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A Study of the Efficacy and Safety of Ranibizumab Injection in Patients With Macular Edema Secondary to Central Retinal Vein Occlusion (CRUISE) (CRUISE)

Primary Purpose

Macular Edema, Retinal Vein Occlusion

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Sham injection
Ranibizumab injection 0.3 mg
Ranibizumab injection 0.5 mg
Sponsored by
Genentech, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Macular Edema focused on measuring CRVO, RVO, Lucentis, Edema

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Willingness to provide signed Informed Consent Form
  • Age ≥ 18 years
  • For sexually active women of childbearing potential, use of an appropriate form of contraception (or abstinence) for the duration of the study
  • Ability and willingness to return for all scheduled visits and assessments

Ocular Inclusion Criterion (Study Eye):

  • Foveal center-involved macular edema secondary to CRVO
  • BCVA using ETDRS charts of 20/40 to 20/320 (Snellen equivalent)
  • Mean central subfield thickness ≥ 250 μm on two optical coherence tomography (OCT) measurements (at screening [confirmed by the central reading center] and Day 0 [confirmed by the evaluating physician])
  • Media clarity, pupillary dilation, and participant cooperation sufficient to obtain adequate fundus photographs

Exclusion Criteria:

  • History of cerebral vascular accident or myocardial infarction within 3 months prior to Day 0
  • History of any anti-vascular endothelial growth factor (VEGF) or treatment in the fellow eye within 3 months prior to Day 0
  • History of any systemic anti-VEGF or pro-VEGF treatment within 6 months prior to Day 0
  • History of allergy to fluorescein
  • History of allergy to ranibizumab injection or related molecule
  • Relevant systemic disease that may be associated with increased systemic VEGF levels (namely, all active malignancies); history of successfully treated malignancies is not an exclusion criterion.
  • Uncontrolled blood pressure
  • Pregnancy or lactation
  • Any condition that, in the opinion of the investigator, would preclude participation in the study (e.g., chronic alcoholism or drug abuse, personality disorder or use of major tranquilizers, indicated difficulty in long-term follow-up, and likelihood of survival of less than 1 year)
  • Participation in an investigational trial within 30 days prior to Day 0 that involved treatment with any drug (excluding vitamins and minerals) or device that has not received regulatory approval at time of study entry

Ocular Exclusion Criteria (Study Eye):

  • Prior episode of retinal vein occlusion (RVO)
  • Brisk afferent pupillary defect
  • History of radial optic neurotomy or sheathotomy
  • History or presence of age-related macular degeneration (AMD; dry or wet form)
  • History of any anti-VEGF treatment in the study eye within 3 months prior to Day 0
  • History of laser photocoagulation for macular edema within 4 months prior to Day 0
  • History of panretinal scatter photocoagulation or sector laser photocoagulation within 3 months prior to randomization or anticipated within the next 4 months following randomization
  • History of intraocular corticosteroid use within 3 months prior to Day 0
  • History of pars plana vitrectomy
  • History of intraocular surgery (including cataract extraction, scleral buckle, etc.) within 2 months prior to Day 0 or anticipated within the next 7 months following Day 0
  • History of yttrium-aluminum-garnet capsulotomy performed within 2 months prior to Day 0
  • Previous filtration surgery in the study eye
  • History of herpetic ocular infection
  • History of ocular toxoplasmosis
  • History of rhegmatogenous retinal detachment
  • History of idiopathic central serous chorioretinopathy
  • Evidence upon examination of vitreoretinal interface disease (e.g., vitreomacular traction, epiretinal membrane), either on clinical examination or OCT, thought to be contributing to macular edema
  • An eye that, in the investigator's opinion, would not benefit from resolution of macular edema, such as eyes with foveal atrophy, dense pigmentary changes, or dense subfoveal hard exudates
  • Presence of an ocular condition that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the study (e.g., uveitis or other ocular inflammatory disease, neovascular glaucoma, Irvine-Gass syndrome, or prior macula-off rhegmatogenous retinal detachment)
  • Visually significant hemorrhage obscuring the fovea and felt to be a major contributor to reduced visual acuity
  • Presence of a substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by 3 lines or more (i.e., a 20/40 cataract)
  • Aphakia
  • Relevant ocular disease that may be associated with increased intraocular VEGF levels (namely, uveitis, neovascular glaucoma, neovascular AMD, diabetic retinopathy, diabetic maculopathy, or ocular ischemic syndrome)
  • Improvement of > 10 letters on best corrected visual acuity (BCVA) between screening and Day 0

