Efficacy and safety of two different aflibercept regimens in subjects with nAMD.
- Conditions
- eovascular Age-Related Macular Degeneration (nAMD)MedDRA version: 18.0Level: PTClassification code 10071129Term: Neovascular age-related macular degenerationSystem Organ Class: 10015919 - Eye disordersMedDRA version: 18.0Level: SOCClassification code 10015919Term: Eye disordersSystem Organ Class: 10015919 - Eye disordersTherapeutic area: Diseases [C] - Eye Diseases [C11]
- Registration Number
- EUCTR2013-000120-33-ES
- Lead Sponsor
- Bayer HealthCare AG
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 335
First set of inclusion criteria:
All of the following criteria must have been met at the initial start of aflibercept treatment (i.e. start of aflibercept treatment before this study):
- Subject had primary subfoveal choroidal neovascularization (CNV) lesions secondary to nAMD, including juxtafoveal lesions that affect the fovea, as evidenced by FA/FP of the study eye within 3 weeks before the initiation of aflibercept treatment.
- The area of CNV occupied at least 50% of the total lesion within 3 weeks before the initiation of aflibercept treatment.
- Documented BCVA was 20/40 to 20/320 (letter score of 73 to 25) in the study eye at the initiation of treatment. Because BCVA may not have been assessed by the ETDRS protocol at initiation of aflibercept treatment, guidance for conversion of data, (e.g. Snellen to approximate ETDRS) will be provided in the study manual.
Second set of inclusion criteria:
All of the following criteria must be met at the time of screening include the following (incomplete list):
- Men and women >= 51 years of age
- The subject's history of aflibercept treatment meets ALL of the following:
a) Treatment in the study eye was initiated with three monthly (-1 week/+2 weeks) doses of 2 mg aflibercept and improvements of visual and anatomic outcomes were observed
b) Following the above initiation phase, the intervals between treatments were between 6 weeks and 12 weeks (one exception will be allowed)
c) The interval between the last two pre-study injections was >= 8 weeks, and visual and anatomic outcomes have been stable over this interval.
d) The subject received the last IVT injection of aflibercept in the study eye >= 2 months (±10 days) before the first treatment in this study
e) Total prior treatment duration with aflibercept (i.e. from first treatment to randomization into this study) was >= 12 months
- Subject is willing, committed, and able to return for ALL clinic visits and complete all study-related procedures.
- Women and men of reproductive potential must agree to utilize two reliable and acceptable methods of contraception simultaneously when sexually active. This applies for the time period between signing of the informed consent form and 3 months after the last administration of study drug.
Acceptable methods of contraception include, but are not limited to, (i) condoms (male or female) with or without a spermicidal agent; (ii) diaphragm or cervical cap with spermicide; (iii) intra-uterine device; (iv) hormone-based contraception.
Postmenopausal women must be amenorrheic for at least 12 months in order not to be considered of child bearing potential.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 85
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 245
First set of exclusion criteria:
A subject who has met any of the following criteria at the initial start of aflibercept treatment (i.e. start of aflibercept treatment before this study) will be excluded from this study.
- Any prior or concomitant therapy with an investigational or approved agent to treat neovascular AMD in the study eye.
- Total lesion size > 12 disc areas (30.5 mm2, including blood, scars and neovascularization) as assessed by FA in the study eye
- Subretinal hemorrhage that was:
a) 50% or more of the total lesion area, or
b) if the blood was under the fovea, and
c) the blood under the fovea was 1 or more disc areas in size in the study eye.
- Scar or fibrosis making up more than 50% of the total lesion in the study eye.
- Scar, fibrosis, or atrophy involving the center of the fovea in the study eye.
- Presence of retinal pigment epithelial tears or rips involving the macula in the study eye.
- Causes of CNV other than AMD in the study eye.
Second set of exclusion criteria:
Criteria leading to exclusion if met at the time of screening include the following (incomplete list):
- Subjects who currently meet any of the first set of exclusion criteria with the exception of prior treatment with aflibercept
- Any prior ocular (in the study eye) or systemic treatment or surgery for neovascular AMD, except dietary supplements, vitamins and IVT injections of aflibercept, during the time (i.e. at least 12 months) between initiation of aflibercept treatment and randomization into this study
- Any prior treatment with anti-VEGF therapy in the study eye, with the exception of IVT injections of aflibercept, during the time (i.e. at least 12 months) between initiation of aflibercept treatment and randomization into this study
- Prior systemic anti-VEGF therapy, investigational or approved, within the last 15 months prior to randomization
- Any vitreous hemorrhage within 4 weeks before randomization
- Active intraocular, extraocular and periocular inflammation or infection in either eye.
- Any ocular or periocular infection within 4 weeks of randomization
- Any serious adverse event related to aflibercept during prior treatment
- Any history of allergy to povidone iodine.
- Known serious allergy to the fluorescein sodium for injection in angiography
- Presence of any contraindications indicated in the EU commission/locally approved label for aflibercept: Hypersensitivity to the active substance aflibercept or to any of the excipients; active or suspected ocular or periocular infection; active severe intraocular inflammation
- Prior vitrectomy in the study eye
- History of vitreomacular traction
- History of retinal detachment or treatment or surgery for retinal detachment in the study eye.
- Any history of macular hole of stage 2 and above in the study eye
- Prior trabeculectomy or other filtration surgery in the study eye
- Uncontrolled glaucoma (defined as intraocular pressure more than 25 mmHg despite treatment with antiglaucoma medication) in the study eye
- Aphakia or pseudophakia with absence of posterior capsule (unless it occurred as a result of an yttrium aluminum garnet [YAG] posterior capsulotomy) in the study eye
- Previous therapeutic radiation in the region of the study eye
- History of corneal transplant or corneal dystrophy in the study eye
- Significant media opacities, including cataract, in the study eye that interferes with visual acuity or fundus photography
- History or clinical evidence of DME or any retinal v
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To compare the efficacy of 2 mg aflibercept administered by two different intravitreal (IVT) treatment regimens to subjects with nAMD.;Secondary Objective: To assess the safety and tolerability of aflibercept in this subject population.;Primary end point(s): Change in ETDRS BCVA letter score for the study eye from baseline<br>to Week 52.;Timepoint(s) of evaluation of this end point: Week 52
- Secondary Outcome Measures
Name Time Method Timepoint(s) of evaluation of this end point: Baseline, Week 52.;Secondary end point(s): Efficacy assessments:<br>- Proportion of subjects maintaining vision (i.e. loss of < 15 letters) in<br>the study eye at Week 52<br>- Proportion of subjects who gained >= 5 letters from baseline to<br>Week 52<br>- Mean change in central retinal thickness (CRT) in the study eye from<br>baseline to Week 52<br>- Mean change in CNV area in the study eye from baseline to Week 52<br>- Proportion of subjects who lost >= 30 letters from baseline to Week 52<br>- Mean change from baseline to Week 52 in total score for NEI VFQ-25