Is there a difference in the visual recovery of toxic optic neuropathies treated with intravenous methylprednisolone in comparison with those treated with intravenous erythropoietin?
Read the detailed description

A double-blind prospective randomized clinical trial of treatment for toxic optic neuropathies comparing visual outcome of patients treated by standard treatment (intravenous methylprednisolone) vs intravenous erythropoietin.

Enrollment: 18. Randomized groups (2)

  1. Standard treatment (intravenous methylprednisolone)
  2. Intravenous erythropoietin

Masking: Double (participant and outcomes assessor) Participants won't be aware to which group they were assigned. Investigator in charge of assessing outcomes and analyzing data won't be aware to which group participants were assigned

02

Conditions studied

  • Toxic Optic Neuropathy
  • Treatment
  • Methylprednisolone
  • Erythropoietin

Keywords

  • Toxic Optic Neuropathy
  • Methylprednisolone
  • Erythropoietin
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Both genres.
  • Age between 18 and 75 years.
  • Clinical diagnosis of toxic optic neuropathy (afferent pupillary defect, acquired dyschromatopsia, visual loss and bilateral prechiasmatic field defect).
  • Exposure with a temporal relationship of less than two weeks to a known toxicant for the function of the optic nerve.
  • Up to 21 days from symptom onset.
  • Informed consent signature.

Exclusion criteria

Exclusion Criteria:

  • History of previous optic neuropathy.
  • History of additional ophthalmological or neurological pathology that has caused permanent visual loss.
  • History of previous treatment with intravenous methylprednisolone or some other experimental treatment since the onset of symptoms.
  • Poorly controlled diabetes mellitus.
  • Poorly controlled systemic arterial hypertension.
  • Hemoglobin >16 mg/dL
  • Patients with a history of thromboembolic event.
  • Patients with a history of coronary heart disease, myocardial infarction or cerebral vascular event.
  • Pregnancy or lactation.
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
18 participants (estimated)

Study arms

  • Experimental
    Experimental group

    The patients will receive intravenous erythropoietin - 10,000 IU every 24 hours for 5 days.

    Drug: Recombinant human erythropoietin 4,000 UI and 2,000 UI

  • Placebo comparator
    Control group

    The patients will receive intravenous methylprednisolone - 1 g every 24 hours for 5 days.

    Drug: Methylprednisolone succinate 500 mg

Interventions

  • DrugRecombinant human erythropoietin 4,000 UI and 2,000 UI

    Intravenous recombinant human erythropoietin (10,000 IU every 24 hours for 5 days)

    Also known as: Experimental Group

  • DrugMethylprednisolone succinate 500 mg

    Intravenous Methylprednisolone succinate (1 g daily for 5 days)

    Also known as: Control Group

05

What researchers measure

Primary outcomes

  1. Change from Baseline Visual Capacity

    Best corrected visual acuity

    Time frame: Initial visit, 2-week visit, 1-month visit, 3-month visit

Secondary outcomes

  1. Change from Baseline Color vision

    Color vision as measured by Ishihara plates

    Time frame: Initial visit, 2-week visit, 1-month visit, 3-month visit

  2. Change from Baseline Visual field defect

    Visual fields as measured by Goldmann perimetry

    Time frame: Initial visit, 2-week visit, 1-month visit, 3-month visit

  3. Change from Baseline Oct pRNFL (microns)

    Nerve fiber thickness as measured by OCT

    Time frame: Initial visit, 3-month visit

06

Study locations

1 of 1 sites recruiting
  • Jorge Cárdenas Belaunzarán
    Ciudad de mexico, 04030, Mexico
    • Jorge Cárdenas-Belaunzarán, MD, MSc · Contact · 5510841400
    Recruiting
07

