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Comparison of Age-related Macular Degeneration Treatments Trials: Lucentis-Avastin Trial

Phase 3
Completed
Conditions
Age Related Macular Degeneration
Interventions
Registration Number
NCT00593450
Lead Sponsor
University of Pennsylvania
Brief Summary

The purpose of the study is to evaluate the relative efficacy and safety of treatment of neovascular AMD with Lucentis on a fixed schedule, Avastin on a fixed schedule, Lucentis on a variable schedule, and Avastin on a variable schedule.

A five year follow-up visit is being conducted in 2014 to gather information on long term outcomes.

Detailed Description

Age related macular degeneration (AMD) is the leading cause of severe vision loss in people over the age of 65 in the United States and other Western countries. More than 1.6 million people in the US currently have one or both eyes affected by the advanced stage of AMD.

Lucentis® is the most effective treatment for neovascular AMD studied to date. Bevacizumab (Avastin®) and Lucentis® are derived from the same monoclonal antibody. Following the encouraging clinical trial results with Lucentis®, several investigators began evaluating intravitreal Avastin® for the treatment of CNV. Given its molecular similarity to Lucentis, its low cost, and its availability, the interest in Avastin® has been considerable. Avastin® has not been evaluated relative to Lucentis®.

In addition, previous studies do not answer the question of whether a reduced dosing schedule is as effective as a fixed schedule of monthly injections. Treatment dependent on clinical response has the potential to reduce the treatment burden to patients as well as to reduce the overall cost of therapy.

Only a single eye in each patient was analyzed.

At the five year follow-up visit, the subjects will undergo the same examinations and procedures as in the original study; however, the five year follow-up visit deos not involve any study treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1208
Inclusion Criteria
  • Active, subfoveal choroidal neovascularization (CNV)
  • Fibrosis < 50% of total lesion area
  • Visual acuity (VA) 20/25-20/320
  • Age ≥ 50 yrs
  • At least 1 drusen (>63μ) in either eye or late AMD in fellow eye
Exclusion Criteria
  • Previous treatment for CNV in study eye
  • Other progressive retinal disease likely to compromise VA
  • Contraindications to injections with Lucentis or Avastin

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
3ranibizumabLucentis® on a variable dosing schedule for 2 years; i.e., after initial treatment, monthly evaluation for treatment based on signs of lesion activity.
1ranibizumabLucentis® on a fixed schedule of every 4 weeks for 1 year; at 1 year, re-randomization to Lucentis® every 4 weeks or to variable dosing.
2bevacizumabAvastin® on a fixed schedule of every 4 weeks for 1 year; at 1 year, re-randomization to Avastin® every 4 weeks or to variable dosing.
4bevacizumabAvastin® on a variable dosing schedule for 2 years; i.e., after initial treatment, monthly evaluation for treatment based on signs of lesion activity.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Visual-acuity Score (Continuous)Baseline and 1 Year

Visual acuity testing was performed with the Electronic Visual Tester (EVA) following the ETDRS protocol. VA score is measured as number of letters read correctly. The VA score change is the difference of the VA score at 1 Year and the VA score at baseline.

In this study, the outcome VA score change is ranged from -71 to 52, with the higher VA score change the better visual acuity improvement.

Secondary Outcome Measures
NameTimeMethod
Number of Treatments1 Year

Cumulative over the 1 year of trial

Visual-acuity Score and Snellen Equivalent (Frequency)at 1 Year
Visual-acuity Score and Snellen Equivalent (Continuous)at 1 Year

Visual acuity testing was performed with the Electronic Visual Tester (EVA) following the ETDRS protocol. VA score is measured as number of letters read correctly.

In this study, the outcome VA score is ranged from 0 to 97, with the higher score the better visual acuity.

Change in Diastolic Blood Pressure From BaselineBaseline and 1 Year
Change From Baseline Visual-acuity Score (Frequency)Baseline and 1 Year
Total Thickness Change From Baseline at FoveaBaseline and 1 Year
Retinal Thickness Plus Subfoveal-fluid Thickness Change From Baseline at FoveaBaseline and 1 Year
Fluid on Optical Coherence Tomographyat 1 Year
Average Cost of Drug/Patientat 1 Year
Total Thickness at Foveaat 1 Year
Area of Lesionat 1 Year
Retinal Thickness Plus Subfoveal-fluid Thickness at Foveaat 1 Year
Change in Systolic Blood Pressure From BaselineBaseline and 1 Year
Dye Leakage on Angiogramat 1 Year
Area of Lesion Change From BaselineBaseline and 1 Year

Trial Locations

Locations (51)

Retina Consultants of Arizona

🇺🇸

Mesa, Arizona, United States

Retinal Consultants of Arizona

🇺🇸

Phoenix, Arizona, United States

Retina Associates Southwest, P.C.

🇺🇸

Tucson, Arizona, United States

California Retina Consultants

🇺🇸

Bakersfield, California, United States

Retina-Vitreous Associates Medical Group

🇺🇸

Beverly Hills, California, United States

University of California-Davis Medical Center

🇺🇸

Sacramento, California, United States

Retinal Consultants Medical Group, Inc.

🇺🇸

Sacramento, California, United States

West Coast Retina Medical Group, Inc.

🇺🇸

Walnut Creek, California, United States

California Retinal Consultants

🇺🇸

Santa Barbara, California, United States

Colorado Retina Associates

🇺🇸

Denver, Colorado, United States

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Retina Consultants of Arizona
🇺🇸Mesa, Arizona, United States

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