Investigation of the Change of Vision-related Quality of Life in Subjects Treated With Aflibercept According to EU Label for DME. (AQUA)
Primary Purpose
Macular Edema
Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Eylea (Aflibercept, VEGF Trap-Eye, BAY86-5321)
Sponsored by
About this trial
This is an interventional treatment trial for Macular Edema focused on measuring Diabetic macular edema, Intravitreal injection
Eligibility Criteria
Inclusion Criteria:
- Type 1 or 2 diabetes mellitus
- Diagnosis of DME secondary to diabetes mellitus involving the center of the macula (defined as the area of the center subfield on OCT) in the study eye
- Decrease in vision determined to be primarily the result of DME in the study eye
- BCVA in the study eye of ETDRS letter score 73 to 24 (This corresponds to a Snellen equivalent of approximately 20/40 to 20/320.)
Exclusion Criteria:
- Pregnancy and lactation
- Mismatch with inclusion criteria
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Arm 1 / Quality of Life
Arm Description
Aflibercept treatment in subjects with diabetic macular edema (DME)
Outcomes
Primary Outcome Measures
Change From Baseline to Week 52 in NEI VFQ-25 Total Score
National eye institute 25-item visual function questionnaire (NEI VFQ-25) is a condition-specific measure which was designed to capture the specific impact of vision loss on health-related quality of life (HRQoL). The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". The NEI VFQ-25 consists of a base set of 25 vision-targeted questions representing 11 vision-related constructs, plus an additional single-item general health rating question. All items are scored so that a high score represents better functioning. Each item is then converted to a 0 to 100 scale so that the lowest and highest possible scores are set at 0 and 100 points, respectively. In this format scores represent the achieved percentage of the total possible score, e.g. a score of 50 represents 50% of the highest possible score.
Secondary Outcome Measures
Change From Baseline to Week 52 in the NEI VFQ 25 Near Activities Subscale
NEI VFQ-25 is a condition-specific measure which was designed to capture the specific impact of vision loss on HRQoL. The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". Items within each sub-scale are averaged together to create the 12 sub-scale Scores. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Sub-scales with at least one item answered can be used to generate a sub-scale score. Hence, scores represent the average for all items in the subscale that the respondent answered.The NEI VFQ-25 near activities subscale was scored from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. Near activities are defined as reading ordinary print in newspapers, performing work or hobbies requiring near vision, or finding something on a crowded shelf.
Change From Baseline to Week 52 in the NEI VFQ 25 Distant Activities Subscale
NEI VFQ-25 is a condition-specific measure which was designed to capture the specific impact of vision loss on HRQoL. The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". Items within each sub-scale are averaged together to create the 12 sub-scale Scores. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Sub-scales with at least one item answered can be used to generate a sub-scale score. Hence, scores represent the average for all items in the subscale that the respondent answered. The NEI VFQ-25 distant activities subscale was scored from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. Distant activities are defined as activities requiring distance vision, such as recognizing faces or reading street signs.
Change From Baseline to Week 52 in Best Corrected Visual Acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] Letter Score])
Visual function was assessed using the ETDRS protocol (Early Treatment Diabetic Retinopathy Study Research Group 1985) starting at 4 meters. The values might range from 0 to 100. A higher score represents better functioning.
Change From Baseline to Week 52 in Central Retinal Thickness (CRT) Measured by Optical Coherence Tomography (OCT)
Retinal and lesion characteristics were evaluated using spectral domain optical coherence tomography (OCT). For all visits where the OCT procedure was scheduled, images were captured and read by the investigator. All OCTs were electronically archived at the study sites as part of the source documentation.
Proportion of Participants Progressing to Greater or Equal to (>=) 61 on the ETDRS Diabetic Retinopathy Severity Scale (DRSS) as Assessed by Fundus Photography (FP)
The ETDRS DRSS was assessed by FP according to the following scale for both eyes. The following severities are possible.
10 = Diabetic retinopathy (DR) absent, 14 = DR questionable, 15 = DR questionable, 20 = Micro-aneurysms only, 35 = Mild Non-proliferative diabetic retinopathy (NPDR), 43 = Moderate NPDR, 47 = Moderately severe NPDR, 53 = Severe NPDR, 61 = Mild Proliferative diabetic retinopathy (PDR), 65 = Moderate PDR, 71 = High-risk PDR, 75 = High-risk PDR, 81 = Advanced PDR: fundus partially obscured, center of macula attached, 85 = Advanced PDR: posterior fundus obscured, or center of macula detached, 90 = cannot grade, even sufficiently for level 81 or 85.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02581995
Brief Title
Investigation of the Change of Vision-related Quality of Life in Subjects Treated With Aflibercept According to EU Label for DME.
