En undersøgelse af responsen på behandling efter overgang til portleveringssystemet med Ranibizumab [Susvimo (Ranibizumab-injektion)] hos patienter med neovaskulær aldersrelateret makuladegeneration, der tidligere er behandlet med andre intravitreale midler end Ranibizumab (Belvedere)
En fase IV, multicenter, open-label, enkeltarmsundersøgelse af responsen på behandling efter overgang til portleveringssystemet med ranibizumab [Susvimo (Ranibizumab-injektion)] hos patienter med neovaskulær aldersrelateret makuladegeneration, der tidligere er behandlet med intravitreale midler Andet End Ranibizumab
This study will assess corneal endothelial cells in participants with nAMD treated with PDS refilled every 24 weeks (Q24W).
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
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Arizona
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Mesa, Arizona, Forenede Stater, 85206-2747
- Barnet Dulaney Perkins Eye Center
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California
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Bakersfield, California, Forenede Stater, 93309
- California Retina Consultants
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Huntington Beach, California, Forenede Stater, 92647
- Retina Associates of Southern California
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Pasadena, California, Forenede Stater, 91107-3747
- California Eye Specialists Medical group Inc.
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Sacramento, California, Forenede Stater, 95841-2013
- Retinal Consultants Med Group
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San Francisco, California, Forenede Stater, 94158-2510
- University of California San Francisco
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Santa Ana, California, Forenede Stater, 92705-6504
- Orange County Retina Med Group
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Torrance, California, Forenede Stater, 90503-3270
- Macula Retina Vitreous Research Institute
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Colorado
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Durango, Colorado, Forenede Stater, 81303
- Southwest Retina Consultants
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Longmont, Colorado, Forenede Stater, 80503-6499
- Advanced Vision Research Institute
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Florida
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Pensacola, Florida, Forenede Stater, 32503-2030
- Retina Specialty Institute
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St. Petersburg, Florida, Forenede Stater, 33711-1141
- Retina Vitreous Associates of Florida
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Georgia
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Augusta, Georgia, Forenede Stater, 30909-6440
- Southeast Retina Center
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Illinois
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Lemont, Illinois, Forenede Stater, 60439-7421
- University Retina and Macula Associates, PC
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Maine
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Portland, Maine, Forenede Stater, 04101
- Maine Eye Center
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Maryland
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Baltimore, Maryland, Forenede Stater, 21287-0005
- Wilmer Eye Institute Johns Hopkins University
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Baltimore, Maryland, Forenede Stater, 21209-2219
- The Retina Care Center
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Hagerstown, Maryland, Forenede Stater, 21740
- Cumberland Valley Retina Consultants PC
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Michigan
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Royal Oak, Michigan, Forenede Stater, 48073
- Associated Retinal Consultants PC
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Minnesota
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Minneapolis, Minnesota, Forenede Stater, 55435-3004
- VitreoRetinal Surgery, PLLC.
