- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00695682
Intravitreal Infliximab for Diabetic Macular Edema (DME) and Choroidal Neovascularization (CNV) (ITVR)
The Safety and Tolerability of Intravitreal Infliximab (Remicade) in Patients With Refractory Diabetic Macular Edema or Choroidal Neovascularization Secondary to Age Related Macular Degeneration- A Pilot Study
Injections of medicine into the middle of the eye (intravitreal injections) are commonly used in a multitude of retinal diseases. We are looking for new treatments that may be beneficial in treating retinal disease and improving patients' vision.
Infliximab (Remicade) is a genetically engineered antibody against a molecule in the body called TNF-α. It neutralizes the effects of TNF-α by binding to it. Intravenous Infliximab has been used for inflammatory arthritic conditions and Crohn's disease since 1998. We do not know if infliximab injections into the eye are safe. We are performing this pilot study to determine if they can be safe.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Intravenous Infliximab is currently used for the treatment of systemic inflammatory conditions and inflammatory disease of the eye with a relatively favorable safety profile. However, systemic administration carries the risk of systemic side effects, which in the case of infliximab can be severe, such as increased risk of infection, reactivation of tuberculosis or Hepatosplenic T-cell Lymphoma.
Direct intravitreal administration of medication is the preferred method of treatment for retinal vascular disorders. The eye is a self contained organ relatively isolated from the systemic circulation by the tight blood retinal barrier. Effective intraocular drug levels can be achieved with a much smaller amount of medication if injected intravitreally and this also results in minimal systemic exposure to the patient. Preliminary studies have shown that Infliximab may have a positive role in the management of retinal vascular disorders in humans when administered intravenously, and can be an effective treatment intravitreally in animal models. No data has been published yet on intravitreal use of infliximab in human subjects.
We plan to study the safety and tolerability of intravitreal injections of infliximab in human subjects with refractory diabetic macular edema or choroidal neovascularization. Our infliximab dose will be 0.5mg/0.5ml, as it follows the reconstitution instructions in the Product Insert. This dosing will fall within the therapeutic dosing found within the animal study as it leads to the same vitreous concentration as the7.5 µg dose in group B rat eye study. (4)
Study Type
Enrollment (Anticipated)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
New York
-
SLingerlands, New York, United States, 12159
- Recruiting
- Retina Consultants
-
Contact:
- Paul Beer, MD
- Phone Number: 518-533-6550
-
Principal Investigator:
- Paul M Beer, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Ability to provide written informed consent and comply with study assessments for the full duration of the study
- Age > 21 years
- Patients with active CNV secondary to AMD in the study eye which did not improve with conventional therapy
- Patients with refractory diabetic macular edema in the study eye which did not improve with conventional therapy
- BCVA 20/70 or less as measured on an ETDRS chart.
Exclusion Criteria:
- Are participating in another clinical study requiring follow up examinations
- Have received any other experimental drug within 12 weeks prior to enrollment
- Are unwilling or unable to follow or comply with all study-related procedures
- Inability to obtain photographs, fluorescein angiography, or optical coherence tomography to document CNV, e.g. due to media opacity, allergy to fluorescein dye or lack of venous access
- Aphakia or pseudophakia with the absence of posterior capsule (unless it resulted from a yttrium aluminum garner [YAG]) posterior capsulotomy)
- Within two months prior to screening, have had intraocular surgery (including cataract surgery) in the study eye
- Within 1 month prior to screening had YAG laser in the study eye
- Have had intravitreal anti VEGF or intravitreal steroids in the last 6 weeks
- Have had previous pars plana vitrectomy in the study eye
- Are pregnant or are trying to become pregnant
- Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated
- Have a history of allergies to murine monoclonal antibodies, mice or mouse products.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
This is a pilot study to study the safety and tolerability of intravitreal Infliximab in patients with refractory diabetic macular edema and choroidal neovascularization (CNV)
Time Frame: 3 m
|
3 m
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
(BCVA)
Time Frame: 3m
|
3m
|
Standard Electroretinogram
Time Frame: 3m
|
3m
|
OCT
Time Frame: 3m
|
3m
|
Fluorescein angiography
Time Frame: 3m
|
3m
|
Nidek Microperimetry
Time Frame: 3m
|
3m
|
Incidence and severity of adverse events
Time Frame: 3m
|
3m
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Vascular Diseases
- Eye Diseases
- Endocrine System Diseases
- Diabetic Angiopathies
- Diabetes Complications
- Diabetes Mellitus
- Retinal Degeneration
- Retinal Diseases
- Uveal Diseases
- Choroid Diseases
- Metaplasia
- Macular Degeneration
- Diabetic Retinopathy
- Macular Edema
- Choroidal Neovascularization
- Neovascularization, Pathologic
- Antirheumatic Agents
- Gastrointestinal Agents
- Dermatologic Agents
- Infliximab
Other Study ID Numbers
- 101606
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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