UNcovering the Difference Between Ranibizumab and Aflibercept, Focusing on Systemic Anti-vascular Endothelial Growth Factor (VEGF) Effects in Patients With neovascuLar Age-related Macular Degeneration (AMD) (UNRAVEL)

March 30, 2017 updated by: Novartis Pharmaceuticals

A 3 Months, patient-and Rater Blinded, Randomized, Prospective Study Comparing Systemic Anti-VEGF Effects Between Ranibizumab and Aflibercept in Treatment naïve Neovascular Age-related Macular Degeneration (nAMD) Patients

This study assessed systemic vascular endothelial growth factor (VEGF) level in patients with neovascular Age-related Macular Degeneration following treatment with Ranibizumab or Aflibercept.

Free plasma VEGF-A level was measured in this study .

Study Overview

Study Type

Interventional

Enrollment (Actual)

205

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Be'er Sheva, Israel, 84101
        • Novartis Investigative Site
      • Haifa, Israel, 3525408
        • Novartis Investigative Site
      • Haifa, Israel, 3436212
        • Novartis Investigative Site
      • Kfar-Saba, Israel, 4428164
        • Novartis Investigative Site
      • Petach Tikva, Israel, 49100
        • Novartis Investigative Site
      • Rehovot, Israel, 7610001
        • Novartis Investigative Site
      • Tel Aviv, Israel, 6423906
        • Novartis Investigative Site
      • Daegu, Korea, Republic of, 705-703
        • Novartis Investigative Site
      • Seoul, Korea, Republic of, 150-950
        • Novartis Investigative Site
      • Seoul, Korea, Republic of, 06273
        • Novartis Investigative Site
    • Korea
      • Seoul, Korea, Korea, Republic of, 05505
        • Novartis Investigative Site
      • Seoul, Korea, Korea, Republic of, 03722
        • Novartis Investigative Site
      • Kuala Lumpur, Malaysia, 59200
        • Novartis Investigative Site
    • Selangor Darul Ehsan
      • Petaling Jaya, Selangor Darul Ehsan, Malaysia, 46200
        • Novartis Investigative Site
      • Makati City, Philippines, 1209
        • Novartis Investigative Site
      • Pasig City, Philippines, 1605
        • Novartis Investigative Site
      • Quezon City, Philippines, 1102
        • Novartis Investigative Site
      • Singapore, Singapore, 117549
        • Novartis Investigative Site
      • Singapore, Singapore, 574623
        • Novartis Investigative Site
      • Lin-Kou, Taiwan, 33305
        • Novartis Investigative Site
      • Taipei, Taiwan, 10002
        • Novartis Investigative Site
      • Bangkok, Thailand, 10330
        • Novartis Investigative Site
      • Bangkok, Thailand, 10400
        • Novartis Investigative Site
    • Bangkoknoi
      • Bangkok, Bangkoknoi, Thailand, 10700
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Key Inclusion Criteria

  • Newly diagnosed Age-related Macular Degeneration (AMD)
  • No previous treatment received for diagnosed AMD
  • Visual Acuity 6/7.5 to 6/96

Key Exclusion Criteria:

  • standard exclusion criteria for anti-VEGF treatment
  • Visual Acuity <6/96
  • nAMD in both eyes, or any condition in other eye which may have required anti- VEGF treatment during study period
  • other disease in candidate eye which could have compromised visual acuity or required medical/surgical intervention during study period
  • participation to other clinical study with 'not approved' treatment within a year prior to UNRAVEL study participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Ranibizumab
104 patients with an eligible study eye were randomized to be treated with Ranibizumab IVT. 0.5 mg of commercially available Ranibizumab were used for intravitreal injection adminstered by an unblinded injecting physician. 3 injections were performed (Baseline, Month 1, Month 2).
Blood measurement
Other Names:
  • Lucentis, Eylea
Active Comparator: Aflibercept
101 patients with an eligible study eye were randomized to be treated with Aflibercept IVT. 2.0 mg of commercially available Aflibercept were used for intravitreal injection admistered by an unblinded injecting physician. 3 injections were performed (Baseline, Month 1, Month 2).
Blood measurement
Other Names:
  • Lucentis, Eylea

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change From Baseline at Month 3 in Plasma VEGF Following Intravitreal (IVT) Injection of Anti-VEGF Agent
Time Frame: Change from baseline at Month 3
Percent change in blood VEGF level is calculated as the difference in blood VEGF level measured after 3 month of anti-VEGF agent IVT treatment (Ranibizumab or Aflibercept) when compared to baseline blood VEGF level.
Change from baseline at Month 3

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change From Baseline in Plasma VEGF Level Overtime
Time Frame: Change from baseline up to month 3
Plasma VEGF measurement performed at all visits and compared to baseline level
Change from baseline up to month 3
Correlation Between Percent Change From Baseline Plasma VEGF Level and the Serum Anti-VEGF Agent Overtime
Time Frame: pre-dose to post-dose at Baseline, week 1, week 2, month 1, month 2, and month 3
VEGF level and anti-VEGF concentration measured in the blood at each single visit, including pre- and post-dose measurement at the dosing visits.
pre-dose to post-dose at Baseline, week 1, week 2, month 1, month 2, and month 3
Mean Change From Baseline in Best Corrected Visual Acuity (BCVA) of the Study Eye Over Time
Time Frame: Baseline, month 1, month 2, month 3
BCVA score is assessed on study eye based on the number of letters read correctly on the Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity charts at a testing distance of 4 meters. An increase in score indicates an improvement in acuity. Change from baseline calculated as observed post-baseline value - baseline value.
Baseline, month 1, month 2, month 3
Mean Change From Baseline in Central Retinal Thickness (CRT) of the Study Eye Over Time
Time Frame: Baseline, month 1, month 2, month 3

CRT in micrometers assessed by Optical Tomography (OCT) at each single study visit. A reduction is thickness indicates an improvement is the lesion area.

Change from baseline calculated as observed post-baseline - baseline value.

Baseline, month 1, month 2, month 3
Number of Patients With Ocular and Systemic Adverse Events
Time Frame: Day 1 to day 85
The incidence of reported treatment emergent adverse events (TEAEs) and treatment emergent serious adverse events (TESAE).
Day 1 to day 85

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2014

Primary Completion (Actual)

September 1, 2015

Study Completion (Actual)

September 1, 2015

Study Registration Dates

First Submitted

November 14, 2013

First Submitted That Met QC Criteria

November 14, 2013

First Posted (Estimate)

November 20, 2013

Study Record Updates

Last Update Posted (Actual)

May 3, 2017

Last Update Submitted That Met QC Criteria

March 30, 2017

Last Verified

March 1, 2017

More Information

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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