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Trial registered on ANZCTR
Registration number
ACTRN12624000545561
Ethics application status
Approved
Date submitted
15/01/2024
Date registered
30/04/2024
Date last updated
30/04/2024
Date data sharing statement initially provided
30/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Safety and efficacy studies of neostigmine administration as a topical ophthalmic solution for diagnosing ocular myasthenia gravis in adults presenting with ptosis
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Scientific title
Safety and efficacy studies of neostigmine administration as a topical ophthalmic solution for diagnosing ocular myasthenia gravis in adults presenting with ptosis
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Secondary ID [1]
311321
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myasthenia gravis
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Condition category
Condition code
Neurological
329269
329269
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0
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Other neurological disorders
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Eye
329894
329894
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will receive neostigmine solution delivered as eye drops. Each participants will be received only one of four dose level (1 drop of 1 mg/ml; 1 drop of 1.5 mg/ml; 1 drop of 2.5 mg/ml; 2 drops of 2.5 mg/ml) and only one time on day 1. There will be different cohorts for each dose level. Single instillation of eye drops will be administered into the symptomatic eye or the eye with more severe ptosis in patients with bilateral ptosis. The instillation will be performed by an ophthalmologist at the ophthalmology clinic.
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Intervention code [1]
327765
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Diagnosis / Prognosis
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Safety of neostigmine
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Assessment method [1]
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Ocular examinations: visual acuity by ETDRS chart, intraocular pressure by applanation tonometer, and, slit-lamp examination
Vital signs: blood pressure and heart rate by digital blood pressure monitor, and respiratory rate by direct observation
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Timepoint [1]
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Baseline, 15, 30, 60, 90, 120, 180 minutes, 24 hours, and 7 days after instillation
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Secondary outcome [1]
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Efficacy of neostigmine
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Assessment method [1]
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Change in vertical palpebral fissure: recorded by photography with scaling at the observed timepoints and then measured by ImageJ
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Timepoint [1]
430646
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Baseline, 15, 30, 60, 90, 120, 180 minutes and 24 hours after instillation
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Eligibility
Key inclusion criteria
Patients aged 18 years or older who presented with ptosis and were diagnosed with myasthenia gravis by neuro-ophthalmologists or neurologists in the King Chulalongkorn Memorial Hospital
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with generalized myasthenia gravis currently requiring medications, ocular myasthenia gravis currently requiring immunosuppressants, aponeurotic ptosis, mechanical ptosis, traumatic ptosis, other diseases of myogenic or neurogenic ptosis, ophthalmic diseases requiring ophthalmic drops except lubrications, history of eyelid surgery or trauma, patients who had abnormal movement of the eyelids that interfere with the evaluation of the test e.g., eyelid myokymia, facial tics, blepharospasm, and facial spasm, history of neostigmine allergy, or contraindication to neostigmine.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/06/2024
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Thailand
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State/province [1]
26076
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University
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Address [1]
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1873 Rama 4 road, Pathum Wan Bangkok 10330
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Country [1]
315573
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Thailand
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Primary sponsor type
University
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Name
Faculty of Medicine, Chulalongkorn University
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Address
Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathum Wan Bangkok 10330
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Country
Thailand
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Secondary sponsor category [1]
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None
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Name [1]
318215
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Address [1]
318215
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Country [1]
318215
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Institutional Review Board (IRB) of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Ethics committee address [1]
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Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathum Wan Bangkok 10330
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Ethics committee country [1]
314471
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Thailand
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Date submitted for ethics approval [1]
314471
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27/06/2023
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Approval date [1]
314471
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17/08/2023
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Ethics approval number [1]
314471
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Summary
Brief summary
We aim to evaluate safety and efficacy of using various dosage of neostigmine as an ophthalmic administration for diagnosing myasthenia gravis. The first cohort of patients will be instilled with a starting dose of neostigmine solution which will be determined by the preclinical animal models, and the next cohort will receive the higher dose level of neostigmine in a stepwise pattern. We hypothesized that topical neostigmine is safe and can increase vertical palpebral fissure in myasthenia gravis patients presenting with ptosis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Miss Chuthamas Ongprakobkul
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Address
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Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathum Wan Bangkok 10330
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Country
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Thailand
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Phone
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+669 5814 5928
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Fax
131698
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Email
131698
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[email protected]
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Contact person for public queries
Name
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Chuthamas Ongprakobkul
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Address
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Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathum Wan Bangkok 10330
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Country
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Thailand
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Phone
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+66 2 256 4000
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Fax
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Email
131699
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[email protected]
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Contact person for scientific queries
Name
131700
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Chuthamas Ongprakobkul
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Address
131700
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Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathum Wan Bangkok 10330
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Country
131700
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Thailand
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Phone
131700
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+66 2 256 4000
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Fax
131700
0
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Email
131700
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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