Long-Term Efficacy and Safety of Aflibercept Intravitreal Injections for the Treatment of Diabetic Macular Edema (Endurance3)
Primary Purpose
Clinically Significant Diabetic Macular Edema
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Assigned Intervention
aflibercept 2.0 mg
Sponsored by
About this trial
This is an interventional treatment trial for Clinically Significant Diabetic Macular Edema
Eligibility Criteria
Inclusion Criteria:
- Enrolled and completed VISTA DME (VGFT-OD-1009) clinical trial
- Willing and able to comply with clinic visits and study-related procedures
- Provide signed informed consent
- Enrollment in the trial within 12 weeks of trial activation
Exclusion Criteria:
- Prior treatment with anti-VEGF therapy in the study eye within 28 days of baseline
- Pregnant or breast-feeding women
- Sexually active ment or women of childbearing potential who are unwilling to practice adequate contraception during the study
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Open-Label Arm
Arm Description
2mg Aflibercept, as needed, intravitreal administration. All subjects will be treated with intravitreal (IVT) aflibercept injections as needed in the presence of clinically relevant diabetic macular edema (CR-DME). If CR-DME is not present the subject will not receive an IVT aflibercept injection and will be observed. If a subject has recurrent CR-DME they will receive an IVT aflibercept 2.0 mg injection and interval between visits will be reduced to 4 weeks. At week 12 through end of study, all subjects will be evaluated for focal laser treatment.
Outcomes
Primary Outcome Measures
Mean number of intravitreal aflibercept injections in 52 weeks
Proportion of subjects receiving 0 aflibercept injections in 52 weeks
Longer-term efficacy of aflibercept intravitreal injections as assessed by the mean number of injections in 52 weeks
Safety of ongoing aflibercept intravitreal injections as assessed by the incidence and severity of ocular and systemic adverse events
Secondary Outcome Measures
Vision Change
Mean change in visual acuity from baseline to week 52
Vision loss
Proportion of subjects with gain or loss of 0 to 5 letters from baseline to week 52
Change in central retinal thickness
Mean change in central retinal thickness from baseline to week 52
Development of clinically relevant diabetic macular edema
Percentage of subjects with no clinically relevant diabetic macular edema seen on SD-OCT from baseline to week 52
Evaluation of Diabetic Retinopathy (Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging)
Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging
Role of focal laser treatment in management of DME (Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment)
Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment
Ocular and systemic adverse events
Incidence and severity of ocular and systemic adverse events as identified by eye examinations, imaging, and subject reporting
Full Information
NCT ID
NCT02734407
First Posted
December 16, 2014
Last Updated
March 25, 2019
Sponsor
Retina-Vitreous Associates Medical Group
1. Study Identification
Unique Protocol Identification Number
NCT02734407
Brief Title
Long-Term Efficacy and Safety of Aflibercept Intravitreal Injections for the Treatment of Diabetic Macular Edema
Acronym
Endurance3
Official Title
Long-Term Efficacy and Safety of Aflibercept Intravitreal Injections for the Treatment of Diabetic Macular Edema in Subjects Who Completed the Three Year VISTA-DME Trial
Study Type
Interventional
2. Study Status
Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
September 27, 2017 (Actual)
Study Completion Date
September 27, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Retina-Vitreous Associates Medical Group
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The Endurance Trial is a Phase IV open label clinical study to assess the need for ongoing intravitreal aflibercept injections after the 3-year VISTA DME (VGFT-OD-1009) endpoint. Subjects will be treated with intravitreal aflibercept injections pro re nata (PRN) based on the presence of CR-DME (Clinically Relevant-DME). In addition, subjects who meet re-treatment criteria will be eligible for focal laser treatment every 90 days
Detailed Description
The Endurance3 Trial is a Phase IV open label study to assess the need for ongoing intravitreal aflibercept injections after the 3 year VISTA DME (VGFT-OD-1009) endpoint. Subjects will be treated with intravitreal aflibercept injections pro re nata (PRN) upon the presence of CR-DME (Clinically Relevant DME) as noted by OCT (Optical Coherence Tomography) imaging and examination. In addition, subjects who meet the re-treatment criteria will be eligible for focal laser treatment every 90 days.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clinically Significant Diabetic Macular Edema
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Open-Label Arm
Arm Type
Experimental
Arm Description
2mg Aflibercept, as needed, intravitreal administration.
