Efficacy and Safety Study of iSONEP With & Without Lucentis/Avastin/Eylea to Treat Wet AMD (Nexus)
Exudative Age-related Macular Degeneration
About this trial
This is an interventional treatment trial for Exudative Age-related Macular Degeneration focused on measuring choroidal neovascularization, age-related macular degeneration, iSONEP, sonepcizumab, Lucentis, ranibizumab, Avastin, bevacizumab, Eylea, aflibercept
Eligibility Criteria
Inclusion Criteria:
- ≥50 years of age with a diagnosis of wet AMD
- Subjects who have received 3 injections of Lucentis or Avastin or Eylea within 12 months prior to screening
- Active subfoveal CNV secondary to AMD (leakage on FA)
- Presence of residual subretinal or intraretinal fluid on Cirrus or Spectralis SDOCT
- SDOCT in the 1 mm central macular subfield on the retinal map analysis of ≥250 μm at screening
- ETDRS BCVA of ≥25 and ≤73 letters (approximately 20/320 and 20/40 on the Snellen scale) at screening and on Day 0
- In the fellow eye, ETDRS BCVA of 20/400 or better
- Subject with serous pigment epithelial detachment (PED) (any part of which may be subfoveal) with intraretinal and/or subretinal fluid may be included
Exclusion Criteria:
- Most recent IVT injection of Lucentis or Avastin fewer than 28 days and more than 65 days prior to screening
- Most recent IVT injection of Eylea fewer than 42 days and more than 79 days prior to screening
- Previous photodynamic therapy (PDT) or Macugen® at any time point
- Focal thermal laser or grid laser within 3 months prior to Day 0
- Use of IVT, subtenon or subconjunctival steroids within 3 months prior to Day 0
- Use of topical ophthalmic corticosteroids 2 weeks prior to Day 0
- Intraocular surgery, including cataract surgery, and / or laser of any type within 3 months prior to Day 0 or anticipated need for ocular surgery or ophthalmic laser treatment during the study period
- Subjects previously treated with, or are currently receiving treatment with another investigational agent or device for neovascular AMD in the study eye
- Retinal total lesion size >12 disc areas (30.5 mm2), including blood, scars and neovascularization as assessed by FA in the study eye
- Presence of a fibrovascular PED extending underneath the center of the fovea
- Presence of retinal angiomatous proliferation (RAP) lesions
- Presence of polypoidal choroidal vasculopathy (PCV) (if suspected, Indocyanine Green Angiography (ICG) should be performed at the discretion of the Investigator)
- Subretinal hemorrhage in the study eye if any of the following is true: (i) the subretinal hemorrhage represents 50% or more of the total lesion area; (ii) subfoveal blood is 1 or more disc areas in size (iii) subfoveal blood where the fovea is surrounded by less than 270 degrees of visible CNV on FA
- Scar or fibrosis making up >50% of total lesion area in the study eye
- Anatomic damage to the center of the fovea including fibrosis, scarring or atrophy
- History of a retinal pigment epithelial tear
- History of vitreous hemorrhage within 4 weeks prior to screening in the study eye
- Clinical evidence of diabetic retinopathy, diabetic macular edema or any other vascular disease affecting the retina, other than AMD, in either eye
- Uncontrolled glaucoma defined as: (i) as intraocular pressure ≥25 mmHg despite treatment with anti glaucoma medication in the study eye or (ii) by the Investigator
- Prior trabeculectomy or other filtration surgery in the study eye (prior laser trabeculoplasty is allowed)
Sites / Locations
- Retina Consultants of Arizona
- Retina Consultants of Arizona
- Associated Retina Consultants
- Retina Centers, P.C.
- Retina-Vitreous Associates Medical Group
- Retinal Diagnostic Center
- Specialty Eye Care Medical Center
- Retina Associates of Orange County
- Northern California Retina Vitreous Associates
- Sagar Kenyon American Eye Institute
- Retinal Consultants Medical Group, Inc.
- Orange County Retina Medical Group
- Miramar Eye Specialists
- Florida Eye Microsurgical Institute
- Retina Health Center
- Retina Specialty Institute
- Fort Lauderdale Eye Institute
- East Florida Eye Institute
- Center for Retina & Macular Disease
- Retina Consultants of Hawaii
- Midwest Eye Institute
- Central Plains Eye MDs
- Bennett & Bloom Eye Centers
- Retina Group of Washington
- Retina Specialists
- Ophthalmic Consultants of Boston
- Henry Ford Health System
- TLC Eye Care and Laser Center
- Retina Consultants of Michigan
- Island Retina
- Charlotte Eye Ear Nose & Throat Associates
- Retina & Vitreous Center SO
- Associates in Ophthalmology
- Palmetto Retina Center
- Retina Research Institute of Texas
- Austin Retina Associates
- Retina Research Center
- Texas Retina Associates
- Valley Retina Institute
- Medical Center Ophthalmology Associates
- Retina Associates of South Texas
- Rocky Mountain Retina Consultants
- Retina Group of Washington
- Spokane Eye Clinical Research
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Monotherapy
0.5 mg iSONEP & Lucentis/Avastin/Eylea
4.0 mg iSONEP & Lucentis/Avastin/Eylea
Lucentis or Avastin or Eylea
4.0 mg iSONEP followed by sham injection; given monthly intravitreously for 4 months
0.5 mg iSONEP and 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea; given monthly intravitreously for 4 months
4.0 mg iSONEP followed by 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea; given monthly intravitreously for 4 months
0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea followed by a sham injection; given monthly intravitreously for 4 months