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A Study to Evaluate the Efficacy and Safety of Intravitreal KSI-301 in Participants With Moderately Severe to Severe Non-proliferative Diabetic Retinopathy (NPDR)

Phase 3
Terminated
Conditions
Non-proliferative Diabetic Retinopathy
Interventions
Other: Sham injection
Registration Number
NCT05066230
Lead Sponsor
Kodiak Sciences Inc
Brief Summary

This Phase 3 Study will evaluate the efficacy and safety of KSI-301 in participants with moderately severe to severe non-proliferative diabetic retinopathy (NPDR).

Detailed Description

This is a Phase 3, prospective, randomized, double-masked, sham-controlled, two-arm, multicenter study evaluating the efficacy and safety of repeated intravitreal dosing of KSI-301 5 mg in participants with moderately severe to severe non-proliferative diabetic retinopathy (NPDR).

The primary endpoint will be assessed at Week 48; additional secondary endpoints for efficacy will be assessed at Week 48, Week 96 and if applicable, over time.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
253
Inclusion Criteria
  • Signed informed consent prior to participation in the study.
  • Type 1 or 2 diabetes mellitus
  • Moderately severe to severe NPDR in the Study Eye (DRSS levels 47 and 53 as determined by the reading center), in which pan-retinal photocoagulation (PRP) can be safely deferred for at least 6 months per the Investigator.
  • BCVA ETDRS letter score in the Study Eye of ≥69 letters (approximate Snellen equivalent of 20/40 or better)
  • HbA1c of ≤12%.
  • Other protocol-specified inclusion criteria may apply.
Exclusion Criteria
  • Presence of center-involved DME in the Study Eye
  • Prior PRP in the Study Eye.
  • Current anterior segment neovascularization (ASNV), vitreous hemorrhage, or tractional retinal detachment in the Study Eye.
  • Prior intravitreal anti-VEGF treatment in the Study Eye for DR or DME.
  • Prior intravitreal or periocular steroid in the Study Eye for DR or DME.
  • Prior use of an investigational intravitreal treatment for DR or DME in the Study Eye.
  • Any history or evidence of a concurrent ocular condition present in the Study Eye, that in the opinion of the Investigator could require either medical or surgical intervention or alter visual acuity during the study
  • Active or suspected ocular or periocular infection or inflammation.
  • Women who are pregnant or lactating or intending to become pregnant during the study.
  • History of a medical condition that, in the judgment of the Investigator, would preclude scheduled study visits, completion of the study, or a safe administration of investigational product.
  • Recent history (within the 6 months prior to screening) of myocardial infarction, stroke, transient ischemic attack, acute congestive heart failure or any acute coronary event.
  • Uncontrolled blood pressure defined as a systolic value ≥ 180 mmHg or diastolic value ≥ 100 mmHg while at rest.
  • Other protocol-specified exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Treatment Group BSham injectionSham injection on the same schedule as Treatment Group A
KSI-301 - Treatment Group AKSI-301Intravitreal injection of KSI-301 (5 mg): three initiating doses, and then every 24 weeks through Week 92
Primary Outcome Measures
NameTimeMethod
Percentage of Patients Improving ≥2 Steps on DRSSDay 1 to Week 48

Percentage of patients improving ≥2 steps on the Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 48 using last observation carried forward (LOCF). The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).

Secondary Outcome Measures
NameTimeMethod
Percentage of Patients Developing Any Sight-Threatening ComplicationDay 1 to Week 48

Percentage of patients developing any of the following Sight-Threatening Complication: Proliferative Diabetic Retinopathy (PDR), Anterior segment neovascularization (ASNV), Vitreous hemorrhage or tractional retinal detachment believed to be due to PDR, or Diabetic Macular Edema (DME) from baseline through Week 48

Percentage of Patients Improving ≥3 Steps on DRSSDay 1 to Week 48

Percentage of patients improving ≥3 steps on the Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 48 using last observation carried forward (LOCF). The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).

Percentage of Patients Developing PDRDay 1 to Week 48

Percentage of patients developing Proliferative Diabetic Retinopathy (PDR) from baseline through Week 48

Percentage of Patients Developing PDR or ASNVDay 1 to Week 48

Percentage of patients developing Proliferative Diabetic Retinopathy (PDR) or Anterior segment neovascularization (ASNV) from baseline through Week 48

Percentage of Patients Developing Vitreous Hemorrhage or Tractional Retinal Detachment Believed to be Due to PDRDay 1 to Week 48

Percentage of patients developing vitreous hemorrhage or tractional retinal detachment believed to be due to Proliferative Diabetic Retinopathy (PDR) from baseline through Week 48

Percentage of Patients Developing DMEDay 1 to Week 48

Percentage of patients developing Diabetic Macular Edema (DME) from baseline through Week 48

Percentage of Patients With a ≥2-step or ≥3-step Worsening on DRSSDay 1 to Week 48

Percentage of patients with a ≥2-step or ≥3-step worsening on the Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 48 using last observation carried forward (LOCF). The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).

Percentage of Patients Who Lost ≥5, ≥10, or ≥15 Letters in BCVADay 1 to Week 48

Percentage of patients who lost ≥5, ≥10, or ≥15 letters in Best-corrected Visual Acuity (BCVA) from baseline by visit over time. Best Corrected Visual Acuity (BCVA) was measured on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters. The BCVA letter score ranges from 0 to 100 (best score), and a gain in BCVA letter score from baseline indicates an improvement in visual acuity.

