A Study of Ranibizumab Administered Monthly or on an As-needed Basis in Patients With Subfoveal Neovascular Age-related Macular Degeneration (HARBOR) (HARBOR)
A Phase III, Double-masked, Multicenter, Randomized, Active Treatment-controlled Study of the Efficacy and Safety of 0.5 mg and 2.0 mg Ranibizumab Administered Monthly or on an As-needed Basis (PRN) in Patients With Subfoveal Neovascular Age-related Macular Degeneration
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Arizona
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Phoenix, Arizona, United States, 85020
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Tucson, Arizona, United States, 85704
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California
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Arcadia, California, United States, 91007
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Beverly Hills, California, United States, 90211
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Campbell, California, United States, 95008
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Chico, California, United States, 95973
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La Jolla, California, United States, 92093-0946
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Los Angeles, California, United States, 90033
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Los Angeles, California, United States, 90095-7000
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Mountain View, California, United States, 94040
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Oakland, California, United States, 94609
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Palm Desert, California, United States, 92211
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Poway, California, United States, 92064
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Sacramento, California, United States, 95817
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San Francisco, California, United States, 94115
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San Francisco, California, United States, 94107
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Santa Ana, California, United States, 92705
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Santa Barbara, California, United States, 93103
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Torrance, California, United States, 90503
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Ventura, California, United States, 93003
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Westlake Village, California, United States, 91361
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Colorado
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Aurora, Colorado, United States, 80045
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Colorado Springs, Colorado, United States, 80909
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Golden, Colorado, United States, 80401
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Connecticut
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Danbury, Connecticut, United States, 06810
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Hamden, Connecticut, United States, 06518
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New Haven, Connecticut, United States, 06510
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New London, Connecticut, United States, 06320
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Florida
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Altamonte Springs, Florida, United States, 32701
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Boynton Beach, Florida, United States, 33426
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Fort Lauderdale, Florida, United States, 33334
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Fort Myers, Florida, United States, 33912
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Palm Beach Gardens, Florida, United States, 33410
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Pensacola, Florida, United States, 32503
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Stuart, Florida, United States, 34994
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Tampa, Florida, United States, 33609
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Tampa, Florida, United States, 33612
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Winter Haven, Florida, United States, 33880
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Georgia
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Augusta, Georgia, United States, 30909
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Hawaii
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Aiea, Hawaii, United States, 96701
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Illinois
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Chicago, Illinois, United States, 60637
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Oak Park, Illinois, United States, 60304
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Indiana
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Indianapolis, Indiana, United States, 46290
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Kansas
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Shawnee Mission, Kansas, United States, 66204
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Wichita, Kansas, United States, 67214
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Kentucky
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Lexington, Kentucky, United States, 40509
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Paducah, Kentucky, United States, 42001
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Maine
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Portland, Maine, United States, 04102
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Maryland
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Baltimore, Maryland, United States, 21287
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Hagerstown, Maryland, United States, 21740
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Massachusetts
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Boston, Massachusetts, United States, 02111
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Boston, Massachusetts, United States, 02114
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Worcester, Massachusetts, United States, 01605
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Michigan
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Jackson, Michigan, United States, 49201
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Minnesota
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Edina, Minnesota, United States, 55435
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Missouri
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Saint Louis, Missouri, United States, 63144
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Nebraska
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Lincoln, Nebraska, United States, 68506
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Nevada
