NAMinGA Phase III, Double-masked, Randomised, Placebo-controlled Trial Investigating the Safety and Efficacy of Nicotinamide (NAM) to Slow Visual Field Loss in Adults With Open-angle Glaucoma
Nicotinomide
+ Matching placebo
Maladies oculaires+1
+ Glaucome à angle ouvert
+ Glaucome
Étude thérapeutique
Résumé
Date de début de l'étude : 18 janvier 2024
Date à laquelle le premier participant a commencé l'étude.Open Angle Glaucoma (OAG) is a chronic optic neuropathy causing progressive vision loss. It is well established that IOP is the only currently modifiable risk factor for glaucoma progression, and it is widely accepted that other risk factors modulate the susceptibility of an eye to IOP. This has led to a considerable body of research into neurodegenerative mechanisms and potential neuroprotective approaches. Various pathways contributing to the neurodegeneration have been implicated, and many have focussed on the role of mitochondria. Neuroprotection would significantly reduce sight loss and the burden of IOP-lowering eye drop treatment needed for disease control. There is evidence that susceptibility to IOP is related to mitochondrial function and ageing is associated with mitochondrial functional decline. The knowledge gap addressed in this trial is the relative contribution that mitochondrial function makes to glaucomatous neurodegeneration and whether boosting mitochondrial function with NAM slows progression in humans in the same way that it does in animal models. Biomarkers for mitochondrial-related susceptibility have not yet been established in humans. The proposal therefore is a new mechanism neuroprotection to improve resistance to eye pressure and evaluate the long-term safety and efficacy of NAM to preserve vision and its mechanism of action. There is strong evidence that mitochondrial dysfunction is associated with OAG susceptibility and that NAM improves mitochondrial function. Research has shown short-term vision improvement with high-dose NAM in glaucoma patients. NAM is safe and well-tolerated.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.496 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.À partir de 18 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
Inclusion Criteria: 1. Patients who have been recently diagnosed (within the last 12 months) with early to moderate open-angle glaucoma (OAG) in at least one eye (including primary OAG, normal tension glaucoma (NTG) and pseudoexfoliation glaucoma) 2. Open angle on gonioscopy 3. Adults aged 18 years or over 4. Snellen visual acuity 6/12 or better in at least one eye meeting the visual field (VF) criteria 5. Visual Field (VF) mean deviation (MD) no worse than -12dB in either eye 6. A negative pregnancy test result at the screening and baseline visit prior to randomisation for women of childbearing potential 7. Ability to provide informed consent to participate 8. Able and willing to attend trial visits and comply with trial procedures for the duration of the trial Exclusion Criteria: 1. Pigment dispersion glaucoma 2. Pregnancy (or planned pregnancy during the trial) and/or breastfeeding 3. Women of childbearing potential and male participants with a partner of childbearing potential not willing to use highly effective contraception for the duration of the trial treatment and for the time period specified following last trial treatment administration. 4. Current treatment with either isoniazid, pyrazinamide, carbamazepine, phenobarbital or primidone 5. Current liver disease or laboratory results with elevated levels of liver transaminases (AST or ALT \>3 x ULN) at screening visit. 6. Renal failure (eGFR \<30mL/min/1.73m²) at screening visit. 7. Conditions affecting both eyes which may affect the Visual Field test result: 1. Diabetic retinopathy or any other retinal disease causing VF loss 2. Clinically relevant cataract (likely to require cataract surgery within the next 2 years) 3. Dementia or other non-glaucomatous neurological disease causing VF loss 4. Adnexal conditions causing VF loss (including but not limited to blepharochalasis) 8. Diagnosed with cancer in the last 5 years (with exception of non-melanoma skin cancer). 9. Any clinical condition that, in the investigator's opinion would make the participant unsuitable for the trial. 10. Concurrently enrolled in any other interventional trial or participation in previous clinical trial of glaucoma. 11. Current use of, and unwilling to abstain from, over-the-counter additional vitamin B3/NAM oral supplements (including skin preparations such as ointments/emulsions), Ginkgo Biloba and/or Coenzyme Q10 supplements, throughout the duration of their participation in the trial.
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.2 groupes d'intervention sont désignés dans cette étude
50% de chances d'être dans le groupe placebo en aveugle
Groupes de traitement
Groupe I
ExpérimentalGroupe II
PlaceboObjectifs de l'étude
Objectifs principaux
Objectifs secondaires
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 10 sites
Queen Victoria Hospital NHS Foundation Trust
East Grinstead, United KingdomOuvrir Queen Victoria Hospital NHS Foundation Trust dans Google MapsMoorfields Eye Hospital NHS Foundation Trust
London, United KingdomKing's College Hospital NHS Foundation Trust
London, United KingdomQueen Alexandra Hospital
Portsmouth, United Kingdom