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Investigator Sponsored Trial of Polypoidal Choroidal Vasculopathy (PCV) Evaluation Assessing High-Dose Ranibizumab Prospectively (PEARL2) (PEARL2)

Primary Purpose

PCV, Polypoidal Choroidal Vasculopathy

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
high-dose ranibizumab
ranibizumab
Sponsored by
Hawaii Pacific Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for PCV focused on measuring PEARL2, PCV, Polypoidal Choroidal Vasculopathy

Eligibility Criteria

25 Years - 95 Years (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 > 25 years
  • Polypoidal choroidal vasculopathy as noted on fluorescein and ICG angiography: active leakage, active bleeding or recent decrease in vision
  • BCVA using ETDRS of 20/32 to 20/400

Exclusion Criteria:

  • Any history of previous vitrectomy
  • Any prior treatment with verteporfin photodynamic therapy in the study eye.
  • Previous cataract surgery within the preceding 2 months of Day 0
  • Active intraocular inflammation in the study eye
  • Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye
  • A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease)
  • Participation in an investigational trial within 30 days of randomization that involved treatment with any drug that has not received regulatory approval at the time of study entry.
  • Prior anti-vascular endothelial growth factor (VEGF) (Macugen, Avastin, Lucentis) in the study eye prior within 30 days prior to enrollment in this study
  • Known allergy to any component of the study drug
  • Blood pressure >180/110 (systolic above 180 or diastolic above 110) If blood pressure if brought below 180/110 by anti-hypertensive treatment, the patient can become eligible.
  • Major surgery within 28 days prior to randomization or major surgery planned within the next 12 months. Major surgery is defined as a surgical procedure that is more extensive than needle biopsy/aspiration placement of a central venous access device, removal/biopsy of a skin lesion, or placement of a peripheral venous catheter.
  • Myocardial infraction, other cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 6 months prior to randomization.
  • Systemic anti-VEGF or pro-VEGF treatment within 3 months prior to randomization.
  • History of recurrent significant infections or bacterial infections
  • 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 spermicide gel, an intra uterine device (IUD), or contraceptive hormone implant or patch
  • Prior enrollment in the study
  • 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 medical investigation or trial.

Sites / Locations

  • Retina Consultants of Hawaii
  • The Retina Center at Pali Momi
  • Retina Consultants of Hawaii

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

Cohort 1

Cohort 2

Cohort 3

Arm Description

12 monthly, intravitreal injections of 2.0mg ranibizumab followed by 12 monthly, intravitreal injections of 1.0mg ranibizumab

6-months of monthly, intravitreal injections of ranibizumab 2.0mg followed by 18 months of monthly, intravitreal injections of ranibizumab 1.0mg

24 months of monthly, intravitreal injections of ranibizumab 1.0mg

Outcomes

Primary Outcome Measures

BCVA
Mean change in best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the Early Treatment Diabetic Retinopathy Study (ETDRS) eye chart at a starting test distance of 4 meters from Baseline to Month 12.
BCVA
Mean change in best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the ETDRS eye chart at a starting test distance of 4 meters from Baseline to Month 24

Secondary Outcome Measures

Ocular Adverse Events (AE)
Incidence and severity of ocular adverse events, as identified by eye examination (including visual acuity testing)
Systemic AEs
Incidence and severity of other adverse events, as identified by physical examination, subject reporting, and changes in vital signs
BCVA
Best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the ETDRS eye chart at a starting test distance of 4 meters, at Baseline, Day 14, Month 1, Month 3, Month 6, Month 9 , Month 12, Month 15, Month 18, Month 21 and Month 24
Macular Edema
Optical Coherence Tomography (OCT) central macular and peripapillary thickness
PCV Anatomic Changes
Decrease and/or resolution in the branching vascular network of the PCV complex as measured by mean size of the branched vascular network (BVN) on ICG and fluorescein angiography Decrease and/or resolution of the polyps of the PCV complex as measured on ICG and fluorescein angiography
Fundus Clinical Findings
Decrease in subretinal hemorrhage or exudates as measured by mean size as noted on fundus photography and clinic exam

Full Information

First Posted
June 1, 2012
Last Updated
September 8, 2017
Sponsor
Hawaii Pacific Health
Collaborators
Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01884597
Brief Title
Investigator Sponsored Trial of Polypoidal Choroidal Vasculopathy (PCV) Evaluation Assessing High-Dose Ranibizumab Prospectively (PEARL2)
Acronym
PEARL2
Official Title
Investigator Sponsored Trial of Polypoidal Choroidal Vasculopathy (PCV) Evaluation Assessing High-Dose Ranibizumab Prospectively
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
August 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hawaii Pacific Health
Collaborators
Genentech, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a 24-month study of ranibizumab (2.0 mg and 1.0 mg) in subjects with polypoidal choroidal vasculopathy as diagnosed by fluorescein/indocyanine green (FA/ICG) angiography.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
PCV, Polypoidal Choroidal Vasculopathy
Keywords
PEARL2, PCV, Polypoidal Choroidal Vasculopathy