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Las Vegas, Nevada, United States, 89144
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New Jersey
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Lawrenceville, New Jersey, United States, 08648
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New Brunswick, New Jersey, United States, 08901
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Northfield, New Jersey, United States, 08225
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Teaneck, New Jersey, United States, 07666
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Vauxhall, New Jersey, United States, 07088
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New York
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Great Neck, New York, United States, 11021
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Lynbrook, New York, United States, 11563
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New York, New York, United States, 10021
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Rochester, New York, United States, 14620
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Shirley, New York, United States, 11967
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North Carolina
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Asheville, North Carolina, United States, 28803
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Charlotte, North Carolina, United States, 28210
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Ohio
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Beachwood, Ohio, United States, 44122
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Cincinnati, Ohio, United States, 45242
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Columbus, Ohio, United States, 43212
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Oregon
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Portland, Oregon, United States, 97210
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Pennsylvania
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Camp Hill, Pennsylvania, United States, 17011
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Huntingdon Valley, Pennsylvania, United States, 19006
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Johnstown, Pennsylvania, United States, 15904
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Philadelphia, Pennsylvania, United States, 19107
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Pittsburgh, Pennsylvania, United States, 15212
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Pittsburgh, Pennsylvania, United States, 15213
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West Mifflin, Pennsylvania, United States, 15122
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South Carolina
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Greenville, South Carolina, United States, 29605
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Ladson, South Carolina, United States, 29456
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West Columbia, South Carolina, United States, 29169
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South Dakota
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Rapid City, South Dakota, United States, 57701
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Tennessee
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Nashville, Tennessee, United States, 37203
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Texas
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Abilene, Texas, United States, 79606
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Austin, Texas, United States, 78705
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Desoto, Texas, United States, 75115
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Houston, Texas, United States, 77030
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McAllen, Texas, United States, 78503
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San Antonio, Texas, United States, 78240
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Temple, Texas, United States, 76508
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The Woodlands, Texas, United States, 77384
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Utah
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Salt Lake City, Utah, United States, 84107
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Virginia
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Richmond, Virginia, United States, 23235
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Virginia Beach, Virginia, United States, 23454
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
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Wyoming
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Casper, Wyoming, United States, 82601
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- For sexually active women of childbearing potential, agreement to the use of an appropriate form of contraception (or abstinence) for the duration of the study.
Ocular Inclusion Criteria (Study Eye)
- Best corrected visual acuity (BCVA), using Early Treatment Diabetic Retinopathy Study (ETDRS) charts, of 20/40-20/320 (Snellen equivalent).
- Choroidal neovascularization (CNV) lesions with classic CNV component, occult CNV, or with some classic CNV component were permissible.
- Total area of lesion < 12 disc area or 30.48 mm^2.
Exclusion Criteria:
- History of vitrectomy surgery, submacular surgery, or other surgical intervention for age-related macular degeneration (AMD) in the study eye.
- Prior treatment with Visudyne(R), external-beam radiation therapy, or transpupillary thermotherapy (TTT) in the study eye.
- Previous intravitreal drug delivery (eg, intravitreal corticosteroid injection, anti-angiogenic drugs, or device implantation) in the study eye.
- Previous treatment or participation in a clinical trial involving anti-angiogenic drugs (Avastin(R), anecortave acetate, protein kinase C inhibitors, etc), in the non-study eye within 3 months of Day 0 (first day of treatment). The patient may not have received Lucentis(R) or Macugen(R) in the non-study eye within 7 days of Day 0.
- Treatment with Visudyne(R) in the non-study eye < 7 days preceding Day 0.
- Subretinal hemorrhage in the study eye that involves the center of the fovea, if the size of the hemorrhage is either > 50% of the total area of the lesion or > 1 disc area (2.54 mm^2) in size.
- Subfoveal fibrosis or atrophy in the study eye.
- CNV in either eye due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia.
- Retinal pigment epithelial tear involving the macula in the study eye.
- Any concurrent intraocular condition in the study eye (eg, cataract or diabetic retinopathy) that, in the opinion of the investigator, could either: Require medical or surgical intervention during the 24-month study period to prevent or treat visual loss that might result from that condition; or if allowed to progress untreated, could likely contribute to loss of at least 2 Snellen equivalent lines of best corrected visual acuity (BCVA) over the 24-month study period.
- Uncontrolled blood pressure.
