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Aflibercept After Ranibizumab in Exudative Age-related Macular Degeneration

Phase 3
Completed
Conditions
Eye Diseases
Retinal Degeneration
Retinal Diseases
Macular Degeneration
Wet Macular Degeneration
Interventions
Registration Number
NCT02157077
Lead Sponsor
Centre Hospitalier Intercommunal Creteil
Brief Summary

The purpose of the current study is to evaluate the ability of Eylea to induce a regression of PED height on patients previously extensively treated by Lucentis.

The regimen proposed for this study is the 3 monthly injection followed by a 6 weeks interval injection until week 26.

Detailed Description

The regimen proposed for this study is the 3 monthly injection followed by a 6 weeks interval injection until week 26.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Men and women ≥ 50 years of age
  • Active primary subfoveal choroidal neovascularization (CNV) lesions secondary to AMD including juxtafoveal lesions that affect the fovea evidenced by Fluorescein Angiography in the study eye
  • Patient having been treated for at least 12 months with Ranibizumab (≥ 8 injections)
  • Patient with a PED > 250 µm, defined by spectral domain optical coherent tomography (SD-OCT), measured at two consecutive visits before inclusion with any persisting sub retinal fluid at baseline
  • Patient affiliated to a social security scheme
  • Signed Informed Consent
Exclusion Criteria
  • Patient with subfoveal atrophy and/or atrophy with a diameter greater than 150µm in the subfoveal or juxtafoveal area
  • Patient with a subfoveal fibrosis
  • Subretinal hemorrhage that is either 50 percent or more of the total lesion area or 1 or more disc areas in size in the study eye.
  • Scar, fibrosis or atrophy making up > 50% of total lesion in the study eye.
  • Presence of retinal pigment epithelial tears or rips involving the macula in the study eye.
  • History of any vitreous hemorrhage within 4 weeks prior to Visit 1 in the study eye.
  • Presence of other causes of choroidal neovascularization, including pathologic myopia (spherical equivalent of -8 diopters or more negative, or axial length of 25mm or more), ocular histoplasmosis syndrome, angioid streaks, choroidal rupture, or multifocal choroiditis in the study eye or clinical evidence of diabetic retinopathy, diabetic macular edema or any retinal vascular disease other than AMD in either eye.
  • Any history of macular hole of stage 3 and above in the study eye.
  • Uncontrolled glaucoma (defined as intraocular pressure ≥25 mmHg despite treatment with antiglaucoma medication) or prior laser treatment for glaucoma in the study eye.
  • Active intraocular inflammation or uveitis of scleritis or episcleritis in the study eye or ocular or periocular infection in either eye
  • Presence or history of scleromalacia in the study eye.
  • Aphakia or pseudophakia with absence of posterior capsule (unless it occurred as a result of a yttrium aluminum garnet (YAG) posterior capsulotomy) in the study eye.
  • Previous therapeutic radiation in the study eye.
  • History of corneal transplant or corneal dystrophy in the study eye.
  • Significant media opacities, including cataract, in the study eye which might interfere with visual acuity, assessment of toxicity, or fundus photography.
  • Any concurrent intraocular condition in the study eye (e.g. cataract) that, in the opinion of the investigator, could require either medical or surgical intervention during the 24 month study period.
  • Any concurrent ocular condition in the study eye which, in the opinion of the investigator, could either increase the risk to the subject beyond what is to be expected from standard procedures of intraocular injection, or which otherwise may interfere with the injection procedure or with evaluation of efficacy or safety.
  • Any systemic treatment with an investigational agent except dietary supplements or vitamins in the past 6 months prior to Day 1 for any condition.
  • Any history of allergy to povidone iodine.
  • Contraindications as listed
  • Patient enrolled in another interventional research or not
  • Patient already included in the study for the treatment of one of his eye
  • Pregnant or nursing woman
  • Lack of effective contraception for women of childbearing age

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AfliberceptAfliberceptPatients will receive 2 mg of aflibercept by intravitreal injection every 4 weeks until week 8, followed by every 6 weeks to week 26
Primary Outcome Measures
NameTimeMethod
Change from baseline in maximal height of pigment epithelium detachment (PED) at 12 weeksBaseline and 12 weeks
Secondary Outcome Measures
NameTimeMethod
Change from Baseline in visual acuity at 32 weeksBaseline and 32 weeks
Change from Baseline in volume of pigment epithelium detachment at 32 weeksBaseline and 32 weeks
Change from Baseline in visual acuity at 12 weeksBaseline and 12 weeks
Association with genes involved in AMD historygenetic testing will be performed when all the particpitants will be recruited
Change from baseline in central retinal thickness by SD OCT at 12 weeksBaseline and 12 weeks
Number of participants with adverse events from baseline to 32 weeksfrom baseline to 32 weeks
Change from Baseline in volume of pigment epithelium detachment at 12 weeksBaseline and 12 weeks
Change from Baseline in pigment epithelium detachment height at 12 weeksBaseline and 12 weeks
Change from Baseline in pigment epithelium detachment height at 32 weeksBaseline and 32 weeks
Change from baseline in central retinal thickness at 32 weeksbaseline and 32 weeks

Trial Locations

Locations (9)

Cabinet Alpes Rétine

🇫🇷

Montbonnot-Saint-Martin, France

CHR Hôtel Dieu

🇫🇷

Nantes, France

Hôpital Pellegrin

🇫🇷

Bordeaux, France

Centre Hospitalier Intercommunal de Créteil

🇫🇷

Créteil, France

Hôpital général de Dijon

🇫🇷

Dijon, France

Clinique Mathilde

🇫🇷

Rouen, France

Centre d'Ophtalmologie Rabelais

🇫🇷

Lyon, France

Centre d'explorations ophtalmologiques de l'odéon

🇫🇷

Paris, France

Hôpital des Quinze-Vingts

🇫🇷

Paris, France

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