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

10 maj 2021 uppdaterad av: 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.

Studieöversikt

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

31

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Ohio
      • Cleveland, Ohio, Förenta staterna, 44195
        • Cole Eye Institute, Cleveland Clinic

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: 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.
Andra namn:
  • Eylea

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Panretinal Leakage Index at Month 12 From Baseline
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Mean Change in Total Leakage Index
Tidsram: 6 months
Mean change in total leakage index from baseline to month 6
6 months
Change in Panretinal Ischemic Index
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 12 months
12 months
Number of Patients Who Gained 15 ETDRS Letters or More of Vision
Tidsram: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/40 or Better
Tidsram: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/200 or Worse
Tidsram: 6 months
6 months
Ocular Serious Adverse Events
Tidsram: 12 months
12 months
Number of Participants Who Lost 15 ETDRS Letters or More of Vision
Tidsram: 12 months
12 months
Number of Participants Who Lost 15 ETDRS Letters or More of Vision
Tidsram: 6 months
6 months
Number of Patients That Showed Visual Acuity 20/40 or Better
Tidsram: 12 months
12 months
Number of Patients That Showed Visual Acuity 20/200 or Worse
Tidsram: 12 months
12 months
Mean Change From Baseline Central Subfield Thickness
Tidsram: 12 months
12 months
Systemic Serious Adverse Events
Tidsram: 12 Months
Incidence of systemic SAEs
12 Months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Samarbetspartners

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

18 augusti 2015

Primärt slutförande (Faktisk)

6 februari 2018

Avslutad studie (Faktisk)

6 februari 2018

Studieregistreringsdatum

Först inskickad

17 juli 2015

Först inskickad som uppfyllde QC-kriterierna

20 juli 2015

Första postat (Uppskatta)

21 juli 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

12 maj 2021

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 maj 2021

Senast verifierad

1 maj 2021

Mer information

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