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Brief Title: Topical Infliximab in Autoimmune Eyes With Keratoprosthesis
Official Title: Topical Infliximab in Autoimmune Eyes With Keratoprosthesis
Study ID: NCT02126020
Brief Summary: The Boston Keratoprosthesis type I (KPro) is a prosthetic cornea used to treat several causes of corneal blindness. Some categories of patients, including those with auto-immune diseases such as Stevens-Johnson syndrome, toxic epidermal necrolysis syndrome and mucous membrane pemphigoid, have a higher risk of failure for the KPro. Because of chronic inflammation, the cornea supporting the KPro may melt, leading to a higher risk of infection, loss of the KPro and loss of the eye. Infliximab is an antibody against tumor necrosis factor alpha and is used intravenously to control inflammation in several diseases. It has been used in some cases of corneal melting with significant success. This study's hypothesis is that infliximab can be successfully used as an eye drop (instead of the usual administration through veins) and that its regular use may prevent melt in eyes with a Boston Keratoprosthesis type I and underlying auto-immune disease.
Detailed Description: This is an unmasked, prospective, multicenter clinical trial of four patients that are candidates for a Boston Keratoprosthesis or have had prior KPro surgery and have a diagnosis of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis syndrome (TENS) or mucous membrane pemphigoid (MMP). Only one eye per patient will be considered for inclusion. This is a phase I/II study to evaluate the safety and tolerance of topical infliximab 10 mg/mL eye drops. Research subjects will be required to administer infliximab eye drops four times per day for three months followed by twice daily administration for nine months. The subjects will be monitored while on the study medication as well as for one year following discontinuation of the drug. The total study duration for each patient will be two years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
Name: James Chodosh, MD, MPH
Affiliation: Massachusetts Eye and Ear Infirmary
Role: PRINCIPAL_INVESTIGATOR
Name: Claes H Dohlman, MD, PhD
Affiliation: Massachusetts Eye and Ear Infirmary
Role: STUDY_CHAIR
Name: Mona Harissi-Dagher, MD
Affiliation: Centre hospitalier de l'Université de Montréal (CHUM)
Role: STUDY_CHAIR