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Lucentis Utilizing Visudyne (LUV Trial) Combination Therapy in the Treatment of Age-Related Macular Degeneration

Primary Purpose

Age-Related Macular Degeneration

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Ranibizumab (Lucentis)
0.5mg ranibizumab
Sponsored by
David M. Brown, M.D.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Age-Related Macular Degeneration focused on measuring LUV, Lucentis, Visudyne, PDT, AMD, ARMD, Age, Related, Macular, Degeneration

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Ability to provide written informed consent and comply with study assessments for the full duration of the study
  • Age > 55 years
  • Subfoveal neovascular membrane confirmed by fluorescein angiography and or ICG
  • Visual acuity not better than 20/32 and not worse than 20/320 by ETDRS refraction

Exclusion Criteria:

  • Any previous vitrectomy in study eye (posterior or anterior associated with vitreous loss in cataract surgery)
  • Intracapsular cataract extraction (posterior capsule needs to be present)
  • Previous treatment with ranibizumab
  • Previous treatment with pegaptanib
  • Previous treatment with ITV triamcinolone
  • Any previous treatment with photodynamic therapy
  • Previous history of retinal detachment in study eye
  • Any previous radiation treatments to head/ neck
  • Significant cardiovascular disease or cancer that would prevent follow-up visits or completion of the 12 month study
  • Prior enrollment in any study for AMD in the study eye
  • Participation in another simultaneous medical investigator or trial
  • Ocular disorders in the study eye that may confound interpretation of study results, including retinal detachment or macular hole.
  • Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the study period
  • Aphakia or absence of the posterior capsule in the study eye
  • Previous violation of the posterior capsule is also excluded unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
  • History of idiopathic or autoimmune uveitis in either eye
  • Significant structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema, including atrophy of the retinal pigment epithelium, subretinal fibrosis, laser scar(s)
  • Vitreomacular traction or epiretinal membrane in the study eye evident biomicroscopically or by OCT
  • Ocular inflammation (including trace or above) in the study eye
  • Uncontrolled glaucoma (defined as intraocular pressure ≥30 mm Hg despite treatment with anti- medications) or previous filtration surgery in the study eye
  • Infectious blepharitis, keratitis, scleritis, or conjunctivitis (in either eye) or current treatment for serious systemic infection
  • Spherical equivalent of the refractive error in the study eye of more than -8 diopters myopia (For patients who have had refractive or cataract surgery in the study eye, pre-operative spherical equivalent refractive error of more than -8 diopters myopia is not allowed)

Systemic Conditions

  • Uncontrolled Blood pressure exceeding diastolic pressure of 100 mm Hg (sitting) during the screening period
  • Uncontrolled diabetes mellitus
  • Renal failure requiring dialysis or renal transplant
  • Premenopausal women not using adequate contraception
  • Previous participation in other studies of investigational drugs (excluding vitamins and minerals) within 3 months preceding Day 0
  • History of other disease, metabolic dysfunction, physical examination finding, or other findings giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications
  • INR ≥ 3.0 (e.g. due to current treatment with warfarin). The use of aspirin is not an exclusion.

Other

  • History of allergy to fluorescein, not amenable to treatment
  • History of allergy to shellfish
  • History of allergy to intravenous iodine
  • History of allergy to indocyanine green
  • Inability to obtain fundus photographs or angiograms of sufficient quality to be analyzed and graded by the central reading center
  • Inability to comply with study or follow up procedures
  • History of allergy to humanized antibodies or any component of the ranibizumab formulation

Sites / Locations

  • Vitreoretinal Consultants

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Ranibizumab only

40% fluence PDT/procedure

20% fluence photodynamic therapy

Arm Description

drug - intravitreal ranibizumab

40% fluence photodynamic therapy-PDT therapy with 0.5mg ranibizumab

20% fluence photodynamic therapy-PDT therapy with 0.5mg ranibizumab

Outcomes

Primary Outcome Measures

Best-corrected ETDRS Visual Acuity at 6 Months and 12 Months Only Time Points (Gain or Loss of >15 Letters at 12 Months)
Visual Acuity was measured by ETDRS by certified refractionists in certified lanes at 12 months. Visual Acuity was not measured by ETDRS at 6 months.

