Clinical trial NCT03886779: Study Title: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial
Official title: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (Nepafenac Ophthalmic Suspension) 0.3% QD With Extra (Pulse) Dose on Day of Surgery for Treatment of Ocular Inflammation Associated With Cataract Surgery in a Randomized, Single Masked Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Treatment of Ocular Inflammation Associated With Cataract Surgery
Keywords: Post-Ocular Inflammation
Cataract Surgery
Lead sponsor: Silverstein Eye Centers
Sponsor class: OTHER
Collaborators: name: Bausch & Lomb Incorporated
name: Churchhill Communications
name: Statistics & Data Corporation
First posted: 2019-03-22
Enrollment: 57
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This is a single center, randomized, investigator masked, parallel group, and active-comparator controlled study to evaluate the clinical outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% for the treatment of ocular inflammation associated with cataract surgery
Primary purpose: TREATMENT

Brief summary: Clinical Outcomes of Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD vs. Ilevro (nepafenac Ophthalmic Suspension) 0.3% QD with extra (pulse) dose on day of surgery for Treatment of Ocular Inflammation Associated with Cataract Surgery

Detailed description: Name of Finished Product:

Prolensa (Bromfenac Ophthalmic Solution) 0.07% Bausch and Lomb, Rochester, NJ Dose: Subjects will instill one drop into the study (operative) eye once daily for a maximum of 16 days. Dosing will begin one days prior to surgery (Day 1), continue on the day of surgery plus 1 hour before surgery and for 14 days after surgery.

2) Ilevro® (nepafenac ophthalmic suspension ) 0.3% This is a single-center, randomized, investigator and subject-masked, parallel group, and active-comparator controlled study.

Subjects will be screened for this study between 1 and 21 days prior to the initiation of dosing with the test article. Subjects who sign the informed consent form and meet all inclusion/exclusion criteria will be randomized to receive either Prolensa (Bromfenac Ophthalmic Solution) 0.07% QD or Ilevro (nepafenac Ophthalmic Suspension) 0.3% (1:1) for 14 days after cataract extraction.

Eligibility criteria: Inclusion Criteria:

1. Are male or female at least 18 years of age who are scheduled for unilateral cataract surgery VIA phacoemulsification with posterior chamber intraocular lens implantation and for whom no other ophthalmic surgical procedures (e.g., relaxing incisions, iridectomy, conjunctival excisions, etc) are to be conducted during the cataract surgery.
2. Agree not to have any other ocular surgical procedures in the study or fellow (non study) eye within 15 days prior to the initiation of dosing with the test article or throughout the duration of the study.
3. Have a Best Corrected Visual Acuity of 20/200 or better in either eye.
4. Are willing/able to return for all required study visits.
5. Are willing/able to follow instructions from the study investigator and his/her staff.
6. Are able to self administer test article (or have a caregiver available to instill all doses of test article).
7. If a woman capable of becoming pregnant, agree to have urine pregnancy testing performed at screening (must be negative) and agree to use a medically acceptable form of birth control throughout the study duration and for at least one week prior to and after completion of the study. Women considered capable of becoming pregnant include all females who have experienced menarche and who have not experienced menopause (as defined by amenorrhea for greater than 12 consecutive months) or have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy).
8. Have signed informed consent approved by Institutional Review Board or Independent Ethics Committee.
9. Have IOP ≥ 5 mmHg and ≤ 22 mmHg (in study eye) without anti glaucoma therapy at the pre operative screening visit (if \>22 mmHg, adjust following pachymetry)

Exclusion Criteria:

1. Have known hypersensitivity to bromfenac or nepafenac or to any component of the test article (including "procedural" medications such as anesthetic and/or fluorescein drops, dilating drops, etc.).
2. Have a known hypersensitivity to salicylates (i.e., aspirin) or to other non steroidal anti inflammatory drugs (NSAIDs).
3. Have intraocular inflammation (i.e., cells or flare in the anterior chamber as measured on slit lamp examination) in the study eye at the screening visit.
4. Have a known blood dyscrasia or bone marrow suppression, a diagnosis of uncontrolled/unstable peptic ulcer disease, inflammatory bowel disease, or ulcerative colitis, or any uncontrolled/unstable pulmonary, cardiac, vascular, autoimmune, hepatic, renal, or central nervous system disease.
5. Have used ocular, topical, or systemic NSAIDs or ocular, topical, or systemic gentamicin, or cyclosporine ophthalmic emulsion within 7 days prior to initiation of dosing with the test article or throughout the duration of the study.
6. Have used any ocular prostaglandins within 30 days prior to initiation of dosing with the test article or throughout the duration of the study.
7. Have active corneal pathology noted in the study eye at the screening visit. Active corneal pathology is defined as corneal pathology that is non stable, or greater than mild, or will compromise assessment of the safety or efficacy of treatment. Superficial punctate keratitis in the study eye is a criterion for exclusion.
8. Have any extraocular/intraocular inflammation in the study eye noted at the screening visit (blepharitis allowed if mild only, and no concurrent conjunctivitis or lid erythema/edema) or ongoing, unresolved uveitis.
9. Have used topical, ocular, inhaled or systemic steroids within 14 days prior to screening.
10. Have had radial keratotomy, corneal transplant, or corneal refractive surgery in the study eye within the last two years.
11. Have a history of abuse of alcohol/drugs within six months prior to the screening visit.
12. Are pregnant or nursing/lactating.
13. Have participated in any other study of an investigational drug or device within 30 days prior to randomization.

Primary outcomes:
measure: Outcome Change measured by Summed Ocular Inflammation Score (SOIS)
timeFrame: Day 1 through Day 15
Secondary outcomes:
measure: Adverse Events
timeFrame: 42 Days
measure: Slit Lamp Biomicroscopy
timeFrame: 42 Days
measure: Intraocular Pressure
timeFrame: 42 Days
measure: Funduscopic Examination (Dilated)
timeFrame: 42 Days
Other outcomes:
Locations:
Study officials:
affiliation: Silverstein Eye Centers
name: Steven M Silverstein, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Silverstein SM. Bromfenac Ophthalmic Solution 0.07% Versus Nepafenac Ophthalmic Suspension 0.3% for Post-Cataract Surgery Inflammation: A Pilot Study of Identical Dosing Regimens with Pre-Surgical "Pulse" Dose. Ophthalmol Ther. 2019 Dec;8(4):577-587. doi: 10.1007/s40123-019-00215-y. Epub 2019 Sep 24.