Lucentis (Ranibizumab) in Diabetic Macular Oedema: a Treatment Evaluation (LUCIDATE)
Diabetic Macula Oedema. A Prospective Randomised Study Comparing the Detailed Functional and Anatomical Changes of Repeated Pan Anti-VEGF Therapy With Ranibizumab Versus Conventional Macular Laser Therapy.
This exploratory study will compare the effects of ranibizumab treatment with conventional macular laser therapy for patients with diabetic macular oedema.
The study hypothesises that treatment with ranibizumab may be superior to laser treatment in terms of improving vision and decreasing retinal thickness.
Patients will be randomised to receive either repeated injections of ranibizumab every 4 weeks for 48 weeks or macular laser therapy every 12 weeks for 48 weeks.
At baseline, and then at 12, 24 and 48 weeks, patients will undergo detailed testing to provide information on the structure and function of the retina with both of these treatments.
調査の概要
詳細な説明
Adult patients with centre-involving diabetic macular oedema will be recruited to this single-centre study. Patients will undergo detailed baseline evaluation which will include:
- vision testing
- optical coherence tomography scanning
- fundus fluorescein angiography
- microperimetry
- colour contrast sensitivity testing
- electrophysiological testing
Patients will be randomised 2:1 to receive either ranibizumab intravitreal injection 4-weekly for 48 weeks or modified ETDRS macular laser therapy 12-weekly for 48 weeks.
Both groups of patients will return at 12, 24 and 48 weeks for repeat testing of the parameters evaluated at baseline.
研究の種類
入学 (実際)
段階
- フェーズ 4
連絡先と場所
研究場所
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London、イギリス、EC1V 2PD
- Moorfields Eye Hospital
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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:
- Diagnosis of diabetes mellitus (type 1 or type 2)
- Retinal thickening due to diabetic macular oedema involving the centre of the macula and OCT central subfield ≥ 300 microns
- Best corrected visual acuity in the study eye between 55 and 79 ETDRS letters at 1 metre (Snellen equivalent ≥ 6/24 and ≤ 6/9)
- Media clarity, pupillary dilation, and subject cooperation sufficient for adequate fundus photographs
- Intraocular pressure less than 30 mmHg
- Ability to return for study visits
- Visual acuity in fellow eye ≥ 2/60
- Fellow eye has received no anti-VEGF treatment within the past 3 months and no expectation of such treatment in next 12 months
- No previous laser within 3 months of randomisation
- Ability to give informed consent throughout the duration of the study
Exclusion Criteria:
- Macular ischaemia
- Macular oedema from a cause other than diabetic macular oedema
- Co-existent ocular disease
- Presence of an ocular condition such that visual acuity would not improve from resolution of macular oedema
- Presence of an ocular condition that might affect macular oedema or alter visual acuity during the course of the study
- A substantial cataract that is likely to be decreasing visual acuity by 3 lines or more
- History of treatment for diabetic macular oedema at any time in the past 3 months
- History of panretinal scatter photocoagulation (PRP) within 3 months prior to randomisation
- Anticipated need for PRP in the 6 months following randomisation.
- Proliferative diabetic retinopathy in the study eye.
- A condition that, in the opinion of the investigator, would preclude participation in the study.
- Haemoglobin A1c > 11.0 %
- A past medical history of significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant
- Blood pressure >170/100 mmHg
- Myocardial infarction, other cardiac event requiring hospitalisation, stroke, transient ischaemic attack, or treatment for acute congestive heart failure within 6 months prior to randomisation
- Major surgery within 28 days prior to randomisation or major surgery planned during the next 12 months at baseline
- Participation in an investigational trial within 30 days of randomisation that involved treatment with any drug that has not received regulatory approval at the time of study entry. Note: subjects cannot receive another investigational drug while participating in the study
- Systemic anti-VEGF or pro-VEGF treatment within 3 months prior to randomisation
- Pregnant or lactating women or women intending to become pregnant within the study period including 3 months after study cessation
- History of major ocular surgery (including cataract extraction, scleral buckle, any intraocular surgery) within prior 3 months or anticipated within the next 6 months following randomisation.
- Aphakia
- Uncontrolled glaucoma
- External ocular infection, including conjunctivitis, chalazion, or severe blepharitis
- Known allergy to fluorescein dye or to any component of the study drug
- Fertile male unwilling to use contraception for the duration of the study
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:なし(オープンラベル)
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:Ranibizumab
Intravitreal injection of ranibizumab
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Intravitreal injection of 0.5mg in 0.05ml.
One injection at baseline, 4 and 8 weeks then four-weekly as required to 44 weeks.
他の名前:
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アクティブコンパレータ:Laser
Modified ETDRS laser
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Argon laser therapy to the macula in accordance with the modified ETDRS protocol at baseline, 12, 24 and 36 weeks.
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 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Functional and anatomical change in the retina
時間枠:48 weeks
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This is an exploratory study.
The primary outcome measure is the change in retinal function and anatomy at 48 weeks compared to baseline, as assessed by fluorescein angiography, microperimetry and electrophysiological testing.
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48 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Mean ETDRS acuity
時間枠:48 weeks
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Difference in mean ETDRS visual acuity between the two study arms.
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48 weeks
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OCT macular thickness
時間枠:48 weeks
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Difference in mean OCT central retinal thickness between the two study arms.
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48 weeks
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協力者と研究者
協力者
捜査官
- 主任研究者:Philip G Hykin, FRCS FRCOphth、Moorfields Eye Hospital NHS Trust
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
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 (実際)
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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