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CANadian Study in Patients With Wet AMD, Evaluating the Efficacy and Safety of Switching From Intravitreal Aflibercept to RanIbizumab (CANARI)

Primary Purpose

Wet Age-related Macular Degeneration (Wet AMD)

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Ranibizumab
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Wet Age-related Macular Degeneration (Wet AMD) focused on measuring wet AMD, ranibizumab, aflibercept, neovascularization

Eligibility Criteria

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

Inclusion Criteria:

  • BCVA ≥23 ETDRS letters in study eye at both the Screening and Baseline visits.
  • Evidence, at Screening, of active, angiographically confirmed Choroidal Neovascularization (CNV) secondary to AMD, directly or indirectly affecting the center of the fovea in study eye.
  • No prior anti-VEGF treatment other than aflibercept.

Exclusion Criteria:

  • History of cerebrovascular accident, transient ischemic attack or myocardial infarction within 3 months of the Screening visit.
  • Any type of systemic disease or its treatment, including any medical condition (controlled or uncontrolled) that could be expected to progress, recur, or change to such an extent that it may bias the assessment of the clinical status of the patient to a significant degree or put the patient at special risk.

Exclusion criteria for ocular medical history and conditions for either eye:

  • Any active periocular or ocular infection, or active intraocular inflammation at the time of Screening or Baseline (as per contraindications in the Lucentis® Product Monograph).
  • Uncontrolled glaucoma (intraocular pressure [IOP] ≥30 mm Hg on medication or according to Investigator's judgment) at the time of Screening or Baseline
  • Evidence of bilateral active CNV during the Screening Period or at Baseline requiring bilateral anti-VEGF injections.
  • Prior intravitreal injection of ranibizumab or bevacizumab into the study eye and/or prior intravitreal injection of bevacizumab into the fellow eye.

Study eye exclusion criteria:

  • At Baseline, intraocular surgery was performed within the previous 28 days or intraocular surgery is planned at any time during the 6 month study period
  • Cataract (if causing significant visual impairment), aphakia, severe vitreous hemorrhage, rhegmatogenous retinal detachment, proliferative retinopathy or choroidal neovascularization of any other cause than wet AMD (e.g. ocular histoplasmosis, pathologic myopia (≥-8 dioptres)) at the time of Screening and Baseline.
  • Irreversible structural damage involving the center of the fovea (e.g. advanced fibrosis or geographic atrophy) which in the opinion of the Investigator is sufficient to irreversibly impair visual acuity.
  • Polypoidal choroidal vasculopathy (PCV), RPE tear, central serous retinopathy (CSR), or significant vitreomacular traction identified during Screening period or within 4 months of Baseline visit. Note that small vitreomacular adhesions that do not result in deformity of the retina are permitted.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Ranibizumab at 0.5 mg

    Arm Description

    Single arm, intravitreal injection

    Outcomes

    Primary Outcome Measures

    Mean change in Central Subfield Retinal Thickness (CSRT)
    Change (in absolute and percentage terms) in central subfield retinal thickness (CSRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).

    Secondary Outcome Measures

    Mean change in Central Subfield Retinal Thickness (CSRT)
    Change (in absolute and percentage terms) in central subfield retinal thickness (CSRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Mean change in Subfoveal Retinal Thickness (SRT)
    Change (in absolute and percentage terms) in subfoveal retinal thickness (SRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Change in Central Subfield Retinal Volume (CSRV)
    Change (in absolute and percentage terms) in subfoveal retinal thickness (SRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Mean change in Subretinal Fluid (SF)
    Measured through Optical Coherence Tomography (OCT).
    Mean change in Intra-Retinal Cystoid changes (IRCs) volume
    Measured through Optical Coherence Tomography (OCT).
    Mean change in Pigment Epithelial Detachments (PEDs)
    Measured through Optical Coherence Tomography (OCT).
    Mean change of Best-Corrected Visual Acuity (BCVA)
    Best-corrected visual acuity (BCVA) will be assessed in a sitting position using subjective refraction and ETDRS-like visual acuity testing charts.
    Rate of change in Subfoveal Retinal Thickness (SRT)
    Rates will be assessed with the proportion of patients with changes.
    Rate of change in Central Subfield Retinal Thickness (CSRT)
    Rates will be assessed with the proportion of patients with changes.
    Rate of change in Intra-Retinal Cystoid (IRCs)
    Rates will be assessed with the proportion of patients with changes.
    Rate of change in Pigment Epithelial Detachments (PEDs)
    Rates will be assessed with the proportion of patients with changes.
    Rate of Dry Retina
    Rates will be assessed with the proportion of patients with changes.

