Combined aPproach to Treatment Using Ranibizumab and Efalizumab for Diabetic Macular Edema Study: The CAPTURE DME Study (CAPTURE)
Diabetic Macular Edema
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
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
Experimental
Experimental
Experimental
Group 1
Group 2
Group 3
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).