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Study to Evaluate the Effects of Ranibizumab (Lucentis) for Patients With Rubeosis and Neovascular Glaucoma (LucNVG0108)

Primary Purpose

Neovascular Glaucoma, Rubeosis

Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
0.5mg intraocular Ranibizumab (Lucentis)
Sponsored by
University of Luebeck
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neovascular Glaucoma focused on measuring neovascular glaucoma, rubeosis, anterior chamber, intraocular, intravitreal injections, Lucentis, Ranibizumab, short ans longterm effects, best corrected visual acuity, gonioscopy, BCVA, quality of life

Eligibility Criteria

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

Inclusion Criteria:

  1. neo-vascular glaucoma or rubeosis

    • definition of neo-vascular glaucoma: patient with iris neovascularization with intraocular pressure elevation (exceeding 21 mmHg)
    • definition of rubeosis: patient with iris neovascularization without intraocular pressure elevation (≤21 mmHg)
  2. an available follow-up of 12 months
  3. written informed consent
  4. visual acuity of light perception or better.

Exclusion Criteria:

  1. history or evidence of severe cardiac disease (e.g., NYHA functional class III or IV)
  2. clinical or medical history of unstable angina, acute coronary syndrome, myocardial infarction or revascularization with 6 months
  3. ventricular tachyarrhythmias requiring ongoing treatment
  4. History or evidence clinically significant peripheral vascular disease, such as intermittent claudication or prior amputation
  5. Clinically significant impaired renal or hepatic function
  6. Stroke within 12 month before trial entry.
  7. Known serious allergies to the fluorescein dye use in angiography
  8. Known contraindications to the components of Lucentis® formulation.

Ocular concomitant conditions/ diseases

  1. Active intraocular inflammation (grade trace or above) in either eye
  2. Any active infection (e.g. conjunctivitis, keratitis, scleritis, uveitis, endophthalmitis) in either eye
  3. History of uveitis in either eye
  4. Treatment with anti-angiogenic drugs (pegaptanib sodium, anecortave acetate,bevacizumab, ranibizumab, etc.) or intravitreal corticosteroids in either eye within 4 months prior to inclusion
  5. Angle block glaucoma
  6. Phthisis
  7. Intraocular Pressure <10mmHg

Compliance/ Administrative

  1. Previous participation in any clinical studies of investigational drugs (excluding vitamins and minerals) within 1 month (or a period corresponding to 5 half-lives of the investigational drug, whatever is longer) prior to inclusion
  2. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant. including women whose career, lifestyle, or sexual orientation precludes intercourse with a male partner and women whose partners have been sterilized by vasectomy or other means, UNLESS they are using two birth control methods. The two methods can be a double barrier method or a barrier method plus a hormonal method. Adequate barrier methods of contraception include: diaphragm, condom (by the partner), intrauterine device (copper or hormonal), sponge or spermicide. Hormonal contraceptives include any marketed contraceptive agent that includes an estrogen and/or a progestational agent.
  3. Pregnant or nursing (lactating) women
  4. Inability to comply with study or follow-up procedures.
  5. Any treatment with an investigational agent in the past 60 days for any condition.

Sites / Locations

  • University of Lübeck - Department of Ophthalmology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lucentis (Ranibizumab)

Arm Description

Outcomes

Primary Outcome Measures

change of degree of iris rubeosis
Main outcome measure is the change of degree of iris rubeosis as documented by iris fluorescein angiography as measured 12 months after the first ranibizumab injection.

Secondary Outcome Measures

changes in intraocular pressure
• to document changes in intraocular pressure measurements with the Goldmann applanation tonometer
changes in best corrected visual acuity (BCVA)
• to document changes in best corrected visual acuity (BCVA) measured on 4 meters
numbers of additional interventions
• to document numbers of additional interventions or anti-glaucomatous medications 12 months after injection
quality of life
• to document changes of quality of life
Number of adverse events in all participants
• to evaluate the safety of intravitreal injections of ranibizumab (0.5 mg) as adjunctive in patients with rubeosis and neovascular glaucoma using the number of adverse events.
changes in gonioscopy
• to document changes in gonioscopy of the anterior chamber angle

Full Information

First Posted
May 27, 2011
Last Updated
January 15, 2013
Sponsor
University of Luebeck
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1. Study Identification

Unique Protocol Identification Number
NCT01370135
Brief Title
Study to Evaluate the Effects of Ranibizumab (Lucentis) for Patients With Rubeosis and Neovascular Glaucoma
Acronym
LucNVG0108
Official Title
An Open Label, Prospective, Monocenter, Prove of Concept Study to Evaluate the Short- and Long-term Effects of 0.5mg Intraocular Ranibizumab (Lucentis) Injections as Adjuvant for Patients With Rubeosis and Neovascular Glaucoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
November 2008 (undefined)
Primary Completion Date
April 2011 (Actual)
Study Completion Date
July 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Luebeck

