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Withdrawn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
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
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
NCT ID
NCT02634970
First Posted
December 16, 2015
Last Updated
February 14, 2017
Sponsor
Novartis Pharmaceuticals
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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