Faricimab + PRP vs. vitrektomi + endolaser til behandling af PDR (AP)
Et randomiseret klinisk forsøg, der evaluerer kombinationen Faricimab + PRP vs. Vitrektomi + Endolaser til behandling af proliferativ diabetisk retinopati
This randomized trial will compare treatment strategies for proliferative diabetic retinopathy (PDR). Participants will receive either combination a of faricimab + PRP or vitrectomy + endolaser. The participants will be followed for 3 years. The study will evaluate long-term visual acuity as well as differences in number of injections, procedures, and complications during follow-up (after completion of randomization treatment), and cost.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Although some combination of anti-VEGF plus PRP is the most common treatment approach for PDR with and without DME, there are currently no long-term data on a standardized approach. Vitrectomy is not currently used as first-line treatment for early PDR but advances in surgical technique have reduced associated complications and the ability to remove the posterior hyaloid during surgery may have advantages over nonsurgical approaches, especially in the reduction of vitreous hemorrhage and/or traction retinal detachment that may occur later when the hyaloid separates naturally. Protocol S demonstrated both PRP and anti-VEGF alone result in good visual acuity results long-term so it is expected that a combination treatment would also result in good visual acuity results.
This study will evaluate the safety and efficacy of two treatment strategies for PDR: faricimab plus PRP and Vitrectomy with endolaser with the goal to determine whether either approach decreases visit and treatment burden along with decreasing complications compared with the other treatment method while maintaining good visual acuity. The primary objectives of this study are to compare visual acuity at 3 years following vitrectomy with endolaser or faricimab+PRP and to compare number of treatments for PDR (i.e., injections, PRP, vitrectomy) following the end of randomized treatment over 3 years.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Cynthia Stockdale
- Telefonnummer: 8139758690
- E-mail: drcrnet@jaeb.org
Studiesteder
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California
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Huntington Beach, California, Forenede Stater, 92647
- Rekruttering
- Retina Associates of Southern California
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Kontakt:
- Hani Salehi-Had, MD
- Telefonnummer: 657-227-9496
- E-mail: v.phan@retinasocal.com
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Loma Linda, California, Forenede Stater, 92354
- Rekruttering
- Loma Linda University
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Kontakt:
- David I. Sierpina, MD
- Telefonnummer: 909-558-2169
- E-mail: nborntrager@llu.edu
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San Francisco, California, Forenede Stater, 94109
- Rekruttering
- West Coast Retina Medical Group, Inc.
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Kontakt:
- Georgia N. Kamboj, MD
- Telefonnummer: 415-972-4600
- E-mail: ashapiro@westcoastretina.com
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Santa Barbara, California, Forenede Stater, 93103-4223
- Rekruttering
- California Retina Consultants
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Kontakt:
- Dante J. Pieramici, MD
- Telefonnummer: 805-963-1648
- E-mail: Nancyc@californiaretina.com
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Florida
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Jacksonville, Florida, Forenede Stater, 32209
- Rekruttering
- University of Florida - Jacksonville
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Kontakt:
- Sandeep Grover, MD
- Telefonnummer: 904-244-9361
- E-mail: ghulam.hamdani@jax.ufl.edu
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Lakeland, Florida, Forenede Stater, 33805
- Rekruttering
- Florida Retina Consultants
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Kontakt:
- Scott M. Friedman, MD
- Telefonnummer: 863-682-7474
- E-mail: Dfagan@frc2020.com
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Orlando, Florida, Forenede Stater, 32806
- Rekruttering
- Ophthalmic Partners of Florida, PA dba Central Florida Retina
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Kontakt:
- Gokul Kumar, MD
- Telefonnummer: 407-425-7188
- E-mail: vbell@cfretina.com
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Tampa, Florida, Forenede Stater, 33609
- Rekruttering
- Retina Associates of Florida, LLC
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Kontakt:
- Ivan J. Suner, MD
- Telefonnummer: 813-875-6373
- E-mail: retinaklongworth@gmail.com
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Georgia
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Atlanta, Georgia, Forenede Stater, 30322
- Rekruttering
- Emory Eye Center
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Kontakt:
- Andrew M Hendrick, MD
- Telefonnummer: 404-778-4261
- E-mail: mafif@emory.edu
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Augusta, Georgia, Forenede Stater, 30909
- Rekruttering
- Southeast Retina Center, P.C.
