- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02452840
Photodynamic Therapy for PDA in NV AMD
Adjunctive Photodynamic Therapy for Persistent Disease Activity in Patients With Neovascular Age-Related Macular Degeneration
Study Overview
Status
Intervention / Treatment
Detailed Description
NV AMD remains the leading cause of vision loss among people over 65. Intravitreal injections with drugs that block vascular endothelial growth factor (VEGF), a major protein mediator of angiogenesis and vascular leakage, have revolutionized treatment of NV AMD. However, less than 40% of treated patients have clinically significant improvement in vision. Further, in spite of continuous monthly anti-VEGF therapy, up to 40-50% of patients demonstrate persistent disease activity (PDA), defined as (1) unresolved intraretinal, subretinal, or sub-retinal pigment epithelium fluid; (2) progressive lesion enlargement and fibrosis; and/or (3) persistent or new hemorrhage, assessed after either loading dose therapy or after sustained treatment with anti-VEGF. Since affected patients are at increased risk for long-term vision loss, PDA remains a vital clinical unmet need.
Verteporfin PDT (Visudyne®, Bausch+Lomb) was approved over 10 years ago by the FDA for treatment of NV AMD, prior to the advent of anti-VEGF therapy. As a monotherapy, PDT is much less effective than anti-VEGF therapy in improving vision for NV AMD patients. Furthermore, in general, PDT in combination with anti-VEGF therapy does not offer benefit over anti-VEGF therapy alone, when assessed among previously treatment-naïve NV AMD patients. However, it is unknown whether adjunctive PDT may be effective for the treatment of PDA. The investigators have performed several retrospective studies of PDA and adjunctive PDT among NV AMD patients in the Duke Medical Retina practice. Preliminary results indicate that moderate to severe PDA occurs in over 40% of NV AMD patients, and that adjunctive verteporfin PDT may be effective in improving PDA and vision for affected patients.
The present study will assess potential clinical benefits of adjunctive PDT for NV AMD patients with PDA in spite of anti-VEGF therapy in a prospective observational clinical case series.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
-
North Carolina
-
Durham, North Carolina, United States, 27710
- Duke Eye Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Clinical diagnosis of NV AMD
- Evidence of PDA in spite of loading dose intravitreal anti-VEGF therapy. PDA is defined as (1) unresolved intraretinal, subretinal, or sub-retinal pigment epithelium fluid; (2) progressive lesion enlargement and fibrosis; and/or (3) persistent or new hemorrhage.
- Undergoing adjunctive verteporfin PDT for the treatment of PDA
- Able to give written informed consent
Exclusion Criteria:
- Prior PDT treatment
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
NVAMD Patients with PDA
|
No Intervention
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Percentage of subjects with resolution of PDA
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Mean change in best-corrected ETDRS visual acuity from baseline
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Percentage of subjects with 2-line ETDRS visual acuity gain from baseline
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Percentage of subjects with 2-line ETDRS visual acuity loss from baseline
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Mean change in central foveal thickness by SD-OCT from baseline
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Mean change in choroidal neovascularization lesion size by fluorescein angiography from baseline
Time Frame: Six months post-PDT treatment
|
Six months post-PDT treatment
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Scott Cousins, MD, Duke University
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00057705
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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