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Missouri
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Chesterfield, Missouri, Forenede Stater, 63017-5065
- Midwest Vision Research Foundation
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Nevada
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Reno, Nevada, Forenede Stater, 89502-1605
- Sierra Eye Associates
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New Jersey
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Bloomfield, New Jersey, Forenede Stater, 07003
- Envision Ocular, LLC
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New York
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Poughkeepsie, New York, Forenede Stater, 12603-2416
- Seeta Eye Centers
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North Carolina
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Durham, North Carolina, Forenede Stater, 27705-4699
- Duke Eye Center
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Hickory, North Carolina, Forenede Stater, 28602
- Graystone Eye-Hickory - 2415 Century Pl
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North Dakota
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Fargo, North Dakota, Forenede Stater, 58047
- Fargo Retina Consultants
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Ohio
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Blue Ash, Ohio, Forenede Stater, 45242-5537
- Cincinnati Eye Institute
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Cleveland, Ohio, Forenede Stater, 44195
- Cleveland Clinic
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Pennsylvania
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Erie, Pennsylvania, Forenede Stater, 16505
- Erie Retina Research
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Tennessee
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Germantown, Tennessee, Forenede Stater, 38138-2405
- Charles Retina Institute
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Nashville, Tennessee, Forenede Stater, 37203-1596
- Tennessee Retina PC
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Texas
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Amarillo, Texas, Forenede Stater, 79106-1835
- Panhandle Eye Group LLP Southwest Retina Specialists
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Austin, Texas, Forenede Stater, 78750-2298
- Austin Clinical Research, LLC
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Bellaire, Texas, Forenede Stater, 77401
- Retina Consultants of Texas
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Schertz, Texas, Forenede Stater, 78154
- Retina Consultants of Texas
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Utah
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Salt Lake City, Utah, Forenede Stater, 84107-6767
- Retina Associates of Utah, PLLC
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Virginia
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Lynchburg, Virginia, Forenede Stater, 24502-4271
- Piedmont Eye Center
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Norfolk, Virginia, Forenede Stater, 23502-3933
- Wagner Kapoor Institute
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Washington
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Spokane, Washington, Forenede Stater, 99204-2509
- Spokane Eye Clinical Research
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria
Ocular Inclusion Criteria:
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Diagnosis of nAMD prior to screening as determined by the investigator
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Difference of <10% in ECD at screening between the 2 eyes as measured by specular microscopy and determined by the independent reading center
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Availability of historical visual acuity (VA) data and spectral-domain optical coherence tomography (SD-OCT). Additionally, fluorescein angiography or color fundus photography can both be used to support participant eligibility per protocol at investigator discretion
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Availability of comprehensive historical anti-vascular endothelial growth factor (VEGF) injection data, including agent administered and date of administration from the time of diagnosis, or for at least 2 years prior to screening if diagnosis was made more than 2 years before screening
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Response to at least two prior anti-VEGF IVT injections as determined by the investigator based on the following:
- Overall decrease in nAMD disease activity detected on historical or screening OCT
- Stable or improved best-corrected visual acuity (BCVA)
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BCVA of 34 letters (approximate 20/200 Snellen equivalent) or better, using Early Treatment of Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters at screening and enrollment
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All subtypes of nAMD lesions are permissible
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nAMD lesions at the time of diagnosis must involve the macula
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Sufficiently clear ocular media and adequate pupillary dilation to allow for clinical examination and analysis and grading by the central reading center of SD-OCT images
Exclusion Criteria
Prior Ocular Treatment
Study Eye:
- Prior treatment with external-beam radiation therapy or transpupillary thermotherapy
- Previous treatment with verteporfin injection (PDT) or corticosteroid IVT injection within 2 years of screening