Secondary Outcome Measures

Number of Intravitreal Injections With Ranibizumab Needed by Patients at 12 Months
Number of intravitreal injections with ranibizumab needed by patients at 12 months was not determined due to lack of efficacy.
OCT 3 Macular Thickness Improvement (Baseline-1month, 2months, 3months, 6months &12 Months)
OCT 3 macular thickness improvement at Baseline-1month, 2months, 3months, 6months &12 months was not determined due to lack of efficacy.
Choroidal Perfusion as Assessed by ICG Angiography at 1, 2, 3, 6, and 12 Months
Choroidal perfusion as assessed by ICG angiography at 1, 2, 3, 6, and 12 months was not determined due to lack of efficacy
Safety of Combination Therapy With Verteporfin PDT and ITV Ranibizumab
Safety of combination therapy with verteporfin PDT and ITV ranibizumab was not determined due to lack of efficacy.

Full Information

First Posted
January 16, 2007
Last Updated
February 5, 2016
Sponsor
David M. Brown, M.D.
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00423189
Brief Title
Lucentis Utilizing Visudyne (LUV Trial) Combination Therapy in the Treatment of Age-Related Macular Degeneration
Official Title
Lucentis Utilizing Visudyne (LUV Trial)-- Reduced Fluence Photodynamic Therapy With Visudyne Combined With Intravitreal Ranibizumab in the Treatment of Age-Related Macular Degeneration
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
January 2007 (undefined)
Primary Completion Date
January 2009 (Actual)
Study Completion Date
January 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
David M. Brown, M.D.
Collaborators
Novartis Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The PDT/Lucentis trial will be a Phase IV comparative trial comparing the use of combination therapy with ITV ranibizumab and verteporfin PDT to ITV ranibizumab alone in patients with exudative AMD.
Detailed Description
The PDT/Lucentis trial will be a Phase IV comparative trial comparing the use of combination therapy with ITV ranibizumab and verteporfin PDT to ITV ranibizumab alone in patients with exudative AMD. Patients will be randomized to one of three groups. All patients will receive three consecutive monthly treatments with ITV ranibizumab. Patients randomized to group I will receive only ITV ranibizumab. Patients randomized to group II will also receive one treatment with reduced fluence (20% fluence) verteporfin PDT at day 0. Patients randomized to group III will also receive one treatment with reduced fluence (40% fluence) vPDT. All patients will also be evaluated for possible retreatment with ranibizumab according to established criteria. Thirty patients (ten per group) will be recruited from one U.S. sites in a 6-month period. Randomization will occur at the time of entry into the study. Follow-up will continue until month 12 (from day 0) in all subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Age-Related Macular Degeneration
Keywords
LUV, Lucentis, Visudyne, PDT, AMD, ARMD, Age, Related, Macular, Degeneration