References and documents

Publications

  • Behbehani R. Clinical approach to optic neuropathies. Clin Ophthalmol. 2007 Sep;1(3):233-46. PubMed 19668477 ↗
  • Grzybowski A, Zulsdorff M, Wilhelm H, Tonagel F. Toxic optic neuropathies: an updated review. Acta Ophthalmol. 2015 Aug;93(5):402-410. doi: 10.1111/aos.12515. Epub 2014 Aug 27. PubMed 25159832 ↗
  • Karimi S, Arabi A, Shahraki T. Alcohol and the Eye. J Ophthalmic Vis Res. 2021 Apr 29;16(2):260-270. doi: 10.18502/jovr.v16i2.9089. eCollection 2021 Apr-Jun. PubMed 34055263 ↗
  • Kraut JA, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis, and management. Clin J Am Soc Nephrol. 2008 Jan;3(1):208-25. doi: 10.2215/CJN.03220807. Epub 2007 Nov 28. PubMed 18045860 ↗
  • Tan H, Kang X, Zhong Y, Shen X, Cheng Y, Jiao Q, Deng L. Erythropoietin upregulates growth associated protein-43 expression and promotes retinal ganglion cell axonal regeneration in vivo after optic nerve crush. Neural Regen Res. 2012 Feb 5;7(4):295-301. doi: 10.3969/j.issn.1673-5374.2012.04.010. PubMed 25806072 ↗
  • Sharpe JA, Hostovsky M, Bilbao JM, Rewcastle NB. Methanol optic neuropathy: a histopathological study. Neurology. 1982 Oct;32(10):1093-100. doi: 10.1212/wnl.32.10.1093. PubMed 6889696 ↗
  • Naeser P. Optic nerve involvement in a case of methanol poisoning. Br J Ophthalmol. 1988 Oct;72(10):778-81. doi: 10.1136/bjo.72.10.778. PubMed 3191081 ↗
  • Sun Y, Calvert JW, Zhang JH. Neonatal hypoxia/ischemia is associated with decreased inflammatory mediators after erythropoietin administration. Stroke. 2005 Aug;36(8):1672-8. doi: 10.1161/01.STR.0000173406.04891.8c. Epub 2005 Jul 21. PubMed 16040592 ↗
  • Pakdel F, Sanjari MS, Naderi A, Pirmarzdashti N, Haghighi A, Kashkouli MB. Erythropoietin in Treatment of Methanol Optic Neuropathy. J Neuroophthalmol. 2018 Jun;38(2):167-171. doi: 10.1097/WNO.0000000000000614. PubMed 29300238 ↗
  • Sharma R, Marasini S, Sharma AK, Shrestha JK, Nepal BP. Methanol poisoning: ocular and neurological manifestations. Optom Vis Sci. 2012 Feb;89(2):178-82. doi: 10.1097/OPX.0b013e31823ee128. PubMed 22127151 ↗
  • Pakravan M, Esfandiari H, Sanjari N, Ghahari E. Erythropoietin as an adjunctive treatment for methanol-induced toxic optic neuropathy. Am J Drug Alcohol Abuse. 2016 Nov;42(6):633-639. doi: 10.1080/00952990.2016.1198800. Epub 2016 Jul 27. PubMed 27463192 ↗
  • 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 ↗
  • Shayegannejad V, Shahzamani S, Dehghani A, Dast Borhan Z, Rahimi M, Mirmohammadsadeghi A. A double-blind, placebo-controlled trial of adding erythropoietin to intravenous methylprednisolone for the treatment of unilateral acute optic neuritis of unknown or demyelinative origin. Graefes Arch Clin Exp Ophthalmol. 2015 May;253(5):797-801. doi: 10.1007/s00417-014-2925-7. Epub 2015 Jan 22. PubMed 25605544 ↗
  • Feizi S, Alemzadeh-Ansari M, Karimian F, Esfandiari H. Use of erythropoietin in ophthalmology: a review. Surv Ophthalmol. 2022 Mar-Apr;67(2):427-439. doi: 10.1016/j.survophthal.2021.06.002. Epub 2021 Jun 23. PubMed 34157346 ↗

Individual participant data

Plan to share: No — This study is confidential and no information will be shared with the participants.

08

Registry details

Key details

Study ID
NCT05748561
Lead sponsor
Asociación para Evitar la Ceguera en México
Responsible party
Sponsor
First posted
Feb 28, 2023
Start date
Apr 5, 2022
Primary completion
Apr 5, 2024 (estimated)
Completion
Apr 5, 2024 (estimated)
Last update
Feb 28, 2023

Study contacts

Jorge Cárdenas-Belaunzarán, MD, MSc
Contact
jorge.cardenas@apec.com.mx
5544600113
Octavio Turcio-Aceves, MD
Contact
octavioturcioaceves@gmail.com
5526951290
Jorge Cárdenas-Belaunzarán, MD, MSc
study director · Asociación Para Evitar la Ceguera en México I.A.P
Elsa Hernández-Piñamora, MD
principal investigator · Asociación Para Evitar la Ceguera en México I.A.P
Octavio Turcio-Aceves, MD
principal investigator · Asociación Para Evitar la Ceguera en México I.A.P

Oversight

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

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