Acronym
AQUA
Official Title
Open-label Phase-4 Study to Examine the Change of Vision-related Quality of Life in Subjects With Diabetic Macular Edema (DME) During Treatment With Intravitreal Injections of 2 mg Aflibercept According to EU Label for the First Year of Treatment
Study Type
Interventional
2. Study Status
Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
November 19, 2015 (Actual)
Primary Completion Date
August 9, 2017 (Actual)
Study Completion Date
August 9, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bayer
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
To evaluate the change in quality of life (NEI VFQ 25) in subjects with DME during the first year of treatment with aflibercept according to the EU Label.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Macular Edema
Keywords
Diabetic macular edema, Intravitreal injection
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
560 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm 1 / Quality of Life
Arm Type
Experimental
Arm Description
Aflibercept treatment in subjects with diabetic macular edema (DME)
Intervention Type
Drug
Intervention Name(s)
Eylea (Aflibercept, VEGF Trap-Eye, BAY86-5321)
Intervention Description
2 mg aflibercept administered every 8 weeks following 5 initial monthly doses Intravitreal (IVT) injection
Primary Outcome Measure Information:
Title
Change From Baseline to Week 52 in NEI VFQ-25 Total Score
Description
National eye institute 25-item visual function questionnaire (NEI VFQ-25) is a condition-specific measure which was designed to capture the specific impact of vision loss on health-related quality of life (HRQoL). The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". The NEI VFQ-25 consists of a base set of 25 vision-targeted questions representing 11 vision-related constructs, plus an additional single-item general health rating question. All items are scored so that a high score represents better functioning. Each item is then converted to a 0 to 100 scale so that the lowest and highest possible scores are set at 0 and 100 points, respectively. In this format scores represent the achieved percentage of the total possible score, e.g. a score of 50 represents 50% of the highest possible score.
Time Frame
Baseline, Week 52
Secondary Outcome Measure Information:
Title
Change From Baseline to Week 52 in the NEI VFQ 25 Near Activities Subscale
Description
NEI VFQ-25 is a condition-specific measure which was designed to capture the specific impact of vision loss on HRQoL. The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". Items within each sub-scale are averaged together to create the 12 sub-scale Scores. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Sub-scales with at least one item answered can be used to generate a sub-scale score. Hence, scores represent the average for all items in the subscale that the respondent answered.The NEI VFQ-25 near activities subscale was scored from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. Near activities are defined as reading ordinary print in newspapers, performing work or hobbies requiring near vision, or finding something on a crowded shelf.
Time Frame
Baseline, Week 52
Title
Change From Baseline to Week 52 in the NEI VFQ 25 Distant Activities Subscale
Description
NEI VFQ-25 is a condition-specific measure which was designed to capture the specific impact of vision loss on HRQoL. The calculation for NEI VFQ-25 sub-scale scores and total score was performed according to the "NEI VFQ-25 Scoring Algorithm - August 2000". Items within each sub-scale are averaged together to create the 12 sub-scale Scores. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Sub-scales with at least one item answered can be used to generate a sub-scale score. Hence, scores represent the average for all items in the subscale that the respondent answered. The NEI VFQ-25 distant activities subscale was scored from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. Distant activities are defined as activities requiring distance vision, such as recognizing faces or reading street signs.
Time Frame
Baseline, Week 52
Title
Change From Baseline to Week 52 in Best Corrected Visual Acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] Letter Score])
Description
Visual function was assessed using the ETDRS protocol (Early Treatment Diabetic Retinopathy Study Research Group 1985) starting at 4 meters. The values might range from 0 to 100. A higher score represents better functioning.
Time Frame
Baseline, Week 52
Title
Change From Baseline to Week 52 in Central Retinal Thickness (CRT) Measured by Optical Coherence Tomography (OCT)
Description
Retinal and lesion characteristics were evaluated using spectral domain optical coherence tomography (OCT). For all visits where the OCT procedure was scheduled, images were captured and read by the investigator. All OCTs were electronically archived at the study sites as part of the source documentation.
