- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07721298
Intravitreal Ranibizumab for Aggressive Posterior Retinopathy of Prematurity: A Prospective Interventional Case Series
Evaluation of Efficacy & Outcomes of Intra-vitreal Ranibizumab Injection in the Treatment of Aggressive Posterior Retinopathy of Prematurity
Aggressive posterior retinopathy of prematurity (AP-ROP) is a severe form of retinopathy of prematurity that can progress rapidly and lead to retinal detachment and permanent vision loss if not treated promptly. Although laser photocoagulation has traditionally been the standard treatment, intravitreal anti-vascular endothelial growth factor (anti-VEGF) medications such as ranibizumab have emerged as an alternative treatment because they may preserve the developing peripheral retina.
This study was designed to evaluate the effectiveness and safety of intravitreal ranibizumab in premature infants with AP-ROP. The study assessed the initial response to treatment, the frequency and timing of disease reactivation, the need for additional injections, retinal vascularization during follow-up, and treatment-related complications.
The information obtained from this study is intended to improve understanding of the role of ranibizumab in the management of AP-ROP and to guide follow-up strategies for infants receiving anti-VEGF therapy.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
**Detailed Description**
Aggressive posterior retinopathy of prematurity (AP-ROP) is a rapidly progressive and vision-threatening subtype of retinopathy of prematurity (ROP) characterized by prominent plus disease, posterior retinal involvement, and rapid progression to retinal detachment if left untreated. Although laser photocoagulation has long been considered the standard treatment for severe ROP, its application in AP-ROP may be technically challenging because of the posterior location of the disease and is associated with permanent ablation of the peripheral retina, high myopia, and visual field constriction.
Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has emerged as an alternative treatment that promotes rapid regression of retinal neovascularization while preserving peripheral retinal tissue. Ranibizumab is characterized by a shorter systemic and intravitreal half-life than other anti-VEGF agents, which may reduce systemic VEGF suppression but may also be associated with a higher risk of disease reactivation, necessitating prolonged surveillance after treatment.
This prospective interventional study was designed to evaluate the efficacy and safety of intravitreal ranibizumab as primary treatment for AP-ROP. The study aimed to assess the rate and timing of disease regression and reactivation, the need for additional intravitreal injections, retinal vascularization during follow-up, and anatomical outcomes. The study also sought to characterize the morphological patterns of disease reactivation and evaluate treatment-related ocular and systemic complications.
The findings are intended to contribute to the growing body of evidence regarding anti-VEGF therapy for AP-ROP and to provide additional data on long-term disease behavior following ranibizumab treatment in premature infants.
Typ studie
Zápis (Aktuální)
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Cairo, Egypt
- Ainshams University
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Premature infants diagnosed with aggressive posterior retinopathy of prematurity (AP-ROP) according to the International Classification of Retinopathy of Prematurity.
- Gestational age ≤34 weeks or birth weight ≤2000 g.
- Infants with gestational age >34 weeks or birth weight >2000 g were eligible if they had additional systemic risk factors, including respiratory distress syndrome, patent ductus arteriosus, sepsis, necrotizing enterocolitis, need for mechanical ventilation, or blood transfusion.
- Infants whose parents or legal guardians provided written informed consent for treatment and follow-up.
Exclusion Criteria:
- Previous treatment for retinopathy of prematurity with intravitreal anti-VEGF therapy, laser photocoagulation, cryotherapy, or vitreoretinal surgery.
- Presence of retinal disease other than retinopathy of prematurity.
- Major congenital ocular anomalies that could interfere with retinal assessment or treatment response.
- Known genetic syndromes or systemic conditions judged by the investigators to significantly affect retinal vascular development or study follow-up.
- Media opacity or other ocular condition preventing adequate fundus examination or retinal imaging.
- Inability to complete the planned follow-up schedule.
- Refusal or withdrawal of consent by parents or legal guardians.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: N/A
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Intra-vitreal injection of Ranibizumab
Premature infants diagnosed with aggressive posterior retinopathy of prematurity (AP-ROP) received intravitreal ranibizumab (0.25 mg/0.025
mL) as the primary treatment.
Eyes were followed with serial ophthalmic examinations and retinal imaging to evaluate disease regression, reactivation, retinal vascularization, anatomical outcomes, and treatment-related complications.
Eyes demonstrating disease reactivation received repeat intravitreal ranibizumab according to the study protocol.
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Intravitreal ranibizumab (0.25 mg in 0.025 mL) was administered under sterile conditions using a 30-gauge needle through the pars plicata, 1.5 mm posterior to the corneal limbus.
Repeat injections were performed in eyes with disease reactivation according to the study protocol.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Disease regression following intravitreal ranibizumab
Časové okno: 1 week after the initial intravitreal ranibizumab injection
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Proportion of eyes demonstrating regression of aggressive posterior retinopathy of prematurity (AP-ROP), defined by disease resolution or involution in the form of resolution of plus disease, reduction in vascular tortuosity and dilation, regression of extraretinal neovascularization, and continued peripheral retinal vascularization.
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1 week after the initial intravitreal ranibizumab injection
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Disease regression following intravitreal ranibizumab
Časové okno: 1 week after the initial intravitreal ranibizumab injection
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Proportion of eyes demonstrating regression of aggressive posterior retinopathy of prematurity (AP-ROP), defined by disease involution & resolution in the form of resolution of plus disease, reduction in vascular tortuosity and dilation, regression of extraretinal neovascularization, and continued peripheral retinal vascularization.
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1 week after the initial intravitreal ranibizumab injection
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Disease Reactivation
Časové okno: From the initial injection until completion of follow-up (up to 72 weeks postmenstrual age).
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Incidence of AP-ROP reactivation requiring retreatment following initial disease regression
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From the initial injection until completion of follow-up (up to 72 weeks postmenstrual age).
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Time to first reactivation
Časové okno: Up to 72 weeks postmenstrual age.
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Postmenstrual age (PMA) at the first episode of disease reactivation requiring retreatment.
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Up to 72 weeks postmenstrual age.
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Number of intravitreal ranibizumab injections
Časové okno: Up to 72 weeks postmenstrual age.
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Number of intravitreal ranibizumab injections required per eye during the study period.
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Up to 72 weeks postmenstrual age.
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Complete retinal Vascularization
Časové okno: up to 72 weeks postmenstrual age
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Proportion of eyes achieving complete peripheral retinal vascularization.
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up to 72 weeks postmenstrual age
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Treatment-related complications
Časové okno: From treatment until completion of follow-up (up to 72 weeks postmenstrual age).
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Incidence of ocular or systemic complications associated with intravitreal ranibizumab treatment.
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From treatment until completion of follow-up (up to 72 weeks postmenstrual age).
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Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Ahmed Mansour, MD, PhD, Ainshams University
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 163/2021
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- PROTOKOL STUDY
- MÍZA
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