A Study Assessing Corneal Endothelial Cells in Participants With Neovascular Age-related Macular Degeneration(nAMD) Treated With the Port Delivery System With Ranibizumab (PDS)
- Conditions
- Neovascular Age-related Macular Degeneration
- Interventions
- Device: SUSVIMO PDS Implant
- Registration Number
- NCT04853251
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This study will assess corneal endothelial cells in participants with nAMD treated with PDS refilled every 24 weeks (Q24W).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 188
-
Initial diagnosis of nAMD within 18 months prior to screening
-
Difference of <10% in ECD at screening between the 2 eyes as measured by specular microscopy and determined by the independent reading center
-
Availability of historical visual acuity (VA) data and spectral-domain optical coherence tomography (SD-OCT) imaging prior to the first anti-vascular endothelial growth factor (VEGF) intravitreal therapy (IVT) treatment for nAMD
-
Availability of comprehensive historical anti-VEGF injection data including anti-VEGF agent administered and date of administration from the first anti-VEGF treatment for nAMD
-
Demonstrated response to at least two anti-VEGF IVT injections since diagnosis, as evidenced by the following:
- Overall decrease in nAMD disease activity detected on historical or screening OCT as assessed by the investigator and confirmed by the central reading center AND
- Stable or improved BCVA
-
Best-corrected visual acuity (BCVA) of 34 letters (approximate 20/200 Snellen equivalent) or better, using Early Treatment of Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters at screening and enrollment
-
All subtypes of nAMD lesions are permissible
-
nAMD lesions at the time of diagnosis must involve the macula (6 millimetres (mm) diameter centered at the fovea)
-
Sufficiently clear ocular media and adequate pupillary dilation to allow for clinical examination and analysis and grading by the central reading center of SD-OCT images
Exclusion Criteria
Prior Ocular Treatment
Study Eye:
- Prior treatment with verteporfin for injection, external-beam radiation therapy, or transpupillary thermotherapy
- Previous treatment with corticosteroid IVT injection
- Previous laser (any type) used for age related macular degeneration (AMD) treatment
- History of vitreous hemorrhage
- History of rhegmatogenous retinal detachment
- History of corneal transplant
- History of conjunctival surgery in the superotemporal quadrant
Either Eye:
- Previous PDS implantation
- Previous intraocular surgery (including cataract surgery) within 6 months of study enrollment
- Prior pars plana vitrectomy surgery
- Previous intraocular device implantation excluding intraocular lenses
- History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery
- Intraocular laser therapy including selective laser trabeculoplasty, yttrium-aluminum garnet (YAG), prophylactic peripheral iridotomy within 1 year of screening, or YAG capsulotomy within 3 months of screening
- Contact lens wear in either eye within 2 months of screening
- Any prior ocular trauma (blunt or penetrating)
- History of corneal transplantation, including partial-thickness corneal grafts
- Prior treatment with brolucizumab
- Prior treatment with any anti-VEGF biosimilar agents within 2 months of screening
- Prior treatment with faricimab within 2 months of screening
- Prior treatment with aflibercept 8 mg within 2 months of screening
- Prior treatment with external-beam radiation therapy or brachytherapy
Macular Neovascularization Lesion (MNV) Characteristics
Study Eye:
- Subretinal hemorrhage that involves the center of the fovea, if the hemorrhage is greater than 0.5-disc area (1.27 square millimitres (mm^2)) in size at screening
- Subfoveal fibrosis or subfoveal atrophy
Concurrent Ocular Conditions
Study Eye:
- Retinal pigment epithelial tear
- Retinal tears or peripheral retinal breaks on depressed fundus exam that are untreated, or treated within the 3 months prior to study enrollment
- Previous violation of the posterior capsule is also an exclusion criterion unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
- Spherical equivalent of the refractive error demonstrating more than 8 diopters of myopia or evidence of pathologic myopia on depressed fundus exam
- Preoperative refractive error that exceeds 8 diopters of myopia, for participants who have undergone prior refractive or cataract surgery
- Spherical equivalent of the refractive error demonstrating more than 5 diopters of hyperopia
- Preoperative refractive error that exceeds 5 diopters of hyperopia, for participants who have undergone prior refractive or cataract surgery
- Uncontrolled ocular hypertension or glaucoma
- Scleral pathology in the superotemporal quadrant (e.g., scleral thinning or calcification)
- Conjunctival pathologies in the superotemporal quadrant
- History or presence of severe posterior blepharitis, recurrent chalazia or hordeolum, severe dry eye syndrome, or severe allergic conjunctivitis
- Ectropion, entropion or other impairment of the upper or lower eyelid impacting lid functionality needed to protect the ocular surface from exposure
- Trichiasis
- Corneal neuropathy
- Lagophthalmos or incomplete blink • Active or history of facial nerve palsy/paresis
Fellow (Non-Study) Eye:
• Concurrent PDS implantation
Either Eye:
- Aphakia or absence of the posterior capsule
- Any concurrent intraocular condition that would either require surgical intervention during the study to prevent or treat visual loss that might result from that condition or affect interpretation of study results
- Corneal ECD ≤1500 cells/mm2 in either eye at screening as determined by the independent reading center
- Fuchs endothelial corneal dystrophy Grade ≥ 2
- Previous corneal endothelial cell damage, including from blunt or surgical trauma
- Any ocular condition that precludes obtaining an analyzable specular microscopy image
- Active or history of corneal edema
- Active or history of corneal dystrophies
- Active or history of iridocorneal endothelial syndrome
- Active or history of pseudoexfoliation syndrome
- Active or history of herpetic keratitis or kerato-uveitis
- Any active or history of uveitis
- Active or history of keratitis, scleritis, or endophthalmitis
- Active ocular or periocular infection
- Active or history of Sjogren's syndrome or keratoconjunctivitis sicca
- Active or history of floppy eyelid syndrome
- Active or history of chronic eye rubbing
- Active thyroid eye disease
Concurrent Systemic Conditions:
- Uncontrolled blood pressure
- Active or history of autoimmune diseases such as rheumatoid arthritis, lupus, granulomatosis with polyangiitis (Wegner's), etc.
- History of stroke within the last 3 months prior to screening
- Uncontrolled atrial fibrillation within 3 months of screening
- History of myocardial infarction within the last 3 months prior to screening
- History of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the implant and that might affect interpretation of the results of the study or renders the patient at high risk of treatment complications, in the opinion of the investigator
- Current active systemic infection
- Use of any systemic anti-VEGF agents
- Chronic use of oral corticosteroids
- Active cancer within 12 months of enrollment except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, and prostate cancer with a Gleason score of ≤ 6 and a stable prostate-specific antigen for > 12 months
- Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month prior to screening (excluding vitamins and minerals)
- Use of antimitotic or antimetabolite therapy within 30 days or 5 elimination half-lives of the screening visit
- Pregnant or breastfeeding, or intention to become pregnant during the study
- Women of childbearing potential, must have a negative urine pregnancy test result within 28 days prior to initiation of study treatment. If the urine pregnancy test is positive, it must be confirmed by a serum pregnancy test.
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description SUSVIMO SUSVIMO PDS Implant Participants will have the implant (filled prior to implantation with approximately 20 microlitres (uL) of the 100 milligrams/millilitres (mg/ml) formulation of ranibizumab \[approximately 2 milligrams (mg) dose of ranibizumab\]) surgically inserted in the study eye at the Day 1 visit following their enrollment visit. After the initial fill of the implant with ranibizumab, participants will receive implant refill-exchanges at fixed Q24W intervals. SUSVIMO LUCENTIS (ranibizumab injection) Participants will have the implant (filled prior to implantation with approximately 20 microlitres (uL) of the 100 milligrams/millilitres (mg/ml) formulation of ranibizumab \[approximately 2 milligrams (mg) dose of ranibizumab\]) surgically inserted in the study eye at the Day 1 visit following their enrollment visit. After the initial fill of the implant with ranibizumab, participants will receive implant refill-exchanges at fixed Q24W intervals.
- Primary Outcome Measures
Name Time Method Percent Change in Corneal Endothelial Cell Density (ECD) From Baseline at Week 48 in the Study Eye as Compared With the Fellow Eye, as Assessed by Specular Microscopy Baseline, Week 48
- Secondary Outcome Measures
Name Time Method Duration of Ocular AESIs Day 1 to Week 52 Percentage of Participants With Ocular AESIs During the Postoperative Period Baseline up to 37 days of initial implantation Percentage of Participants With Ocular AESIs During the Intermediate Postoperative Period 38 to 93 days after implantation Percent Change in Corneal ECD From Baseline at Week 24 in the Study Eye as Compared With the Fellow Eye Baseline, Week 24 Percent Change in the Coefficient of Variation (CV) of Corneal Endothelial Cell Area From Baseline at Weeks 24 and 48 in the Study Eye as Compared With the Fellow Eye Baseline, Week 24, Week 48 Percent Change in Hexagonal Cells (HEX) From Baseline at Weeks 24 and 48 in the Study Eye as Compared With the Fellow Eye Baseline, Week 24, Week 48 Percentage of Participants With Ocular Serious Adverse Events (SAEs) and Severity of SAEs Day 1 up to approximately Week 52 Percentage of Participants With Ocular Adverse Events of Special Interests (AESIs) and Severity of Ocular AESIs Day 1 to Week 52 Percentage of Participants With Ocular AESIs During the Follow-up Period Week 52 The investigator will follow each adverse event (AE) until the event has resolved to baseline grade or better, the event is assessed as stable by the investigator, the participant is lost to follow-up, or the participant withdraws consent.