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Sham Comparator

    Experimental

    Experimental

    Arm Label

    Sham injection

    Ranibizumab injection 0.3 mg

    Ranibizumab injection 0.5 mg

    Arm Description

    Outcomes

    Primary Outcome Measures

    Mean Change From Baseline in Best Corrected Visual Acuity (BCVA) Score at 6 Months
    BCVA score in the study eye was based on the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.

    Secondary Outcome Measures

    Percentage of Participants Who Gained ≥ 15 Letters in BCVA Score at Month 6 Compared With Baseline
    BCVA score based on the ETDRS visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.
    Percentage of Participants Who Lost < 15 Letters in BCVA Score at Month 6 Compared With Baseline
    BCVA score based on the ETDRS visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.
    Percentage of Participants With a Central Foveal Thickness of ≤ 250 μm at Month 6
    A central reading center assessed all optical coherence tomography (OCT) images. Central foveal thickness was defined as the center point thickness.
    Mean Absolute Change From Baseline in Central Foveal Thickness at Month 6
    A central reading center assessed all OCT images. Central foveal thickness was defined as the center point thickness.
    Mean Change From Baseline in the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) Near Activities Subscale Score at Month 6
    The NEI VFQ-25 (v. 2000; Interviewer Format) consisted of the base set of 25 questions, plus the optional additional questions (where questions A3, A4, and A5 pertained to the Near Activities Subscale). Scores ranged from 0 to 100; a higher score represented better functioning.
    Mean Change From Baseline in the NEI VFQ-25 Distance Activities Subscale Score at Month 6
    The NEI VFQ-25 (v. 2000; Interviewer Format) consisted of the base set of 25 questions, plus the optional additional questions (where questions A6, A7, and A8 pertained to the Distance Activities Subscale). Scores ranged from 0 to 100; a higher score represented better functioning.

    Full Information

    First Posted
    June 11, 2007
    Last Updated
    June 29, 2017
    Sponsor
    Genentech, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00485836
    Brief Title
    A Study of the Efficacy and Safety of Ranibizumab Injection in Patients With Macular Edema Secondary to Central Retinal Vein Occlusion (CRUISE)
    Acronym
    CRUISE
    Official Title
    A Phase III, Multicenter, Randomized, Sham Injection-Controlled Study of the Efficacy and Safety of Ranibizumab Injection Compared With Sham in Subjects With Macular Edema Secondary to Central Retinal Vein Occlusion
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2007 (undefined)
    Primary Completion Date
    June 2009 (Actual)
    Study Completion Date
    December 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Genentech, Inc.

    4. Oversight

    5. Study Description

    Brief Summary
    This was a Phase III, multicenter, randomized, double-masked, sham injection-controlled study of the efficacy and safety of intravitreal ranibizumab compared with sham injections in patients with macular edema secondary to central retinal vein occlusion (CRVO); 392 patients with CRVO were enrolled at 95 investigational sites in the United States. The study included a treatment period (6 months) and an observation period (6 months).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Macular Edema, Retinal Vein Occlusion
    Keywords
    CRVO, RVO, Lucentis, Edema