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
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Active Comparator
Arm Description
12 monthly, intravitreal injections of 2.0mg ranibizumab followed by 12 monthly, intravitreal injections of 1.0mg ranibizumab
Arm Title
Cohort 2
Arm Type
Active Comparator
Arm Description
6-months of monthly, intravitreal injections of ranibizumab 2.0mg followed by 18 months of monthly, intravitreal injections of ranibizumab 1.0mg
Arm Title
Cohort 3
Arm Type
Active Comparator
Arm Description
24 months of monthly, intravitreal injections of ranibizumab 1.0mg
Intervention Type
Drug
Intervention Name(s)
high-dose ranibizumab
Intervention Description
20mg ranibizumab vials, 0.05ml injected intravitreally, monthly
Intervention Type
Drug
Intervention Name(s)
ranibizumab
Other Intervention Name(s)
Lucentis
Intervention Description
3 mg ranibizumab, liquid, vials, 0.1ml injected intravitreally monthly
Primary Outcome Measure Information:
Title
BCVA
Description
Mean change in best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the Early Treatment Diabetic Retinopathy Study (ETDRS) eye chart at a starting test distance of 4 meters from Baseline to Month 12.
Time Frame
From Baseline to Month 12
Title
BCVA
Description
Mean change in best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the ETDRS eye chart at a starting test distance of 4 meters from Baseline to Month 24
Time Frame
Baseline to M24
Secondary Outcome Measure Information:
Title
Ocular Adverse Events (AE)
Description
Incidence and severity of ocular adverse events, as identified by eye examination (including visual acuity testing)
Time Frame
Monthly
Title
Systemic AEs
Description
Incidence and severity of other adverse events, as identified by physical examination, subject reporting, and changes in vital signs
Time Frame
Monthly
Title
BCVA
Description
Best corrected visual acuity (BCVA), as assessed by the number of letters read correctly on the ETDRS eye chart at a starting test distance of 4 meters, at Baseline, Day 14, Month 1, Month 3, Month 6, Month 9 , Month 12, Month 15, Month 18, Month 21 and Month 24
Time Frame
at Baseline, Day 14, Month 1, Month 3, Month 6, Month 9 , Month 12, Month 15, Month 18, Month 21 and Month 24
Title
Macular Edema
Description
Optical Coherence Tomography (OCT) central macular and peripapillary thickness
Time Frame
Baseline, Day 14, Month 1-24
Title
PCV Anatomic Changes
Description
Decrease and/or resolution in the branching vascular network of the PCV complex as measured by mean size of the branched vascular network (BVN) on ICG and fluorescein angiography Decrease and/or resolution of the polyps of the PCV complex as measured on ICG and fluorescein angiography
Time Frame
Baseline, Months 6, 12, 24
Title
Fundus Clinical Findings
Description
Decrease in subretinal hemorrhage or exudates as measured by mean size as noted on fundus photography and clinic exam
Time Frame
Baseline, Months 6, 12, 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
95 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 > 25 years Polypoidal choroidal vasculopathy as noted on fluorescein and ICG angiography: active leakage, active bleeding or recent decrease in vision BCVA using ETDRS of 20/32 to 20/400 Exclusion Criteria: Any history of previous vitrectomy Any prior treatment with verteporfin photodynamic therapy in the study eye. Previous cataract surgery within the preceding 2 months of Day 0 Active intraocular inflammation in the study eye Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease) Participation in an investigational trial within 30 days of randomization that involved treatment with any drug that has not received regulatory approval at the time of study entry. Prior anti-vascular endothelial growth factor (VEGF) (Macugen, Avastin, Lucentis) in the study eye prior within 30 days prior to enrollment in this study Known allergy to any component of the study drug Blood pressure >180/110 (systolic above 180 or diastolic above 110) If blood pressure if brought below 180/110 by anti-hypertensive treatment, the patient can become eligible. Major surgery within 28 days prior to randomization or major surgery planned within the next 12 months. Major surgery is defined as a surgical procedure that is more extensive than needle biopsy/aspiration placement of a central venous access device, removal/biopsy of a skin lesion, or placement of a peripheral venous catheter. Myocardial infraction, other cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 6 months prior to randomization. Systemic anti-VEGF or pro-VEGF treatment within 3 months prior to randomization. History of recurrent significant infections or bacterial infections 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 spermicide gel, an intra uterine device (IUD), or contraceptive hormone implant or patch Prior enrollment in the study 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 medical investigation or trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregg T Kokame, MD, MMM
Organizational Affiliation
Hawaii Pacific Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Retina Consultants of Hawaii
City
'Aiea
State/Province
Hawaii
ZIP/Postal Code
96701
Country
United States
Facility Name
The Retina Center at Pali Momi
City
'Aiea
State/Province
Hawaii
ZIP/Postal Code
96701
Country
United States
Facility Name
Retina Consultants of Hawaii
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96817
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Investigator Sponsored Trial of Polypoidal Choroidal Vasculopathy (PCV) Evaluation Assessing High-Dose Ranibizumab Prospectively (PEARL2)

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