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Prophylactic Ranibizumab for Exudative Age-Related Macular Degeneration (PROTECT)

Primary Purpose

Age-related Macular Degeneration

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ranibizumab 0.5mg
Sponsored by
Leonard Feiner, MD, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Age-related Macular Degeneration

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adults over 50 years old
  • Able to sign informed consent and comply with the study protocol for the duration of the two years.
  • Nonexudative age-related macular degeneration (AMD) in one eye (study eye) •At time of enrollment, fellow non-study eye must have recently diagnosed (not more than 2 years prior to enrollment), angiographically documented, previously untreated prior to diagnosis, CNV lesion (i.e., leakage on fluorescein angiography AND subretinal, intraretinal, or sub-RPE fluid on OCT) secondary to age-related macular degeneration.

Exclusion Criteria:

  • Previous treatment with verteporfin PDT, Macugen®, Lucentis®, intravitreal Avastin®, intravitreal Eylea®, thermal laser, external beam radiation or other AMD therapy in the study eye.
  • History of macular hole in study eye.
  • History of vitrectomy in study eye.
  • Lens extraction or implantation within the last 3 months.
  • Capsulotomy within the last 1 month.
  • Lens or other media opacity that would preclude good fundus photography or angiography within the next 2 years.
  • Nevus > 2 disc areas within 3000 microns of the foveal center or with fluid or leakage on fluorescein angiography.
  • Macular edema or signs of diabetic retinopathy more severe than 10 red dots (microaneurysms or blot hemorrhages).
  • Retinal changes related to high myopia and no myopic correction greater than 8.00 diopters spherical equivalent [sphere + ½ cylinder].
  • Any progressive ocular disease that would affect visual acuity within the next 2 years.
  • Previous participation in any studies of investigational drugs likely to have ocular effects within 30 days preceding the initial study treatment.
  • Concurrent use of systemic anti-VEGF agents.
  • Active or recent (within 4 weeks) intraocular inflammation (grade trace or above) in the study eye.
  • Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye.
  • For subjects who have undergone prior refractive or cataract surgery in the study eye, the preoperative refractive error in the study eye cannot exceed 8 diopters of myopia.
  • Uncontrolled glaucoma in the study eye (defined as intraocular pressure > 25 mmHg) despite treatment with antiglaucoma medication).
  • Patients who are unable to be photographed to document CNV due to known allergy to fluorescein dye, lack of venous access or cataract obscuring the CNV.
  • Patients with other ocular diseases that can compromise the visual acuity of the study eye such as amblyopia and anterior ischemic optic neuropathy.
  • Current treatment for active systemic infection.
  • Evidence of significant uncontrolled concomitant diseases such as cardiovascular disease, nervous system, pulmonary, renal, hepatic, endocrine, or gastrointestinal disorders.
  • History of recurrent significant infections or bacterial infections.
  • Inability to comply with study or follow-up procedures.
  • Pregnancy (positive pregnancy test) or lactation Premenopausal women not using adequate contraception. The following are considered effective means of contraception: surgical sterilization or use of oral contraceptives, barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel, an IUD, or contraceptive hormone implant or patch.
  • Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated
  • Participation in another simultaneous medical investigation or trial

Sites / Locations

  • NJ Retina (Retina Associates of New Jersey)
  • NJ Retina (Retina Associates of New Jersey)

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Active Comparator

Arm Label

Observation

Quarterly Ranibizumab 0.5

Arm Description

No treatment. Observation only

Quarterly intravitreal injection of 0.5mg Ranibizumab Intervention: Drug: Ranibizumab 0.5mg

Outcomes

Primary Outcome Measures

Conversion to neovascular AMD. (CNV leakage on FA and evidence of any fluid on SD-OCT)
The development of CNV will be assessed by CNV leakage on FA and evidence of any fluid on SD-OCT.

Secondary Outcome Measures

Full Information

First Posted
November 25, 2014
Last Updated
August 27, 2018
Sponsor
Leonard Feiner, MD, PhD
Collaborators
NJ Retina (Retina Associates of New Jersey)
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1. Study Identification

