Lucentis (Ranibizumab) for Eales' Disease

The Use of a VEGF Inhibitor (Lucentis) in Refractory Macular Edema Due to Eales' Disease

The primary objective of this protocol is to look at whether Lucentis (ranibizumab) is safe and effective when used for macular edema (retinal swelling) due to Eales' disease. The secondary objective is to see if macular edema comes back within three months after the last dose of study drug is given.

Study Overview

• Status: Completed
• Conditions: Eales' Disease
• Intervention / Treatment: Drug: Ranibizumab

Detailed Description

This is a six-month study. Eligible subjects will receive one injection of the study drug into one eye for each of three months. Visual acuity, blood pressure and eye pressure will be tested. Subjects' retinas will be examined and thickness measured by optical coherence tomography (OCT). Safety visits will be scheduled for the week after the injections. The investigators will monitor the subjects' eyes for infection and inflammation. After the three-month treatment period, subjects will return to the clinic monthly for four follow-up visits. Procedures and tests that will be performed at the follow-up visits include visual acuity, a retinal exam including OCT, blood pressure, and eye pressure.

• Study Type: Interventional
• Enrollment (Actual): 1
• Phase: Phase 2; Phase 3

Contacts and Locations

Study Locations

• United States
  • Oregon
    • Portland, Oregon, United States, 97239
      • Casey Eye Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Ability to provide written informed consent and comply with study assessments for the full duration of the study.
• Age > 21 years.
• Disease related considerations:

• For both treatment naïve and previously treated patients:

  • exclusion of all other causes of cystoid macular edema and retinal nonperfusion including branch or central vein occlusion, diabetic retinopathy, sickle retinopathy, sarcoidosis, systemic lupus and other collagen vascular diseases
  • chronic cystoid macular edema as noted clinically and on OCT 3 testing with persistent loss of visual acuity for 3 months or longer
  • if the eye has received prior treatment (including laser photocoagulation and steroids) a 30 day washout period will be required prior to treatment with Lucentis.
• BCVA using ETDRS charts of 20/40 to 20/400 (Snellen equivalent) in the study eye.
• OCT 3 central subfield > or = 250 on 2 separate readings in the central subfield.
• Only one eye will be assessed in the study. If both eyes are eligible, the investigator will determine which eye will be entered into the study.

Exclusion Criteria:

• Treatment for macular edema with intravitreal steroid or macugen within 30 days prior to enrollment in this study.
• Previous vitrectomy within the past 6 months.
• Previous cataract surgery within the preceding 12 months.
• Active intraocular inflammation in the study eye.
• Current vitreous hemorrhage in the study eye.
• Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye.
• A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
• Participation in an investigational trial within 30 days of randomization that involved.
• Treatment with any drug that has not received regulatory approval at the time of study entry.
• Known allergy to any component of the study drug.
• Blood pressure > 180/110 (systolic above 180 OR diastolic above 110).
• If blood pressure is brought below 180/110 by anti-hypertensive treatment, subject can become eligible.
• Major surgery within 28 days prior to randomization or major surgery planned during the next 6 months. Major surgery is defined as a surgical procedure that is more extensive than fine needle biopsy/aspiration, placement of a central venous access device, removal/biopsy of a skin lesion, or placement of a peripheral venous catheter.
• Myocardial infarction, other cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 6 months prior to randomization.
• Systemic anti-VEGF or pro-VEGF treatment within 3 months prior to randomization.
• Systemic anti-VEGF or pro-VEGF treatment used during the 6 months of the study.
• Current treatment for active systemic infection.
• History of recurrent significant infections or bacterial infections.
• Subject is expecting to move out of the area of the clinical center to an area not covered by another clinical center during the 6 months of the study.

• Subjects meeting any of the following criteria will be excluded from the study:

  • Pregnancy (positive pregnancy test).
  • Prior enrollment in the study.
  • Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated.
  • Participation in another simultaneous medical investigation or trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lucentis (ranibizumab)	Drug: Ranibizumab; Consented, enrolled subjects will receive open-label intravitreal injections of 0.5 mg ranibizumab administered once a month for 3 months; Other Names: Lucentis

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in OCT Thickness.		Baseline and 6 months
Incidence and Severity of Ocular Adverse Events, as Identified by Eye Examination (Including Visual Acuity Testing)		Monthly through Month 6
Incidence and Severity of Other Adverse Events, as Identified by Physical Examination, Subject Reporting, and Changes in Vital Signs	No adverse events.	Monthly through Month 6

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
BCVA, as Assessed by the Number of Letters Read Correctly on the ETDRS Eye Chart at a Starting Test Distance of 4 Meters.		Months 3,4,5 and 6
Incidence of Ocular and Non-ocular Adverse Events Evaluated Through Month 6.	No adverse events.	Monthly through Month 6

Collaborators and Investigators

• Sponsor: Oregon Health and Science University
• Collaborators: Genentech, Inc.
• Investigators: Principal Investigator: Christina J. Flaxel, MD, Casey Eye Institute, Oregon Health & Science University

Publications and helpful links

General Publications

• Gupta SR, Flaxel CJ. The use of a vascular endothelial growth factor inhibitor (ranibizumab) in macular edema due to eales disease. Retin Cases Brief Rep. 2012 Winter;6(1):122-4. doi: 10.1097/ICB.0b013e31821608e8.

Study record dates

Study Major Dates

• Study Start: October 1, 2006
• Primary Completion (Actual): April 1, 2009
• Study Completion (Actual): April 1, 2009

Study Registration Dates

• First Submitted: October 5, 2006
• First Submitted That Met QC Criteria: October 5, 2006
• First Posted (Estimate): October 6, 2006

Study Record Updates

• Last Update Posted (Actual): June 11, 2019
• Last Update Submitted That Met QC Criteria: June 9, 2019
• Last Verified: June 1, 2019

More Information

Terms related to this study

• Keywords: Eales
• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Eye Diseases; Retinal Diseases; Vasculitis; Metaplasia; Neovascularization, Pathologic; Retinal Vasculitis; Physiological Effects of Drugs; Antineoplastic Agents; Angiogenesis Inhibitors; Angiogenesis Modulating Agents; Growth Substances; Growth Inhibitors; Ranibizumab
• Other Study ID Numbers: FVF3849s