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Peripheral and Macular Retinal Vascular Perfusion and Leakage in DME and RVO (PERMEATE)

10 maggio 2021 aggiornato da: Justis Ehlers

Peripheral and Macular Retinal Vascular Perfusion and Leakage Dynamics in Diabetic Macular Edema and Retinal Venous Occlusions During Intravitreal Aflibercept Injection (IAI) Treatment for Retinal Edema: PERMEATE Study

This interventional study will evaluate the retinal vascular dynamics associated with Intravitreal Aflibercept Injection (IAI) therapy in eyes with diabetic macular edema (DME) or macular edema secondary to retinal vein occlusion (RVO). Ultra-widefield fluorescein angiography and optical coherence tomography (OCT) angiography will be performed at multiple timepoints to assess the changes in retinal vascular leakage, ischemia, and vascular abnormalities throughout the study duration and compare these alterations to baseline.

Panoramica dello studio

Descrizione dettagliata

Diabetic macular edema (DME) and macular edema secondary to retinal venous occlusive diseases are the most common cause of vision loss from a retinal vascular disease. Recently, vascular endothelial growth factor (VEGF) inhibitors (bevacizumab, aflibercept, and ranibizumab) have been described as new first-line therapies for these conditions. Aflibercept is the most recently approved VEGF inhibitor for the management of these conditions. Clinical trials have shown that treatment with aflibercept improves visual acuity and reduces macular edema in a large percentage of patients.

This study will examine the changes that occur with intravitreal aflibercept to perfusion and leakage in treatment naive eyes over the course of 1 year.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

31

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Ohio
      • Cleveland, Ohio, Stati Uniti, 44195
        • Cole Eye Institute, Cleveland Clinic

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria

A subject must meet the following criteria to be eligible for inclusion in the study:

  1. Signed Informed Consent.
  2. Men and women ≥ 18 years of age.
  3. Foveal-involving retinal edema secondary to DME or RVO based on investigator review of SDOCT.
  4. E-ETDRS best-corrected visual acuity of: 20/25 to 20/400 in the study eye or Hand Motion (HM) in the study eye.
  5. Willing, committed, and able to return for all clinic visits and complete all study related procedures.
  6. Able to read, (or, if unable to read due to visual impairment, be read to verbatim by the person administering the informed consent or a family member) understand and willing to sign the informed consent form.

Exclusion Criteria

A subject who meets any of the following criteria will be excluded from the study:

  1. Any prior or concomitant therapy with another investigational agent to treat DME or RVO in the study eye.
  2. Prior panretinal photocoagulation in the study eye.
  3. Prior intravitreal anti-VEGF therapy in the study eye.
  4. Prior focal/grid laser photocoagulation in the study eye.
  5. Prior history of intravitreal steroid therapy in the study eye.
  6. Any history of allergy to fluorescein sodium or other reason that the patient is unable to undergo fluorescein angiography (e.g., inability to get vascular access, unable to tolerate procedure)
  7. Prior systemic anti-VEGF therapy, investigational or FDA-approved, is only allowed up to 3 months prior to first dose, and will not be allowed during the study.
  8. Significant vitreous hemorrhage obscuring view to the macula or the retinal periphery as determined by the investigator on clinical exam and ultra-widefield angiography.
  9. Presence of other causes of macular edema, including myopic degeneration, ocular histoplasmosis syndrome, angioid streaks, choroidal rupture, choroidal neovascularization, neovascular age-related macular degeneration or multifocal choroiditis in the study eye. Epiretinal membranes are allowed.
  10. Presence of macula-threatening traction retinal detachment.
  11. Prior vitrectomy in the study eye.
  12. History of retinal detachment or treatment or surgery for retinal detachment in the study eye.
  13. Any history of macular hole of stage 2 and above in the study eye.
  14. Any intraocular or periocular surgery within 3 months of Day 1 on the study eye, except lid surgery, which may not have taken place within 1 month of day 1, as long as it's unlikely to interfere with the injection.
  15. Prior trabeculectomy or other filtration surgery in the study eye.
  16. Uncontrolled glaucoma at baseline evaluation (defined as intraocular pressure ≥25 mmHg despite treatment with anti-glaucoma medication) in the study eye.
  17. Active intraocular inflammation in either eye.
  18. Active ocular or periocular infection in either eye.
  19. Any ocular or periocular infection within the last 2 weeks prior to Screening in either eye.
  20. Any history of uveitis in either eye.
  21. Active scleritis or episcleritis in either eye.
  22. Presence or history of scleromalacia in either eye.
  23. Aphakia in the study eye.
  24. Previous therapeutic radiation in the region of the study eye.
  25. History of full-thickness penetrating keratoplasty in the study eye. Partial thickness corneal transplants including Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty are allowed.
  26. Significant media opacities, including cataract, in the study eye which might interfere with visual acuity, assessment of safety, or fundus photography.
  27. Any concurrent intraocular condition in the study eye (e.g. cataract) that, in the opinion of the investigator, could require either medical or surgical intervention during the 52 week study period.
  28. Any concurrent ocular condition in the study eye which, in the opinion of the investigator, could either increase the risk to the subject beyond what is to be expected from standard procedures of intraocular injection, or which otherwise may interfere with the injection procedure or with evaluation of efficacy or safety.
  29. Participation as a subject in any clinical study within the 12 weeks prior to Day 1.
  30. Any systemic therapy with an investigational agent in the past 3 months prior to Day 1.
  31. Any history of allergy to povidone iodine.
  32. Pregnant or breast-feeding women
  33. 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)

