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Variable Interval Versus Set Interval Aflibercept for DME (EVADE)

Primary Purpose

Cystoid Macular Edema, Diabetic Macular Edema

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Intravitreal Aflibercept Injection
Sponsored by
California Retina Consultants
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystoid Macular Edema

Eligibility Criteria

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

Inclusion Criteria:

  1. Adults 18 years and older with Type 1 or Type 2 diabetes mellitus
  2. Patients with diabetic macular edema involving the center of the macular in the study eye (CST must measure at least 350µm on Heidelberg SDOCT, or 333µm on Cirrus SDOCT)
  3. Decrease in vision determined to be primarily due to DME in the study eye
  4. BCVA ETDRS letter score 78 to 24 (20/32 to 20/320) in the study eye
  5. Willing and able to comply with clinical visits and study related procedures
  6. Willing and able to provide signed informed consent

Exclusion Criteria:

  1. History of vitreoretinal surgery in the study eye
  2. Laser photocoagulation (panretinal or macular) in the study eye within 90 days of baseline
  3. Previous use of intraocular or periocular corticosteroids in the study eye within 90 days of baseline
  4. History of intravitreal anti-VEGF treatments in the study within 90days prior to baseline (not including prior intravitreal aflibercept injection [see exclusion criteria #5])
  5. Any history of intravitreal aflibercept
  6. Active proliferative diabetic retinopathy (PDR) in the study eye
  7. History of idiopathic or autoimmune uveitis in the study eye
  8. Cataract surgery in the study eye within 90 days of baseline
  9. Aphakia in the study eye
  10. Yttrium aluminum garnet (YAG) capsulotomy in the study eye within 30 days of baseline
  11. Any intraocular surgery in the study eye within 90 days of day 1
  12. Vitreomacular traction or epiretinal membrane in the study eye that is thought to affect central vision
  13. Current iris neovascularization, vitreous hemorrhage, or traction retinal detachment in the study eye
  14. Pre-retinal fibrosis involving the macula in the study eye
  15. Uncontrolled glaucoma (defined as any patient who has had filtration surgery in the past, or likely to need filtration surgery in the future, or has IOP ≥30mmHg)
  16. Myopia of a spherical equivalent prior to any possible refractive or cataract surgery of ≥-8 diopters
  17. Concurrent disease in the study eye, other than DME, that could compromise BCVA, require medical or surgical intervention during the study period, or could confound interpretation of the results (including retinal vascular occlusion, retinal detachment, macular hole, or choroidal neovascularization of any cause)
  18. Ocular media of insufficient quality to obtain fundus and SDOCT images
  19. Current treatment for a systemic infection
  20. Administration of systemic anti-angiogenic agents within 180 days of baseline
  21. Uncontrolled diabetes mellitus, in the opinion of the investigator
  22. Uncontrolled blood pressure (define as systolic >180mmHg, or diastolic >110mmHg while patient is sitting)
  23. History of CVA or MI within 180 days of baseline
  24. Renal failure requiring dialysis or renal transplant
  25. Known serious allergy to fluorescein
  26. Participation in an investigational study within 30 days prior to baseline that involved treatment with any drug (excluding vitamins and minerals) or device
  27. Any women who are pregnant, breast-feeding, or attempting to become pregnant
  28. Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD]; bilateral tubal ligation; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly) *Contraception is not required for men with documented vasectomy. **Postmenopausal women must be amenorrheic for at least 12 months in order not to be considered of child bearing potential. Pregnancy testing and contraception are not required for women with documented hysterectomy or tubal ligation.

Sites / Locations

  • California Retina Consultants - Bakersfield
  • California Retina Consultants - Santa Barbara Office

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Variable Treatment Dosing Arm

Monthly Treatment Arm

Arm Description

Group 1 will receive injections every 4 weeks until diabetic macular edema on the OCT is decreased and stable. At that point, the length of time between injections may increase, depending on how the study eye is doing. The interval between study eye treatments may maintain, increase, or decrease once the variable treatment dosing has begun. This will be determined by an algorithm designed into a computer program

Group 2 will receive 5 intravitreal injections, monthly, for the first 5 months of the study. After those initial injections, visits/treatment will be every 8 weeks.

