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Pilot Study of X-82 in Patients With Wet AMD

Primary Purpose

Exudative Macular Degeneration

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
X-82 oral
ranibizumab (Lucentis)
Sponsored by
Tyrogenex
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Exudative Macular Degeneration focused on measuring VEGF, PDGF, AMD

Eligibility Criteria

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

Inclusion Criteria:

  1. Active choroidal neovascularization (CNV) associated with AMD, as evidenced on fluorescein angiography (FA) and OCT.
  2. No previous treatment with anti-VEGF therapy or prior anti-VEGF therapy with evidence of response to treatment and the need for additional treatment.
  3. Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA 20/32 to 20/320 in the study eye(s).
  4. Adequate bone marrow function.
  5. PT within the institutional upper limit of normal.
  6. Adequate hepatic function.
  7. Adequate renal function; serum creatinine.
  8. Ability to swallow oral medication.
  9. Age ≥ 50 years.
  10. Willing and able to provide written informed consent, comply with the investigational study protocol and return for all study visits.

Exclusion Criteria:

  1. Previous treatment with photodynamic therapy (PDT) within 4 months of screening in the study eye.
  2. CNV due to causes other than AMD.
  3. Geographic atrophy involving the foveal center in the study eye.
  4. Any retinal vascular disease or retinal degeneration other than AMD in the study eye.
  5. In the opinion of the investigator, any significant disease in the study eye that could compromise best-corrected visual acuity.
  6. Cataract surgery in the study eye within three months of screening.
  7. Trabeculectomy or aqueous shunt or valve in the study eye.
  8. Intraocular surgery in the study eye within three months of screening; Nd:YAG capsulotomy or laser iridotomy within 30 days of screening.
  9. Inadequate pupillary dilation or significant media opacities in the study eye.
  10. Use of any investigational agent or participation in any other clinical trial of an investigational agent or investigational therapy within thirty (30) days of baseline with the exception of subjects who are participating in the AREDS2 study.
  11. Females of child bearing potential that are pregnant or not using medically acceptable contraception; males unwilling to take adequate contraceptive measures. Females that are breastfeeding are also excluded.
  12. Serious allergy to or prior significant adverse reaction to fluorescein.
  13. Undiagnosed acute illness first observed during screening or between screening and baseline, or severe concurrent medical conditions that, in the investigators judgment, represent a safety concern.
  14. Severe cardiac disease, symptomatic congestive heart failure, unstable angina, acute coronary syndrome, myocardial infarction or coronary artery revascularization, or arterial thrombosis within 12 months of start of study drug, inadequately controlled hypertension, or ventricular tachyarrhythmias requiring ongoing treatment.
  15. QTc ≥450 msec or subjects with a history of risk factors for Torsades de Pointes or other clinically significant ECG abnormalities as determined by the investigator.
  16. Stroke or transient ischemic attack within 12 months of trial entry.
  17. Clinically significant impaired renal or hepatic function.
  18. Any major surgical procedure within one month of trial entry.
  19. Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of X-82.
  20. Receiving treatment with anti-coagulants other than 325 mg of aspirin per day.
  21. Serious active infection, other serious medical condition or any other condition that would impair the ability of the subject to administer the investigational drug or to adhere to the study protocol requirements.
  22. Presence of any condition which, in the judgment of the investigator, would prevent the subject from completing the study.
  23. No herbal medications with the exception of bilberry are allowed within 7 days of start of study drug.

Sites / Locations

  • Retina Vitreous Associates Medical Group
  • New England Retina Associates
  • Elman Retina Group
  • Retina Research Institute of Texas
  • Retina Consultants of Houston

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

50 mg X-82 oral alternate days

50 mg X-82 oral QD

100 mg X-82 oral alternate days

100 mg X-82 oral QD

200 mg X-82 oral QD

300 mg X-82 oral QD

Arm Description

50 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity develops

50 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria.for 24 weeks or until unacceptable toxicity develops

100 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria.for 24 weeks or until unacceptable toxicty develops

100 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs

200 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs

300 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs.

Outcomes

Primary Outcome Measures

Change From Baseline Visual Acuity at 6 Months
The best corrected visual acuity by the Early Treatment Diabetic Retinopathy Study (ETDRS) method was determined at baseline and at various times during the study. The ETDRS method records the number of letters of decreasing size on a chart that a subject can read from a defiend distance. During the study the ETDRS visual acuity was used to monitor the need for rescue therapy. The primary endpoint of the study was the change from baseline visual ETDRS visual acuity at 6 months. It was calculated by subtracting the baseline visual acuity from the visual acuity at 6 months for each individual subject. A positive change from baseline indicates improvement in visual acuity.

Secondary Outcome Measures

Full Information

First Posted
August 23, 2012
Last Updated
July 31, 2018
Sponsor
Tyrogenex
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1. Study Identification

Unique Protocol Identification Number
NCT01674569
Brief Title
Pilot Study of X-82 in Patients With Wet AMD
Official Title
A Phase 1 Open-label, Dose Escalation Clinical Trial to Evaluate the Safety and Preliminary Biologic Activity/Efficacy of the VEGFR/PDGFR Inhibitor X-82 Administered Per Os in Subjects With Neovascular Age-related Macular Degeneration (AMD)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
February 2015 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tyrogenex