All subjects will be treated with intravitreal (IVT) aflibercept injections as needed in the presence of clinically relevant diabetic macular edema (CR-DME). If CR-DME is not present the subject will not receive an IVT aflibercept injection and will be observed.
If a subject has recurrent CR-DME they will receive an IVT aflibercept 2.0 mg injection and interval between visits will be reduced to 4 weeks.
At week 12 through end of study, all subjects will be evaluated for focal laser treatment.
Intervention Type
Procedure
Intervention Name(s)
Assigned Intervention
Other Intervention Name(s)
FLT
Intervention Description
All subjects receiving PRN IVT aflibercept injections will be evaluated for focal laser treatment beginning at week 12 through the end of the study as assigned intervention. If the subject meets any of the criteria for focal laser treatment (FLT), fluorescein angiography (FA) will be performed to guide the focal laser treatment. Focal laser treatment and focal laser re-treatment will be administered no more than once every 90 days.
Intervention Type
Drug
Intervention Name(s)
aflibercept 2.0 mg
Other Intervention Name(s)
Eylea, VEGF-Trap
Intervention Description
If a subject has recurrent CR-DME they will receive an IVT aflibercept injection
Primary Outcome Measure Information:
Title
Mean number of intravitreal aflibercept injections in 52 weeks
Time Frame
12 months
Title
Proportion of subjects receiving 0 aflibercept injections in 52 weeks
Time Frame
12 months
Title
Longer-term efficacy of aflibercept intravitreal injections as assessed by the mean number of injections in 52 weeks
Time Frame
12 months
Title
Safety of ongoing aflibercept intravitreal injections as assessed by the incidence and severity of ocular and systemic adverse events
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Vision Change
Description
Mean change in visual acuity from baseline to week 52
Time Frame
12 months
Title
Vision loss
Description
Proportion of subjects with gain or loss of 0 to 5 letters from baseline to week 52
Time Frame
12 months
Title
Change in central retinal thickness
Description
Mean change in central retinal thickness from baseline to week 52
Time Frame
12 months
Title
Development of clinically relevant diabetic macular edema
Description
Percentage of subjects with no clinically relevant diabetic macular edema seen on SD-OCT from baseline to week 52
Time Frame
12 months
Title
Evaluation of Diabetic Retinopathy (Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging)
Description
Proportion of subjects with stable, worsened, or improved diabetic retinopathy as identified by eye examination and imaging
Time Frame
12 months
Title
Role of focal laser treatment in management of DME (Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment)
Description
Proportion of subjects that receive focal laser treatment and mean number of intravitreal aflibercept injections before and after receiving focal laser treatment
Time Frame
12 months
Title
Ocular and systemic adverse events
Description
Incidence and severity of ocular and systemic adverse events as identified by eye examinations, imaging, and subject reporting
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Enrolled and completed VISTA DME (VGFT-OD-1009) clinical trial
Willing and able to comply with clinic visits and study-related procedures
Provide signed informed consent
Enrollment in the trial within 12 weeks of trial activation
Exclusion Criteria:
Prior treatment with anti-VEGF therapy in the study eye within 28 days of baseline
Pregnant or breast-feeding women
Sexually active ment or women of childbearing potential who are unwilling to practice adequate contraception during the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Boyer, MD
Organizational Affiliation
Retina-Vitreous Associates Medical Group
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Long-Term Efficacy and Safety of Aflibercept Intravitreal Injections for the Treatment of Diabetic Macular Edema
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