-
Kontakt:
- Dennis M. Marcus, MD
- Telefonnummer: (706) 650-0061
- E-mail: amitchell@southeastretina.com
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Sandy Springs, Georgia, Forenede Stater, 30328
- Rekruttering
- Thomas Eye Group
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Kontakt:
- Paul L Kaufman, MD
- Telefonnummer: 404-256-1507
- E-mail: kathyw@thomaseye.com
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Illinois
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Chicago, Illinois, Forenede Stater, 60612
- Rekruttering
- Rush University Medical Center
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Kontakt:
- Sara Fard
- Telefonnummer: 312-942-2117
- E-mail: luma_halig@rush.edu
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Oak Park, Illinois, Forenede Stater, 60304
- Rekruttering
- Illinois Retina Associates SC Oak Park Site
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Kontakt:
- Naryan S. Sabherwal, MD
- Telefonnummer: 708-660-8450
- E-mail: vruiz@illinoisretina.com
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Indiana
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Carmel, Indiana, Forenede Stater, 46032
- Rekruttering
- Midwest Eye Institute
-
Kontakt:
- Raj K. Maturi, MD
- Telefonnummer: 317-817-1414
- E-mail: haydenb@midwesteye.com
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Indianapolis, Indiana, Forenede Stater, 46202
- Rekruttering
- The Trustees of Indiana University
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Kontakt:
- Amir R. Hajrasouliha, MD
- Telefonnummer: 317-944-2020
- E-mail: skarra@iu.edu
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Iowa
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West Des Moines, Iowa, Forenede Stater, 50266
- Rekruttering
- Wolfe Clinic, P.C.- West Des Moines
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Kontakt:
- David J. Massop
- Telefonnummer: 515-223-8685
- E-mail: twoehl@wolfeclinic.com
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Kansas
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Overland, Kansas, Forenede Stater, 66211
- Rekruttering
- Mid-America Retina Consultants, P.A.
-
Kontakt:
- William N. Rosenthal, MD
- Telefonnummer: (913) 663-5900
- E-mail: sjohnson@midamericaretina.com
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Kentucky
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Lexington, Kentucky, Forenede Stater, 40508
- Rekruttering
- University of Kentucky Advanced Eye Care
-
Kontakt:
- Leanne M. Clevenger, MD
- Telefonnummer: 8595623570
- E-mail: evelyn.Gonzalez@uky.edu
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Louisiana
-
West Monroe, Louisiana, Forenede Stater, 71291-4452
- Rekruttering
- Joseph E. Humble and Raymond Haik PTRS DBA Eye Assoc of Northeast Louisiana
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Kontakt:
- Ruben A. Grigorian
- Telefonnummer: 318-325-2610
- E-mail: lbmoore@eyenela.com
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Maryland
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Baltimore, Maryland, Forenede Stater, 21237
- Rekruttering
- Elman Retina Group, P.A.
-
Kontakt:
- Michael J. Elman, MD
- Telefonnummer: 410-686-3000
- E-mail: Starr@elmanretina.com
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02215
- Rekruttering
- Joslin Diabetes Center
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Kontakt:
- Jennifer K Sun, MD, MPH
- Telefonnummer: 617-309-2520
- E-mail: cashrafz@joslin.harvard.edu
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Boston, Massachusetts, Forenede Stater, 02118
- Rekruttering
- Boston Medical Center Corporation
-
Kontakt:
- Nicole H. Siegel, MD
- Telefonnummer: 617-414-4020
- E-mail: sreevardhan.alluri@bmc.org
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Minnesota
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Rochester, Minnesota, Forenede Stater, 55905
- Rekruttering
- Mayo Clinic
-
Kontakt:
- Andrew J. Barkmeier, MD
- Telefonnummer: 507-538-8119
- E-mail: Taylor.Laura2@mayo.edu
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Saint Louis Park, Minnesota, Forenede Stater, 55416
- Rekruttering
- Retina Consultants of Minnesota
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Kontakt:
- Abdhish R. Bhavsar, MD
- Telefonnummer: 612-871-2292
- E-mail: agilchrist@RetinaMN.com
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Missouri
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St Louis, Missouri, Forenede Stater, 63128
- Rekruttering
- Retina Research Institute, LLC
-
Kontakt:
- Kevin J. Blinder, MD
- Telefonnummer: 314-367-1181
- E-mail: rhonda.weeks@rc-stl.com
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New York
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Rochester, New York, Forenede Stater, 14620
- Rekruttering
- Retina Associates of Western NY, P.C.
-
Kontakt:
- Edward F. Hall, MD
- Telefonnummer: 585-442-3411
- E-mail: mdoran@retinaassociatesofwny.com
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North Carolina
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Chapel Hill, North Carolina, Forenede Stater, 27517-8923
- Rekruttering
- University of North Carolina at Chapel Hill
-
Kontakt:
- Jan N. Ulrich, MD
- Telefonnummer: 919-966-5296
- E-mail: wrena@email.unc.edu
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Oklahoma
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Edmond, Oklahoma, Forenede Stater, 73013
- Rekruttering
- Retina Vitreous Center
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Kontakt:
- Sandeep N. Shah
- Telefonnummer: (405) 607-6699
- E-mail: bell@rvcoklahoma.com
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Pennsylvania
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Monroeville, Pennsylvania, Forenede Stater, 15146
- Rekruttering
- Retina-Vitreous Consultants, Inc.
