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Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 With or Without Lucentis™ in Patients With Wet AMD

Primary Purpose

Eye Diseases, Macular Degeneration, Retinal Diseases

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
OPT-302
Lucentis™
Sponsored by
Opthea Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Eye Diseases

Eligibility Criteria

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

Inclusion Criteria:

  • Able and willing to provide written informed consent
  • Age ≥ 50 years of either gender
  • Active CNV lesions secondary to AMD (i.e., subretinal or intraretinal fluid on SD-OCT and / or leakage on fluorescein angiography)
  • Either no previous treatment in the study eye with IVT anti-VEGF-A therapy (treatment naïve) or prior IVT anti-VEGF-A therapy (previously treated) with sub-optimal response to treatment and the need for additional treatment
  • Best corrected visual acuity in the study eye, using ETDRS testing, of 20/320 or better (Snellen equivalent) in Part 1 (dose escalation) and between 20/40 and 20/320 (Snellen equivalent), inclusive, in Part 2 (dose expansion).
  • Women of child bearing potential and male subjects with female partners of child bearing potential must be practicing effective contraception during the trial and for at least 3 months following the last dose of study medication

Exclusion Criteria:

  • Previous or concurrent use of systemic anti-VEGF-A agents
  • Most recent IVT injection of bevacizumab or ranibizumab <28 days prior to screening or aflibercept <42 days prior to screening
  • Previous treatment with photodynamic therapy, thermal laser or external beam radiation in the study eye
  • Concurrent treatment in either eye for any ocular condition with an investigational drug or device that has not received regulatory approval
  • Anatomic damage to the center of the fovea including fibrosis and scarring making up >50% of total lesion area including the CNV in the study eye
  • Geographic atrophy involving the center of the fovea in the study eye
  • History or presence of a retinal pigment epithelial tear
  • Presence of polypoidal choroidal vasculopathy (if in the opinion of the investigator, anti-VEGF treatment would not be of benefit) or retinal angiomatous proliferation
  • Active or recent (within 4 weeks) intraocular inflammation (grade trace or above) in the study eye
  • History of rhegmatogenous retinal detachment or macular hole in the study eye
  • History of vitrectomy
  • Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye
  • History of vitreous hemorrhage within 4 weeks prior to screening in the study eye
  • History of major ocular surgery within prior 6 months or anticipated within next 3 months following dosing on day 1
  • Uncontrolled glaucoma in the study eye (defined as intraocular pressure of >25 mmHg despite treatment with maximal medical therapy)
  • Uncontrolled hypertension ≥180 mmHg systolic or ≥110 mmHg diastolic at baseline
  • Uncontrolled diabetes mellitus (Disease must be controlled with hemoglobin A1c (HgbA1c) < 9.0%)
  • Clinical evidence of diabetic retinopathies, diabetic macular edema or any other vascular disease affecting the retina, other than AMD, in either eye that, in the opinion of the investigator, would be likely to limit improvement in the macular anatomy and/or function
  • Pregnancy or lactation

Sites / Locations

  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site
  • Opthea Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Part 1 Dose escalation - Cohort 1

Part 1 Dose escalation - Cohort 2

Part 1 Dose escalation - Cohort 3

Part 1 Dose escalation - Cohort 4

Part 2 Dose expansion - Cohort 5

Part 2 Dose expansion - Cohort 6

Arm Description

Dose Level 1 of OPT-302 in combination with Lucentis™

Dose Level 2 of OPT-302 in combination with Lucentis™

Dose Level 3 of OPT-302 in combination with Lucentis™

Dose Level 3 of OPT-302 monotherapy

OPT-302 (at Maximum Tolerated Dose [MTD] or highest dose tested in Part 1) in combination with Lucentis™

OPT-302 (at MTD or highest dose tested in Part 1) monotherapy

Outcomes

Primary Outcome Measures

Safety (Adverse Events)
Subject incidences of ophthalmic and systemic Adverse Events during study and follow-up period

Secondary Outcome Measures

Mean change in Best Corrected Visual Acuity (BCVA) from baseline
Mean change in Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA from baseline
Mean change in central retinal thickness from baseline
Changes in intra- or sub-retinal fluid measured as mean change in central retinal thickness or macula volume by Spectral Domain Optical Coherence Tomography (SD-OCT)
Mean change in Choroidal Neovascularization (CNV) lesion area from baseline
Change in CNV size according to fluorescein angiogram
Mean number of retreatment injections of anti-VEGF-A therapy during long term follow-up (week 12 to 24)
Need for 'rescue therapy' with ranibizumab in subjects receiving OPT-302 monotherapy
Assess the Pharmacokinetic profile of OPT-302 alone and in combination with ranibizumab following intravitreal administration
Mean systemic OPT-302 Concentration-Time profile
Anti-OPT-302 antibody formation
Incidence of anti-OPT-302 antibody formation

Full Information

First Posted
August 25, 2015
Last Updated
November 2, 2017
Sponsor
Opthea Limited
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1. Study Identification

Unique Protocol Identification Number
NCT02543229
Brief Title
Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 With or Without Lucentis™ in Patients With Wet AMD
Official Title
A Phase 1 Dose Escalation Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 in Combination With Ranibizumab in Subjects With Wet AMD
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
July 2015 (undefined)
Primary Completion Date
February 7, 2017 (Actual)
Study Completion Date
September 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Opthea Limited