- Previous laser (except PDT as stated above) used for age related macular degeneration (AMD) treatment
- History of corneal transplant
- History of conjunctival surgery in the superotemporal quadrant
- History of intraocular inflammation following anti-VEGF injection
Either Eye:
- Previous PDS implantation
- Previous intraocular surgery (including cataract surgery) within 6 months of study enrollment
- Prior vitrectomy surgery, submacular surgery, or other surgical intervention for age-related macular degeneration (AMD)
- Prior pars plana vitrectomy surgery
- Previous intraocular device implantation, excluding intraocular lenses
- History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery
- Prior participation in a clinical trial involving any intravitreal agents that are not approved at time of screening
- Intraocular laser therapy, including selective laser trabeculoplasty, yttrium-aluminum garnet (YAG), prophylactic peripheral iridotomy within 1 year of screening, or YAG capsulotomy within 3 months of screening
- Contact lens wear in either eye within 2 months of screening
- Any prior penetrating ocular trauma
- Any prior ocular blunt trauma affecting corneal or retinal health in the opinion of the investigator, or any ocular blunt trauma within 6 months of screening
- History of corneal transplantation, including partial-thickness corneal grafts
- Prior treatment with brolucizumab
- Prior treatment with external-beam radiation therapy or brachytherapy
- History of hypersensitivity to ranibizumab or any excipients of Susvimo
Macular Neovascularization Lesion (MNV) Characteristics
Study Eye:
- Subretinal hemorrhage that involves the center of the fovea, if the hemorrhage is greater than 0.5-disc area [1.27 square millimeters (mm^2)] in size
- Subfoveal fibrosis or subfoveal atrophy
Either Eye:
- MNV due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
- MNV masquerading lesions (e.g., cone dystrophy, adult vitelliform dystrophy, pattern dystrophy)
Current or Historical Ocular Conditions
Study Eye:
- Retinal pigment epithelial tear
- Retinal tears or peripheral retinal breaks on depressed fundus exam that are untreated, or treated within the 3 months prior to study enrollment
- Current vitreous hemorrhage
- Current or history of retinal detachment
- Previous violation of the posterior capsule is also an exclusion criterion unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
- Spherical equivalent of the refractive error demonstrating more than 8 diopters of myopia or evidence of pathologic myopia on depressed fundus examination
- Preoperative refractive error that exceeds 8 diopters of myopia, for participants who have undergone prior refractive or cataract surgery
- Spherical equivalent of the refractive error demonstrating more than 5 diopters of hyperopia
- Preoperative refractive error that exceeds 5 diopters of hyperopia, for participants who have undergone prior refractive or cataract surgery
- Uncontrolled ocular hypertension or glaucoma and any such condition the investigator determines may require a glaucoma-filtering surgery during a patient's participation in the study
- Scleral pathology in the superotemporal quadrant (e.g., scleral thinning or calcification)
- Conjunctival pathologies in the superotemporal quadrant
- History or presence of severe posterior blepharitis, recurrent chalazia or hordeolum, severe dry eye syndrome, or severe allergic conjunctivitis
- Ectropion, entropion or other impairment of the upper or lower eyelid impacting lid functionality needed to protect the ocular surface from exposure
- Trichiasis
- Corneal neuropathy
- Lagophthalmos or incomplete blink
- Active or history of facial nerve palsy/paresis
Fellow (Non-Study) Eye:
• Concurrent or history of PDS implantation
Either Eye:
- Aphakia or absence of the posterior capsule
- Any concurrent intraocular condition that would either require surgical intervention during the study to prevent or treat visual loss that might result from that condition or affect interpretation of study results
- Corneal ECD ≤1500 cells/mm2 in either eye at screening as determined by the independent reading center
- Fuchs endothelial corneal dystrophy Grade ≥ 2
- Previous corneal endothelial cell damage, including from blunt or surgical trauma
- Any ocular condition that precludes obtaining an analyzable specular microscopy image
- Active or history of corneal edema
- Active or history of corneal dystrophies
- Active or history of iridocorneal endothelial syndrome
- Active or history of pseudoexfoliation syndrome
- Active or history of herpetic keratitis or kerato-uveitis
- Any active or history of uveitis
- Active intraocular inflammation
- Active or history of keratitis, scleritis, or endophthalmitis
- Active ocular or periocular infection
- Active or history of Sjogren's syndrome or keratoconjunctivitis sicca
- Active or history of floppy eyelid syndrome
- Active or history of chronic eye rubbing
- Active thyroid eye disease
Concurrent Systemic Conditions:
- History of uncontrolled blood pressure
- Active or history of autoimmune diseases such as rheumatoid arthritis, lupus, granulomatosis with polyangiitis (Wegener's)
- History of stroke within the last 3 months prior to screening
- Uncontrolled atrial fibrillation within 3 months of screening
- History of myocardial infarction within the last 3 months prior to screening
- History of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the implant and that might affect interpretation of the results of the study or renders the patient at high risk of treatment complications, in the opinion of the investigator
