Pilot Study Reduced Fluence PDT /Visudyne With Ranibizumab vs Ranibizumab Monotherapy for Exudative Age-related Macular Degeneration (AMD)
A Pilot Study With Reduced Fluence Photodynamic Therapy With Visudyne Ranibizumab VS. Ranibizumab Only to Treat Exudative AMD
The purposes of this study is to determine if combination reduced fluence photodynamic therapy and Ranibizumab has:
Similar efficacy to Ranibizumab (Lucentis) alone. The ability to reduce the number of intravitreal injection of Ranibizumab or a 13 month period The ability to reduce the number of PDT treatments. The study will also collect information on the safety of combination therapy and single therapy.
調査の概要
詳細な説明
This will be a 13 month prospective, blinded, randomized sham controled parallel safety study. There will be 2 treatment arms.
Arm 1 will receive reduced fluence PDT at baseline followed immediately by an intravitreal injection of Lucentis. Subjects in arm 1 will receive 2 additional injections of Ranibizumab (Lucentis) over the next 2 months. Starting at month 3, they will receive combination reduced fluence PDT and intravitreal Ranibizumab (Lucentis) if they develop recurrence of the subretinal fluid, cystoid macular edema, increased pigment epithelial detachment (PED), or increased retinal thickness > 100 microns compared to the best prior thickness measure on OCT. Patients will be eligible for repeat combination reduced fluence PDT + intravitreal Ranibizumab (Lucentis) every 3 months thereafter. Group 1 patients are eligible for treatment with combination reduced fluence PDT and Ranibizumab (Lucentis) at any point at the 3 month time point or thereafter. After month 3, if patients were not eligible for combined therapy (<3 months since the last combination therapy) and have >2 lines of vision loss or > 100 microns of increased retinal thickness on OCT compared to most recent measure at their monthly visit, they would be eligible for an injection of Ranibizumab (Lucentis) as monotherapy. Thereafter, subjects will have combination therapy if retreatment criteria were met and it has been >3 months since the last PDT treatment.
Study arm 2 will receive 3 monthly intravitreal injections of Ranibizumab (Lucentis). Following month 2, they will be eligible for re-treatment with Ranibizumab (Lucentis) if retreatment criteria are met (same criteria as study arm 1). At intervals of no less than 3 months from the previous sham PDT, they will receive sham PDT if retreatment criteria are met.
研究の種類
段階
- 適用できない
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Male / Female > 50 years of age
- FA diagnosis of CNV lesions as described above
- Have a best corrected visual acuity letter score in the study eye between 72-24 letters (approximately 20/40 to 20/320) using ETDRS chart measured at 4 meters
- Central retinal (including lesion) thickness greater than or equal to 250 microns as measured by OCT
- Subretinal hemorrhage making up less than 50% of total lesion size and sparing the fovea
- Sufficiently clear ocular media including the lens to allow photography of the retina
- Written informed consent has been obtained.
Exclusion Criteria:
- Dense subfoveal hemorrhage (>50% of the lesion)
- Tear or rip of the retina pigment epithelium, idiopathic parafoveal telangiectasis or serous pigment epithelial detachment without CNV
- Geographic atrophy involving the foveal center
- Subretinal fibrotic scar in the study eye greater than 25% of the lesion
- Presence of any condition in study eye other than AMD known to be associated with CNV
- History diabetic retinopathy or diabetic macular edema
- Previous pars plana vitrectomy
- Previous photodynamic therapy in the study eye
- Previous photodynamic therapy in the fellow eye with resultant choroidal hypoperfusion
- Previous intravitreal anti-VEGF or steroid injection in the study eye
- Previous thermal subfoveal laser treatment in study eye
- Anticipated need for ocular surgery in the study eye during the 13 month study period
- Known allergy or sensitivity to the study medication(s) its components, diagnostic agents used during the study (Fluorescein, dilation drops) or other agents required for the study procedures (ie: povidone iodine)
- Porphyria or other porphyrin sensitivity
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：1
Reduced fluence (3300mW/cm2-50% standard fluence) PDT + ranibizumab
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Ranibizumab, and reduced fluence PDT or sham PDT and Ranibizumab.
For 2 months injected intravitreal Ranibizumab will be given.
At month 3 subjects will receive combination reduced fluence PDT and intravitreal Ranibizumab.
If they develop recurrence of subretinal fluid, cystoid macular edema, increased pigment epithelial detachment (PED), or increased retinal thickness >100 microns compared to best thickness measure of OCT, subjects will be eligible for repeat combination reduced fluence PDT + intravitreal Ranibizumab every 3 months thereafter.
他の名前：
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アクティブコンパレータ：2
Ranibizumab monotherapy
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3 monthly intravitreal injections of Ranibizumab monotherapy.
After month 2 they are eligible for retreatment with Ranibizumab if retreatment criteria are met (same as arm 1) At intervals of no less than 3 months from the previous sham PDT they will receive sham PDT if retreatment criteria are met.
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Primary efficacy will be proportion of subjects with best corrected visual acuity improvement of 15 or more letters from baseline and wil visual acuity stabilization, less than 15 letter loss from baseline at 13 months
時間枠：at conclusion of subject enrollment
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at conclusion of subject enrollment
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Mean change in ETDRS from baseline, number of Ranibizumab treatments w/reduced fluence PDT, proportion of patients with 6 lines of vision loss
時間枠：at conclusion of subject enrollment
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at conclusion of subject enrollment
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Jeffrey L Marx, M.D.、Lahey Clinic Medical Center
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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