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Proliferative ischemic retinopathies lead to a formation of abnormal vessels on the iris surface induced by an increased level of vascular endothelial growth factor (VEGF). In progressive stages fibrovascular membranes occlude the anterior chamber angle which inhibits aqueous outflow resulting in neovascular glaucoma. The increased intraocular pressure is often difficult to control and frequently results in loss of vision. The aim of this study is to analyze the short- and long-term outcome after adjuvant intraocular Ranibizumab application in patients with neovascular glaucoma and rubeosis and to analyze the role of ranibizumab within a holistic treatment regime.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neovascular Glaucoma, Rubeosis
Keywords
neovascular glaucoma, rubeosis, anterior chamber, intraocular, intravitreal injections, Lucentis, Ranibizumab, short ans longterm effects, best corrected visual acuity, gonioscopy, BCVA, quality of life

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lucentis (Ranibizumab)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
0.5mg intraocular Ranibizumab (Lucentis)
Intervention Description
short- and long-term effects of 0.5mg intraocular Ranibizumab (Lucentis) injections as adjuvant for patients with rubeosis and neovascular glaucoma
Primary Outcome Measure Information:
Title
change of degree of iris rubeosis
Description
Main outcome measure is the change of degree of iris rubeosis as documented by iris fluorescein angiography as measured 12 months after the first ranibizumab injection.
Time Frame
12 Months
Secondary Outcome Measure Information:
Title
changes in intraocular pressure
Description
• to document changes in intraocular pressure measurements with the Goldmann applanation tonometer
Time Frame
12 Months
Title
changes in best corrected visual acuity (BCVA)
Description
• to document changes in best corrected visual acuity (BCVA) measured on 4 meters
Time Frame
12 Months
Title
numbers of additional interventions
Description
• to document numbers of additional interventions or anti-glaucomatous medications 12 months after injection
Time Frame
12 Months
Title
quality of life
Description
• to document changes of quality of life
Time Frame
12 Months
Title
Number of adverse events in all participants
Description
• to evaluate the safety of intravitreal injections of ranibizumab (0.5 mg) as adjunctive in patients with rubeosis and neovascular glaucoma using the number of adverse events.
Time Frame
12 Months
Title
changes in gonioscopy
Description
• to document changes in gonioscopy of the anterior chamber angle
Time Frame
12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: neo-vascular glaucoma or rubeosis definition of neo-vascular glaucoma: patient with iris neovascularization with intraocular pressure elevation (exceeding 21 mmHg) definition of rubeosis: patient with iris neovascularization without intraocular pressure elevation (≤21 mmHg) an available follow-up of 12 months written informed consent visual acuity of light perception or better. Exclusion Criteria: history or evidence of severe cardiac disease (e.g., NYHA functional class III or IV) clinical or medical history of unstable angina, acute coronary syndrome, myocardial infarction or revascularization with 6 months ventricular tachyarrhythmias requiring ongoing treatment History or evidence clinically significant peripheral vascular disease, such as intermittent claudication or prior amputation Clinically significant impaired renal or hepatic function Stroke within 12 month before trial entry. Known serious allergies to the fluorescein dye use in angiography Known contraindications to the components of Lucentis® formulation. Ocular concomitant conditions/ diseases Active intraocular inflammation (grade trace or above) in either eye Any active infection (e.g. conjunctivitis, keratitis, scleritis, uveitis, endophthalmitis) in either eye History of uveitis in either eye Treatment with anti-angiogenic drugs (pegaptanib sodium, anecortave acetate,bevacizumab, ranibizumab, etc.) or intravitreal corticosteroids in either eye within 4 months prior to inclusion Angle block glaucoma Phthisis Intraocular Pressure <10mmHg Compliance/ Administrative Previous participation in any clinical studies of investigational drugs (excluding vitamins and minerals) within 1 month (or a period corresponding to 5 half-lives of the investigational drug, whatever is longer) prior to inclusion Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant. including women whose career, lifestyle, or sexual orientation precludes intercourse with a male partner and women whose partners have been sterilized by vasectomy or other means, UNLESS they are using two birth control methods. The two methods can be a double barrier method or a barrier method plus a hormonal method. Adequate barrier methods of contraception include: diaphragm, condom (by the partner), intrauterine device (copper or hormonal), sponge or spermicide. Hormonal contraceptives include any marketed contraceptive agent that includes an estrogen and/or a progestational agent. Pregnant or nursing (lactating) women Inability to comply with study or follow-up procedures. Any treatment with an investigational agent in the past 60 days for any condition.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Salvatore Grisanti, M.D. Prof.
Organizational Affiliation
University of Lübeck - Department of Ophthalmology: Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Lübeck - Department of Ophthalmology
City
Lübeck
ZIP/Postal Code
23538
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
23893090
Citation
Luke J, Nassar K, Luke M, Grisanti S. Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma--results from a prospective interventional case series. Graefes Arch Clin Exp Ophthalmol. 2013 Oct;251(10):2403-13. doi: 10.1007/s00417-013-2428-y. Epub 2013 Jul 28.
Results Reference
derived
Links:
URL
http://www.uksh.de/Augenklinik_Luebeck/index.html
Description
University of Lübeck - Department of Ophthalmology - Germany

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Study to Evaluate the Effects of Ranibizumab (Lucentis) for Patients With Rubeosis and Neovascular Glaucoma

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