A double masked randomised 4-week, placebo-controlled study in the USA, Thailand and Taiwan to compare the efficacy of oral valganciclovir and topical 2% ganciclovir in the treatment of cytomegalovirus anterior uveitis: study protocol.

Autor:	Takhar JS; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; John Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA., Joye AS; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Touro University California College of Osteopathic Medicine, Vallejo, California, USA., Somkijrungroj T; Ophthalmology, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand.; Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand., Laovirojjanakul W; Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand., Lin CP; Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan., Lietman TM; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California, San Francisco, California, USA., Porco TC; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA., Keenan JD; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA., Gebreegziabher EA; Proctor Foundation, University of California San Francisco, San Francisco, California, USA., Seitzman GD; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA., Rose-Nussbaumer J; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Kaiser Permanente, Redwood City, California, USA., Doan TA; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA., Acharya NR; Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA., Gonzales JA; Proctor Foundation, University of California San Francisco, San Francisco, California, USA john.gonzales@ucsf.edu.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Dec 19; Vol. 9 (12), pp. e033175. Date of Electronic Publication: 2019 Dec 19.
DOI:	10.1136/bmjopen-2019-033175
Abstrakt:	Introduction: Cytomegalovirus (CMV) anterior uveitis is a recognised cause of anterior uveitis in immunocompetent patients and is preventable cause of vision loss. Ocular sequelae include corneal endothelial damage which can cause corneal oedema and failure, as well as glaucoma. Recurrences of inflammation are common and therefore patients are often exposed to long-term therapy. Oral therapy is available in the form of valganciclovir, although with the caveat of systemic side effects such as bone marrow suppression and renal failure necessitating regular interval laboratory monitoring. Recent reports have demonstrated that topical 2% ganciclovir solution may offer promising treatment outcomes in patients with CMV anterior uveitis with superior safety, cost-effectiveness and convenience profiles. An investigation into the relative equipoise of these therapies is warranted for these reasons. Methods and Analysis: The Systemic and Topical Control of Cytomegalovirus Anterior uveitis: Treatment Outcomes (STACCATO) trial is designed as a multicentre, block randomised by site, double-masked, placebo-controlled trial comparing the efficacy of oral valganciclovir, 2% topical ganciclovir and placebo in treating PCR-proven CMV anterior uveitis. Participant clinical evaluation will occur at three study time points by a masked study ophthalmologist over a 28-day period to assess resolution of ocular inflammation (secondary outcome). A control group will provide additional information about the possible impact that the infected host's immune response may play in controlling local viral replication. The primary analysis is an analysis of covariance (three arms) correcting for baseline to compare quantitative CMV viral load in the anterior chamber (AC) aqueous fluid before and 7 days after treatment. Ethics and Dissemination: The University of California San Francisco Committee on Human Research and the Khon Kaen University Institutional Review Board have given ethical approval. The results of this trial will be presented at local and international meetings and submitted for peer-reviewed journals for publication. Trial Registration Number: NCT03576898. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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