    Full Information

    First Posted
    December 16, 2015
    Last Updated
    February 14, 2017
    Sponsor
    Novartis Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02634970
    Brief Title
    CANadian Study in Patients With Wet AMD, Evaluating the Efficacy and Safety of Switching From Intravitreal Aflibercept to RanIbizumab
    Acronym
    CANARI
    Official Title
    CANadian Study in Patients With Wet AMD, Evaluating the Efficacy and Safety of Switching From Intravitreal Aflibercept to RanIbizumab
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2017
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    March 2016 (Anticipated)
    Primary Completion Date
    December 2017 (Anticipated)
    Study Completion Date
    December 2017 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Novartis Pharmaceuticals

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    There are limited prospective data regarding the potential benefit and risks associated with switching between anti-VEGF therapies in patients with nAMD who have initially achieved a favorable response to the first anti-VEGF therapy used but subsequently have evidence of increasing disease activity despite continuation of therapy. This study will fill this knowledge gap by prospectively evaluating the effectiveness and safety of switching from aflibercept to ranibizumab in nAMD patients that have non - sustained response to initial treatment with aflibercept.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Wet Age-related Macular Degeneration (Wet AMD)
    Keywords
    wet AMD, ranibizumab, aflibercept, neovascularization

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Ranibizumab at 0.5 mg
    Arm Type
    Experimental
    Arm Description
    Single arm, intravitreal injection
    Intervention Type
    Drug
    Intervention Name(s)
    Ranibizumab
    Intervention Description
    0.5 mg, intravitreal injection
    Primary Outcome Measure Information:
    Title
    Mean change in Central Subfield Retinal Thickness (CSRT)
    Description
    Change (in absolute and percentage terms) in central subfield retinal thickness (CSRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Time Frame
    at Day 90 (Month 3) and Day 180 (Month 6)
    Secondary Outcome Measure Information:
    Title
    Mean change in Central Subfield Retinal Thickness (CSRT)
    Description
    Change (in absolute and percentage terms) in central subfield retinal thickness (CSRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Mean change in Subfoveal Retinal Thickness (SRT)
    Description
    Change (in absolute and percentage terms) in subfoveal retinal thickness (SRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Change in Central Subfield Retinal Volume (CSRV)
    Description
    Change (in absolute and percentage terms) in subfoveal retinal thickness (SRT) measured by spectral domain/ high definition optical coherence tomography (SD/HD-OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Mean change in Subretinal Fluid (SF)
    Description
    Measured through Optical Coherence Tomography (OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Mean change in Intra-Retinal Cystoid changes (IRCs) volume
    Description
    Measured through Optical Coherence Tomography (OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Mean change in Pigment Epithelial Detachments (PEDs)
    Description
    Measured through Optical Coherence Tomography (OCT).
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Mean change of Best-Corrected Visual Acuity (BCVA)
    Description
    Best-corrected visual acuity (BCVA) will be assessed in a sitting position using subjective refraction and ETDRS-like visual acuity testing charts.
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Rate of change in Subfoveal Retinal Thickness (SRT)
    Description
    Rates will be assessed with the proportion of patients with changes.
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Rate of change in Central Subfield Retinal Thickness (CSRT)
    Description
    Rates will be assessed with the proportion of patients with changes.
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Rate of change in Intra-Retinal Cystoid (IRCs)
    Description
    Rates will be assessed with the proportion of patients with changes.
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Rate of change in Pigment Epithelial Detachments (PEDs)
    Description
    Rates will be assessed with the proportion of patients with changes.
    Time Frame
    Monthly, from baseline to Month 6
    Title
    Rate of Dry Retina
    Description
    Rates will be assessed with the proportion of patients with changes.
    Time Frame
    Monthly, from baseline to Month 6

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: BCVA ≥23 ETDRS letters in study eye at both the Screening and Baseline visits. Evidence, at Screening, of active, angiographically confirmed Choroidal Neovascularization (CNV) secondary to AMD, directly or indirectly affecting the center of the fovea in study eye. No prior anti-VEGF treatment other than aflibercept. Exclusion Criteria: History of cerebrovascular accident, transient ischemic attack or myocardial infarction within 3 months of the Screening visit. Any type of systemic disease or its treatment, including any medical condition (controlled or uncontrolled) that could be expected to progress, recur, or change to such an extent that it may bias the assessment of the clinical status of the patient to a significant degree or put the patient at special risk. Exclusion criteria for ocular medical history and conditions for either eye: Any active periocular or ocular infection, or active intraocular inflammation at the time of Screening or Baseline (as per contraindications in the Lucentis® Product Monograph). Uncontrolled glaucoma (intraocular pressure [IOP] ≥30 mm Hg on medication or according to Investigator's judgment) at the time of Screening or Baseline Evidence of bilateral active CNV during the Screening Period or at Baseline requiring bilateral anti-VEGF injections. Prior intravitreal injection of ranibizumab or bevacizumab into the study eye and/or prior intravitreal injection of bevacizumab into the fellow eye. Study eye exclusion criteria: At Baseline, intraocular surgery was performed within the previous 28 days or intraocular surgery is planned at any time during the 6 month study period Cataract (if causing significant visual impairment), aphakia, severe vitreous hemorrhage, rhegmatogenous retinal detachment, proliferative retinopathy or choroidal neovascularization of any other cause than wet AMD (e.g. ocular histoplasmosis, pathologic myopia (≥-8 dioptres)) at the time of Screening and Baseline. Irreversible structural damage involving the center of the fovea (e.g. advanced fibrosis or geographic atrophy) which in the opinion of the Investigator is sufficient to irreversibly impair visual acuity. Polypoidal choroidal vasculopathy (PCV), RPE tear, central serous retinopathy (CSR), or significant vitreomacular traction identified during Screening period or within 4 months of Baseline visit. Note that small vitreomacular adhesions that do not result in deformity of the retina are permitted.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Study Director
    Organizational Affiliation
    Novartis Pharmaceuticals
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    CANadian Study in Patients With Wet AMD, Evaluating the Efficacy and Safety of Switching From Intravitreal Aflibercept to RanIbizumab

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