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Combined aPproach to Treatment Using Ranibizumab and Efalizumab for Diabetic Macular Edema Study: The CAPTURE DME Study (CAPTURE)

Primary Purpose

Diabetic Macular Edema

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Efalizumab
Ranibizumab
Sponsored by
Johns Hopkins University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Macular Edema focused on measuring Diabetic, Macular, Edema, DME, Clinically Significant Macular Edema (CSME)

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent and authorization of use and disclosure of protected health information
  • 18 years of Age
  • Diagnosis of diabetes mellitus (type 1 or type 2)
  • Serum HbA1c 5.5% within 12 months of randomization
  • Retinal thickening (diabetic macular edema) involving the center of the fovea
  • Diagnosis must be confirmed by fluorescein angiography and OCT images over 250
  • Best corrected visual acuity score in the study eye of 20/40 to 20/320
  • If a female of childbearing potential, a negative pregnancy test and commitment to the use of at least two forms of effective contraception.
  • If a non-sterile male, commitment to the use of two forms of effective contraception.
  • Demonstrate understanding of and ability to perform weekly self sub-cutaneous injections.

Exclusion Criteria:

  • Panretinal or macular photocoagulation within 3 months of study entry in the study eye
  • Use of intraocular or periocular injection of steroids in the study eye within 3 months of study entry
  • Previous participation in a study and receipt of anti-angiogenic drugs (pegaptanib sodium, ranibizumab, bevacizumab, anecortave acetate, protein kinase C inhibitor, etc.) within 2 months of study entry
  • Current or history of prior treatment of psoriasis with subcutaneous efalizumab within 6 months of study entry

    • Proliferative diabetic retinopathy in the study eye, with the exceptions of
    • inactive, fibrotic proliferative diabetic retinopathy that has regressed following pan-retinal laser photocoagulation OR
    • tufts of neovascularization elsewhere (NVE) less than one disc area with no vitreous hemorrhage
    • Vitreomacular traction or epiretinal membrane in the study eye
    • Structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema.
    • Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the first 6-months.
    • Cataract surgery in the study eye within 3 months of study entry; (YAG) laser capsulotomy within 1 month of study entry; or any other intraocular surgery within 3 months preceding Day 0.
    • History of vitreoretinal surgery in the study eye within 3 months of study entry
    • Uncontrolled glaucoma .
    • Blood pressure exceeding 180/100 (sitting) during the screening period
    • Uncontrolled diabetes mellitus, as evidenced by glycosylated hemoglobin > or = 13%(HbA1c) value
    • Renal failure requiring dialysis or renal transplant
    • Premenopausal women unwilling to commit to adequate contraception
    • History of other diseases or finding giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications
    • International Normalized Ratio (INR) > or = 3.0 (e.g. due to current treatment with warfarin).
    • History of cerebral vascular accident, myocardial infarction, transient ischemic attacks within 6 months of study enrollment.
    • Have a history of hypersensitivity to efalizumab
    • Have a history of ongoing uncontrolled serious bacterial, viral, fungal, or atypical mycobacterial infection. Have a history of opportunistic infections.
    • Have the presence or history of malignancy, including lymphoproliferative disorders.
    • Have a history of thrombocytopenia, clinically significant hemolytic anemia, or unexplained anemia
    • Have a platelet count < 100,000 cells/microliter (uL)
    • Inability to comply
    • Patients receiving immunosuppressive agents
    • All acellular, live and live-attenuated vaccines are excluded from 14 days prior to the first dose of efalizumab until a minimum of 4 weeks after the last dose of efalizumab
    • Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated.
    • Participation in another simultaneous medical investigation or trial

Sites / Locations

  • Diego H. Calonje, M.D., P.C.
  • Sharp Rees-Stealy Medical Group
  • Retina Macula Institute
  • Retina Associates of Maine
  • Retina Center of Maine
  • Wilmer Eye Institute at the Johns Hopkins University
  • Ophthalmic Consultants of Boston
  • Eye Care Specialists
  • Texas Retina Associates
  • University of Utah

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Group 1

Group 2

Group 3

Arm Description

Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks.

Ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).

Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks in combination with ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).

Outcomes

Primary Outcome Measures

To assess the safety and tolerability of efalizumab, compared to and in combination with ranibizumab, measuring the frequency and severity of adverse events.

Secondary Outcome Measures

To measure the mean change from Baseline to Month 6 and Month 12 in Best correct visual acuity (BCVA)
To evaluate the anatomic retinal changes as assessed by color fundus photography, fluorescein angiography, and Optical Coherence Tomography (OCT)

Full Information

First Posted
May 8, 2008
Last Updated
August 25, 2016
Sponsor
Johns Hopkins University
Collaborators
Juvenile Diabetes Research Foundation, Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00676559
Brief Title
Combined aPproach to Treatment Using Ranibizumab and Efalizumab for Diabetic Macular Edema Study: The CAPTURE DME Study
Acronym
CAPTURE
Official Title
Combined aPproach to Treatment Using Ranibizumab and Efalizumab for Diabetic Macular Edema Study: The CAPTURE DME Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Withdrawn
Why Stopped
Unrelated serious adverse events involving one of the proposed medications
Study Start Date
April 2008 (undefined)
Primary Completion Date
April 2009 (Anticipated)
Study Completion Date
April 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Johns Hopkins University
Collaborators
Juvenile Diabetes Research Foundation, Genentech, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study looks to continue the study of anti-vegf therapy in patients with macular edema, and compare it to an anti-inflammatory therapy and a combined Anti-vegf and anti-inflammatory.
Detailed Description
Cell adhesion molecules are key mediators of inflammatory processes, which have been shown to play a role in the pathogenesis of diabetic retinopathy . Efalizumab inhibits the binding of leukocyte function-associated antigen-1 (LFA-1) to intercellular adhesion molecule-1 (ICAM-1) thereby inhibiting the adhesion of leukocytes to other cell types. Clinical studies have demonstrated the bioactivities of intravitreal ranibizumab, a Vascular endothelial growth factor (VEGF) antagonist, in reducing retinal thickness and improving visual acuity in patients with diabetic macular edema (DME). The objective of the CAPTURE Study is to assess the safety and tolerability of efalizumab, administered subcutaneously as a weekly (1 mg/kg) dose, compared to and in combination with ranibizumab, administered intravitreally (0.5 mg), in the treatment of DME.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Macular Edema
Keywords
Diabetic, Macular, Edema, DME, Clinically Significant Macular Edema (CSME)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Factorial Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks.
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).
Arm Title
Group 3
Arm Type
Experimental
Arm Description
Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks in combination with ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).
Intervention Type
Drug
Intervention Name(s)
Efalizumab
Other Intervention Name(s)
Raptiva
Intervention Description
Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks.
Intervention Type
Drug
Intervention Name(s)
Ranibizumab
Other Intervention Name(s)
Lucentis
Intervention Description
Ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).
Primary Outcome Measure Information:
Title
To assess the safety and tolerability of efalizumab, compared to and in combination with ranibizumab, measuring the frequency and severity of adverse events.
Time Frame
6 mos
Secondary Outcome Measure Information:
Title
To measure the mean change from Baseline to Month 6 and Month 12 in Best correct visual acuity (BCVA)
Time Frame
6 and 12 mos.
Title
To evaluate the anatomic retinal changes as assessed by color fundus photography, fluorescein angiography, and Optical Coherence Tomography (OCT)
Time Frame
6 mos and 12 mos

