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Efficacy and Safety of Ranibizumab in Two "Treat and Extend" Treatment Algorithms Versus Ranibizumab As Needed in Patients With Macular Edema and Visual Impairment Secondary to Diabetes Mellitus (RETAIN)

10. september 2014 opdateret af: Novartis Pharmaceuticals

A 2 Year Randomized, Single-masked, Multicenter, Controlled Phase IIIb Trial Assessing the Efficacy and Safety of 0.5 mg Ranibizumab in Two "Treat and Extend" Treatment Algorithms vs. 0.5 mg Ranibizumab As Needed in Patients With Macular Edema and Visual Impairment Secondary to Diabetes Mellitus

The purpose of this study is to demonstrate that two investigational treatment regimens have the potential to result in a superior visual acuity improvement as compared to a ranibizumab pro re nata (PRN=as needed) treatment regimen.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

373

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Belgien
      • Gent, Belgien, 9000
        • Novartis Investigative Site
      • Kortrijk, Belgien, 8500
        • Novartis Investigative Site
      • Leuven, Belgien, 3000
        • Novartis Investigative Site
  • Det Forenede Kongerige
      • Aberdeen, Det Forenede Kongerige, AB25 2ZN
        • Novartis Investigative Site
      • Bristol, Det Forenede Kongerige, BS1 2LX
        • Novartis Investigative Site
      • Leeds, Det Forenede Kongerige, LS9 7TF
        • Novartis Investigative Site
      • Manchester, Det Forenede Kongerige, M13 9WL
        • Novartis Investigative Site
      • Newcastle Upon Tyne, Det Forenede Kongerige, NE1 4LP
        • Novartis Investigative Site
      • Sheffield, Det Forenede Kongerige, S10 2JF
        • Novartis Investigative Site
      • Southampton, Det Forenede Kongerige, SO16 6YD
        • Novartis Investigative Site
      • Sunderland, Det Forenede Kongerige, SR2 9HP
        • Novartis Investigative Site
      • Wolverhampton, Det Forenede Kongerige, WV10 0QP
        • Novartis Investigative Site
    • Surrey
      • Frimley, Surrey, Det Forenede Kongerige, GU16 7UJ
        • Novartis Investigative Site
  • Frankrig
      • Bordeaux, Frankrig, 33 000
        • Novartis Investigative Site
      • Dijon, Frankrig, 21034
        • Novartis Investigative Site
      • Lille, Frankrig, 59 037
        • Novartis Investigative Site
      • Limoges Cedex, Frankrig, 87042
        • Novartis Investigative Site
      • Lyon, Frankrig, 69003
        • Novartis Investigative Site
      • Nantes Cedex 1, Frankrig, 44093
        • Novartis Investigative Site
      • Nice, Frankrig, 6 000
        • Novartis Investigative Site
      • Paris, Frankrig, 75015
        • Novartis Investigative Site
      • Paris cedex 10, Frankrig, 75475
        • Novartis Investigative Site
  • Grækenland
      • Athens, Grækenland, 152 31
        • Novartis Investigative Site
      • Thessaloniki, Grækenland, 546 36
        • Novartis Investigative Site
    • Crete
      • Heraklion Crete, Crete, Grækenland, GR-71110
        • Novartis Investigative Site
  • Holland
      • Amsterdam, Holland, 1081 HV
        • Novartis Investigative Site
      • Amsterdam, Holland, 1105 AZ
        • Novartis Investigative Site
      • Leiden 2333 ZA, Holland, 2333
        • Novartis Investigative Site
      • Nijmegen, Holland, 6525 EX
        • Novartis Investigative Site
      • Rotterdam, Holland, 3011 BH
        • Novartis Investigative Site
  • Irland
      • Dublin, Irland
        • Novartis Investigative Site
      • Dublin 7, Irland
        • Novartis Investigative Site
      • Kilkenny, Irland
        • Novartis Investigative Site
      • Limerick, Irland
        • Novartis Investigative Site
  • Italien
    • FI
      • Firenze, FI, Italien, 50134
        • Novartis Investigative Site
    • MI
      • Milano, MI, Italien, 20132
        • Novartis Investigative Site
      • Milano, MI, Italien, 20122
        • Novartis Investigative Site
      • Milano, MI, Italien, 20157
        • Novartis Investigative Site
    • RM
      • Roma, RM, Italien, 00133
        • Novartis Investigative Site
      • Roma, RM, Italien, 00198
        • Novartis Investigative Site
  • Polen
      • Bielsko-Biala, Polen, 43-300
        • Novartis Investigative Site
      • Lublin, Polen, 20-954
        • Novartis Investigative Site
      • Warszawa, Polen, 00-416
        • Novartis Investigative Site
      • Wroclaw, Polen, 50-367
        • Novartis Investigative Site
  • Portugal
      • Coimbra, Portugal, 3000-354
        • Novartis Investigative Site
      • Lisboa, Portugal, 1150-199
        • Novartis Investigative Site
      • Porto, Portugal, 4099-001
        • Novartis Investigative Site
  • Schweiz
      • Bern, Schweiz, 3010
        • Novartis Investigative Site
      • Bern, Schweiz, 3012
        • Novartis Investigative Site
      • Binningen, Schweiz, 4102
        • Novartis Investigative Site
      • Zürich, Schweiz, 8063
        • Novartis Investigative Site
  • Spanien
      • Las Palmas de Gran Canaria, Spanien, 35016
        • Novartis Investigative Site
      • Madrid, Spanien, 28040
        • Novartis Investigative Site
    • Andalucia
      • Málaga, Andalucia, Spanien, 29010
        • Novartis Investigative Site
    • Castilla y Leon
      • Valladolid, Castilla y Leon, Spanien, 47011
        • Novartis Investigative Site
    • Cataluña
      • L'Hospitalet de Llobregat, Cataluña, Spanien, 08907
        • Novartis Investigative Site
    • Comunidad Valenciana
      • Alicante, Comunidad Valenciana, Spanien, 03016
        • Novartis Investigative Site
      • Valencia, Comunidad Valenciana, Spanien, 46015
        • Novartis Investigative Site
    • Galicia
      • Santiago de Compostela, Galicia, Spanien, 15705
        • Novartis Investigative Site
  • Tjekkiet
      • Hradec Kralove, Tjekkiet, 505 05
        • Novartis Investigative Site
      • Olomouc, Tjekkiet, 775 20
        • Novartis Investigative Site
      • Plzen, Tjekkiet, 301 00
        • Novartis Investigative Site
      • Prague 2, Tjekkiet, 128 08
        • Novartis Investigative Site
      • Praha 6, Tjekkiet, 169 02
        • Novartis Investigative Site
  • Ungarn
      • Budapest, Ungarn, 1083
        • Novartis Investigative Site
      • Budapest, Ungarn, 1133
        • Novartis Investigative Site
      • Debrecen, Ungarn, 4012
        • Novartis Investigative Site
      • Gyor, Ungarn, 9024
        • Novartis Investigative Site