-
Kontakt:
- Shripaad Shukla, MD
- Telefonnummer: 412-683-5300
- E-mail: merlottil@retinapittsburgh.com
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Texas
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Austin, Texas, Forenede Stater, 78705
- Rekruttering
- Austin Research Center for Retina
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Kontakt:
- Chirag Jhaveri, MD
- Telefonnummer: 737-704-0130
- E-mail: beatris.ramirez@nvisioncenters.com
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Bellaire, Texas, Forenede Stater, 77401
- Rekruttering
- Retina Consultants of Texas, PA
-
Kontakt:
- Hasenin Al-Khersan, MD
- Telefonnummer: 713-524-3434
- E-mail: rebecca.clark@retinaconsultantstexas.com
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Dallas, Texas, Forenede Stater, 75390
- Rekruttering
- UT Southwestern Medical Center
-
Kontakt:
- Yu-Guang He, MD
- Telefonnummer: 214-645-2012
- E-mail: norma.ortegon@utsouthwestern.edu
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Houston, Texas, Forenede Stater, 77030-4101
- Rekruttering
- Baylor College of Medicine, Baylor Eye Physicians and Surgeons
-
Kontakt:
- Christina Y Weng, MD, MBA
- Telefonnummer: 713-798-3493
- E-mail: Peter.Rico@bcm.edu
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Lubbock, Texas, Forenede Stater, 79424
- Rekruttering
- Texas Retina Associates
-
Kontakt:
- Michel Shami, MD
- Telefonnummer: 806-792-0066
- E-mail: afuller@texasretina.com
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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:
Individual:
- ≥ 18 years old
- Diagnosis of diabetes mellitus (type 1 or type 2)
Study Eye:(A participant can have one or two study eyes if both eyes are eligible at screening.)
- Presence of PDR requiring treatment, defined as moderate PDR or worse on global grading of ultrawide field fundus photos or NV meeting criteria for moderate PDR or worse on global grading of ultrawide field FA, confirmed by a central reading center
- Best corrected visual acuity ≥49 letters (20/100 Snellen equivalent or better)
Exclusion Criteria:
-
Individual:
-
Significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant.
-
Blood pressure > 160/100 (systolic above 160 or diastolic above 100).
o If blood pressure is brought below 160/100 by anti-hypertensive treatment, individual can become eligible.
-
For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 3 years.
- Women of childbearing potential will be required to have pregnancy testing or use an acceptable method of pregnancy prevention. Women who are potential study participants should be questioned about the potential for pregnancy at baseline and prior to each injection. Pregnancy test is required for all women of childbearing potential at baseline. Investigator judgment is used to determine when a pregnancy test is needed during follow up.
-
Study Eye: (A participant can have two study eyes.)
- Traction retinal detachment involving the macula
- Significant vitreous hemorrhage that would preclude completion of a full PRP
- Significant vitreomacular traction
- Any prior vitrectomy
- Any prior PRP (defined as ≥100 burns outside of the posterior pole)
- Treatment for DME within the prior 6 months
- Intravitreal anti-VEGF for any indication, other than DME, within the prior year
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Vitrektomi + endolaser
|
The vitrectomy must occur within 4 weeks of randomization. A single injection of faricimab is allowed at any point before the vitrectomy. It is recommended that this injection is within 1 week of the vitrectomy. Requirement of triamcinolone staining to assist in complete elevation and removal of the posterior hyaloid and in removal of as much peripheral vitreous as is safely possible, 20 gauge not permitted. Allows subconjunctival steroid at investigator discretion; however, sub-tenon's triamcinolone or other long-acting steroid will not be permitted. Complete panretinal photocoagulation (PRP) during vitrectomy |
|
Eksperimentel: Faricimab + PRP
PRP = Panretinal Photocoagulation |
Treatment must be initiated on the day of randomization with one faricumab injection. The remainder of the randomized treatment includes 2 additional injections every 4-weeks. Injections must be completed within 90 days of randomization. Complete PRP. PRP may be completed in 1-3 sessions, with the timing at the investigator's discretion. All PRP sessions must be completed within 90 days of randomization. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Visual Acuity Change from Baseline
Tidsramme: Baseline to 3- years
|
Visual acuity is measured as a continuous integer letter score from 0 to 100, with higher numbers indicating better visual acuity. A letter score of 85 is approximately 20/20 and a letter score of 70 is approximately 20/40. |
Baseline to 3- years
|
|
Number of Post-Randomization Treatments for Proliferative Diabetic Retinopathy
Tidsramme: Over 3 Years
|
Initial randomized treatment will be excluded. |
Over 3 Years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
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
- Protocol AP
- UG1EY014231 (U.S. NIH-bevilling/kontrakt)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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