DHA and X-Linked Retinitis Pigmentosa
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Purpose
Purpose:
Retinitis pigmentosa (RP) is characterized by progressive loss of visual function due to specific genetic mutations. This trial is focused on patients with one of the most severe forms of the disease, X-linked inherited RP (XLRP). This disease is characterized by early onset (typically loss of night vision as a child) followed by loss of peripheral vision as a teenager and young adult. There is no male-to-male transmission of the disease in the family.
There is no cure for RP and treatment options are limited. Two clinical trials have not found a benefit from nutritional supplementation with the long-chain polyunsaturated fatty acid, docosahexaenoic acid (DHA), at low daily doses although there is evidence that it slows disease progression in certain instances. In this clinical trial, we propose that a high dose nutritional DHA supplement will slow the loss of visual function and preserve usable vision in patients with XLRP.
This study is a 4-year placebo-controlled randomized clinical trial meaning that patients have a 50-50 chance of receiving placebo or experimental treatment. A total of 66 patients will be enrolled; 33 will receive placebo and 33 will receive the treatment. Entry criteria include diagnosis of XLRP by an ophthalmologist, age 7 to 32 years, male, sufficient visual function such that disease progression can be followed for the entire duration of the trial, and a willingness to visit the testing site (Dallas, TX) once a year.
Annual visual function testing includes ETDRS visual acuity, full-field and multifocal electroretinography (ERG), static peripheral visual fields, and fundus photography. Cone ERG function is the primary outcome measure. All testing is free of charge to study participants, expenses for travel and accommodations in Dallas (for example, Holiday Inn) are covered as well as a $200 incentive for each completed visit.
Funding Source - FDA OOPD
| Condition | Intervention | Phase |
|---|---|---|
|
Retinitis Pigmentosa X-linked Genetic Diseases |
Drug: docosahexaenoic acid |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Prevention |
| Official Title: | Investigation of Effectiveness and Safety of High Dose Docosahexaenoic Acid (DHA) in X-Linked Retinitis Pigmentosa |
- rate of loss of 31 hz cone ERG function [ Time Frame: 4 years ] [ Designated as safety issue: Yes ]
- biological safety measures [ Time Frame: 4 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 66 |
| Study Start Date: | September 2004 |
| Estimated Study Completion Date: | March 2014 |
| Primary Completion Date: | May 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1.
Oral Docosahexaenoic acid...dosage based on body weight
|
Drug: docosahexaenoic acid
daily intake of DHA based on body weight; 4 year trial
Other Name: DHA; omega-3 fatty acid
|
|
Placebo Comparator: 2
Oil not containing DHA...dosage based on body weight
|
Drug: docosahexaenoic acid
daily intake of DHA based on body weight; 4 year trial
Other Name: DHA; omega-3 fatty acid
|
Detailed Description:
Location & Contact Information:
Retina Foundation of the Southwest, 9600 N. Central Expressway, Suite 200, Dallas, TX 75231 Contact: Dr. D. Hoffman (dhoffman@retinafoundation.org) or Dr. D. Birch (dbirch@retinafoundation.org).
Eligibility| Ages Eligible for Study: | 7 Years to 32 Years |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of RP by a retinal specialist
- Clinical diagnosis consistent with X-linked inheritance
- Enrolling minors and young adults (early onset of X-linked disease; ages 7 to 32)
- Measurable cone ERG responses --patients with less than 0.64 microvolt response to 31-Hz flicker will be excluded as they are more likely to become undetectable during the study
- Both eyes must meet entry criteria as both will be tested (i.e., no cataracts requiring surgery or retinal detachments).
- Media clarity sufficient for fundus photography
- Able to return to study site at yearly intervals
- Willing to supply blood samples at 6-month intervals
- Judiciously take the placebo or DHA supplement for the 4-year study duration
- Patient/parent/guardian understands and signs consent form.
Exclusion Criteria:
- Excessive fish consumption (e.g., cold water fish such as salmon, tuna, sardines) and/or fish oil supplementation (or other oil containing DHA)
- Baseline RBC-DHA levels showing evidence of supplementation (a typical level of RBC-DHA in normals is about 3.8%)
- Chronic metabolic disease that may interfere with fatty acid metabolism or require anti-coagulant medication
No ethnic or racial groups will be excluded.
Contacts and Locations| United States, Texas | |
| Retina Foundation of the Southwest | |
| Dallas, Texas, United States, 75231 | |
| Principal Investigator: | Dennis R. Hoffman, Ph.D. | Retina Foundation of the Southwest |
More Information
Additional Information:
No publications provided
| Responsible Party: | Dennis Hoffman, Senior Research Scientist (Retina Foundation of the Southwest), Retina Foundation of the Southwest |
| ClinicalTrials.gov Identifier: | NCT00100230 History of Changes |
| Other Study ID Numbers: | 2543, FD-R-002543-01 |
| Study First Received: | December 27, 2004 |
| Last Updated: | February 20, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Retina Foundation of the Southwest:
|
retina electroretinography clinical trial |
docosahexaenoic acid omega-3 fatty acid x-linked inheritance |
Additional relevant MeSH terms:
|
Genetic Diseases, Inborn Retinitis Retinitis Pigmentosa Genetic Diseases, X-Linked Retinal Diseases |
Eye Diseases Eye Diseases, Hereditary Retinal Dystrophies Retinal Degeneration |
ClinicalTrials.gov processed this record on May 23, 2013