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High-Dose Lucentis (Ranibizumab 2.0mg) for the Treatment of Nonproliferative Idiopathic Parafoveal Telangiectasia (HD-LIPT)

Primary Purpose

Retinal Diseases, Telangiectasis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ranibizumab 2.0mg
Sponsored by
Eye Center of Northern Colorado, P.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retinal Diseases focused on measuring Idiopathic Parafoveal Telangiectasia, Macular Telangiectasia, Macula Lutea/pathology, Retinal Diseases/pathology, Retinal Pigments/metabolism, Telangiectasis/metabolism, Telangiectasis/pathology

Eligibility Criteria

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

Inclusion Criteria:

  • Ability to provide written informed consent and comply with study assessments for the full duration of the study
  • Age > 18 years
  • Presence of nonproliferative IPT confirmed by fluorescein angiography and spectral-domain OCT
  • Age greater than 18
  • Vision equal to or worse than 20/25 and better than or equal to 20/400 by ETDRS chart, without co-existing choroidal neovascularization.
  • Physical ability and reasonable expectation to maintain all follow-up appointments.

Exclusion Criteria:

  • Pregnancy (positive pregnancy test) or lactation
  • Premenopausal women not using adequate contraception. The following are considered effective means of contraception: surgical sterilization or use of oral contraceptives, barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel, an IUD, or contraceptive hormone implant or patch.
  • 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 ophthalmologic investigation or trial
  • Any patient with proliferative diabetic retinopathy, diabetic macular edema, uveitis, history of ocular trauma, severe glaucoma, neovascular age-related macular degeneration
  • Duration of previous treatment of IPT that exceeds two years.
  • Any concurrent intraocular condition in the study eye (e.g., cataract or diabetic retinopathy) that, in the opinion of the investigator, could either:
  • Require medical or surgical intervention during the 12-month study period to prevent or treat visual loss that might result from that condition, or
  • If allowed to progress untreated, could likely contribute to loss of at least 2 Snellen equivalent lines of Best Corrected Visual Acuity (BCVA) over the study period
  • Prior/Concomitant Treatment:
  • Previous steroids (oral) within 30 days preceding Day 0
  • Previous participation in any studies of investigational drugs within 30 days preceding Day 0 (excluding vitamins and minerals)
  • Prior participation in a Genentech ranibizumab clinical trial within 60 days.
  • History of receiving intravitreal injections of ranibizumab, bevacizumab, pegaptanib, or any other intravitreal medication within 60 days of first injection. History of receiving intravitreal or subtenons triamcinolone within 90 days of first injection.

Sites / Locations

  • Eye Center of Northern Colorado

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Observation

Intravitreal ranibizumab 2.0mg

Arm Description

Observation; No treatment given

Initial dose 2.0mg switched to 1.0mg at near conclusion of study.

Outcomes

Primary Outcome Measures

Visual Acuity Change From Baseline to Month 12 of the Study

Secondary Outcome Measures

Change in Visual Acuity From Baseline to Month 6 and From Baseline to 9 Months
Change in Standard Central Subfield Thickness (CST) as Measured by OCT From Baseline to 6, 9, and 12 Months
A large decrease in CST thickness may be indicative of a worse clinical outcome. These measurements are done to ensure safety of the participants.
Number of Adverse Events Associated to the Administration of Ranibizumab 2.0mg
Angiographic Leakage From Baseline to Month 6 and 12
Angiography was taken via fluorescein angiography. Any increases of angiographic leakage was counted between baseline and month 6. Also any decreases of angiographic leakage was counted between baseline and 6 month. The same was done between baseline and 12 month. Any increase of angiographic leakage was counted as a +1. Likewise, any decrease of angiographic leakage was counted as a -1. The sum was calculated based on the number of participants in each arm and the total shown in the outcome. For example: if across the three injected participants for their 6 month visit, two of them showed an increase of angiographic leakage and one showed a decrease, then the outcome would be, (+1) + (+1) + (-1)= +1. Likewise, if the same three participant's 12 month visit showed two with a decrease in leakage and one with no changes in leakage, the outcome would be, (-1) + (-1) + (0)= -2

