Gevokizumab Treatment for Active Scleritis By IL-1 Inhibition (GATSBY)

Date de début de l'étude : 1 mars 2013

INCLUSION CRITERIA: Participant must be 18 years of age or older. Participant must have a diagnosis of non-infectious anterior scleritis requiring treatment. Participant must agree not to undergo elective major surgery for the first 16 weeks of the study. Participant must not have received any the following: Another systemic biologic immunosuppressive agent within the last three months prior to enrollment (e.g., infliximab, daclizumab, etanercept, adalimumab, anakinra); Rituximab or alkylating agent (e.g., cyclophosphamide) within the last 12 months prior to enrollment. Participants on systemic anti-inflammatory therapy (including corticosteroids) must not have had a dose escalation in any of their immunosuppressive treatments within the last four weeks prior to enrollment. Participant must stop all immunosuppressives upon enrollment in the study, with the exception of ≤ 20 mg/day of prednisone or equivalent. Participant must have chest X-ray results (frontal and lateral) within the last 12 weeks prior to enrollment with no evidence of active pulmonary infection, active tuberculosis (TB) or malignancy. Participant must be cleared by internal medicine for enrollment. Female participants of childbearing potential must not be pregnant or breast-feeding, must have a negative pregnancy test at screening and must be willing to undergo pregnancy tests throughout the study. Both female participants of childbearing potential and male participants able to father a child must have (or have a partner who has) had a hysterectomy or vasectomy, be completely abstinent from intercourse or must agree to practice two acceptable methods of contraception throughout the course of the study and for four months after the last investigational product injection. Acceptable methods of contraception include: hormonal contraception (i.e., birth control pills, injected hormones, dermal patch or vaginal ring), intrauterine device, barrier methods (diaphragm, condom) with spermicide, or surgical sterilization (tubal ligation). Participant must be able to undergo slit lamp biomicroscopy on both eyes. Participant must understand and sign the protocol's informed consent document. EXCLUSION CRITERIA: Participant has a significant active infection that requires treatment or has a history of recurrent systemic infections. Participant has a history of TB and s/he has not received a full course of TB treatment, OR participant has a history of latent TB infection [or a positive Interferon-Gamma Release Assay (IGRA)] and has not received prophylactic treatment with isoniazid [also known as isonicotinylhydrazine (INH)] or rifampicin within the last six months prior to enrollment. Participant is seropositive for human immunodeficiency virus (HIV) or Hepatitis C. Participant has Hepatitis B. Positivity for Hepatitis B without evidence of active disease (per investigator judgment) is not exclusionary. Participant has a history of cancer (other than a non-melanoma skin cancer or carcinoma in situ of the cervix) diagnosed within the last five years. Participant has a history of severe allergic or anaphylactic reaction to monoclonal antibodies. Participant has a history of previous treatment with gevokizumab. Participant received live (attenuated) vaccine within the last three months prior to enrollment. Live seasonal flu and H1N1 vaccines are permitted ≥ two weeks prior to enrollment. Recombinant or killed vaccines are permitted at any time. Participant has received an investigational drug or device within the last three months. Participant has active joint or systemic inflammation requiring immediate addition or increase in systemic anti-inflammatory medications. Participant has a condition (e.g., psychiatric illness, severe alcoholism or drug abuse) or situation that may put the participant at significant risk, may confound the study results or may interfere significantly with his/her participation or cooperation in the study. STUDY EYE ELIGIBILITY CRITERIA: The participant must have at least one eye meeting all inclusion criteria and none of the exclusion criteria listed below. STUDY EYE INCLUSION CRITERIA: Participant must have scleritis with a grade of ≥ +1 in the study eye. Participant must have visual acuity of 20/640 or better in the study eye. Participant must agree not to undergo elective ocular surgery (e.g., cataract extraction) in the study eye for the first 16 weeks of the study. STUDY EYE EXCLUSION CRITERIA: Participant has had any of the following in the study eye: periocular, intravitreal steroid injection within the last six weeks prior to enrollment, Ozurdex within the last six months prior to enrollment, or Retisert within the last three years prior to enrollment. Participant has had intraocular surgery in the study eye in the last four weeks prior to enrollment.