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and preliminary biologic activity/efficacy of X-82 in patients with wet Age-related Macular Degeneration (AMD). Preliminary efficacy will be assessed by change from baseline in visual acuity, fluorescein leakage, retinal thickness and fibrosis, if detectable, based on fundus examination, fundus photography, fluorescein angiography and optical coherence tomography (OCT).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Exudative Macular Degeneration
Keywords
VEGF, PDGF, AMD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
50 mg X-82 oral alternate days
Arm Type
Experimental
Arm Description
50 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity develops
Arm Title
50 mg X-82 oral QD
Arm Type
Experimental
Arm Description
50 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria.for 24 weeks or until unacceptable toxicity develops
Arm Title
100 mg X-82 oral alternate days
Arm Type
Experimental
Arm Description
100 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria.for 24 weeks or until unacceptable toxicty develops
Arm Title
100 mg X-82 oral QD
Arm Type
Experimental
Arm Description
100 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs
Arm Title
200 mg X-82 oral QD
Arm Type
Experimental
Arm Description
200 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs
Arm Title
300 mg X-82 oral QD
Arm Type
Experimental
Arm Description
300 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs.
Intervention Type
Drug
Intervention Name(s)
X-82 oral
Intervention Description
X-82 oral for 24 weeks or until unacceptable toxicity develops
Intervention Type
Drug
Intervention Name(s)
ranibizumab (Lucentis)
Intervention Description
Rescue treatment with intravitreal ranibizumab (Lucentis) as needed
Primary Outcome Measure Information:
Title
Change From Baseline Visual Acuity at 6 Months
Description
The best corrected visual acuity by the Early Treatment Diabetic Retinopathy Study (ETDRS) method was determined at baseline and at various times during the study. The ETDRS method records the number of letters of decreasing size on a chart that a subject can read from a defiend distance. During the study the ETDRS visual acuity was used to monitor the need for rescue therapy. The primary endpoint of the study was the change from baseline visual ETDRS visual acuity at 6 months. It was calculated by subtracting the baseline visual acuity from the visual acuity at 6 months for each individual subject. A positive change from baseline indicates improvement in visual acuity.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Active choroidal neovascularization (CNV) associated with AMD, as evidenced on fluorescein angiography (FA) and OCT. No previous treatment with anti-VEGF therapy or prior anti-VEGF therapy with evidence of response to treatment and the need for additional treatment. Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA 20/32 to 20/320 in the study eye(s). Adequate bone marrow function. PT within the institutional upper limit of normal. Adequate hepatic function. Adequate renal function; serum creatinine. Ability to swallow oral medication. Age ≥ 50 years. Willing and able to provide written informed consent, comply with the investigational study protocol and return for all study visits. Exclusion Criteria: Previous treatment with photodynamic therapy (PDT) within 4 months of screening in the study eye. CNV due to causes other than AMD. Geographic atrophy involving the foveal center in the study eye. Any retinal vascular disease or retinal degeneration other than AMD in the study eye. In the opinion of the investigator, any significant disease in the study eye that could compromise best-corrected visual acuity. Cataract surgery in the study eye within three months of screening. Trabeculectomy or aqueous shunt or valve in the study eye. Intraocular surgery in the study eye within three months of screening; Nd:YAG capsulotomy or laser iridotomy within 30 days of screening. Inadequate pupillary dilation or significant media opacities in the study eye. Use of any investigational agent or participation in any other clinical trial of an investigational agent or investigational therapy within thirty (30) days of baseline with the exception of subjects who are participating in the AREDS2 study. Females of child bearing potential that are pregnant or not using medically acceptable contraception; males unwilling to take adequate contraceptive measures. Females that are breastfeeding are also excluded. Serious allergy to or prior significant adverse reaction to fluorescein. Undiagnosed acute illness first observed during screening or between screening and baseline, or severe concurrent medical conditions that, in the investigators judgment, represent a safety concern. Severe cardiac disease, symptomatic congestive heart failure, unstable angina, acute coronary syndrome, myocardial infarction or coronary artery revascularization, or arterial thrombosis within 12 months of start of study drug, inadequately controlled hypertension, or ventricular tachyarrhythmias requiring ongoing treatment. QTc ≥450 msec or subjects with a history of risk factors for Torsades de Pointes or other clinically significant ECG abnormalities as determined by the investigator. Stroke or transient ischemic attack within 12 months of trial entry. Clinically significant impaired renal or hepatic function. Any major surgical procedure within one month of trial entry. Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of X-82. Receiving treatment with anti-coagulants other than 325 mg of aspirin per day. Serious active infection, other serious medical condition or any other condition that would impair the ability of the subject to administer the investigational drug or to adhere to the study protocol requirements. Presence of any condition which, in the judgment of the investigator, would prevent the subject from completing the study. No herbal medications with the exception of bilberry are allowed within 7 days of start of study drug.
Facility Information:
Facility Name
Retina Vitreous Associates Medical Group
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
New England Retina Associates
City
New London
State/Province
Connecticut
ZIP/Postal Code
06320
Country
United States
Facility Name
Elman Retina Group
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21237
Country
United States
Facility Name
Retina Research Institute of Texas
City
Abilene
State/Province
Texas
ZIP/Postal Code
79606
Country
United States
Facility Name
Retina Consultants of Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28570723
Citation
Jackson TL, Boyer D, Brown DM, Chaudhry N, Elman M, Liang C, O'Shaughnessy D, Parsons EC, Patel S, Slakter JS, Rosenfeld PJ. Oral Tyrosine Kinase Inhibitor for Neovascular Age-Related Macular Degeneration: A Phase 1 Dose-Escalation Study. JAMA Ophthalmol. 2017 Jul 1;135(7):761-767. doi: 10.1001/jamaophthalmol.2017.1571.
Results Reference
result

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Pilot Study of X-82 in Patients With Wet AMD

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