    • 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.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Altro: Aflibercept
Monthly aflibercept for 6 months and then every other month for 6 months.
Intravitreal aflibercept will be given q4 wks for 6 treatments and then q 8 weeks through month 12.
Altri nomi:
  • Eylea

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in Panretinal Leakage Index at Month 12 From Baseline
Lasso di tempo: 12 months
Change in panretinal leakage index (defined as the proportion of retinal area involved in angiographic leakage) at month 12 from baseline as measured by ultra-widefield angiography (UWFA).
12 months

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Mean Change in Total Leakage Index
Lasso di tempo: 6 months
Mean change in total leakage index from baseline to month 6
6 months
Change in Panretinal Ischemic Index
Lasso di tempo: 12 months
Change in panretinal ischemic index from baseline to postoperative month 12
12 months
Change in Panretinal Ischemic Index From Baseline at 6 Months
Lasso di tempo: 6 months
Change in panretinal ischemic index (defined as the proportion of retinal area with nonperfusion) from baseline at 6 months
6 months
Mean Change From Baseline Central Subfield Thickness
Lasso di tempo: 6 months
OCT central subfield thickness change from baseline to 6 months
6 months
Mean Change From Baseline in Best-corrected Visual Acuity (BCVA) Score Based on ETDRS
Lasso di tempo: 12 months
Mean change from baseline in best-corrected visual acuity (BCVA) score from baseline to month 12
12 months
Number of Participants Who Gained 15 ETDRS Letters or More of Vision
Lasso di tempo: 12 months
12 months
Number of Patients Who Gained 15 ETDRS Letters or More of Vision
Lasso di tempo: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/40 or Better
Lasso di tempo: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/200 or Worse
Lasso di tempo: 6 months
6 months
Ocular Serious Adverse Events
Lasso di tempo: 12 months
12 months
Number of Participants Who Lost 15 ETDRS Letters or More of Vision
Lasso di tempo: 12 months
12 months
Number of Participants Who Lost 15 ETDRS Letters or More of Vision
Lasso di tempo: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/40 or Better
Lasso di tempo: 12 months
12 months
Number of Patients That Showed Visual Acuity 20/200 or Worse
Lasso di tempo: 12 months
12 months
Mean Change From Baseline Central Subfield Thickness
Lasso di tempo: 12 months
12 months
Systemic Serious Adverse Events
Lasso di tempo: 12 Months
Incidence of systemic SAEs
12 Months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Justis P Ehlers, MD, Cole Eye Institute, Cleveland Clinic, OH 44195

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

18 agosto 2015

Completamento primario (Effettivo)

6 febbraio 2018

Completamento dello studio (Effettivo)

6 febbraio 2018

Date di iscrizione allo studio

Primo inviato

17 luglio 2015

Primo inviato che soddisfa i criteri di controllo qualità

20 luglio 2015

Primo Inserito (Stima)

21 luglio 2015

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

12 maggio 2021

Ultimo aggiornamento inviato che soddisfa i criteri QC

10 maggio 2021

Ultimo verificato

1 maggio 2021

Maggiori informazioni

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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