Time Frame
Baseline, Week 52
Title
Proportion of Participants Progressing to Greater or Equal to (>=) 61 on the ETDRS Diabetic Retinopathy Severity Scale (DRSS) as Assessed by Fundus Photography (FP)
Description
The ETDRS DRSS was assessed by FP according to the following scale for both eyes. The following severities are possible.
10 = Diabetic retinopathy (DR) absent, 14 = DR questionable, 15 = DR questionable, 20 = Micro-aneurysms only, 35 = Mild Non-proliferative diabetic retinopathy (NPDR), 43 = Moderate NPDR, 47 = Moderately severe NPDR, 53 = Severe NPDR, 61 = Mild Proliferative diabetic retinopathy (PDR), 65 = Moderate PDR, 71 = High-risk PDR, 75 = High-risk PDR, 81 = Advanced PDR: fundus partially obscured, center of macula attached, 85 = Advanced PDR: posterior fundus obscured, or center of macula detached, 90 = cannot grade, even sufficiently for level 81 or 85.
Time Frame
Baseline, Week 52
Other Pre-specified Outcome Measures:
Title
Change From Baseline in Pre-injection Intraocular Pressure for Study Eye Every 4 Weeks
Description
Intraocular pressure (IOP) was measured using applanation tonometry Goldmann, Tonopen or approved alternative). The same method of intraocular pressure measurement was used in each participant throughout the study. For the measurement of intraocular pressure, a local anesthetic combined with fluorescein was applied topically to the eye being tested (example: one drop of oxybuprocain plus fluorescein). In the below table, pre-injection intraocular pressure for study eye was reported.
Time Frame
Baseline, Weeks 4, 8, 12, 16, 24, 32, 40, 48, 52
Title
Change From Baseline in Systolic Blood Pressure at Week 52
Description
Systolic blood pressure was measured in a consistent and standardized way according to locally established practice.
Time Frame
Baseline, Week 52
Title
Change From Baseline in Diastolic Blood Pressure at Week 52
Description
Diastolic blood pressure was measured in a consistent and standardized way according to locally established practice.
Time Frame
Baseline, Week 52
Title
Change From Baseline in Heart Rate at Week 52
Description
Heart rate was measured in a consistent and standardized way according to locally established practice.
Time Frame
Baseline, Week 52
Title
Change From Baseline in Body Temperature at Week 52
Description
Temperature was measured in a consistent and standardized way according to locally established practice.
Time Frame
Baseline, Week 52
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Type 1 or 2 diabetes mellitus
Diagnosis of DME secondary to diabetes mellitus involving the center of the macula (defined as the area of the center subfield on OCT) in the study eye
Decrease in vision determined to be primarily the result of DME in the study eye
BCVA in the study eye of ETDRS letter score 73 to 24 (This corresponds to a Snellen equivalent of approximately 20/40 to 20/320.)
Exclusion Criteria:
Pregnancy and lactation
Mismatch with inclusion criteria
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bayer Study Director
Organizational Affiliation
Bayer
Official's Role
Study Director
Facility Information:
City
Graz
State/Province
Steiermark
ZIP/Postal Code
8036
Country
Austria
City
Wien
ZIP/Postal Code
1090
Country
Austria
City
Wien
ZIP/Postal Code
1140
Country
Austria
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 2Y9
Country
Canada
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4V2
Country
Canada
City
Mississauga
State/Province
Ontario
ZIP/Postal Code
L4W 1W9
Country
Canada
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M3C 0G9
Country
Canada
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H4P 2S4
Country
Canada
City
Sherbrooke
State/Province
Quebec
ZIP/Postal Code
J1G 2V4
Country
Canada
City
Hradec Kralove
ZIP/Postal Code
500 05
Country
Czechia
City
Praha 10
ZIP/Postal Code
100 34
Country
Czechia
City
Usti nad Labem
ZIP/Postal Code
401 13
Country
Czechia
City
Creteil Cedex
ZIP/Postal Code
94010
Country
France
City
Marseille
ZIP/Postal Code
13285
Country
France
City
Darmstadt
State/Province
Hessen
ZIP/Postal Code
