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Safety and Efficacy of Intravitreal Fluocinolone Acetonide Implants in Patients With Diabetic Macular Edema

Primary Purpose

Diabetic Macular Edema

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
0.59 mg fluocinolone acetonide intravitreal implant
2.1 mg fluocinolone acetonide intravitreal implant
standard of care laser photocoagulation
Sponsored by
Bausch & Lomb Incorporated
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Macular Edema

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects with type 1 or 2 diabetes.
  • Subjects with clinically significant macular edema as defined by the ETDRS.
  • A best corrected visual acuity between +0.30 and +1.00 logMAR (70 and 35 letters or approximately 20/40 to 20/200) as measured on an ETDRS chart.
  • Subjects with laser treatment status/history as follows: [1] Naïve to laser photocoagulation or Focal laser photocoagulation more than 16 weeks prior to screening or PRP more than 24 weeks prior to screening, [2] No laser scars within 500µm (4x the width of a retinal vein at the disc margin) of the central macula.
  • The subject's ocular media had to be sufficiently clear to allow for quality fundus photography.
  • If aphakic or pseudophakic, lens removal had to have occurred at least 40 weeks prior to screening.
  • Subjects had to be males or non-pregnant females of at least 18 years.
  • Subjects had to display the ability and willingness to comply with treatment, follow up process, and sign an Informed Consent Form.

Exclusion Criteria:

  • Subjects who have had previous grid macular photocoagulation for diffuse macular edema.
  • Presence of posterior hyaloid membrane, epiretinal membranes, fibrovascular proliferation, and vitreopapillary traction, which causes tractional distortion on the macula as demonstrated by OCT or funduscopy.
  • History of or current retinal detachment requiring surgical treatment or a scleral buckle.
  • Diabetic Retinopathy that required immediate PRP.
  • Ocular disease other than diabetic retinopathy that could confound the outcome of the study (e.g., age-related macular degeneration, drug toxicity, uveitis, hypertensive retinopathy, ischemic maculopathy, etc.).
  • Glaucoma, or history of glaucoma in either the study eye or the fellow eye.
  • Ocular hypertension, or history of ocular hypertension requiring IOP lowering treatment.
  • A media opacity that precludes visualization and/or diagnosis of the status of the eye.
  • Concurrent coumadin therapy or known bleeding diathesis.
  • Subjects requiring chronic systemic corticosteroid therapy or systemic immunosuppressive therapy to manage non-ocular disease.
  • Concurrent treatment with a new investigational drug.
  • Subjects with a best-corrected visual acuity worse than +1.0 logMAR (20/200 or 35 ETDRS letters) in the fellow eye.
  • Pregnant or lactating females.
  • Females of childbearing potential considering becoming pregnant during the course of the study and those not taking effective contraception/precautions to avoid pregnancy.
  • History of hypersensitivity to fluorescein, known allergies to steroids or any component of the intraocular device.
  • Subjects with photophobia that will preclude the ability to do fundus evaluations.

Sites / Locations

  • The Chinese University of Hong Kong
  • LV Prasad Eye Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Fluocinolone acetonide 0.59 mg

Fluocinolone acetonide 2.1 mg

Laser photocoagulation

Arm Description

0.59 mg fluocinolone acetonide intravitreal implant

2.1 mg fluocinolone acetonide intravitreal implant

standard of care laser photocoagulation

Outcomes

Primary Outcome Measures

Between group difference in mean visual acuity change (from baseline)

Secondary Outcome Measures

Differences in the proportions of subjects in each treatment group experiencing changes in: the area of retinal thickening; retinal leakage and cystoid scores; grade of diabetic retinopathy
Ocular adverse events, non-ocular adverse events, and intraocular pressure >/= 30 mm Hg

Full Information

First Posted
December 18, 2007
Last Updated
December 7, 2011
Sponsor
Bausch & Lomb Incorporated
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1. Study Identification

Unique Protocol Identification Number
NCT00576459
Brief Title
Safety and Efficacy of Intravitreal Fluocinolone Acetonide Implants in Patients With Diabetic Macular Edema
Official Title
A Randomized, Controlled Pilot Study to Evaluate the Safety and Efficacy of Intravitreal Fluocinolone Acetonide (0.5mg and 2mg) Implants in Patients With Clinically Significant Diabetic Macular Edema
Study Type
Interventional

2. Study Status

Record Verification Date
July 2011
Overall Recruitment Status
Completed
Study Start Date
March 2003 (undefined)
Primary Completion Date
June 2006 (Actual)
Study Completion Date
July 2006 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bausch & Lomb Incorporated