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

Patient

  • Patients with Type 1 or Type 2 diabetes mellitus (according to American Diabetes Association or World Health Organization [WHO] guidelines) with glycosylated hemoglobin (HbA1c) ≤ 12.0% at screening (Visit 1). Patients should be on diet, exercise, and/or pharmacological treatment for diabetes. Treatment for diabetes must have been stable for at least 3 month.

Ocular

  • Patients with visual impairment due to DME in at least one eye who are eligible for laser treatment in the opinion of the investigator. If both eyes are eligible, the one with the worse visual acuity, as assessed at Visit 1, will be selected by the investigator as the study eye.
  • BCVA ≥ 39 and ≤78 letters in the study eye and, inclusively, using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity testing charts at a testing distance of 4 meters (approximate Snellen equivalent of 20/32 to 20/160) at screening.
  • Concomitant conditions in the study eye are only permitted if, in the opinion of the investigator, they do not prevent improvement of visual acuity on study treatment.

Exclusion Criteria:

Patient Compliance/ Administrative

  • Pregnant or nursing (lactating) women.

Ocular medical history

  • Active intraocular inflammation (grade trace or above) in either eye at enrollment.
  • Any active infection (e.g. conjunctivitis, keratitis, scleritis, uveitis, endophthalmitis) in either eye at the time of enrollment.
  • History of uveitis in either eye at any time.
  • Structural damage within 0.5 disc diameter of the center of the macular in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema.
  • Uncontrolled glaucoma in either eye at screening.

Prior Ocular treatments

  • Panretinal laser photocoagulation in the study eye within 6 months prior to randomization.
  • Focal/grid laser photocoagulation in the study eye within 3 months prior to randomization.
  • Treatment with anti-angiogenic drugs in either eye.

Systemic conditions or treatments

  • History of stroke within 6 months prior to enrollment.
  • Renal failure requiring dialysis.
  • Untreated diabetes mellitus.
  • Blood pressure systolic > 160 mmHg or diastolic > 100 mmHg.