Full Information

First Posted
September 16, 2010
Last Updated
March 30, 2015
Sponsor
Eye Center of Northern Colorado, P.C.
Collaborators
Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01205035
Brief Title
High-Dose Lucentis (Ranibizumab 2.0mg) for the Treatment of Nonproliferative Idiopathic Parafoveal Telangiectasia
Acronym
HD-LIPT
Official Title
High-Dose Lucentis (Ranibizumab 2.0mg) for the Treatment of Nonproliferative Idiopathic Parafoveal Telangiectasia [HD-LIPT]
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
October 2012 (Actual)
Study Completion Date
October 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Eye Center of Northern Colorado, P.C.
Collaborators
Genentech, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Idiopathic Parafoveal Telangiectasia (IPT) [also known as Idiopathic Perifoveal Telangiectasia, Idiopathic Juxtafoveal Telangiectasia (IJT, JFT) and Macular Telangiectasia (MacTel)] is a disorder of unknown etiology. IPT is classified as Group 2A in the Gass classification of macular telangiectasias (Reference 1,5) - a bilateral, but not always symmetric disorder. It is characterized in its early stages by dilation and loss of parafoveal capillaries accompanied by angiographic leakage, "right angle" venules, central and parafoveal intraretinal cysts.
Detailed Description
DESCRIPTION OF THE STUDY This is an open-label, Phase I/II study of intravitreally administered ranibizumab in subjects with nonproliferative Idiopathic Parafoveal Telangiectasia (IPT). Consented, enrolled subjects will be randomized into two groups: observation and treatment. The observation group will be monitored monthly while the treatment group will receive three open-label intravitreal injections of 1.0 mg ranibizumab administered every 30 days for 3 months and then as needed monthly, based on defined criteria. NOTE: The original protocol had the treatment group dosed at 2.0 mg/0.05mL. However, the 2.0mg dose will become unavailable beginning January 31, 2012. Therefore, the protocol amendment submitted in December 2011 changed the 2.0mg arm to a 1.0mg/ 0.10mL arm. Please note that three patients were already treated with 2.0mg before the amendment was submitted, so they will be switched to 1.0mg if they have not completed the study when the 2.0 dose is no longer available in January 2012. Protocol: FVF4875s Final 6/P 29MAR2010 3.2 RATIONALE FOR STUDY DESIGN As IPT is a chronically progressive condition, the purpose of this study is to see if high-dose ranibizumab can slow or stop the leakage and growth of existing, dilated, macular vessels in cases where no co-existing neovascularization exists as defined by fluorescein angiography and Ocular Coherence Tomography (OCT). Other outcomes include stabilization of visual acuity compared to observation group (defined by best corrected Early Treatment Diabetic Retinopathy Study (ETDRS) measurements), and changes in ultrastructural features, as defined by OCT, 3.3 OUTCOME MEASURES 3.3.1 Primary Outcome Measures To compare the change in visual acuity from baseline to one year in patients with nonproliferative IPT who are either treated with high-dose (1.0mg) ranibizumab or observed. 3.3.2 Secondary Outcome Measures i. To compare the change in visual acuity from baseline to 6 months and 9 months in patients with nonproliferative IPT who are either treated with high- dose (1.0mg) ranibizumab or observed. ii. To assess OCT changes in standard Central Subfield Thickness (CST) from baseline to 6 months, 9 months and 12 months. iii. To assess safety of administering 1.0mg ranibizumab (Lucentis) in patients with nonproliferative IPT at 6 months, 9 months and 12 months. iv. To assess changes in angiographic leakage from baseline at 6 and 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retinal Diseases, Telangiectasis
Keywords
Idiopathic Parafoveal Telangiectasia, Macular Telangiectasia, Macula Lutea/pathology, Retinal Diseases/pathology, Retinal Pigments/metabolism, Telangiectasis/metabolism, Telangiectasis/pathology

