The aim of this clinical trial is to investigate the efficacy (by monitoring neovascularization and epithelial defects) of up to four doses of the investigational medicinal product (IMP) LSC2 topically administered on the target eye of patients with LSCD. Further, safety of the IMP during and after application will be investigated (by monitoring adverse events \[AEs\]).
This is an interventional, open-label, phase I/IIa clinical trial to investigate the efficacy and safety of up to four doses of the IMP topically administered on the target eye of patients with LSCD. Patients will be treated in up to four ascending dose groups. The allogeneic investigational product LSC2 contains ABCB5-positive limbal stem cells (from corneal rims of cadaveric donors, expanded ex vivo, isolated and stored in a donor cell bank). The IMP will be applied on the target eye. Prior to application, the conjunctival pannus will be removed under general or local anesthesia. Patients will be followed up for efficacy for 1 year. Efficacy of the IMP will be monitored by assessing neovascularization and epithelial defects. To assess long-term safety of LSC2 one follow-up visit at Month 24 post IMP application is included.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
16
Topical application of IMP on target eye
Massachusetts Eye and Ear Infirmary
Boston, Massachusetts, United States
Universitäts-Klinikum Köln, Augenklinik
Cologne, Germany
Universitäts-Klinikum Heidelberg, Kopfklinik
Heidelberg, Germany
Universitäts-Klinikum Jena, Augenklinik
Jena, Germany
Response rate at 12 months after IMP application
Response rate at 12 months after IMP application, where response is defined as: * no or mild corneal neovascularization (no vessel penetration or vessel penetration up to 1 quadrant, without central cornea) AND * no or mild epithelial defects (no corneal erosion or ulcer are present (corneal wounds are closed) or minimal superficial staining)
Time frame: Month 12
Assessment of adverse event (AE) occurrence
All AEs occurring during the clinical trial will be registered, documented and evaluated.
Time frame: Up to 24 months.
Response rate at 3 months after IMP application
Response rate at 3 months after IMP application, where response is defined as: * no or mild corneal neovascularization (no vessel penetration or vessel penetration up to 1 quadrant, without central cornea) AND * no or mild epithelial defects (no corneal erosion or ulcer are present (corneal wounds are closed) or minimal superficial staining)
Time frame: Month 3
Neovascularization
Corneal neovascularization will be assessed as "none" (no blood vessel penetration), "mild" (blood vessel penetration of 1 quadrant, without central cornea involvement), "moderate" (blood vessel penetration of 1 quadrant, with central cornea involvement or blood vessel penetration of 2 or 3 quadrants, with or without central cornea involvement) or "strong" (blood vessel penetration of all quadrants, with or without central cornea involvement).
Time frame: Baseline, week 1, 2, 3, 4, 5, 6, 7, 12, month 6 and 12
Epithelial defects
Epithelial defects will be assessed as "none" (no corneal erosion or ulcer are present (corneal wounds are closed)) or "mild" (minimal superficial staining) or "moderate" (dense coalescent staining up to 2 mm in diameter) or "strong" (dense coalescent staining greater than 2 mm in diameter) by means of fluorescein staining.
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Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Augenklinik und Poliklinik
Mainz, Germany
Time frame: Baseline, week 2, 4, 6, month 3, 6 and 12
Ocular symptoms of pain, photophobia, burning
Photophobia and burning will be assessed as "no complaint" (grade 0), "mild" (grade 1), "moderate" (grade 2) or "severe" (grade 3). Pain assessment will be done by the patient using a 11-point numerical rating scale ranging between no pain (zero) and worst imaginable pain (ten).
Time frame: Baseline, week 2, 4, 6, 12, month 6 and 12
Ocular inflammation
The assessment of inflammation will be categorized as present (yes) or nonexistent (no).
Time frame: Baseline, week 2, 4, 6, 12, month 6 and 12
Corneal opacity
Corneal opacification will be assessed as "none" (no corneal opacification), "mild" (corneal opacification in up to 1 quadrant, without central cornea involvement), "moderate" (corneal opacification in 1 quadrant, with central cornea involvement or corneal opacification in 2 or 3 quadrants, with or without central cornea involvement) or "strong" (corneal opacification in all quadrants, with or without central cornea involvement). Additional densitometric Pentacam® measurements are optional. Opacity values of the following ring-shaped corneal segments will be record: * 0 - 2 mm, 2 - 6 mm, 6 - 10 mm, 10 - 12 mm (anterior, central and posterior corneal layer for each segment) * 0 - 2 mm, 2 - 6 mm, 6 - 10 mm, 10 - 12 mm (full thickness average for each segment) * Anterior layer of the complete cornea (0 - 12 mm) * Central layer of the complete cornea (0 - 12 mm) * Posterior of the complete cornea (0 - 12 mm) * Overall cornea (0 - 12 mm, full thickness)
Time frame: Baseline, week 2, 4, 6, 12, month 6 and 12
Visual acuity
Clarity of vision.
Time frame: Baseline, week 2, 4, 6, 12, month 6 and 12
Quality of life assessment
Quality of life (visual function questionnaire-25 \[VFQ-25\]) questionnaire to be answered.
Time frame: Baseline, week 12, month 12
Physical examination
A full physical examination will be performed at week 12 and abnormal physical examination results will be evaluated and reported as AEs.
Time frame: Baseline, week 12, month 12
Tonometry
Time frame: Baseline,week 1, 3, 7 and 12
Vital signs: Body temperature at Baseline, week 12, month 12
Body temperature at Baseline, week 12 and month 12 will be evaluated.
Time frame: Baseline, week 12, month 12
Vital signs: Blood pressure at Baseline, week 12, month 12
Blood pressure at Baseline, week 12 and month 12 will be evaluated.
Time frame: Baseline, week 12, month 12
Vital signs: Heart rate at Baseline, week 12, month 12
Heart rate at Baseline, week 12 and month 12 will be evaluated.
Time frame: Baseline, week 12, month 12