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Assessment of Safety, Tolerability and Pharmacokinetics of Intravitreal Pegcetacoplan (APL-2) for Patients With Wet AMD (ASAP II)

Primary Purpose

Neovascular Age-Related Macular Degeneration

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Pegcetacoplan
Sponsored by
Apellis Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neovascular Age-Related Macular Degeneration focused on measuring AMD, Wet AMD, Neovascular AMD

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or Female
  2. Age ≥ 50 years
  3. The presence of an active choroidal neovascular lesion secondary to AMD
  4. On treatment with anti-VEGF therapy (Lucentis®, Eylea® or Avastin®)
  5. Must have received at least 3 anti-VEGF treatments over the 26-week period prior to screening (Screening Visit)
  6. Evidence that the macular fluid has responded to anti-VEGF in the past based on OCT in the opinion of PI
  7. At screening, evidence of subretinal fluid and retinal cystic changes
  8. Must have received anti-VEGF treatment within 10 days prior to pegcetacoplan treatment (anti-VEGF can be administered on the same day of the screening visit after the screening procedures have been completed)
  9. OCTs of sufficient quality to allow for the assessment of the central macular fluid can be obtained
  10. Female subjects must be:

    • Women of non-child-bearing potential (WONCBP), Or
    • Women of child-bearing potential (WOCBP) with a negative pregnancy test at screening and must agree to use protocol defined methods of contraception for the duration of the study
  11. Males with female partners of child-bearing potential must agree to use protocol defined methods of contraception and agree to refrain from donating sperm for the duration of the study
  12. Willing and able to give informed consent

Exclusion Criteria:

  1. Choroidal neovascularization associated with other ocular diseases such as pathologic myopia, ocular histoplasmosis or posterior uveitis, etc
  2. Decreased vision due to retinal disease not attributable to choroidal neovascularization, such as nonexudative forms of AMD, geographic atrophy, inherited retinal dystrophy, uveitis or epiretinal membrane, a vitelliform-like lesion of the outer retina (e.g., as in pattern dystrophies or basal laminar drusen), idiopathic parafoveal telangiectasis, or central serous retinopathy
  3. Additional ocular diseases that have irreversibly compromised or, during follow-up, could likely compromise the VA of the study eye including amblyopia, anterior ischemic optic neuropathy, clinically significant diabetic macular edema, severe non proliferative diabetic retinopathy, or proliferative diabetic retinopathy
  4. Decreased vision due to significant media opacity such as corneal disease or cataract, or opacity precluding photography of the retina
  5. Cataract surgery within three months of enrollment
  6. Presence of any hemorrhage
  7. History of treatment for CNV:

    1. Previous PDT treatment within 30 days prior to enrollment in the study
    2. Previous extrafoveal or juxtafoveal thermal laser photocoagulation within 30 days prior to enrollment in the study
  8. Intraocular surgery (including lens replacement surgery) within 3 months prior to randomization
  9. Medical problems that make consistent follow-up over the treatment period unlikely (e.g. stroke, severe MI, end stage malignancy), or in general a poor medical risk because of other systemic diseases or active uncontrolled infections
  10. Hypersensitivity to fluorescein

Sites / Locations

  • United States, California
  • United States, Florida
  • United States, New Hampshire
  • Australia, New South Wells

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Pegcetacoplan Cohort 1

Pegcetacoplan Cohort 2

Pegcetacoplan Cohort 3

Arm Description

4 mg of pegcetacoplan 100 μL IVT injection

10 mg of pegcetacoplan 100 μL IVT injection

20 mg of pegcetacoplan 100 μL IVT injection

Outcomes

Primary Outcome Measures

Number of Subjects Who Experienced Ocular and Systemic Adverse Events (AEs), Including by Severity
Safety was assessed throughout the study. A TEAE was defined as any AE that started on/after the IVT injection of pegcetacoplan.
Number of Dose Limiting Toxicities (DLTs)
The occurrence of any of the following AEs were considered DLTs: intraocular inflammation (vitritis or uveitis), endophthalmitis, sustained elevation of intraocular pressure ≥30 millimeters (mm) of mercury, and/or sustained loss of visual acuity ≥15 letters not attributable to the injection procedure or progression of disease.
Median Area Under the Serum Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUC[0-t])
The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The median AUC(0-t) is presented for each cohort.
Median Dose Normalized AUC(0-t)
The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The dose normalized AUC(0-t) was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized AUC(0-t) is presented for each cohort.
Maximum Observed Serum Concentration (Cmax)
The median Cmax is presented for each cohort.
Median Dose Normalized Cmax
The dose normalized Cmax was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized Cmax is presented for each cohort.
Median Time to the Maximum Measured Serum Concentration (Tmax)
The median Tmax is presented for each cohort. If the maximum value occurred at more than 1 time point, Tmax was defined as the first time point with this value.

