Immediate Effects of Lucentis® in Conjunction With Photodynamic Therapy With Visudyne® in Exudative AMD(IECOMB)
Primary Purpose
Age Related Macular Degeneration
Status
Completed
Phase
Phase 2
Locations
Switzerland
Study Type
Interventional
Intervention
Intravitreal ranibizumab with photodynamic therapy
Sponsored by
About this trial
This is an interventional treatment trial for Age Related Macular Degeneration focused on measuring age related macular degeneration, anti-VEGF therapy
Eligibility Criteria
Inclusion Criteria:
- Patients 50 years of age or greater
- Patients with subfoveal choroidal neovascularization lesions secondary to AMD, either predominantly classic, occult, or minimally classic.
- CNV lesion in the study eye is ≤5400 microns in greatest linear dimension
- Patients who have a best corrected visual acuity (BCVA) score between 73 and 24 letters, inclusively, in the study eye using ETDRS-like grading charts (approximately 20/40 to 20/320) measured at 4 meters
- Willing to return for follow up scheduled visits for a 6 months period
- Only one eye will be assessed in the study. If both eyes are eligible, the one with the worse visual acuity will be selected for treatment and study unless, based on medical reasons, the investigator deems the other eye the more appropriate candidate for treatment and study
Exclusion Criteria:
- Patients who have a BCVA of < 33 letters (approximately 20/200) in both eyes
- Prior treatment in the study eye with verteporfin, external-beam radiation therapy, vitrectomy, submacular surgery, other surgical intervention for AMD, or transpupillary thermotherapy
- Previous or current intravitreal drug delivery (e.g., intravitreal corticosteroid injection or device implantation) in the study eye
- Focal laser photocoagulation (juxta-, extra- or subfoveal ) in the study eye
- Concomitant use of chronic NSAIDs or steroids (by any route) for the duration of study participation (chronic use is defined as multiple doses taken daily for three or more consecutive days at any time during the study). Note that ASA (aspirin) taken as "low dose" up to 100 mg daily (qd) for prophylaxis of myocardial infarction (MI) and/or stroke is permitted during study
- Current use or likely need for systemic medications known to be toxic to the lens, retina or optic nerve, including Deferoxamine, Chloroquine/ hydroxychloroquine (Plaquenil), Tamoxifen, Phenothiazines and Ethambutol is excluded
- History of glaucoma filtration surgery, corneal transplant surgery or extracapsular extraction of cataract with phacoemulsification within six months preceding Day One, or a history of post-operative complications within the last 12 months preceding Day One in the study eye (uveitis, cyclitis etc.)
- History of uncontrolled glaucoma in the study eye (defined as intraocular pressure ≥ 25 mmHg despite treatment with topical anti-glaucomatous medication).
- Aphakia or absence of the posterior capsule in the study eye
- Previous violation of the posterior capsule in the study eye is also excluded unless it occurred as a result of YAG posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
- Spherical equivalent of the refractive error in the study eye demonstrating more than -8 diopters of myopia
- Presence of a retinal pigment epithelial tear involving the macula in the study eye
- Angioid streaks or precursors of CNV in either eye due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
- Active intraocular inflammation (grade trace or above) in the study eye
- Any active infection involving an eyeball adnexa
- Vitreous hemorrhage or history of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the study eye
Sites / Locations
- Klinik und Poliklinik fuer Augenheilkunde, Inselspital
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
1
Arm Description
Outcomes
Primary Outcome Measures
incidence of CNV closure one week after combined therapy as assessed with high speed ICG angiography
Secondary Outcome Measures
retinal thickness as measured by OCT over time
change of total lesion area, area of CNV and area of leakage over time as assessed by FA
mean change of VA from baseline over time
Full Information
NCT ID
NCT00413829
First Posted
December 19, 2006
Last Updated
January 13, 2010
Sponsor
Insel Gruppe AG, University Hospital Bern
Collaborators
Novartis
1. Study Identification
Unique Protocol Identification Number
NCT00413829
Brief Title
Immediate Effects of Lucentis® in Conjunction With Photodynamic Therapy With Visudyne® in Exudative AMD(IECOMB)
Official Title
Open-label, Phase II Study Assessing Immediate Effects of Lucentis®(Ranibizumab) Administered in Conjunction With Photodynamic Therapy With Visudyne® in Patients With Choroidal Neovascularization Secondary to AMD
Study Type
Interventional
2. Study Status
Record Verification Date
January 2010
Overall Recruitment Status
Completed
Study Start Date
October 2006 (undefined)
Primary Completion Date
May 2007 (Actual)
Study Completion Date
March 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Insel Gruppe AG, University Hospital Bern
Collaborators
Novartis
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is an evaluation of the short term effects on CNV perfusion of a same-day administration of photodynamic therapy (PDT) with Visudyne® and an intravitreal injection of Lucentis® (ranibizumab, 0.3 mg). An evaluation of the short term effects on CNV perfusion of this combined treatment is needed for better understanding of treatment effects.
