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Comparing Alternative Ranibizumab Dosages for Safety and Efficacy in Retinopathy of Prematurity

Phase 2
Completed
Conditions
Retinopathy of Prematurity (ROP)
Interventions
Biological: ranibizumab
Registration Number
NCT02134457
Lead Sponsor
University Hospital Freiburg
Brief Summary

This study is designed as an exploratory study to assess safety and efficacy of two different doses of the anti-VEGF agent ranibizumab (0.12 mg vs. 0.20 mg) in the treatment of infants with retinopathy of prematurity. Furthermore it shall help to improve safety in the treatment of ROP and provide explorative data on long-term effects of ranibizumab after intravitreal injection in neonates.

The primary objective is to assess clinical efficacy of ranibizumab in children with ROP

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
19
Inclusion Criteria
  • Bilateral ROP in zone I (stage 1+, 2+, 3+/-, AP-ROP) or ROP in central (=posterior) zone II (stage 3+, AP-ROP). Zone I is defined as twice the distance from the optic disc to the fovea measured temporally, posterior zone II is defined as three times the distance from the optic disc to the fovea measured temporally.
  • Legal representatives or their designates willing and able to attend regular study visits with the study infant.
  • Written informed consent to participate in the study (signed by all patient's legal representatives).
Exclusion Criteria
  • Pediatric conditions rendering the infant ineligible to anti-VEGF treatment or to repeated blood draws as evaluated by a neonatal ICU specialist and a study ophthalmologist.
  • Congenital brain lesions significantly impairing optic nerve function.
  • Severe hydrocephalus with significantly increased intracranial pressure.
  • Advanced stages of ROP with partial or complete retinal detachment (ROP stage 4 and 5).
  • ROP involving only the peripheral retina (i.e. peripheral zone II or zone III).
  • Known hypersensitivity to the study drug or to drugs with similar chemical structures.
  • Contraindications for an intravitreal injection as listed in ranibizumab SmPC.
  • Systemic use of anti-VEGF therapeutics.
  • Use of other investigational drugs - excluding vitamins and minerals - at the time of enrollment, or within 30 days or 5 half-lives prior to enrollment, whichever is longer.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ranibizumab 0.12 mgranibizumab20 µl of the 6 mg/ml ranibizumab concentration will be applied intravitreally. After an initial response the same dose as in the first injection can be re-applied after at least four weeks post injection. A maximum number of 3 regular re-injections can be applied.
Ranibizumab 0.20 mgranibizumab20 µl of the 10 mg/ml ranibizumab concentration will be applied intravitreally. After an initial response the same dose as in the first injection can be re-applied after at least four weeks post injection. A maximum number of 3 re-injections can be applied.
Primary Outcome Measures
NameTimeMethod
Efficacy of treatmentUp to 24 weeks post first injection

Efficacy is determined by the number of infants without need for rescue treatment up to week 24 post first injection.

Re-injection of study dose is not considered rescue treatment if applied after an initial response to treatment and after at least 4 weeks post injection.

Secondary Outcome Measures
NameTimeMethod
Progression of peripheral intraretinal vascularization beyond ridgeUp to 24 weeks post first injection
Number and kind of AEs and SAEsUp to 24 weeks post first injection
Number of re-injections of study doseUp to 24 weeks post first injection
Number of patients with complete vascularization of the peripheral retina to within one disc diameter of the ora serrataUp to 24 weeks post first injection
Regression of plus diseaseUp to 24 weeks post first injection
Regression of preretinal vascularized ridgeUp to 24 weeks post first injection
Number of patients progressing to stage 4 or 5 ROPUp to 24 weeks post first injection
Changes in vascular endothelial growth factor (VEGF) levels in the systemic circulationUp to 24 weeks post first injection

Trial Locations

Locations (1)

University Eye Hospital

🇩🇪

Tuebingen, Germany

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