64276
Country
Germany
City
Frankfurt
State/Province
Hessen
ZIP/Postal Code
60596
Country
Germany
City
Marburg
State/Province
Hessen
ZIP/Postal Code
35043
Country
Germany
City
Göttingen
State/Province
Niedersachsen
ZIP/Postal Code
37099
Country
Germany
City
Bonn
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
53105
Country
Germany
City
Köln
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
50937
Country
Germany
City
Ludwigshafen
State/Province
Rheinland-Pfalz
ZIP/Postal Code
67063
Country
Germany
City
Mainz
State/Province
Rheinland-Pfalz
ZIP/Postal Code
55131
Country
Germany
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01067
Country
Germany
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01307
Country
Germany
City
Leipzig
State/Province
Sachsen
ZIP/Postal Code
04103
Country
Germany
City
Budapest
ZIP/Postal Code
1083
Country
Hungary
City
Budapest
ZIP/Postal Code
1106
Country
Hungary
City
Budapest
ZIP/Postal Code
1133
Country
Hungary
City
Debrecen
ZIP/Postal Code
4032
Country
Hungary
City
Pecs
ZIP/Postal Code
7621
Country
Hungary
City
Roma
State/Province
Lazio
ZIP/Postal Code
00133
Country
Italy
City
Genova
State/Province
Liguria
ZIP/Postal Code
16132
Country
Italy
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20122
Country
Italy
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20132
Country
Italy
City
Torino
State/Province
Piemonte
ZIP/Postal Code
10122
Country
Italy
City
Cagliari
State/Province
Sardegna
ZIP/Postal Code
09124
Country
Italy
City
Sassari
State/Province
Sardegna
ZIP/Postal Code
07100
Country
Italy
City
Firenze
State/Province
Toscana
ZIP/Postal Code
50134
Country
Italy
City
Padova
State/Province
Veneto
ZIP/Postal Code
35128
Country
Italy
City
Kaunas
ZIP/Postal Code
LT-50009
Country
Lithuania
City
Vilnius
ZIP/Postal Code
LT-08661
Country
Lithuania
City
Bydgoszcz
ZIP/Postal Code
85-631
Country
Poland
City
Gdansk
ZIP/Postal Code
80-809
Country
Poland
City
Katowice
ZIP/Postal Code
40-594
Country
Poland
City
Krakow
ZIP/Postal Code
31-501
Country
Poland
City
Lodz
ZIP/Postal Code
91-134
Country
Poland
City
Lublin
ZIP/Postal Code
20-079
Country
Poland
City
Poznan
ZIP/Postal Code
61-285
Country
Poland
City
Warszawa
ZIP/Postal Code
01-013
Country
Poland
City
Warszawa
ZIP/Postal Code
04-141
Country
Poland
City
Coimbra
ZIP/Postal Code
3000-548
Country
Portugal
City
Leiria
ZIP/Postal Code
2410-197
Country
Portugal
City
Lisboa
ZIP/Postal Code
1649-035
Country
Portugal
City
Porto
ZIP/Postal Code
4200-319
Country
Portugal
City
Vila Franca de Xira
ZIP/Postal Code
2600-178
Country
Portugal
City
Bratislava
ZIP/Postal Code
826 06
Country
Slovakia
City
Bratislava
ZIP/Postal Code
85107
Country
Slovakia
City
Nitra
ZIP/Postal Code
949 01
Country
Slovakia
City
Zilina
ZIP/Postal Code
01207
Country
Slovakia
City
Zvolen
ZIP/Postal Code
960 01
Country
Slovakia
City
L'Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08907
Country
Spain
City
San Cugat Del Vallès
State/Province
Barcelona
ZIP/Postal Code
08190
Country
Spain
City
Albacete
ZIP/Postal Code
02006
Country
Spain
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
City
Valencia
ZIP/Postal Code
46014
Country
Spain
City
Bern
Country
Switzerland
City
Genève
ZIP/Postal Code
1204
Country
Switzerland
City
Southampton
State/Province
Hampshire
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
City
Camberley
State/Province
Surrey
ZIP/Postal Code
GU16 7UJ
Country
United Kingdom
City
Guildford
State/Province
Surrey
ZIP/Postal Code
GU2 7XX
Country
United Kingdom
City
Newcastle Upon Tyne
State/Province
Tyne And Wear
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
City
Sunderland
State/Province
Tyne And Wear
ZIP/Postal Code
SR2 9HP
Country
United Kingdom
City
Leeds
State/Province
West Yorkshire
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
City
London
ZIP/Postal Code
EC1V 2PD
Country
United Kingdom
12. IPD Sharing Statement
Learn more about this trial
Investigation of the Change of Vision-related Quality of Life in Subjects Treated With Aflibercept According to EU Label for DME.
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