Percentage of Participants With Adverse Device Effects (ADEs) Day 1 to Week 52 Number of Participants with Anticipated Serious Adverse Device Effects (ASADEs) and Severity of ASADEs Day 1 to Week 52 Duration of ASADEs Day 1 to Week 52
Trial Locations
- Locations (49)
Barnet Dulaney Perkins Eye Center
🇺🇸Mesa, Arizona, United States
California Retina Consultants
🇺🇸Bakersfield, California, United States
Retina Associates of Southern California
🇺🇸Huntington Beach, California, United States
California Eye Specialists Medical group Inc.
🇺🇸Pasadena, California, United States
Retinal Consultants Med Group
🇺🇸Sacramento, California, United States
Advanced Vision Research Institute
🇺🇸Longmont, Colorado, United States
University of California San Francisco
🇺🇸San Francisco, California, United States
Orange County Retina Med Group
🇺🇸Santa Ana, California, United States
Macula Retina Vitreous Research Institute
🇺🇸Torrance, California, United States
Southwest Retina Consultants
🇺🇸Durango, Colorado, United States
Retina Group of New England
🇺🇸Waterford, Connecticut, United States
Retina Specialty Institute
🇺🇸Pensacola, Florida, United States
Ft Lauderdale Eye Institute
🇺🇸Plantation, Florida, United States
Retina Vitreous Associates of Florida
🇺🇸Saint Petersburg, Florida, United States
Southeast Retina Center
🇺🇸Augusta, Georgia, United States
University Retina and Macula Associates, PC
🇺🇸Lemont, Illinois, United States
Wolfe Eye Clinic
🇺🇸West Des Moines, Iowa, United States
Retina Associates of Kentucky
🇺🇸Lexington, Kentucky, United States
Maine Eye Center
🇺🇸Portland, Maine, United States
The Retina Care Center
🇺🇸Baltimore, Maryland, United States
Wilmer Eye Institute Johns Hopkins University
🇺🇸Baltimore, Maryland, United States
Retina Group of Washington
🇺🇸Chevy Chase, Maryland, United States
Cumberland Valley Retina Consultants PC
🇺🇸Hagerstown, Maryland, United States
Associated Retinal Consultants PC
🇺🇸Royal Oak, Michigan, United States
Seeta Eye Centers
🇺🇸Poughkeepsie, New York, United States
VitreoRetinal Surgery, PLLC.
🇺🇸Minneapolis, Minnesota, United States
Midwest Vision Research Foundation
🇺🇸Chesterfield, Missouri, United States
Sierra Eye Associates
🇺🇸Reno, Nevada, United States
Envision Ocular, LLC
🇺🇸Bloomfield, New Jersey, United States
Western Carolina Retinal Associate PA
🇺🇸Asheville, North Carolina, United States
Duke Eye Center
🇺🇸Durham, North Carolina, United States
Fargo Retina Consultants
🇺🇸Fargo, North Dakota, United States
Cincinnati Eye Institute
🇺🇸Blue Ash, Ohio, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Tulsa Retina Consultants
🇺🇸Tulsa, Oklahoma, United States
Erie Retina Research
🇺🇸Erie, Pennsylvania, United States
Mid Atlantic Retina
🇺🇸Philadelphia, Pennsylvania, United States
Palmetto Retina Center
🇺🇸Florence, South Carolina, United States
Palmetto Retina Center, LLC
🇺🇸West Columbia, South Carolina, United States
Charles Retina Institute
🇺🇸Germantown, Tennessee, United States
Tennessee Retina PC
🇺🇸Nashville, Tennessee, United States
Panhandle Eye Group LLP Southwest Retina Specialists
🇺🇸Amarillo, Texas, United States
Austin Retina Associates
🇺🇸Austin, Texas, United States
Retina Consultants of Texas
🇺🇸Schertz, Texas, United States
Retina Associates of Utah, PLLC
🇺🇸Salt Lake City, Utah, United States
Piedmont Eye Center
🇺🇸Lynchburg, Virginia, United States
Wagner Kapoor Institute
🇺🇸Norfolk, Virginia, United States
Retina Institute of Virginia
🇺🇸Richmond, Virginia, United States
Spokane Eye Clinical Research
🇺🇸Spokane, Washington, United States