Unique Protocol Identification Number
NCT02302989
Brief Title
Prophylactic Ranibizumab for Exudative Age-Related Macular Degeneration
Acronym
PROTECT
Official Title
Prospective Double-blind Randomized Study to Evaluate Lucentis for Prophylaxis Against the Conversion to Neovascular Age-related Macular Degeneration (AMD) in High-risk Eyes (Let's ProTECT AMD Eyes)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
May 2015 (Actual)
Primary Completion Date
July 2018 (Actual)
Study Completion Date
July 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Leonard Feiner, MD, PhD
Collaborators
NJ Retina (Retina Associates of New Jersey)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate Ranibizumab as prophylaxis against the conversion to neovascular Age-Related Macular Degeneration
Detailed Description
This is an open-label, prospective, randomized study of intravitreally administered ranibizumab 0.5 mg in subjects with unilateral neovascular AMD in which the fellow (study) eye is at high-risk for also developing conversion to neovascular AMD. The Study will determine the efficacy of a quarterly injection of Ranibizumab to prevent the conversion of dry age-related macular degeneration to neovascular AMD in high risk eyes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Age-related Macular Degeneration

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Observation
Arm Type
No Intervention
Arm Description
No treatment. Observation only
Arm Title
Quarterly Ranibizumab 0.5
Arm Type
Active Comparator
Arm Description
Quarterly intravitreal injection of 0.5mg Ranibizumab Intervention: Drug: Ranibizumab 0.5mg
Intervention Type
Drug
Intervention Name(s)
Ranibizumab 0.5mg
Other Intervention Name(s)
Lucentis
Primary Outcome Measure Information:
Title
Conversion to neovascular AMD. (CNV leakage on FA and evidence of any fluid on SD-OCT)
Description
The development of CNV will be assessed by CNV leakage on FA and evidence of any fluid on SD-OCT.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults over 50 years old Able to sign informed consent and comply with the study protocol for the duration of the two years. Nonexudative age-related macular degeneration (AMD) in one eye (study eye) •At time of enrollment, fellow non-study eye must have recently diagnosed (not more than 2 years prior to enrollment), angiographically documented, previously untreated prior to diagnosis, CNV lesion (i.e., leakage on fluorescein angiography AND subretinal, intraretinal, or sub-RPE fluid on OCT) secondary to age-related macular degeneration. Exclusion Criteria: Previous treatment with verteporfin PDT, Macugen®, Lucentis®, intravitreal Avastin®, intravitreal Eylea®, thermal laser, external beam radiation or other AMD therapy in the study eye. History of macular hole in study eye. History of vitrectomy in study eye. Lens extraction or implantation within the last 3 months. Capsulotomy within the last 1 month. Lens or other media opacity that would preclude good fundus photography or angiography within the next 2 years. Nevus > 2 disc areas within 3000 microns of the foveal center or with fluid or leakage on fluorescein angiography. Macular edema or signs of diabetic retinopathy more severe than 10 red dots (microaneurysms or blot hemorrhages). Retinal changes related to high myopia and no myopic correction greater than 8.00 diopters spherical equivalent [sphere + ½ cylinder]. Any progressive ocular disease that would affect visual acuity within the next 2 years. Previous participation in any studies of investigational drugs likely to have ocular effects within 30 days preceding the initial study treatment. Concurrent use of systemic anti-VEGF agents. Active or recent (within 4 weeks) intraocular inflammation (grade trace or above) in the study eye. Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye. For subjects who have undergone prior refractive or cataract surgery in the study eye, the preoperative refractive error in the study eye cannot exceed 8 diopters of myopia. Uncontrolled glaucoma in the study eye (defined as intraocular pressure > 25 mmHg) despite treatment with antiglaucoma medication). Patients who are unable to be photographed to document CNV due to known allergy to fluorescein dye, lack of venous access or cataract obscuring the CNV. Patients with other ocular diseases that can compromise the visual acuity of the study eye such as amblyopia and anterior ischemic optic neuropathy. Current treatment for active systemic infection. Evidence of significant uncontrolled concomitant diseases such as cardiovascular disease, nervous system, pulmonary, renal, hepatic, endocrine, or gastrointestinal disorders. History of recurrent significant infections or bacterial infections. Inability to comply with study or follow-up procedures. Pregnancy (positive pregnancy test) or lactation Premenopausal women not using adequate contraception. The following are considered effective means of contraception: surgical sterilization or use of oral contraceptives, barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel, an IUD, or contraceptive hormone implant or patch. Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated Participation in another simultaneous medical investigation or trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonard Feiner, MD, MD, PhD
Organizational Affiliation
NJ Retina (Retina Associates of New Jersey)
Official's Role
Principal Investigator
Facility Information:
Facility Name
NJ Retina (Retina Associates of New Jersey)
City
Teaneck
State/Province
New Jersey
ZIP/Postal Code
07666
Country
United States
Facility Name
NJ Retina (Retina Associates of New Jersey)
City
Vauxhall
State/Province
New Jersey
ZIP/Postal Code
07088
Country
United States

12. IPD Sharing Statement

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Prophylactic Ranibizumab for Exudative Age-Related Macular Degeneration

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