Intraocular Cytokines in Non-responders to Ranibizumab Treatment for Neovascular AMD
Neovascular Age-related Macular Degeneration: Intraocular Inflammatory Cytokines in the Non-responder to Ranibizumab Treatment
調査の概要
詳細な説明
In the treatment of CNV (Choroidal NeoVascularization) secondary from AMD (Age Related Macular Degeneration) by using ranibizumab, patients who are non-responders can be found in approximately 1-10% of treatments. Thus, failure of treatment can lead to loss of vision. Growth factors and cytokines, such as vascular endothelial growth factor (VEGF), pigment epithelium derived factor (PEDF), interleukin 6 (IL-6) and placenta growth factor (PLGF) are known to play an important role in the development of CNV angiogenesis.
The rationale for conducting this study to compare VEGF, PEDF, IL-6 and PLGF cytokine levels in the aqueous humor of wet AMD and Polypoidal Choroidal Vasculopathy (PCV) patients who are poor responders to anti VEGF treatment and age-matched "good" responders to anti VEGF. Ranibizumab poor responders in AMD and PCV, who are treated with a combination of PDT/ranibizumab or intravitreous injection of aflibercept (Eyelea®, Regeneron Pharmaceuticals Inc. Tarrytown, NY, USA and Bayer, Basel, Switzerland) will be enrolled to the study. An aqueous humor sample will be obtained when patient receives intravitreal injection treatment and also at 1, 2 months follow up period. VEGF, PEDF,IL-6 and PLGF in aqueous will be analyzed and used to compare between the poor response group and age matched patient with good response to ranibizumab. Age, gender, visual acuity, central macular thickness by OCT, lesion size and fundus autofluorescence data will be collected and used to compare between these groups. Subgroup analysis of different treatment comparison with ranibizumab good responder group will be evaluated. Factors associated with the non-responders of ranibizumab will be analyzed.
Non-responders to ranibizumab treatment in AMD may have different levels and responses of inflammatory cytokines compared to the responder group. Understanding the pathogenesis and characteristic of this specific group of patients can help narrow down a specific choice of treatment and prevent the reduction of visual acuity of the patient. This study also helps identify factors associated to poor responders from ranibizumab treatment for wAMD.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Ontario
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Toronto、Ontario、カナダ、M2N4H3
- Toronto Western 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
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Age 50 years or more
- Ranibizumab resistance/poor responder patients in all AMD entities (typical AMD, PCV and RAP) who will be treated with intravitreous ranibizumab in combination with verteporfin photodynamic therapy
- Ranibizumab resistance/poor responder patients in all AMD entity (typical AMD, PCV and RAP) who will be treated with intravitreous aflibercept injection
- AMD patient who is good response to the treatment of ranibizumab (control group)
Exclusion Criteria:
- Any evidence of good response in treatment of ranibizumab,
- Uncooperative patients to intravitreal treatment
- Patients who have clinically active ocular inflammation
- Patients who have previous PDT treatment within 6 months
- Patient who previously have ocular treatment of immunosuppressive agent within 3 months
- Patient who previously have ocular treatment of steroid with in 3 months
- Patients who are currently on systemic treatment of anti-VEGF medication or immunosuppressive agents.
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
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Non-responders receiving aflibercept therapy
Non-responders to ranibizumab who are now receiving aflibercept therapy
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anti-VEGF treatment for wet age related macular degeneration
他の名前：
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Non-responders receiving PDT combo therapy
patients who are non-responders to ranibizumab who have been switched to combination photodynamic therapy (PDT)
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Use of cold laser with an intravitreal injection of dexamethasone to treat wet age related macular degeneration
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Responders to ranibizumab
Patients who are responders to ranibizumab and are continuing monthly injections.
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anti-VEGF treatment for wet age related macular degeneration
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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Aqueous Humour Cytokine Levels
時間枠：At time of Intravitreal Injection
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At time of Intravitreal Injection
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Demographic Data
時間枠：At time of appointment
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At time of appointment
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Number of anti-VEGF injections before developing non-responder characteristics
時間枠：At time of appointment
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At time of appointment
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History of Previous Treatment
時間枠：At time of appointment
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At time of appointment
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Optical Coherence Tomography (OCT) results
時間枠：At time of appointment
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At time of appointment
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Fluorescein Angiography Results and Indocyanine Green Angiography Results
時間枠：At time of appointment
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At time of appointment
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協力者と研究者
捜査官
- 主任研究者：Wai-Ching Lam, MD、Toronto Western Hospital, University Health Network, University of Toronto
出版物と役立つリンク
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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