- Atrial fibrillation not managed by patient's primary care physician or cardiologist within 3 months of screening visit.
- History of stroke within the last 3 months of screening visit.
- History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug or that might affect interpretation of the results of the study or renders the patient at high risk for treatment complications.
- Current treatment for active systemic infection.
- Active malignancy.
- History of allergy to fluorescein, not amenable to treatment.
- Previous participation in any studies of investigational drugs within 1 month preceding Day 0 (excluding vitamins and minerals).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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EXPERIMENTAL: Ranibizumab 0.5 mg monthly
Patients received ranibizumab 0.5 mg monthly administered intravitreally for 24 months.
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Sterile solution for intravitreal injection.
Other Names:
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EXPERIMENTAL: Ranibizumab 2.0 mg monthly
Patients received ranibizumab 2.0 mg monthly administered intravitreally for 24 months.
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Sterile solution for intravitreal injection.
Other Names:
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EXPERIMENTAL: Ranibizumab 0.5 mg as-needed (pro re nata [PRN])
Patients received ranibizumab 0.5 mg monthly administered intravitreally for 3 months.
Thereafter, patients' visual acuity and eye disease activity were assessed monthly for an additional 21 months.
If study defined criteria were met at a monthly assessment, patients received ranibizumab 0.5 mg administered intravitreally.
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Sterile solution for intravitreal injection.
Other Names:
|
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EXPERIMENTAL: Ranibizumab 2.0 mg as-needed (pro re nata [PRN])
Patients received ranibizumab 2.0 mg monthly administered intravitreally for 3 months.
Thereafter, patients' visual acuity and eye disease activity were assessed monthly for an additional 21 months.
If study defined criteria were met at a monthly assessment, patients received ranibizumab 2.0 mg administered intravitreally.
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Sterile solution for intravitreal injection.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change From Baseline in Best Corrected Visual Acuity (BCVA) at Month 12
Time Frame: Baseline to Month 12
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BCVA was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) chart starting at a test distance of 4 meters.
The BCVA score is the number of letters read correctly by the patient.
A decrease in the BCVA score indicates a worsening of vision.
A positive change score indicates improvement.
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Baseline to Month 12
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Ranibizumab Injections up to But Not Including Month 12
Time Frame: Baseline to Month 12
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Baseline to Month 12
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Percentage of Patients Who Gained ≥ 15 Letters in Best Corrected Visual Acuity (BCVA) From Baseline at Month 12
Time Frame: Baseline to Month 12
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BCVA was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) chart starting at a test distance of 4 meters.
The BCVA score is the number of letters read correctly by the patient.
An increase in the BCVA score indicates an improvement of vision.
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Baseline to Month 12
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Percentage of Patients With a Visual Acuity (VA) Snellen Equivalent of 20/40 or Better at Month 12
Time Frame: Month 12
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VA was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart starting at a test distance of 4 meters.
An increase in the number of lines read correctly by the patient in the ETDRS chart indicates an improvement of vision.
The Snellen equivalent of 20/40 is 14 lines correctly read in the EDTRS chart.
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Month 12
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Percentage of Patients With no Evidence of Fluid From Choroidal Neovascularization (CNV) at Month 12
Time Frame: Month 12
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The presence of fluid from choroidal neovascularization (CNV) was assessed by spectral domain optical coherence tomography (SD-OCT).
No evidence of fluid was defined as no subretinal fluid thickness, no cystoid spaces, no intraretinal fluid, no pigment epithelial defect thickness, and average central subfield thickness < 270 µm.
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Month 12
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Change From Baseline in Central Foveal Thickness at Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
Time Frame: Baseline to Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
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Central foveal thickness was assessed by spectral domain optical coherence tomography (SD-OCT).
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Baseline to Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
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Change From Baseline in Macular Volume at Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
Time Frame: Baseline to Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
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Macular volume was assessed by spectral domain optical coherence tomography (SD-OCT).
