Clinical Study to Compare Efficacy and Safety of AVT06 and EU-Eylea (ALVOEYE)

Phase 1

• Conditions: eovascular (wet) Age-related Macular Degeneration; MedDRA version: 20.0Level: PTClassification code 10071129Term: Neovascular age-related macular degenerationSystem Organ Class: 10015919 - Eye disorders; Therapeutic area: Diseases [C] - Eye Diseases [C11]

• Registration Number: EUCTR2021-003651-42-LT
• Lead Sponsor: Alvotech Swiss AG

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2022-08-16
• Last Update Posted: 18 September 2023

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: All
• Target Recruitment: 690

Inclusion Criteria

Age
• Subject must be =50 years of age, at the time of signing the informed consent.

Study Eye
• Subjects must be diagnosed with neovascular (wet) AMD in the study eye.
• Subjects must have active, treatment naïve, subfoveal CNV lesions secondary to neovascular (wet) AMD, including juxtafoveal lesions with foveal involvement (demonstrated by leakage on FA and/or intraretinal fluid or subretinal fluid on SD-OCT) in the study eye at screening.
• Subjects with total lesion area =9.0 Disc Areas in size (including blood, scars [not involving the center of the fovea], and neovascularization) in the study eye at screening.
• Subjects with active CNV area must occupy at least 50% of total lesion in the study eye.
• Subjects with BCVA of 20/40 to 20/200 (between 73 and 34 letters inclusive), in the study eye as assessed by ETDRS letter score at screening and on Day 1 prior to randomization.
• Presence of intra and/or subretinal fluid as identified in the center subfield by SD-OCT attributable to active CNV in the study eye at screening.
• Subjects with central retinal thickness of =300 µm in the study eye as determined by SD OCT at screening.
Sex
Male or female
a) Male subjects:
• A male subject must agree to use contraception as detailed in Appendix 6 of this protocol during the treatment period and for at least 3 months after the last intravitreal injection of study treatment and refrain from donating sperm during this period.
b) Female subjects:
• A female subject is eligible to participate if she is not pregnant (see Appendix 6), not breastfeeding, not intending to become pregnant during the treatment period and for at least 3 months after the last intravitreal injection of study treatment, and at least 1 of the following conditions applies:
i) Not a woman of childbearing potential (WOCBP) as defined in Appendix 6.
OR
ii) A WOCBP who agrees to follow the contraceptive guidance in Appendix 6 during the treatment period and for at least 3 months after the last intravitreal injection of study treatment.
Informed Consent
Capable of giving signed informed consent as described in Appendix 2, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

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 200
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 490

Exclusion Criteria

Study Eye
• Scar, fibrosis, or atrophy involving the center of the fovea in the study eye.
History of retinal detachment in the study eye.
Presence of RPE tears involving the macula in the study eye.
History of any vitreous hemorrhage within 4 weeks before randomization in the study eye.
Prior vitrectomy or laser surgery of the macula (including photodynamic therapy or focal laser photocoagulation) in the study eye.
Uncontrolled ocular hypertension (defined as IOP =25 mmHg despite treatment with anti glaucoma medication) at screening and randomization visits in the study eye.
Any history of macular hole in the study eye.
Any concurrent macular abnormality other than wet AMD which could affect central vision or the efficacy of the study treatment in the study eye.
Aphakia or absence of the posterior capsule (unless it occurred as a result of a posterior capsulotomy with neodymium doped yttrium aluminium garnet [YAG] laser following cataract surgery with intraocular lens implantation) in the study eye.
Significant media opacities, including cataract or inadequate pupil dilatation, which might interfere with visual acuity or assessment of safety in the study eye.
History of corneal transplant, corneal dystrophy, or corneal ectasia (such as either keratoconus or keratoglobus) in the study eye.
Subjects with previous ocular (intraocular and peribulbar) corticosteroids injection/implant within 1 year in the study eye prior to randomization.
Topical ocular corticosteroids for 30 or more consecutive days within 90 days prior to randomization in the study eye.
Previous therapeutic radiation in the region of the study eye.
Any prior ocular treatment, including surgery or another investigational product for neovascular AMD (including anti-VEGF therapy), in the study eye, except dietary supplements or vitamins.
Concurrent ocular condition which, in the opinion of the Investigator, could require medical or surgical intervention during the study period and/or confound the interpretation of the study results.
Either Eye
History or clinical evidence of uveitis, diabetic retinopathy, diabetic macular edema, or any other vascular disease affecting the retina, other than neovascular AMD.
Active or suspected ocular or periocular infection, within 2 weeks before randomization.
Active scleritis or episcleritis or presence of scleromalacia.
Fellow Eye
Any ocular treatment, including surgery or another investigational product for neovascular AMD (including anti-VEGF treatment), in the fellow eye, within 6 months before randomization, except dietary supplements or vitamins.
Subjects with BCVA of 20/200 or less (34 letters or less) in the fellow eye as assessed by ETDRS letter score at screening and on Day 1 prior to randomization.
Subjects with any diagnosis and/or signs of neovascular AMD requiring intravitreal anti VEGF in the fellow eye, or in the opinion of the Investigator, are expected to require such treatments before the evaluation of the primary efficacy endpoint (ie, Week 8) and completion of PK sampling (ie, Week 12) for the subjects in the PK sub-study.
Other
Any prior systemic treatment with anti-VEGF therapy.
History of hypersensitivity or anaphylaxis to study treatments (including any excipient), and/or history of hypersensitivity to fluorescein sodium for injection in angiography or to any other compound used for the study procedures.
Prior treatment with any investigational drugs within 30 days or 5 half-lives (whichever is longer) of the pr

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: To demonstrate the equivalent efficacy of AVT06 to Eylea in subjects with neovascular (wet) age-related macular degeneration (AMD);Secondary Objective: • To evaluate the efficacy of AVT06 compared with Eylea in subjects with neovascular (wet) AMD.<br>• To evaluate the safety and tolerability of AVT06 compared with Eylea.<br>• To assess immunogenicity of AVT06 compared with Eylea.<br>• To evaluate the systemic PK of AVT06 and Eylea in a subset of subjects.;Primary end point(s): • Change from baseline to Week 8 in BCVA as measured by ETDRS letter score.;Timepoint(s) of evaluation of this end point: From baseline to Week 8 in BCVA as measured by ETDRS letter score.