Detailed Description
The primary objective is to quantify the short term effects on CNV perfusion of the same-day administration of photodynamic therapy with Visudyne® and an intravitreal injection of ranibizumab. These short term effects will be assessed with visual acuity measurements and ophthalmic examinations including indocyanine green (ICG) and fluorescein angiography (FA) as well as Optical Coherence Tomography (OCT) measurements. The primary variable for this assessment is the incidence of CNV closure one week after combined therapy as assessed with high speed ICG angiography. Fluorescein and ICG angiography will be performed using a scanning laser ophthalmoscope (HRA). All angiographic studies and OCT examinations will be evaluated by the Bern Photographic Reading Center in a masked fashion. Visual acuity assessments will be performed with Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity testing charts.
A secondary objective is to explore the effect of the same-day administration of photodynamic therapy with Visudyne® and an intravitreal injection of ranibizumab:
on retinal thickness as measured by OCT over time
in change of total lesion area, area of CNV assessed by FA
in mean change of VA from baseline over time
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Age Related Macular Degeneration
Keywords
age related macular degeneration, anti-VEGF therapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Other
Intervention Type
Drug
Intervention Name(s)
Intravitreal ranibizumab with photodynamic therapy
Intervention Description
Intravitreal injection, photodynamic therapy
Primary Outcome Measure Information:
Title
incidence of CNV closure one week after combined therapy as assessed with high speed ICG angiography
Time Frame
24 months
Secondary Outcome Measure Information:
Title
retinal thickness as measured by OCT over time
Time Frame
24 months
Title
change of total lesion area, area of CNV and area of leakage over time as assessed by FA
Time Frame
24 months
Title
mean change of VA from baseline over time
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients 50 years of age or greater
Patients with subfoveal choroidal neovascularization lesions secondary to AMD, either predominantly classic, occult, or minimally classic.
CNV lesion in the study eye is ≤5400 microns in greatest linear dimension
Patients who have a best corrected visual acuity (BCVA) score between 73 and 24 letters, inclusively, in the study eye using ETDRS-like grading charts (approximately 20/40 to 20/320) measured at 4 meters
Willing to return for follow up scheduled visits for a 6 months period
Only one eye will be assessed in the study. If both eyes are eligible, the one with the worse visual acuity will be selected for treatment and study unless, based on medical reasons, the investigator deems the other eye the more appropriate candidate for treatment and study
Exclusion Criteria:
Patients who have a BCVA of < 33 letters (approximately 20/200) in both eyes
Prior treatment in the study eye with verteporfin, external-beam radiation therapy, vitrectomy, submacular surgery, other surgical intervention for AMD, or transpupillary thermotherapy
Previous or current intravitreal drug delivery (e.g., intravitreal corticosteroid injection or device implantation) in the study eye
Focal laser photocoagulation (juxta-, extra- or subfoveal ) in the study eye
Concomitant use of chronic NSAIDs or steroids (by any route) for the duration of study participation (chronic use is defined as multiple doses taken daily for three or more consecutive days at any time during the study). Note that ASA (aspirin) taken as "low dose" up to 100 mg daily (qd) for prophylaxis of myocardial infarction (MI) and/or stroke is permitted during study
Current use or likely need for systemic medications known to be toxic to the lens, retina or optic nerve, including Deferoxamine, Chloroquine/ hydroxychloroquine (Plaquenil), Tamoxifen, Phenothiazines and Ethambutol is excluded
History of glaucoma filtration surgery, corneal transplant surgery or extracapsular extraction of cataract with phacoemulsification within six months preceding Day One, or a history of post-operative complications within the last 12 months preceding Day One in the study eye (uveitis, cyclitis etc.)
History of uncontrolled glaucoma in the study eye (defined as intraocular pressure ≥ 25 mmHg despite treatment with topical anti-glaucomatous medication).
Aphakia or absence of the posterior capsule in the study eye
Previous violation of the posterior capsule in the study eye is also excluded unless it occurred as a result of YAG posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
Spherical equivalent of the refractive error in the study eye demonstrating more than -8 diopters of myopia
Presence of a retinal pigment epithelial tear involving the macula in the study eye
Angioid streaks or precursors of CNV in either eye due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
Active intraocular inflammation (grade trace or above) in the study eye
Any active infection involving an eyeball adnexa
Vitreous hemorrhage or history of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the study eye
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sebastian Wolf, MD PhD
Organizational Affiliation
Klinik und Poliklinik fuer Augenheilkunde, Inselspital
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Ute Wolf-Schnurrbusch, MD
Organizational Affiliation
Klinik und Polklinik fuer Augenheilkunde, Inselspital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinik und Poliklinik fuer Augenheilkunde, Inselspital
City
Bern
Country
Switzerland
12. IPD Sharing Statement
Citations:
PubMed Identifier
19878113
Citation
Wolf-Schnurrbusch UE, Brinkmann CK, Berger L, Wolf S. Effects of combination therapy with verteporfin photodynamic therapy and ranibizumab in patients with age-related macular degeneration. Acta Ophthalmol. 2011 Sep;89(6):585-90. doi: 10.1111/j.1755-3768.2009.01747.x. Epub 2009 Oct 30.
Results Reference
result
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Immediate Effects of Lucentis® in Conjunction With Photodynamic Therapy With Visudyne® in Exudative AMD(IECOMB)
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