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Observation
Arm Type
No Intervention
Arm Description
Observation; No treatment given
Arm Title
Intravitreal ranibizumab 2.0mg
Arm Type
Experimental
Arm Description
Initial dose 2.0mg switched to 1.0mg at near conclusion of study.
Intervention Type
Drug
Intervention Name(s)
ranibizumab 2.0mg
Other Intervention Name(s)
Lucentis
Intervention Description
Baseline monthly intravitreal injection of ranibizumab 2.0mg for 3 months followed by possible monthly injections up to 9 additional injections
Primary Outcome Measure Information:
Title
Visual Acuity Change From Baseline to Month 12 of the Study
Time Frame
Baseline to 12 months
Secondary Outcome Measure Information:
Title
Change in Visual Acuity From Baseline to Month 6 and From Baseline to 9 Months
Time Frame
Baseline to 6 months and baseline to 9 months
Title
Change in Standard Central Subfield Thickness (CST) as Measured by OCT From Baseline to 6, 9, and 12 Months
Description
A large decrease in CST thickness may be indicative of a worse clinical outcome. These measurements are done to ensure safety of the participants.
Time Frame
Baseline to 6, 9, and 12 months
Title
Number of Adverse Events Associated to the Administration of Ranibizumab 2.0mg
Time Frame
Baseline to 6 month, baseline to 9 month and baseline to 12 months
Title
Angiographic Leakage From Baseline to Month 6 and 12
Description
Angiography was taken via fluorescein angiography. Any increases of angiographic leakage was counted between baseline and month 6. Also any decreases of angiographic leakage was counted between baseline and 6 month. The same was done between baseline and 12 month. Any increase of angiographic leakage was counted as a +1. Likewise, any decrease of angiographic leakage was counted as a -1. The sum was calculated based on the number of participants in each arm and the total shown in the outcome. For example: if across the three injected participants for their 6 month visit, two of them showed an increase of angiographic leakage and one showed a decrease, then the outcome would be, (+1) + (+1) + (-1)= +1. Likewise, if the same three participant's 12 month visit showed two with a decrease in leakage and one with no changes in leakage, the outcome would be, (-1) + (-1) + (0)= -2
Time Frame
Baseline to 6 and baseline to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to provide written informed consent and comply with study assessments for the full duration of the study Age > 18 years Presence of nonproliferative IPT confirmed by fluorescein angiography and spectral-domain OCT Age greater than 18 Vision equal to or worse than 20/25 and better than or equal to 20/400 by ETDRS chart, without co-existing choroidal neovascularization. Physical ability and reasonable expectation to maintain all follow-up appointments. Exclusion Criteria: Pregnancy (positive pregnancy test) or lactation Premenopausal women not using adequate contraception. The following are considered effective means of contraception: surgical sterilization or use of oral contraceptives, barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel, an IUD, or contraceptive hormone implant or patch. 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 ophthalmologic investigation or trial Any patient with proliferative diabetic retinopathy, diabetic macular edema, uveitis, history of ocular trauma, severe glaucoma, neovascular age-related macular degeneration Duration of previous treatment of IPT that exceeds two years. Any concurrent intraocular condition in the study eye (e.g., cataract or diabetic retinopathy) that, in the opinion of the investigator, could either: Require medical or surgical intervention during the 12-month study period to prevent or treat visual loss that might result from that condition, or If allowed to progress untreated, could likely contribute to loss of at least 2 Snellen equivalent lines of Best Corrected Visual Acuity (BCVA) over the study period Prior/Concomitant Treatment: Previous steroids (oral) within 30 days preceding Day 0 Previous participation in any studies of investigational drugs within 30 days preceding Day 0 (excluding vitamins and minerals) Prior participation in a Genentech ranibizumab clinical trial within 60 days. History of receiving intravitreal injections of ranibizumab, bevacizumab, pegaptanib, or any other intravitreal medication within 60 days of first injection. History of receiving intravitreal or subtenons triamcinolone within 90 days of first injection.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arthur Korotkin, M.D.
Organizational Affiliation
Eye Center of Northern Colorado
Official's Role
Principal Investigator
Facility Information:
Facility Name
Eye Center of Northern Colorado
City
Fort Collins
State/Province
Colorado
ZIP/Postal Code
80525
Country
United States

12. IPD Sharing Statement

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High-Dose Lucentis (Ranibizumab 2.0mg) for the Treatment of Nonproliferative Idiopathic Parafoveal Telangiectasia

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