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The Endurance 1 Trial (Endurance)

1 février 2019 mis à jour par: Rahul Khurana, M.D., Northern California Retina Vitreous Associates

Long-Term Efficacy and Safety of Intravitreal Aflibercept Injections for the Treatment of Diabetic Macular Edema in Subjects Who Completed the Three Year VISTA-DME Trial (The Endurance 1 Trial)

The Endurance Trial is a phase IV open label clinical study to assess the need for ongoing intravitreal aflibercept injections after the 3-year VISTA DME (VGFT-OD-1009) end-point. Subjects will be treated with intravitreal aflibercept injections pro re nata (PRN) based on the presence of CR-DME (Clinically Relevant-Diabetic Macular Edema). In addition, subjects who meet re-treatment criteria will be eligible for focal laser treatment every 90 days.

Aperçu de l'étude

Description détaillée

The safety and tolerability of intravitreal aflibercept injections have been investigated in previous Phase I, I/II and III studies in AMD, RVO, and DME trials. Potential safety issues associated with the route of administration or the pharmacology of aflibercept in the study population include decreased BCVA, intraocular inflammation, intraocular infection, transient and/or sustained elevation of intraocular pressure (IOP), cataract development or progression, retinal or intravitreal hemorrhage, macular edema, retinal break or detachment, and arterial thromboembolic events (ATEs). Safety will be assessed by visual acuity, ophthalmic examinations, fluorescein angiograms, OCT, intraocular pressure, vital signs, and adverse event documentation.

To minimize the risks of intraocular infections, all injections will be performed employing sterile techniques as described in Appendix A. Study drug administration will be held for subjects who experience certain ocular events or infections. In the event any subject develops an adverse event in the study eye that is considered by the evaluating physician to be severe in intensity, serious consideration should be given to withdrawing the subject from the study.

The PI or designated Sub-Investigators will review all adverse events on an ongoing basis to determine causality and relationship to study drug and/or study procedures.

Type d'étude

Interventionnel

Inscription (Réel)

9

Phase

  • Phase 4

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Femelle

La description

Inclusion Criteria:

  1. Enrolled and Completed VISTA DME (VGFT-OD-1009) clinical trial
  2. Willing and able to comply with clinic visits and study-related procedures
  3. Provide signed informed consent
  4. Enrollment in the trial within 12 weeks of trial activation.

Exclusion Criteria:

  1. Prior treatment with anti-VEGF therapy in the study eye within 28 days of baseline
  2. Pregnant or breast-feeding women
  3. Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD]; bilateral tubal ligation; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly).

    • Contraception is not required for men with documented vasectomy. **Postmenopausal women must be amenorrheic for at least 12 months in order not to be considered of child bearing potential. Pregnancy testing and contraception are not required for women with documented hysterectomy or tubal ligation.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: La prévention
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: aflibercept

2mg, as needed, intravitreal administration. All subjects will be treated with intravitreal (IVT) aflibercept injections as needed in the presence of clinically relevant diabetic macular edema (CR-DME). If CR-DME is not present the subject will not receive an IVT aflibercept injection and will be observed.

If a subject has recurrent CR-DME they will receive an IVT aflibercept 2.0 mg injection and interval between visits will be reduced to 4 weeks.

At week 12 through end of study, all subjects will be evaluated for focal laser treatment.

All subjects receiving PRN IVT aflibercept injections will be evaluated for focal laser treatment beginning at week 12 through the end of the study. If the subject meets any of the criteria for focal laser treatment (FLT), fluorescein angiography (FA) will be performed to guide the focal laser treatment. Focal laser treatment and focal laser re-treatment will be administered no more than once every 90 days.
Autres noms:
  • FLT
Si un sujet a un CR-DME récurrent, il recevra une injection d'aflibercept IVT
Autres noms:
  • Eylea

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Need for ongoing intravitreal aflibercept injections in the management of DME
Délai: 12 months
To assess the need for ongoing intravitreal aflibercept injections for subjects who were enrolled and completed the 3-year VISTA DME (VGFT-OD-1009) trial and to characterize long-term efficacy and safety of aflibercept intravitreal injections in the management of DME by evaluating mean number of injections in 52 weeks and proportion of subjects receiving 0 (zero) injections in 52 weeks.
12 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Vision change
Délai: 12 months
Mean change in visual acuity from baseline to week 52.
12 months
Vision loss
Délai: 12 months
Proportion of subjects with gain or loss of 0 to 5 letters from baseline to week 52.
12 months
Change in central retinal thickness
Délai: 12 months
Mean change in central retinal thickness from baseline to week 52.
12 months
Développement d'un œdème maculaire diabétique cliniquement pertinent
Délai: 12 mois
Pourcentage de sujets sans œdème maculaire diabétique cliniquement pertinent vu sur SD-OCT de la ligne de base à la semaine 52
12 mois
Role of focal laser treatment in management of DME (Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment.)
Délai: 12 months
Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment.
12 months
Evaluation of Diabetic Retinopathy (Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging.)
Délai: 12 months
Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging.
12 months
Ocular and systemic adverse events
Délai: 12 months
Incidence and severity of ocular and systemic adverse events as identified by eye examinations, imaging, and subject reporting.
12 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 novembre 2014

Achèvement primaire (Réel)

13 décembre 2017

Achèvement de l'étude (Réel)

19 mars 2018

Dates d'inscription aux études

Première soumission

14 novembre 2014

Première soumission répondant aux critères de contrôle qualité

20 novembre 2014

Première publication (Estimation)

21 novembre 2014

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

4 février 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

1 février 2019

Dernière vérification

1 février 2019

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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