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    392 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Sham injection
    Arm Type
    Sham Comparator
    Arm Title
    Ranibizumab injection 0.3 mg
    Arm Type
    Experimental
    Arm Title
    Ranibizumab injection 0.5 mg
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Sham injection
    Other Intervention Name(s)
    Lucentis
    Intervention Description
    Sham injection in a single-dose regimen given every month (Day 0 through the Month 5 visit), for a total of six sham injections.
    Intervention Type
    Drug
    Intervention Name(s)
    Ranibizumab injection 0.3 mg
    Intervention Description
    Ranibizumab injection 0.3 mg in a single-dose regimen given every month (Day 0 through the Month 5 visit), for a total of six injections.
    Intervention Type
    Drug
    Intervention Name(s)
    Ranibizumab injection 0.5 mg
    Other Intervention Name(s)
    Lucentis
    Intervention Description
    Ranibizumab injection 0.5 mg in a single-dose regimen given every month (Day 0 through the Month 5 visit), for a total of six injections.
    Primary Outcome Measure Information:
    Title
    Mean Change From Baseline in Best Corrected Visual Acuity (BCVA) Score at 6 Months
    Description
    BCVA score in the study eye was based on the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.
    Time Frame
    Baseline and 6 months
    Secondary Outcome Measure Information:
    Title
    Percentage of Participants Who Gained ≥ 15 Letters in BCVA Score at Month 6 Compared With Baseline
    Description
    BCVA score based on the ETDRS visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.
    Time Frame
    Baseline and 6 months
    Title
    Percentage of Participants Who Lost < 15 Letters in BCVA Score at Month 6 Compared With Baseline
    Description
    BCVA score based on the ETDRS visual acuity charts (number of correct letters) and assessed at a starting distance of 4 meters.
    Time Frame
    Baseline and 6 months
    Title
    Percentage of Participants With a Central Foveal Thickness of ≤ 250 μm at Month 6
    Description
    A central reading center assessed all optical coherence tomography (OCT) images. Central foveal thickness was defined as the center point thickness.
    Time Frame
    6 months
    Title
    Mean Absolute Change From Baseline in Central Foveal Thickness at Month 6
    Description
    A central reading center assessed all OCT images. Central foveal thickness was defined as the center point thickness.
    Time Frame
    Baseline and 6 months
    Title
    Mean Change From Baseline in the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) Near Activities Subscale Score at Month 6
    Description
    The NEI VFQ-25 (v. 2000; Interviewer Format) consisted of the base set of 25 questions, plus the optional additional questions (where questions A3, A4, and A5 pertained to the Near Activities Subscale). Scores ranged from 0 to 100; a higher score represented better functioning.
    Time Frame
    Baseline and 6 months
    Title
    Mean Change From Baseline in the NEI VFQ-25 Distance Activities Subscale Score at Month 6
    Description
    The NEI VFQ-25 (v. 2000; Interviewer Format) consisted of the base set of 25 questions, plus the optional additional questions (where questions A6, A7, and A8 pertained to the Distance Activities Subscale). Scores ranged from 0 to 100; a higher score represented better functioning.
    Time Frame
    Baseline and 6 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willingness to provide signed Informed Consent Form Age ≥ 18 years For sexually active women of childbearing potential, use of an appropriate form of contraception (or abstinence) for the duration of the study Ability and willingness to return for all scheduled visits and assessments Ocular Inclusion Criterion (Study Eye): Foveal center-involved macular edema secondary to CRVO BCVA using ETDRS charts of 20/40 to 20/320 (Snellen equivalent) Mean central subfield thickness ≥ 250 μm on two optical coherence tomography (OCT) measurements (at screening [confirmed by the central reading center] and Day 0 [confirmed by the evaluating physician]) Media clarity, pupillary dilation, and participant cooperation sufficient to obtain adequate fundus photographs Exclusion Criteria: History of cerebral vascular accident or myocardial infarction within 3 months prior to Day 0 History of any anti-vascular endothelial