Time to First Development of PDR, ASNV, or DMEDay 1 to Week 48

Time to first development of Proliferative Diabetic Retinopathy (PDR), Anterior segment neovascularization (ASNV), or Diabetic Macular Edema (DME) through Week 48

Time to First Development of PDR or ASNVDay 1 to Week 48

Time to first development of Proliferative Diabetic Retinopathy (PDR) or Anterior segment neovascularization (ASNV) through Week 48

Time to First Development of Vitreous Hemorrhage or Tractional Retinal Detachment Believed to be Due to PDRDay 1 to Week 48

Time to first development of vitreous hemorrhage or tractional retinal detachment believed to be due to Proliferative Diabetic Retinopathy (PDR) through Week 48

Trial Locations

Locations (61)

Charleston Neurosciences Institute

🇺🇸

Beaufort, South Carolina, United States

Retina Specialists of Idaho

🇺🇸

Boise, Idaho, United States

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Med Eye Associates

🇺🇸

Miami, Florida, United States

University of Chicago

🇺🇸

Chicago, Illinois, United States

Springfield Clinic LLP

🇺🇸

Springfield, Illinois, United States

MidAtlantic Retina

🇺🇸

Bethlehem, Pennsylvania, United States

Retina Research Institute of Texas

🇺🇸

Abilene, Texas, United States

Retina Consultants of San Antonio

🇺🇸

San Antonio, Texas, United States

Tennessee Retina PC

🇺🇸

Nashville, Tennessee, United States

Medical Center Ophthalmology Associates

🇺🇸

San Antonio, Texas, United States

Retina Associates PA

🇺🇸

Lenexa, Kansas, United States

Ophthalmic Consultants of Long Island

🇺🇸

Oceanside, New York, United States

Latvian American Eye Center

🇱🇻

Rīga, Latvia

Connecticut Eye Consultants

🇺🇸

Danbury, Connecticut, United States

Foundation for Vision Research

🇺🇸

Grand Rapids, Michigan, United States

Retina Group of New England

🇺🇸

Waterford, Connecticut, United States

Center for Retina & Macular Disease

🇺🇸

Winter Haven, Florida, United States

Envision Ocular LLC

🇺🇸

Bloomfield, New Jersey, United States

The Macula Center/ Blue Ocean Clinical Research

🇺🇸

Clearwater, Florida, United States

Retina Group of Florida

🇺🇸

Fort Lauderdale, Florida, United States

Cumberland Valley Retina Consultants PC

🇺🇸

Hagerstown, Maryland, United States

Pauls Stradins Clinical University Hospital

🇱🇻

Riga, Latvia

Sierra Eye Associates

🇺🇸

Reno, Nevada, United States

Optimum Profesorskie Centrum Okulistyki

🇵🇱

Gdansk, Pomorskie, Poland

Southeastern Retina Associates PC

🇺🇸

Knoxville, Tennessee, United States

Charles Retina Institute

🇺🇸

Memphis, Tennessee, United States

Florida Eye Associates

🇺🇸

Melbourne, Florida, United States

Fakultna nemocnica s poliklinikou F. D. Roosevelta

🇸🇰

Banska Bystrica, Slovakia

Fakultna nemocnica Trencin

🇸🇰

Trencin, Slovakia

Charleston Neuroscience Center

🇺🇸

Charleston, South Carolina, United States

Cascade Medical Research Institute

🇺🇸

Eugene, Oregon, United States

Warszawski Szpital Okulistyczny

🇵🇱

Warszawa, Mazowieckie, Poland

Oftalmika Sp. z o.o.

🇵🇱

Bydgoszcz, Poland

Emanuelli Research & Development Center LLC

🇵🇷

Arecibo, Puerto Rico

Hospital Universitario de Bellvitge

🇪🇸

L'hospitalet de Llobregat, Barcelona, Spain

Hospital Universitari General de Catalunya - Grupo Quironsalud

🇪🇸

Sant Cugat del Valles, Barcelona, Spain

Retinal Research Institute, LLC

🇺🇸

Phoenix, Arizona, United States

Retina Consultants of Southern California

🇺🇸

Redlands, California, United States

California Retina Consultants - Santa Maria

🇺🇸

Santa Maria, California, United States

Retina Consultants of Orange County

🇺🇸

Fullerton, California, United States

Retina Vitreous Associates

🇺🇸

Beverly Hills, California, United States

Southeast Retina Center

🇺🇸

Augusta, Georgia, United States

Graystone Eye

🇺🇸

Hickory, North Carolina, United States

Long Island Vitreoretinal Consultants

🇺🇸

Hauppauge, New York, United States

Austin Retina Associates

🇺🇸

Austin, Texas, United States

Retina Consultants of Texas (Katy)

🇺🇸

Katy, Texas, United States

Austin Retina Associates (Round Rock)

🇺🇸

Round Rock, Texas, United States

Retina Consultants of Texas (Houston)

🇺🇸

Bellaire, Texas, United States

Panhandle Eye Group, LLP

🇺🇸

Amarillo, Texas, United States

Star Vision Consultants

🇺🇸

Burleson, Texas, United States

Texas Retina Associates

🇺🇸

Plano, Texas, United States

Retina Consultants of Texas - (Woodlands)

🇺🇸

The Woodlands, Texas, United States

OFTEX s.r.o.

🇨🇿

Pardubice, Pardubický Kraj, Czechia

Piedmont Eye Center

🇺🇸

Lynchburg, Virginia, United States

Axon Clinical, s.r.o.

🇨🇿

Praha 5, Czechia

Spokane Eye

🇺🇸

Spokane, Washington, United States

Hospital Universitario Puerta de Hierro - Majadahonda

🇪🇸

Madrid, Majadanonda, Spain

Hospital Clinico Universitario Lozano Blesa

🇪🇸

Zaragoza, Spain

Retinal Consultants Medical Group Inc

🇺🇸

Sacramento, California, United States

Florida Retina Institute

🇺🇸

Orlando, Florida, United States

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