Secondary Outcome Measures

Median Change From Baseline in Visual Acuity for the Study Eye
Best Corrected Visual Acuity (BCVA) letter score was determined using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart assessed at a starting distance of 4 meters. The score ranges from 0 to 100 letters, lower number indicating reduced visual acuity; a positive value of change from baseline indicates visual acuity gain and a negative value indicates visual acuity loss.
Median Change From Baseline in Central Retinal Thickness, Central Retinal Lesion Thickness and Central Subfield Thickness in the Study Eye
Central retinal thickness, central retinal lesion thickness and central subfield thickness were determined using Spectral Domain Optical Coherence Tomography (SD-OCT).
Median Change From Baseline in Macular Cube Volume in the Study Eye
Macular cube volume was determined using SD-OCT.

Full Information

First Posted
June 2, 2015
Last Updated
September 11, 2020
Sponsor
Apellis Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02461771
Brief Title
Assessment of Safety, Tolerability and Pharmacokinetics of Intravitreal Pegcetacoplan (APL-2) for Patients With Wet AMD
Acronym
ASAP II
Official Title
Assessment of Safety, Tolerability and Pharmacokinetics of Intravitreal APL-2 Therapy for Neovascular Age-Related Macular Degeneration (AMD)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
January 28, 2015 (Actual)
Primary Completion Date
March 8, 2016 (Actual)
Study Completion Date
March 8, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Apellis Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to provide initial safety, tolerability and pharmacokinetics information of intravitreal administration of pegcetacoplan in order to support further development into larger Phase II studies for treatment of patients with AMD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neovascular Age-Related Macular Degeneration
Keywords
AMD, Wet AMD, Neovascular AMD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pegcetacoplan Cohort 1
Arm Type
Experimental
Arm Description
4 mg of pegcetacoplan 100 μL IVT injection
Arm Title
Pegcetacoplan Cohort 2
Arm Type
Experimental
Arm Description
10 mg of pegcetacoplan 100 μL IVT injection
Arm Title
Pegcetacoplan Cohort 3
Arm Type
Experimental
Arm Description
20 mg of pegcetacoplan 100 μL IVT injection
Intervention Type
Drug
Intervention Name(s)
Pegcetacoplan
Other Intervention Name(s)
APL-2
Intervention Description
On treatment day, subjects will be administered a single 100 μL IVT injection of pegcetacoplan at the dose corresponding to their treatment assignment.
Primary Outcome Measure Information:
Title
Number of Subjects Who Experienced Ocular and Systemic Adverse Events (AEs), Including by Severity
Description
Safety was assessed throughout the study. A TEAE was defined as any AE that started on/after the IVT injection of pegcetacoplan.
Time Frame
Day 1 to Day 113
Title
Number of Dose Limiting Toxicities (DLTs)
Description
The occurrence of any of the following AEs were considered DLTs: intraocular inflammation (vitritis or uveitis), endophthalmitis, sustained elevation of intraocular pressure ≥30 millimeters (mm) of mercury, and/or sustained loss of visual acuity ≥15 letters not attributable to the injection procedure or progression of disease.
Time Frame
Day 1 to Day 15
Title
Median Area Under the Serum Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUC[0-t])
Description
The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The median AUC(0-t) is presented for each cohort.
Time Frame
Predose (screening), postdose Day 3 to Day 113
Title
Median Dose Normalized AUC(0-t)
Description
The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The dose normalized AUC(0-t) was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized AUC(0-t) is presented for each cohort.
Time Frame
Predose (screening), postdose Day 3 to Day 113
Title
Maximum Observed Serum Concentration (Cmax)
Description
The median Cmax is presented for each cohort.
Time Frame
Predose (screening), postdose Day 3 to Day 113
Title
Median Dose Normalized Cmax
Description
The dose normalized Cmax was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized Cmax is presented for each cohort.
Time Frame
Predose (screening), postdose Day 3 to Day 113
Title
Median Time to the Maximum Measured Serum Concentration (Tmax)
Description
The median Tmax is presented for each cohort. If the maximum value occurred at more than 1 time point, Tmax was defined as the first time point with this value.
Time Frame
Predose (screening), postdose Day 3 to Day 113
Secondary Outcome Measure Information:
Title
Median Change From Baseline in Visual Acuity for the Study Eye
Description
Best Corrected Visual Acuity (BCVA) letter score was determined using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart assessed at a starting distance of 4 meters. The score ranges from 0 to 100 letters, lower number indicating reduced visual acuity; a positive value of change from baseline indicates visual acuity gain and a negative value indicates visual acuity loss.
Time Frame
Day 1 to Day 113
Title
Median Change From Baseline in Central Retinal Thickness, Central Retinal Lesion Thickness and Central Subfield Thickness in the Study Eye
Description
Central retinal thickness, central retinal lesion thickness and central subfield thickness were determined using Spectral Domain Optical Coherence Tomography (SD-OCT).
Time Frame
Day 1 to Day 113
Title
Median Change From Baseline in Macular Cube Volume in the Study Eye
Description
Macular cube volume was determined using SD-OCT.
Time Frame
Day 1 to Day 113

