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A Single-Center Trial of High Frequency Pegaptanib for Rapid Restoration of VEGF Levels in Diabetic Retinal Edema (GUARDIAN)

Primary Purpose

Diabetic Macular Edema

Status
Available
Phase
Locations
United States
Study Type
Expanded Access
Intervention
Macugen (Pegaptanib Sodium)
Sponsored by
Retina Institute of Hawaii
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an expanded access trial for Diabetic Macular Edema focused on measuring DME

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All Sexes

Inclusion Criteria:

  • Type I or Type II diabetics, with an age of 18 years of older
  • Vision of 20/40-20/400 in the Study Eye
  • Diabetic Macular Edema as documented by SD-OCT and Fluorescein Angiogram.

Exclusion Criteria:

  • Cannot attened all trail required visits
  • Eyes in which retinal surgery is needed now are is likely to be needed within 6 months, which the surgeon believes will not respond to non-surgical intervention.
  • Presence of any abnormality that is likely to confound assessment of visual acuity improvement in eyes in which macular edema resolves, or improves, such as non-perfusion greater than 1 disc area involving the foveal avascular zone, epiretinal membrane associated with signs of contraction and/or significant opacification, or presence of chorioretinal atrophy involving the center of the macula.
  • Vitreomacular traction determined clinically and/or by OCT, which, in the investigator's opinion, contributes to the macular edema, or causes associated foveal detachment, and would preclude improvement with pegaptanib sodium.
  • Previous treatment with intravitreal corticosteroids in the study eye within 3 months of Day 0 visit.
  • Previous treatment with intravitreal anti-angiogenic drugs in the study eye within 2 months of Day 0 visit.
  • Previous intraocular surgery within 30 days of Day 0 visit.
  • Any ocular or periocular infection within 30 days of Day 0 visit.
  • Any of the following underlying diseases including:

History or evidence of severe cardiac disease (e.g., NYHA Functional Class III or IV - see Appendix 16.6), clinical or medical history of unstable angina, acute coronary syndrome, myocardial infarction or revascularization within 6 months, ventricular tachyarrythmias requiring ongoing treatment.

History or evidence of clinically significant peripheral vascular disease, such as intermittent claudication or prior amputation.

History or evidence of clinically significant impaired renal or hepatic function Stroke (within 12 months of trial entry). Any major surgical procedure within one month of trial entry.

  • Any treatment with an investigational agent in the past 30 days for any condition.
  • Known serious allergies to the fluorescein dye used in angiography or to the components of pegaptanib sodium formulation.

Sites / Locations

  • Retina Institute of Hawaii

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
December 5, 2011
Last Updated
December 5, 2011
Sponsor
Retina Institute of Hawaii
Collaborators
Eyetech Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01487044
Brief Title
A Single-Center Trial of High Frequency Pegaptanib for Rapid Restoration of VEGF Levels in Diabetic Retinal Edema
Acronym
GUARDIAN
Official Title
A Single-Center Trial of High Frequency Pegaptanib for Rapid Restoration of VEGF Levels in Diabetic Retinal Edema
Study Type
Expanded Access

2. Study Status

Record Verification Date
December 2011
Overall Recruitment Status
Available
Study Start Date
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Primary Completion Date
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Study Completion Date
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3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Retina Institute of Hawaii
Collaborators
Eyetech Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
Establish the efficacy of initial high frequency loading of intravitreal pegaptanib bi-weekly during the initial treatment period when the VEGF levels are the greatest and then gradually extending the administration frequency to monthly as homeostasis ensues for the treatment of DME, as measured by best-corrected visual acuity.
Detailed Description
Determine if high frequency loading intravitreal pegaptanib will reduce the area and/or volume of DME, as assessed by Spectral Domain optical coherence tomography (SD-OCT) and to determine if this loading with gradual taper schedule of intravitreal pegaptanib will reduce the need for macular laser treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Macular Edema
Keywords
DME

7. Study Design

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Macugen (Pegaptanib Sodium)
Intervention Description
Pegaptanib sodium drug substance is a pegylated (40 kDa branched PEG molecule consisting of two 20 kDa PEG arms) anti-VEGF aptamer. It is formulated in phosphate buffered saline at pH 6-7. Sodium hydroxide or hydrochloric acid may be added for pH adjustment. Pegaptanib sodium is formulated at 0.3mg/90µl and presented in USP Type I glass barrel syringes sealed with a bromobutyl rubber plunger stopper. The syringe has a needle attachment at allows for a 30-guage need to be fixed to the syringe prior to injection. The stoppered syringe is packaged in a foil pouch. The drug product is preservative-free and intended for single use by intravitreous injection only.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Eligibility Criteria
Inclusion Criteria: Type I or Type II diabetics, with an age of 18 years of older Vision of 20/40-20/400 in the Study Eye Diabetic Macular Edema as documented by SD-OCT and Fluorescein Angiogram. Exclusion Criteria: Cannot attened all trail required visits Eyes in which retinal surgery is needed now are is likely to be needed within 6 months, which the surgeon believes will not respond to non-surgical intervention. Presence of any abnormality that is likely to confound assessment of visual acuity improvement in eyes in which macular edema resolves, or improves, such as non-perfusion greater than 1 disc area involving the foveal avascular zone, epiretinal membrane associated with signs of contraction and/or significant opacification, or presence of chorioretinal atrophy involving the center of the macula. Vitreomacular traction determined clinically and/or by OCT, which, in the investigator's opinion, contributes to the macular edema, or causes associated foveal detachment, and would preclude improvement with pegaptanib sodium. Previous treatment with intravitreal corticosteroids in the study eye within 3 months of Day 0 visit. Previous treatment with intravitreal anti-angiogenic drugs in the study eye within 2 months of Day 0 visit. Previous intraocular surgery within 30 days of Day 0 visit. Any ocular or periocular infection within 30 days of Day 0 visit. Any of the following underlying diseases including: History or evidence of severe cardiac disease (e.g., NYHA Functional Class III or IV - see Appendix 16.6), clinical or medical history of unstable angina, acute coronary syndrome, myocardial infarction or revascularization within 6 months, ventricular tachyarrythmias requiring ongoing treatment. History or evidence of clinically significant peripheral vascular disease, such as intermittent claudication or prior amputation. History or evidence of clinically significant impaired renal or hepatic function Stroke (within 12 months of trial entry). Any major surgical procedure within one month of trial entry. Any treatment with an investigational agent in the past 30 days for any condition. Known serious allergies to the fluorescein dye used in angiography or to the components of pegaptanib sodium formulation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Michael D Bennett, MD
Phone
(808) 955-0255
Email
mikebennett@retinahawaii.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael D Bennett, MD
Organizational Affiliation
Retina Institute of Hawaii
Official's Role
Principal Investigator
Facility Information:
Facility Name
Retina Institute of Hawaii
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96815
Country
United States
Individual Site Status
Available
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Debbie Shimabukuro, RN
Phone
808-955-0255
Email
deb@retinahawaii.com
First Name & Middle Initial & Last Name & Degree
Jenny Song
Phone
(808) 955-0255
Ext
177
Email
jenny@retinahawaii.com
First Name & Middle Initial & Last Name & Degree
Michael D Bennett, MD

12. IPD Sharing Statement

Learn more about this trial

A Single-Center Trial of High Frequency Pegaptanib for Rapid Restoration of VEGF Levels in Diabetic Retinal Edema

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