Valganciclovir + Ganciclovir for Cytomegalovirus Anterior Uveitis

(STACCATO I/II Trial)

Not yet recruiting at 5 trial locations
JA
Overseen ByJohn A Gonzales, MD
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: University of California, San Francisco
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

The goal of this clinical trial is to compare antiviral treatment strategies for cytomegalovirus (CMV) anterior uveitis - a viral infection causing inflammation inside the front of the eye - in immunocompetent adults aged 18 years and older. The main questions it aims to answer are:

Does oral valganciclovir reduce aqueous humor CMV viral load more effectively than topical ganciclovir 2% eye drops or placebo after 7 days of treatment (Trial I)? Does long-term suppressive antiviral therapy (oral valganciclovir or topical ganciclovir 2% eye drops) reduce the rate of CMV anterior uveitis recurrence over 12 months compared to placebo (Trial II)?

Researchers will compare oral valganciclovir, topical ganciclovir 2% eye drops, and placebo to see if either antiviral treatment reduces viral load and controls eye inflammation more effectively in the short term, and whether long-term antiviral suppression can prevent the disease from coming back after the inflammation has been controlled.

Participants will:

* Undergo anterior chamber paracentesis (removal of a small amount of fluid from the front of the eye) for PCR testing to confirm CMV as the cause of their eye inflammation before enrollment

* Be randomly assigned to receive oral valganciclovir 900 mg twice daily, topical ganciclovir 2% eye drops six times daily, or placebo for 7 days (Trial I), in addition to standard steroid eye drops

* Return for follow-up visits at Day 7 and Day 21 for eye examinations, laboratory blood tests, and a second anterior chamber paracentesis at Day 7 to measure viral load after treatment

* If eye inflammation is controlled after Trial I, be offered enrollment into Trial II, where they will be randomly assigned to long-term suppressive oral valganciclovir, topical ganciclovir 2% eye drops, or placebo for 12 months, with follow-up visits approximately every 2 months and additional visits if inflammation returns

Who Is on the Research Team?

JA

John A Gonzales, MD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

Inclusion Criteria

Trial I - Willingness and ability to provide written informed consent
Trial II - Female participants must agree to use at least one effective method of contraception
I am able and willing to follow all study visits and procedures.
See 13 more

Exclusion Criteria

Trial I - Known immunocompromising condition
I have inactive anterior uveitis right now.
I have been diagnosed with intermediate, posterior, or panuveitis.
See 26 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks
1 visit (in-person)

Acute Treatment (Trial I)

Participants receive oral valganciclovir, topical ganciclovir, or placebo for 7 days to evaluate short-term virologic and clinical effects.

1 week
2 visits (in-person) at Day 7 and Day 21

Follow-up (Trial I)

Participants are monitored for safety and effectiveness after the acute treatment phase.

3 weeks
1 visit (in-person) at Day 21

Long-Term Suppressive Therapy (Trial II)

Participants receive long-term suppressive oral valganciclovir, topical ganciclovir, or placebo for 12 months to evaluate recurrence prevention.

12 months
Visits approximately every 2 months

Follow-up (Trial II)

Participants are monitored for recurrence of anterior uveitis inflammation over 12 months.

12 months
Scheduled and unscheduled visits as needed

What Are the Treatments Tested in This Trial?

Interventions

  • Ganciclovir
  • Valganciclovir

How Is the Trial Designed?

3

Treatment groups

Active Control

Placebo Group

Group I: Oral valganciclovirActive Control1 Intervention
Group II: Topical ganciclovir 2% eye dropActive Control1 Intervention
Group III: PlaceboPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials
2,636
Recruited
19,080,000+

National Institutes of Health (NIH)

Collaborator

Trials
2,896
Recruited
8,053,000+

National Eye Institute (NEI)

Collaborator

Trials
572
Recruited
1,320,000+