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Baseline to Day 7 and Months 1, 2, 3, 4, 6, 9, and 12
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Change From Baseline in the Total Area of Choroidal Neovascularization (CNV) and Choroidal Neovascular Leakage at Month 12
Time Frame: Baseline to Month 12
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The total area of choroidal neovascularization (CNV) and choroidal neovascular leakage was assessed with fluorescein angiography (FA).
Area was measured in disc area units; 1 disc area unit = 2.54 mm^2.
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Baseline to Month 12
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Pawloff M, Bogunovic H, Gruber A, Michl M, Riedl S, Schmidt-Erfurth U. SYSTEMATIC CORRELATION OF CENTRAL SUBFIELD THICKNESS WITH RETINAL FLUID VOLUMES QUANTIFIED BY DEEP LEARNING IN THE MAJOR EXUDATIVE MACULAR DISEASES. Retina. 2022 May 1;42(5):831-841. doi: 10.1097/IAE.0000000000003385.
- Li E, Donati S, Lindsley KB, Krzystolik MG, Virgili G. Treatment regimens for administration of anti-vascular endothelial growth factor agents for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2020 May 5;5(5):CD012208. doi: 10.1002/14651858.CD012208.pub2.
- Staurenghi G, Cozzi M, Sadda S, Hill L, Gune S. Characteristics That Correlate with Macular Atrophy in Ranibizumab-Treated Patients with Neovascular Age-Related Macular Degeneration. Ophthalmol Retina. 2022 Nov 10:S2468-6530(22)00550-4. doi: 10.1016/j.oret.2022.11.002. Online ahead of print.
- Lally DR, Hill L, Amador-Patarroyo MJ. Subretinal Fluid Resolution and Visual Acuity in Patients with Neovascular Age-Related Macular Degeneration: A HARBOR Post Hoc Analysis. Ophthalmol Retina. 2022 Nov;6(11):1054-1060. doi: 10.1016/j.oret.2022.05.026. Epub 2022 May 30.
- Sheth V, D'Rozario M, Gune S, Blotner S. Fluctuations in central foveal thickness and association with vision outcomes with anti-VEGF therapy for nAMD: HARBOR post hoc analysis. BMJ Open Ophthalmol. 2022 Mar 9;7(1):e000957. doi: 10.1136/bmjophth-2021-000957. eCollection 2022.
- Freund KB, Staurenghi G, Jung JJ, Zweifel SA, Cozzi M, Hill L, Blotner S, Tsuboi M, Gune S. Macular neovascularization lesion type and vision outcomes in neovascular age-related macular degeneration: post hoc analysis of HARBOR. Graefes Arch Clin Exp Ophthalmol. 2022 Aug;260(8):2437-2447. doi: 10.1007/s00417-022-05586-w. Epub 2022 Mar 3.
- Holekamp NM, Sadda S, Sarraf D, Guymer R, Hill L, Blotner S, Spicer G, Gune S. Effect of Residual Retinal Fluid on Visual Function in Ranibizumab-Treated Neovascular Age-Related Macular Degeneration. Am J Ophthalmol. 2022 Jan;233:8-17. doi: 10.1016/j.ajo.2021.06.029. Epub 2021 Jul 18.
- Javaheri M, Hill L, Ghanekar A, Stoilov I. Changes in Treatment-Naive Pigment Epithelial Detachments Associated With the Initial Anti-Vascular Endothelial Growth Factor Injection: A Post Hoc Analysis From the HARBOR Trial. JAMA Ophthalmol. 2021 Feb 1;139(2):219-223. doi: 10.1001/jamaophthalmol.2020.5130. Erratum In: JAMA Ophthalmol. 2021 Feb 1;139(2):256.