Other protocol-defined inclusion/exclusion criteria may apply

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: TE Ranibizumab 0.5 mg and Laser
On Day 1, all patients received an intravitreal injection with 0.5 mg ranibizumab and subsequently entered Phase A which comprised of monthly injections. Laser therapy was applied at Day 1. It could then be re-administered according to ETDRS criteria at any visit with 0.5 mg ranibizumab treatment if deemed necessary by the Treating Investigator with a minimal treatment interval between laser treatments of 3 months. Laser therapy was administered ≥ 30 minutes prior to the ranibizumab injection.
Medicin: Ranibizumab
Ranibizumab (Lucentis®) was supplied in vials containing a dose of 0.5 mg/0.05 mL in an aqueous solution (pH 5.5) with histidine, trehalose, and polysorbate 20.
Eksperimentel: TE Ranibizumab 0.5 mg alone
Patients received ranibizumab intravitreal injection therapy only.
Medicin: Ranibizumab
Ranibizumab (Lucentis®) was supplied in vials containing a dose of 0.5 mg/0.05 mL in an aqueous solution (pH 5.5) with histidine, trehalose, and polysorbate 20.
Aktiv komparator: PRN Ranibizumab 0.5 mg
Patients received ranibizumab intravitreal injection therapy as needed according to signs and symptoms of disease.
Medicin: Ranibizumab
Ranibizumab (Lucentis®) was supplied in vials containing a dose of 0.5 mg/0.05 mL in an aqueous solution (pH 5.5) with histidine, trehalose, and polysorbate 20.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Visual Acuity of the Study Eye: Average Change From Baseline to Month 1 Through Month 12
Tidsramme: Baseline to Month 12
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline to Month 12

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Visual Acuity of the Study Eye: Average Change From Baseline to Month 1 Through Month 24
Tidsramme: Baseline to Month 24
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline to Month 24
Visual Acuity of the Study Eye: Change From Baseline at Month 12
Tidsramme: Baseline and Month 12
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline and Month 12
Visual Acuity of the Study Eye: Change From Baseline at Month 24
Tidsramme: Baseline and Month 24
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline and Month 24
Visual Acuity of the Study Eye: Categorized Change From Baseline at Month 12
Tidsramme: Baseline, Month 12
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline, Month 12
Visual Acuity of the Study Eye: Categorized Change From Baseline at Month 24
Tidsramme: Baseline, 24 month
Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.
Baseline, 24 month
Central Subfield Thickness of the Study Eye: Percent Change From Baseline at Month 12
Tidsramme: Baseline, Month 12
High Resolution OCT was performed at every study visit by Spectral Domain OCT (if not available Time Domain OCT was acceptable) and the images were transferred to a digital video disc. These assessments were performed by trained and adequately qualified experts at the sites and prior to any study drug administration. CSFT is the average retinal thickness of the circular area with 1 mm diameter around the foveal center.
Baseline, Month 12
Central Subfield Thickness of the Study Eye: Percent Change From Baseline at Month 24
Tidsramme: Baseline and 24 month
High Resolution OCT was performed at every study visit by Spectral Domain OCT (if not available Time Domain OCT was acceptable) and the images were transferred to a digital video disc. These assessments were performed by trained and adequately qualified experts at the sites and prior to any study drug administration. CSFT is the average retinal thickness of the circular area with 1 mm diameter around the foveal center.
Baseline and 24 month
Visual Functioning Questionnaire (VFQ-25) Change From Baseline in Total Score at Month 12 and Month 24
Tidsramme: Baseline, Month 12 and Month 24
The National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) was used to measure the influence of visual disability and symptoms on general health. The 12 subscales in the VFQ-25 are general health, general vision, ocular pain, near activities, distance activities, social function, mental health, role difficulties, dependency, driving, color vision, and peripheral vision. For each, the patient was asked to rate their condition on a scale of 1-5 or 1-6, where a low number reflects a better outcome. Each response was recoded per the scoring rules outlined in the National Eye Institute (NEI) VFQ-25 Scoring Algorithm. Under this scoring algorithm , the recoded values range between 0 and 100 and a high score means a better functioning
Baseline, Month 12 and Month 24
EuroQoL (EQ-5D) Thermometer Score: Change From Baseline at Month 12 and Month 24
Tidsramme: Baseline, Month 12 and Month 24
The Euro Quality of Life Questionnaire (EQ-5D) is an indirect utility questionnaire. It is a standardized instrument was utilized to measure health outcomes related to 5 dimensions, namely: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The possible range for each dimension was 1 to 3, where 1= "no problems", 2="some problems" and 3="extreme problems" . A composite health index was then defined by combining the levels for each dimension. Overall, 243 health states are possible. For each health state, the EuroQol group has assigned a utility value typically between 0 and 1 with lower scores representing a higher level of dysfunction
Baseline, Month 12 and Month 24

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Novartis Pharmaceuticals

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2010

Primær færdiggørelse (Faktiske)

1. april 2013

Studieafslutning (Faktiske)

1. april 2013

Datoer for studieregistrering

Først indsendt

27. juli 2010

Først indsendt, der opfyldte QC-kriterier

27. juli 2010

Først opslået (Skøn)

29. juli 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

15. september 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. september 2014

Sidst verificeret

1. september 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CRFB002D2304
  • 2010-019795-74 (EudraCT nummer)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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