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a 3-year randomized, dose masked, three-arm controlled, pilot study to evaluate the safety and efficacy of the intravitreal FA implants (0.59mg and 2.1mg), when compared to laser photocoagulation in the treatment of patients with diabetic macular edema.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Macular Edema

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fluocinolone acetonide 0.59 mg
Arm Type
Experimental
Arm Description
0.59 mg fluocinolone acetonide intravitreal implant
Arm Title
Fluocinolone acetonide 2.1 mg
Arm Type
Experimental
Arm Description
2.1 mg fluocinolone acetonide intravitreal implant
Arm Title
Laser photocoagulation
Arm Type
Active Comparator
Arm Description
standard of care laser photocoagulation
Intervention Type
Drug
Intervention Name(s)
0.59 mg fluocinolone acetonide intravitreal implant
Other Intervention Name(s)
Retisert
Intervention Description
0.59 mg
Intervention Type
Drug
Intervention Name(s)
2.1 mg fluocinolone acetonide intravitreal implant
Intervention Description
2.1 mg
Intervention Type
Procedure
Intervention Name(s)
standard of care laser photocoagulation
Intervention Description
standard of care laser photocoagulation
Primary Outcome Measure Information:
Title
Between group difference in mean visual acuity change (from baseline)
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Differences in the proportions of subjects in each treatment group experiencing changes in: the area of retinal thickening; retinal leakage and cystoid scores; grade of diabetic retinopathy
Time Frame
1 year
Title
Ocular adverse events, non-ocular adverse events, and intraocular pressure >/= 30 mm Hg
Time Frame
throughout study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with type 1 or 2 diabetes. Subjects with clinically significant macular edema as defined by the ETDRS. A best corrected visual acuity between +0.30 and +1.00 logMAR (70 and 35 letters or approximately 20/40 to 20/200) as measured on an ETDRS chart. Subjects with laser treatment status/history as follows: [1] Naïve to laser photocoagulation or Focal laser photocoagulation more than 16 weeks prior to screening or PRP more than 24 weeks prior to screening, [2] No laser scars within 500µm (4x the width of a retinal vein at the disc margin) of the central macula. The subject's ocular media had to be sufficiently clear to allow for quality fundus photography. If aphakic or pseudophakic, lens removal had to have occurred at least 40 weeks prior to screening. Subjects had to be males or non-pregnant females of at least 18 years. Subjects had to display the ability and willingness to comply with treatment, follow up process, and sign an Informed Consent Form. Exclusion Criteria: Subjects who have had previous grid macular photocoagulation for diffuse macular edema. Presence of posterior hyaloid membrane, epiretinal membranes, fibrovascular proliferation, and vitreopapillary traction, which causes tractional distortion on the macula as demonstrated by OCT or funduscopy. History of or current retinal detachment requiring surgical treatment or a scleral buckle. Diabetic Retinopathy that required immediate PRP. Ocular disease other than diabetic retinopathy that could confound the outcome of the study (e.g., age-related macular degeneration, drug toxicity, uveitis, hypertensive retinopathy, ischemic maculopathy, etc.). Glaucoma, or history of glaucoma in either the study eye or the fellow eye. Ocular hypertension, or history of ocular hypertension requiring IOP lowering treatment. A media opacity that precludes visualization and/or diagnosis of the status of the eye. Concurrent coumadin therapy or known bleeding diathesis. Subjects requiring chronic systemic corticosteroid therapy or systemic immunosuppressive therapy to manage non-ocular disease. Concurrent treatment with a new investigational drug. Subjects with a best-corrected visual acuity worse than +1.0 logMAR (20/200 or 35 ETDRS letters) in the fellow eye. Pregnant or lactating females. Females of childbearing potential considering becoming pregnant during the course of the study and those not taking effective contraception/precautions to avoid pregnancy. History of hypersensitivity to fluorescein, known allergies to steroids or any component of the intraocular device. Subjects with photophobia that will preclude the ability to do fundus evaluations.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Taraprasad Das, MD
Organizational Affiliation
LV Prasad Eye Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dennis Lam Shun-Chiu, MD
Organizational Affiliation
Chinese University of Hong Kong
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Chinese University of Hong Kong
City
Hong Kong
Country
China
Facility Name
LV Prasad Eye Institute
City
Banjara Hills
State/Province
Hyderabad
ZIP/Postal Code
500 034
Country
India

12. IPD Sharing Statement

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Safety and Efficacy of Intravitreal Fluocinolone Acetonide Implants in Patients With Diabetic Macular Edema

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