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent and authorization of use and disclosure of protected health information 18 years of Age Diagnosis of diabetes mellitus (type 1 or type 2) Serum HbA1c 5.5% within 12 months of randomization Retinal thickening (diabetic macular edema) involving the center of the fovea Diagnosis must be confirmed by fluorescein angiography and OCT images over 250 Best corrected visual acuity score in the study eye of 20/40 to 20/320 If a female of childbearing potential, a negative pregnancy test and commitment to the use of at least two forms of effective contraception. If a non-sterile male, commitment to the use of two forms of effective contraception. Demonstrate understanding of and ability to perform weekly self sub-cutaneous injections. Exclusion Criteria: Panretinal or macular photocoagulation within 3 months of study entry in the study eye Use of intraocular or periocular injection of steroids in the study eye within 3 months of study entry Previous participation in a study and receipt of anti-angiogenic drugs (pegaptanib sodium, ranibizumab, bevacizumab, anecortave acetate, protein kinase C inhibitor, etc.) within 2 months of study entry Current or history of prior treatment of psoriasis with subcutaneous efalizumab within 6 months of study entry Proliferative diabetic retinopathy in the study eye, with the exceptions of inactive, fibrotic proliferative diabetic retinopathy that has regressed following pan-retinal laser photocoagulation OR tufts of neovascularization elsewhere (NVE) less than one disc area with no vitreous hemorrhage Vitreomacular traction or epiretinal membrane in the study eye Structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema. Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the first 6-months. Cataract surgery in the study eye within 3 months of study entry; (YAG) laser capsulotomy within 1 month of study entry; or any other intraocular surgery within 3 months preceding Day 0. History of vitreoretinal surgery in the study eye within 3 months of study entry Uncontrolled glaucoma . Blood pressure exceeding 180/100 (sitting) during the screening period Uncontrolled diabetes mellitus, as evidenced by glycosylated hemoglobin > or = 13%(HbA1c) value Renal failure requiring dialysis or renal transplant Premenopausal women unwilling to commit to adequate contraception History of other diseases or finding giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications International Normalized Ratio (INR) > or = 3.0 (e.g. due to current treatment with warfarin). History of cerebral vascular accident, myocardial infarction, transient ischemic attacks within 6 months of study enrollment. Have a history of hypersensitivity to efalizumab Have a history of ongoing uncontrolled serious bacterial, viral, fungal, or atypical mycobacterial infection. Have a history of opportunistic infections. Have the presence or history of malignancy, including lymphoproliferative disorders. Have a history of thrombocytopenia, clinically significant hemolytic anemia, or unexplained anemia Have a platelet count < 100,000 cells/microliter (uL) Inability to comply Patients receiving immunosuppressive agents All acellular, live and live-attenuated vaccines are excluded from 14 days prior to the first dose of efalizumab until a minimum of 4 weeks after the last dose of efalizumab Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated. Participation in another simultaneous medical investigation or trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Quan Dong Nguyen, MD, MSc
Organizational Affiliation
Johns Hopkins University
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Diana V Do, MD
Organizational Affiliation
Johns Hopkins University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Diego H. Calonje, M.D., P.C.
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
Sharp Rees-Stealy Medical Group
City
San Diego
State/Province
California
ZIP/Postal Code
92101
Country
United States
Facility Name
Retina Macula Institute
City
Torrance
State/Province
California
ZIP/Postal Code
90503
Country
United States
Facility Name
Retina Associates of Maine
City
Bangor
State/Province
Maine
ZIP/Postal Code
04401
Country
United States
Facility Name
Retina Center of Maine
City
South Portland
State/Province
Maine
ZIP/Postal Code
04106
Country
United States
Facility Name
Wilmer Eye Institute at the Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Ophthalmic Consultants of Boston
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Eye Care Specialists
City
Kingston
State/Province
Pennsylvania
ZIP/Postal Code
18704
Country
United States
Facility Name
Texas Retina Associates
City
Arlington
State/Province
Texas
ZIP/Postal Code
76012
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Combined aPproach to Treatment Using Ranibizumab and Efalizumab for Diabetic Macular Edema Study: The CAPTURE DME Study

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