- Current active systemic infection
- Use of any systemic anti-VEGF agents
- Chronic use of oral corticosteroids
- Active cancer within 12 months of enrollment except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, and prostate cancer with a Gleason score of ≤ 6 and a stable prostate-specific antigen for > 12 months
- Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month prior to screening (excluding vitamins and minerals)
- Use of antimitotic or antimetabolite therapy within 30 days or 5 elimination half-lives of the screening visit
- Requirement for continuous use of any medications or treatments indicated as prohibited therapy
- Pregnant or breastfeeding, or intention to become pregnant during the study
- Women of childbearing potential must have a negative urine pregnancy test result within 28 days prior to initiation of study treatment. If the urine pregnancy test is positive, it must be confirmed by a serum pregnancy test
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: SUSVIMO
Participants will have the PDS implant (filled prior to implantation with approximately 20 microlitres [uL] of the 100 milligrams/millilitres [mg/ml] formulation of ranibizumab [approximately 2 milligrams (mg) dose of ranibizumab]) surgically inserted in the study eye at the Day 1 visit following their enrollment visit. After the initial fill of the implant with ranibizumab, participants will receive implant refill-exchanges at fixed Q24W intervals. |
Ranibizumab 100 mg/mL will be delivered via PDS Ranibizumab (0.5 mg intravitreal [IVT] injections of 10 mg/mL formulation) will be used in the study eye as supplemental treatment. If a participant discontinues study treatment, he/she may start receiving IVT ranibizumab injections in the study eye, per investigator's discretion. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Procentvis ændring i hornhindeendotelcelletæthed (ECD) fra baseline ved uge 48 i undersøgelsesøjet sammenlignet med det andet øje, som vurderet ved spektralmikroskopi
Tidsramme: Baseline, uge 48
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Baseline, uge 48
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Procentvis ændring i hornhinde-ECD fra baseline i uge 24 i undersøgelsesøjet sammenlignet med det andet øje
Tidsramme: Baseline, uge 24
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Baseline, uge 24
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Procent ændring i variationskoefficienten (CV) af hornhindens endotelcelleareal fra baseline i uge 24 og 48 i undersøgelsesøjet sammenlignet med det andet øje
Tidsramme: Baseline, uge 24, uge 48
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Baseline, uge 24, uge 48
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Procent ændring i Hexagonal Cells (HEX) fra baseline i uge 24 og 48 i undersøgelsesøjet sammenlignet med det medfølgende øje
Tidsramme: Baseline, uge 24, uge 48
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Baseline, uge 24, uge 48
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Procentdel af deltagere med okulære alvorlige bivirkninger (SAE) og sværhedsgraden af SAE
Tidsramme: Dag 1 op til cirka uge 52
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Dag 1 op til cirka uge 52
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Procentdel af deltagere med øjenbivirkninger af særlig interesse (AESI'er) og sværhedsgraden af okulære AESI'er
Tidsramme: Dag 1 til uge 52
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Dag 1 til uge 52
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Varighed af okulære AESI'er
Tidsramme: Dag 1 til uge 52
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Dag 1 til uge 52
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Procentdel af deltagere med okulær AESI i den postoperative periode
Tidsramme: Baseline op til 37 dage efter indledende implantation
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Baseline op til 37 dage efter indledende implantation
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Procentdel af deltagere med okulær AESI i den mellemliggende postoperative periode
Tidsramme: 38 til 93 dage efter implantation
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38 til 93 dage efter implantation
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Procentdel af deltagere med uønskede enhedseffekter (ADE'er)
Tidsramme: Dag 1 til uge 52
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Dag 1 til uge 52
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Antal deltagere med forventede alvorlige uønskede anordningseffekter (ASADE'er) og sværhedsgraden af ASADE'er
Tidsramme: Dag 1 til uge 52
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Dag 1 til uge 52
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Varighed af ASADE'er
Tidsramme: Dag 1 til uge 52
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Dag 1 til uge 52
|
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Percentage of Participants With Ocular AESIs During the Follow-up Period
Tidsramme: Week 52
|
The investigator will follow each adverse event (AE) until the event has resolved to baseline grade or better, the event is assessed as stable by the investigator, the participant is lost to follow-up, or the participant withdraws consent. |
Week 52
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studieleder: Clinical Trials, Genentech, Inc.
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- ML43000
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data_sharing
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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