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ranibizumab only
Arm Type
Active Comparator
Arm Description
drug - intravitreal ranibizumab
Arm Title
40% fluence PDT/procedure
Arm Type
Experimental
Arm Description
40% fluence photodynamic therapy-PDT therapy with 0.5mg ranibizumab
Arm Title
20% fluence photodynamic therapy
Arm Type
Experimental
Arm Description
20% fluence photodynamic therapy-PDT therapy with 0.5mg ranibizumab
Intervention Type
Drug
Intervention Name(s)
Ranibizumab (Lucentis)
Other Intervention Name(s)
PDT, Photodynamic Therapy
Intervention Description
as needed, one intravitreal injection of 0.50mg ranibizumab
Intervention Type
Drug
Intervention Name(s)
0.5mg ranibizumab
Other Intervention Name(s)
lucentis
Intervention Description
as needed, one intravitreal injection of 0.50mg ranibizumab
Primary Outcome Measure Information:
Title
Best-corrected ETDRS Visual Acuity at 6 Months and 12 Months Only Time Points (Gain or Loss of >15 Letters at 12 Months)
Description
Visual Acuity was measured by ETDRS by certified refractionists in certified lanes at 12 months. Visual Acuity was not measured by ETDRS at 6 months.
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
Number of Intravitreal Injections With Ranibizumab Needed by Patients at 12 Months
Description
Number of intravitreal injections with ranibizumab needed by patients at 12 months was not determined due to lack of efficacy.
Time Frame
1 Year
Title
OCT 3 Macular Thickness Improvement (Baseline-1month, 2months, 3months, 6months &12 Months)
Description
OCT 3 macular thickness improvement at Baseline-1month, 2months, 3months, 6months &12 months was not determined due to lack of efficacy.
Time Frame
1 Year
Title
Choroidal Perfusion as Assessed by ICG Angiography at 1, 2, 3, 6, and 12 Months
Description
Choroidal perfusion as assessed by ICG angiography at 1, 2, 3, 6, and 12 months was not determined due to lack of efficacy
Time Frame
1 Year
Title
Safety of Combination Therapy With Verteporfin PDT and ITV Ranibizumab
Description
Safety of combination therapy with verteporfin PDT and ITV ranibizumab was not determined due to lack of efficacy.
Time Frame
1 Year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Ability to provide written informed consent and comply with study assessments for the full duration of the study Age > 55 years Subfoveal neovascular membrane confirmed by fluorescein angiography and or ICG Visual acuity not better than 20/32 and not worse than 20/320 by ETDRS refraction Exclusion Criteria: Any previous vitrectomy in study eye (posterior or anterior associated with vitreous loss in cataract surgery) Intracapsular cataract extraction (posterior capsule needs to be present) Previous treatment with ranibizumab Previous treatment with pegaptanib Previous treatment with ITV triamcinolone Any previous treatment with photodynamic therapy Previous history of retinal detachment in study eye Any previous radiation treatments to head/ neck Significant cardiovascular disease or cancer that would prevent follow-up visits or completion of the 12 month study Prior enrollment in any study for AMD in the study eye Participation in another simultaneous medical investigator or trial Ocular disorders in the study eye that may confound interpretation of study results, including retinal detachment or macular hole. Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the study period Aphakia or absence of the posterior capsule in the study eye Previous violation of the posterior capsule is also excluded unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation History of idiopathic or autoimmune uveitis in either eye Significant structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema, including atrophy of the retinal pigment epithelium, subretinal fibrosis, laser scar(s) Vitreomacular traction or epiretinal membrane in the study eye evident biomicroscopically or by OCT Ocular inflammation (including trace or above) in the study eye Uncontrolled glaucoma (defined as intraocular pressure ≥30 mm Hg despite treatment with anti- medications) or previous filtration surgery in the study eye Infectious blepharitis, keratitis, scleritis, or conjunctivitis (in either eye) or current treatment for serious systemic infection Spherical equivalent of the refractive error in the study eye of more than -8 diopters myopia (For patients who have had refractive or cataract surgery in the study eye, pre-operative spherical equivalent refractive error of more than -8 diopters myopia is not allowed) Systemic Conditions Uncontrolled Blood pressure exceeding diastolic pressure of 100 mm Hg (sitting) during the screening period Uncontrolled diabetes mellitus Renal failure requiring dialysis or renal transplant Premenopausal women not using adequate contraception Previous participation in other studies of investigational drugs (excluding vitamins and minerals) within 3 months preceding Day 0 History of other disease, metabolic dysfunction, physical examination finding, or other findings giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications INR ≥ 3.0 (e.g. due to current treatment with warfarin). The use of aspirin is not an exclusion. Other History of allergy to fluorescein, not amenable to treatment History of allergy to shellfish History of allergy to intravenous iodine History of allergy to indocyanine green Inability to obtain fundus photographs or angiograms of sufficient quality to be analyzed and graded by the central reading center Inability to comply with study or follow up procedures History of allergy to humanized antibodies or any component of the ranibizumab formulation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David M Brown, M.D.
Organizational Affiliation
Vitreoretinal Consultants
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vitreoretinal Consultants
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17021319
Citation
Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S; ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1432-44. doi: 10.1056/NEJMoa062655.
Results Reference
background
PubMed Identifier
17021318
Citation
Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY; MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1419-31. doi: 10.1056/NEJMoa054481.
Results Reference
background
PubMed Identifier
16384987
Citation
Michels S, Hansmann F, Geitzenauer W, Schmidt-Erfurth U. Influence of treatment parameters on selectivity of verteporfin therapy. Invest Ophthalmol Vis Sci. 2006 Jan;47(1):371-6. doi: 10.1167/iovs.05-0354.
Results Reference
background
PubMed Identifier
15824216
Citation
Azab M, Boyer DS, Bressler NM, Bressler SB, Cihelkova I, Hao Y, Immonen I, Lim JI, Menchini U, Naor J, Potter MJ, Reaves A, Rosenfeld PJ, Slakter JS, Soucek P, Strong HA, Wenkstern A, Su XY, Yang YC; Visudyne in Minimally Classic Choroidal Neovascularization Study Group. Verteporfin therapy of subfoveal minimally classic choroidal neovascularization in age-related macular degeneration: 2-year results of a randomized clinical trial. Arch Ophthalmol. 2005 Apr;123(4):448-57. doi: 10.1001/archopht.123.4.448.
Results Reference
background
Links:
URL
http://www.houstonretina.com
Description
GreaterHRR website

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Lucentis Utilizing Visudyne (LUV Trial) Combination Therapy in the Treatment of Age-Related Macular Degeneration

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