Outcomes

Primary Outcome Measures

BCVA Change
Change in mean BCVA from baseline to week 52

Secondary Outcome Measures

Full Information

First Posted
March 2, 2015
Last Updated
January 2, 2019
Sponsor
California Retina Consultants
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02392364
Brief Title
Variable Interval Versus Set Interval Aflibercept for DME
Acronym
EVADE
Official Title
Treat and Extend Versus Dosing Every Eight Weeks With Intravitreal Aflibercept Injections for the Treatment of Diabetic Macular Edema (EVADE Study)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
April 15, 2015 (Actual)
Primary Completion Date
November 15, 2018 (Actual)
Study Completion Date
November 15, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
California Retina Consultants
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare the safety and efficacy of intravitreal Eylea injections at a set interval, versus a variable dosing schedule (likely longer than one month), based on a specific individual's disease progression. There will be approximately 50 men and women at least 18 years of age, diagnosed with type 1 or type 2 diabetes, taking part in this study at 5 locations in the United States.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Variable Treatment Dosing Arm
Arm Type
Active Comparator
Arm Description
Group 1 will receive injections every 4 weeks until diabetic macular edema on the OCT is decreased and stable. At that point, the length of time between injections may increase, depending on how the study eye is doing. The interval between study eye treatments may maintain, increase, or decrease once the variable treatment dosing has begun. This will be determined by an algorithm designed into a computer program
Arm Title
Monthly Treatment Arm
Arm Type
Active Comparator
Arm Description
Group 2 will receive 5 intravitreal injections, monthly, for the first 5 months of the study. After those initial injections, visits/treatment will be every 8 weeks.
Intervention Type
Drug
Intervention Name(s)
Intravitreal Aflibercept Injection
Primary Outcome Measure Information:
Title
BCVA Change
Description
Change in mean BCVA from baseline to week 52
Time Frame
Week 0 to Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults 18 years and older with Type 1 or Type 2 diabetes mellitus Patients with diabetic macular edema involving the center of the macular in the study eye (CST must measure at least 350µm on Heidelberg SDOCT, or 333µm on Cirrus SDOCT) Decrease in vision determined to be primarily due to DME in the study eye BCVA ETDRS letter score 78 to 24 (20/32 to 20/320) in the study eye Willing and able to comply with clinical visits and study related procedures Willing and able to provide signed informed consent Exclusion Criteria: History of vitreoretinal surgery in the study eye Laser photocoagulation (panretinal or macular) in the study eye within 90 days of baseline Previous use of intraocular or periocular corticosteroids in the study eye within 90 days of baseline History of intravitreal anti-VEGF treatments in the study within 90days prior to baseline (not including prior intravitreal aflibercept injection [see exclusion criteria #5]) Any history of intravitreal aflibercept Active proliferative diabetic retinopathy (PDR) in the study eye History of idiopathic or autoimmune uveitis in the study eye Cataract surgery in the study eye within 90 days of baseline Aphakia in the study eye Yttrium aluminum garnet (YAG) capsulotomy in the study eye within 30 days of baseline Any intraocular surgery in the study eye within 90 days of day 1 Vitreomacular traction or epiretinal membrane in the study eye that is thought to affect central vision Current iris neovascularization, vitreous hemorrhage, or traction retinal detachment in the study eye Pre-retinal fibrosis involving the macula in the study eye Uncontrolled glaucoma (defined as any patient who has had filtration surgery in the past, or likely to need filtration surgery in the future, or has IOP ≥30mmHg) Myopia of a spherical equivalent prior to any possible refractive or cataract surgery of ≥-8 diopters Concurrent disease in the study eye, other than DME, that could compromise BCVA, require medical or surgical intervention during the study period, or could confound interpretation of the results (including retinal vascular occlusion, retinal detachment, macular hole, or choroidal neovascularization of any cause) Ocular media of insufficient quality to obtain fundus and SDOCT images Current treatment for a systemic infection Administration of systemic anti-angiogenic agents within 180 days of baseline Uncontrolled diabetes mellitus, in the opinion of the investigator Uncontrolled blood pressure (define as systolic >180mmHg, or diastolic >110mmHg while patient is sitting) History of CVA or MI within 180 days of baseline Renal failure requiring dialysis or renal transplant Known serious allergy to fluorescein Participation in an investigational study within 30 days prior to baseline that involved treatment with any drug (excluding vitamins and minerals) or device Any women who are pregnant, breast-feeding, or attempting to become pregnant Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD]; bilateral tubal ligation; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly) *Contraception is not required for men with documented vasectomy. **Postmenopausal women must be amenorrheic for at least 12 months in order not to be considered of child bearing potential. Pregnancy testing and contraception are not required for women with documented hysterectomy or tubal ligation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dilsher S Dhoot, MD
Organizational Affiliation
California Retina Consultants
Official's Role
Principal Investigator
Facility Information:
Facility Name
California Retina Consultants - Bakersfield
City
Bakersfield
State/Province
California
ZIP/Postal Code
93039
Country
United States
Facility Name
California Retina Consultants - Santa Barbara Office
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93103
Country
United States

12. IPD Sharing Statement

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Variable Interval Versus Set Interval Aflibercept for DME

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