TY - JOUR
T1 - A Phase III, Multicenter, Randomized, Placebo-Controlled Clinical Trial of Topical Aminocaproic Acid (Caprogel) in the Management of Traumatic Hyphema
AU - Pieramici, Dante J.
AU - Goldberg, Morton F.
AU - Melia, Michele
AU - Fekrat, Sharon
AU - Bradford, Cynthia A.
AU - Faulkner, Alan
AU - Juzych, Mark
AU - Parker, John S.
AU - McLeod, Stephen D.
AU - Rosen, Richard
AU - Santander, Samuel H.
N1 - Funding Information:
This study was supported by Orphan Medical Inc., Minnetonka, Minnesota. Covance Inc. (Princeton, NJ) was the contract research organization and had primary responsibilities for providing trial initiation, monitoring, data management, project management, and statistical analysis. Also supported in part by core grant no. 2p30EY017652 from the National Eye Institute and by an unrestricted research grant from Research to Prevent Blindness, Inc., New York, New York.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003/11
Y1 - 2003/11
N2 - Objective: To determine the safety and efficacy of topical aminocaproic acid (Caprogel) in the management of traumatic hyphema. Design: Multicenter, randomized, double-masked, placebo-controlled clinical trial. Participants: A total of 51 patients participated in this trial (power = 36%, 2-tailed test). Intervention: Patients presenting with traumatic hyphema were randomly assigned to 5-day treatment with topical aminocaproic acid or a placebo gel. Patients were monitored daily with ocular examination and vital sign testing for the 5 days of treatment and at 24 and 48 hours after treatment. General physical examination and laboratory testing were performed at baseline and day 5. Main Outcome Measures: The main efficacy variable was the rate of rebleeding. Secondary efficacy variables included time to hyphema clearance, intraocular pressure, time to secondary hemorrhage, and visual acuity. Safety variables included adverse events, vital signs, and laboratory measurements. Results: Rebleeding occurred in 30% of the placebo group (8 of 27; 95% confidence interval [CI] = 14-50%), versus 8% of the treatment group (2 of 24; 95% Cl = 1-27%), for an estimated continuity-corrected difference in percentage of patients with bleeding of 17% (95% Cl = -3-38%). Secondary efficacy variables were similar in the groups, except that there was a trend towards more visual improvement in the topical aminocaproic acid group (54%) than in the placebo group (30%) at the last measurement (P = 0.08). Adverse events were similar. Conclusions: This study provides evidence that topical aminocaproic acid is safe and demonstrates trends towards reducing the rebleeding rate in the management of traumatic hyphema. However, because the study was terminated before complete enrollment, more definitive recommendations will require a larger trial.
AB - Objective: To determine the safety and efficacy of topical aminocaproic acid (Caprogel) in the management of traumatic hyphema. Design: Multicenter, randomized, double-masked, placebo-controlled clinical trial. Participants: A total of 51 patients participated in this trial (power = 36%, 2-tailed test). Intervention: Patients presenting with traumatic hyphema were randomly assigned to 5-day treatment with topical aminocaproic acid or a placebo gel. Patients were monitored daily with ocular examination and vital sign testing for the 5 days of treatment and at 24 and 48 hours after treatment. General physical examination and laboratory testing were performed at baseline and day 5. Main Outcome Measures: The main efficacy variable was the rate of rebleeding. Secondary efficacy variables included time to hyphema clearance, intraocular pressure, time to secondary hemorrhage, and visual acuity. Safety variables included adverse events, vital signs, and laboratory measurements. Results: Rebleeding occurred in 30% of the placebo group (8 of 27; 95% confidence interval [CI] = 14-50%), versus 8% of the treatment group (2 of 24; 95% Cl = 1-27%), for an estimated continuity-corrected difference in percentage of patients with bleeding of 17% (95% Cl = -3-38%). Secondary efficacy variables were similar in the groups, except that there was a trend towards more visual improvement in the topical aminocaproic acid group (54%) than in the placebo group (30%) at the last measurement (P = 0.08). Adverse events were similar. Conclusions: This study provides evidence that topical aminocaproic acid is safe and demonstrates trends towards reducing the rebleeding rate in the management of traumatic hyphema. However, because the study was terminated before complete enrollment, more definitive recommendations will require a larger trial.
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U2 - 10.1016/S0161-6420(03)00866-2
DO - 10.1016/S0161-6420(03)00866-2
M3 - Article
C2 - 14597516
AN - SCOPUS:0242349279
SN - 0161-6420
VL - 110
SP - 2106
EP - 2112
JO - Ophthalmology
JF - Ophthalmology
IS - 11
ER -