- Sadda SR, Abdelfattah NS, Lei J, Shi Y, Marion KM, Morgenthien E, Gune S, Balasubramanian S. Spectral-Domain OCT Analysis of Risk Factors for Macular Atrophy Development in the HARBOR Study for Neovascular Age-Related Macular Degeneration. Ophthalmology. 2020 Oct;127(10):1360-1370. doi: 10.1016/j.ophtha.2020.03.031. Epub 2020 Apr 2.
- Khurana RN, Chang L, Day BM, Ghanekar A, Stoilov I. Timing of Peak Vision Gains in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab. Ophthalmol Retina. 2020 Aug;4(8):760-766. doi: 10.1016/j.oret.2020.02.011. Epub 2020 Feb 27.
- Khurana RN, Hill L, Ghanekar A, Gune S. Agreement of Spectral-Domain OCT with Fluorescein Leakage in Neovascular Age-Related Macular Degeneration: Post Hoc Analysis of the HARBOR Study. Ophthalmol Retina. 2020 Nov;4(11):1054-1058. doi: 10.1016/j.oret.2020.04.016. Epub 2020 Apr 28.
- Patel Y, Miller DM, Fung AE, Hill LF, Rosenfeld PJ. Are Dilated Fundus Examinations Needed for OCT-Guided Retreatment of Exudative Age-Related Macular Degeneration? Ophthalmol Retina. 2020 Feb;4(2):141-147. doi: 10.1016/j.oret.2019.09.006. Epub 2019 Sep 18.
- Khurana RN, Chang LK, Hill LF, Ghanekar A, Stoilov I. The Value of Prior Response to Anti-Vascular Endothelial Growth Factor for Age-Related Macular Degeneration: A HARBOR Subanalysis. Ophthalmol Retina. 2020 Jan;4(1):13-18. doi: 10.1016/j.oret.2019.06.008. Epub 2019 Jul 5.
- Nassisi M, Lei J, Abdelfattah NS, Karamat A, Balasubramanian S, Fan W, Uji A, Marion KM, Baker K, Huang X, Morgenthien E, Sadda SR. OCT Risk Factors for Development of Late Age-Related Macular Degeneration in the Fellow Eyes of Patients Enrolled in the HARBOR Study. Ophthalmology. 2019 Dec;126(12):1667-1674. doi: 10.1016/j.ophtha.2019.05.016. Epub 2019 May 29.
- Hallak JA, de Sisternes L, Osborne A, Yaspan B, Rubin DL, Leng T. Imaging, Genetic, and Demographic Factors Associated With Conversion to Neovascular Age-Related Macular Degeneration: Secondary Analysis of a Randomized Clinical Trial. JAMA Ophthalmol. 2019 Jul 1;137(7):738-744. doi: 10.1001/jamaophthalmol.2019.0868.
- Sarraf D, London NJ, Khurana RN, Dugel PU, Gune S, Hill L, Tuomi L. Ranibizumab Treatment for Pigment Epithelial Detachment Secondary to Neovascular Age-Related Macular Degeneration: Post Hoc Analysis of the HARBOR Study. Ophthalmology. 2016 Oct;123(10):2213-24. doi: 10.1016/j.ophtha.2016.07.007. Epub 2016 Aug 23.
- Frenkel RE, Shapiro H, Stoilov I. Predicting vision gains with anti-VEGF therapy in neovascular age-related macular degeneration patients by using low-luminance vision. Br J Ophthalmol. 2016 Aug;100(8):1052-7. doi: 10.1136/bjophthalmol-2015-307575. Epub 2015 Nov 5.
- Busbee BG, Ho AC, Brown DM, Heier JS, Suner IJ, Li Z, Rubio RG, Lai P; HARBOR Study Group. Twelve-month efficacy and safety of 0.5 mg or 2.0 mg ranibizumab in patients with subfoveal neovascular age-related macular degeneration. Ophthalmology. 2013 May;120(5):1046-56. doi: 10.1016/j.ophtha.2012.10.014. Epub 2013 Jan 23.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FVF4579g
- GX01511 (OTHER: Hoffmann-La Roche)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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