Adenoviral conjunctivitis (Ad-Cs) is a prevalent condition comprising as much as 2% of a general practitioner's practice, is highly contagious, and has considerable economic impact. Because of the epidemic potential of some adenoviral serotypes, Ad-Cs is a reportable condition in Germany and Japan. An estimated $670 million is spent annually on the management of acute conjunctivitis, and afflicted patients miss on average five days of work or school (range 2-10). A treatment that reduces patient symptoms or contagion by even two or three days would have significant public health and economic impact. There are no FDA-approved treatments for Ad-Cs. The ideal treatment for Ad-Cs would be safe, effective, low- cost and widely accessible. Povidone iodine (PVP-I) meets these criteria. PVP-I has broad- spectrum antimicrobial effectiveness and an excellent safety profile. Off-label use of PVP-I to treat Ad-Cs has been promoted by influential editorials and reviews within the optometric and ophthalmological communities. A significant minority of clinicians report using PVP-I to treat Ad- Cs. Unfortunately, studies of PVP-I for the treatment of Ad-Cs have been uncontrolled, unmasked and/or underpowered. The urgency for a definitive study has increased with the growing off-label use of PVP-I to treat Ad-Cs. Results from a definitive study will affect clinical practice whether PVP-I is found effective or not. Absence of effect would spare hundreds of thousands from ineffective treatment. Either result would provide a rational basis for deciding whether such treatment should be covered in health insurance plans. Our long-term goal is to conduct a definitive, randomized clinical trial that evaluates whether or not a single, in-office application of 5% PVP-I is more effective than standard care with artificial tears at reducing vira load and improving symptoms in patients with Ad-Cs.
The specific aims of this planning study Reducing Adenoviral Patient-Infected Days (RAPID) is to provide key planning parameters for a national, multi-site clinical trial to test this hypothesis definitively.

Public Health Relevance

Adenoviral conjunctivitis is a prevalent condition that is highly contagious and has considerable economic impact. A treatment that reduces patient symptoms or contagion by even two or three days would have significant public health and economic impact.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Planning Grant (R34)
Project #
5R34EY023633-02
Application #
9001335
Study Section
Special Emphasis Panel (ZEY1-VSN (06))
Program Officer
Bhargava, Sangeeta
Project Start
2015-02-01
Project End
2017-01-31
Budget Start
2016-02-01
Budget End
2017-01-31
Support Year
2
Fiscal Year
2016
Total Cost
$228,750
Indirect Cost
$78,750
Name
Washington University
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Hartwick, Andrew; Shorter, Ellen; Margolis, Mathew et al. (2017) Letter to the Editor: Effect of Povidone Iodine 5% on the Cornea, Vision, and Subjective Comfort. Optom Vis Sci 94:1070