growth factor (VEGF) or treatment in the fellow eye within 3 months prior to Day 0 History of any systemic anti-VEGF or pro-VEGF treatment within 6 months prior to Day 0 History of allergy to fluorescein History of allergy to ranibizumab injection or related molecule Relevant systemic disease that may be associated with increased systemic VEGF levels (namely, all active malignancies); history of successfully treated malignancies is not an exclusion criterion. Uncontrolled blood pressure Pregnancy or lactation Any condition that, in the opinion of the investigator, would preclude participation in the study (e.g., chronic alcoholism or drug abuse, personality disorder or use of major tranquilizers, indicated difficulty in long-term follow-up, and likelihood of survival of less than 1 year) Participation in an investigational trial within 30 days prior to Day 0 that involved treatment with any drug (excluding vitamins and minerals) or device that has not received regulatory approval at time of study entry Ocular Exclusion Criteria (Study Eye): Prior episode of retinal vein occlusion (RVO) Brisk afferent pupillary defect History of radial optic neurotomy or sheathotomy History or presence of age-related macular degeneration (AMD; dry or wet form) History of any anti-VEGF treatment in the study eye within 3 months prior to Day 0 History of laser photocoagulation for macular edema within 4 months prior to Day 0 History of panretinal scatter photocoagulation or sector laser photocoagulation within 3 months prior to randomization or anticipated within the next 4 months following randomization History of intraocular corticosteroid use within 3 months prior to Day 0 History of pars plana vitrectomy History of intraocular surgery (including cataract extraction, scleral buckle, etc.) within 2 months prior to Day 0 or anticipated within the next 7 months following Day 0 History of yttrium-aluminum-garnet capsulotomy performed within 2 months prior to Day 0 Previous filtration surgery in the study eye History of herpetic ocular infection History of ocular toxoplasmosis History of rhegmatogenous retinal detachment History of idiopathic central serous chorioretinopathy Evidence upon examination of vitreoretinal interface disease (e.g., vitreomacular traction, epiretinal membrane), either on clinical examination or OCT, thought to be contributing to macular edema An eye that, in the investigator's opinion, would not benefit from resolution of macular edema, such as eyes with foveal atrophy, dense pigmentary changes, or dense subfoveal hard exudates Presence of an ocular condition that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the study (e.g., uveitis or other ocular inflammatory disease, neovascular glaucoma, Irvine-Gass syndrome, or prior macula-off rhegmatogenous retinal detachment) Visually significant hemorrhage obscuring the fovea and felt to be a major contributor to reduced visual acuity Presence of a substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by 3 lines or more (i.e., a 20/40 cataract) Aphakia Relevant ocular disease that may be associated with increased intraocular VEGF levels (namely, uveitis, neovascular glaucoma, neovascular AMD, diabetic retinopathy, diabetic maculopathy, or ocular ischemic syndrome) Improvement of > 10 letters on best corrected visual acuity (BCVA) between screening and Day 0
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Roman Rubio, M.D.
    Organizational Affiliation
    Genentech, Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    23699977
    Citation
    Suner IJ, Bressler NM, Varma R, Lee P, Dolan CM, Ward J, Colman S, Rubio RG. Reading speed improvements in retinal vein occlusion after ranibizumab treatment. JAMA Ophthalmol. 2013 Jul;131(7):851-6. doi: 10.1001/jamaophthalmol.2013.114.
    Results Reference
    derived
    PubMed Identifier
    23415775
    Citation
    Bhisitkul RB, Campochiaro PA, Shapiro H, Rubio RG. Predictive value in retinal vein occlusions of early versus late or incomplete ranibizumab response defined by optical coherence tomography. Ophthalmology. 2013 May;120(5):1057-63. doi: 10.1016/j.ophtha.2012.11.011. Epub 2013 Feb 14.
    Results Reference
    derived

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    A Study of the Efficacy and Safety of Ranibizumab Injection in Patients With Macular Edema Secondary to Central Retinal Vein Occlusion (CRUISE)

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