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or Female Age ≥ 50 years The presence of an active choroidal neovascular lesion secondary to AMD On treatment with anti-VEGF therapy (Lucentis®, Eylea® or Avastin®) Must have received at least 3 anti-VEGF treatments over the 26-week period prior to screening (Screening Visit) Evidence that the macular fluid has responded to anti-VEGF in the past based on OCT in the opinion of PI At screening, evidence of subretinal fluid and retinal cystic changes Must have received anti-VEGF treatment within 10 days prior to pegcetacoplan treatment (anti-VEGF can be administered on the same day of the screening visit after the screening procedures have been completed) OCTs of sufficient quality to allow for the assessment of the central macular fluid can be obtained Female subjects must be: Women of non-child-bearing potential (WONCBP), Or Women of child-bearing potential (WOCBP) with a negative pregnancy test at screening and must agree to use protocol defined methods of contraception for the duration of the study Males with female partners of child-bearing potential must agree to use protocol defined methods of contraception and agree to refrain from donating sperm for the duration of the study Willing and able to give informed consent Exclusion Criteria: Choroidal neovascularization associated with other ocular diseases such as pathologic myopia, ocular histoplasmosis or posterior uveitis, etc Decreased vision due to retinal disease not attributable to choroidal neovascularization, such as nonexudative forms of AMD, geographic atrophy, inherited retinal dystrophy, uveitis or epiretinal membrane, a vitelliform-like lesion of the outer retina (e.g., as in pattern dystrophies or basal laminar drusen), idiopathic parafoveal telangiectasis, or central serous retinopathy Additional ocular diseases that have irreversibly compromised or, during follow-up, could likely compromise the VA of the study eye including amblyopia, anterior ischemic optic neuropathy, clinically significant diabetic macular edema, severe non proliferative diabetic retinopathy, or proliferative diabetic retinopathy Decreased vision due to significant media opacity such as corneal disease or cataract, or opacity precluding photography of the retina Cataract surgery within three months of enrollment Presence of any hemorrhage History of treatment for CNV: Previous PDT treatment within 30 days prior to enrollment in the study Previous extrafoveal or juxtafoveal thermal laser photocoagulation within 30 days prior to enrollment in the study Intraocular surgery (including lens replacement surgery) within 3 months prior to randomization Medical problems that make consistent follow-up over the treatment period unlikely (e.g. stroke, severe MI, end stage malignancy), or in general a poor medical risk because of other systemic diseases or active uncontrolled infections Hypersensitivity to fluorescein
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Federico Grossi, MD PhD
Organizational Affiliation
Apellis Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
United States, California
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
United States, Florida
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
United States, New Hampshire
City
Portsmouth
State/Province
New Hampshire
ZIP/Postal Code
03801
Country
United States
Facility Name
Australia, New South Wells
City
Parramatta
State/Province
New South Wales
ZIP/Postal Code
2150
Country
Australia

12. IPD Sharing Statement

Learn more about this trial

Assessment of Safety, Tolerability and Pharmacokinetics of Intravitreal Pegcetacoplan (APL-2) for Patients With Wet AMD

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