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this first-in-human study is to evaluate the safety, pharmacokinetics (PK) and pharmacodynamics of OPT-302 administered as monthly intravitreal injections for 3 months with and without Lucentis™ in patients with wet age related macular degeneration (AMD). This study will be conducted in two parts: Part 1 will comprise an open label, sequential dose escalation and Part 2 a randomized dose expansion. OPT-302 is a soluble form of VEGFR-3 comprising the extracellular domains 1-3 of human vascular endothelial growth factor receptor (VEGFR)-3 and the Fc fragment of human IgG1. It functions by binding and neutralizing the activity of vascular endothelial growth factor (VEGF)-C and VEGF-D on endogenous VEGFR-2 and VEGFR-3. VEGF-C and VEGF-D promote blood vessel development (angiogenesis) by binding and activating VEGFR-2 and VEGFR-3. VEGF-C is also a potent inducer of vascular permeability or leakage. Angiogenesis and vascular leakage are key hallmarks of wet AMD. Approved therapies for wet AMD include Eylea™ and Lucentis™ which block the activity of VEGF-A, but not VEGF-C or VEGF-D which are alternate members of the same family of molecules. VEGF-C and VEGF-D can stimulate blood vessel growth and leakage through the same pathway as VEGF-A (via VEGFR-2), as well as through pathways that are independent of VEGF-A (via VEGFR-3). Published studies have also indicated that VEGF-C and VEGF-D play an important role in mediating resistance to therapies that block VEGF-A such as Lucentis™ and Eylea™. Combination therapy with OPT-302 an anti-VEGF-A agent provides a more complete blockade of the VEGF family. This strategy targets functional redundancy in the VEGF pathway and mechanisms of 'resistance' or sub-response to VEGF-A inhibition.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Eye Diseases, Macular Degeneration, Retinal Diseases, Retinal Degeneration, Neovascularization, Pathologic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
51 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1 Dose escalation - Cohort 1
Arm Type
Experimental
Arm Description
Dose Level 1 of OPT-302 in combination with Lucentis™
Arm Title
Part 1 Dose escalation - Cohort 2
Arm Type
Experimental
Arm Description
Dose Level 2 of OPT-302 in combination with Lucentis™
Arm Title
Part 1 Dose escalation - Cohort 3
Arm Type
Experimental
Arm Description
Dose Level 3 of OPT-302 in combination with Lucentis™
Arm Title
Part 1 Dose escalation - Cohort 4
Arm Type
Experimental
Arm Description
Dose Level 3 of OPT-302 monotherapy
Arm Title
Part 2 Dose expansion - Cohort 5
Arm Type
Experimental
Arm Description
OPT-302 (at Maximum Tolerated Dose [MTD] or highest dose tested in Part 1) in combination with Lucentis™
Arm Title
Part 2 Dose expansion - Cohort 6
Arm Type
Experimental
Arm Description
OPT-302 (at MTD or highest dose tested in Part 1) monotherapy
Intervention Type
Drug
Intervention Name(s)
OPT-302
Intervention Description
OPT-302 will be administered by intravitreal injection once every month for 3 months
Intervention Type
Drug
Intervention Name(s)
Lucentis™
Other Intervention Name(s)
Ranibizumab
Intervention Description
Lucentis™ (0.5 mg) will be administered by intravitreal injection once every month for 3 months
Primary Outcome Measure Information:
Title
Safety (Adverse Events)
Description
Subject incidences of ophthalmic and systemic Adverse Events during study and follow-up period
Time Frame
Up to 1 month after the last dose
Secondary Outcome Measure Information:
Title
Mean change in Best Corrected Visual Acuity (BCVA) from baseline
Description
Mean change in Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA from baseline
Time Frame
6 months
Title
Mean change in central retinal thickness from baseline
Description
Changes in intra- or sub-retinal fluid measured as mean change in central retinal thickness or macula volume by Spectral Domain Optical Coherence Tomography (SD-OCT)
Time Frame
6 months
Title
Mean change in Choroidal Neovascularization (CNV) lesion area from baseline
Description
Change in CNV size according to fluorescein angiogram
Time Frame
6 months
Title
Mean number of retreatment injections of anti-VEGF-A therapy during long term follow-up (week 12 to 24)
Time Frame
3 months
Title
Need for 'rescue therapy' with ranibizumab in subjects receiving OPT-302 monotherapy
Time Frame
3 months
Title
Assess the Pharmacokinetic profile of OPT-302 alone and in combination with ranibizumab following intravitreal administration
Description
Mean systemic OPT-302 Concentration-Time profile
Time Frame
Up to 28 days post-dose
Title
Anti-OPT-302 antibody formation
Description
Incidence of anti-OPT-302 antibody formation
Time Frame
Pre-dose and up to 3 months post-dose
Other Pre-specified Outcome Measures:
Title
Exploratory: Changes in the systemic blood levels of angiogenesis-related biomarkers
Description
Change in systemic blood levels of angiogenesis-related biomarkers including, but not limited to: Vascular Endothelial Growth Factor A (VEGF-A), VEGF-C, VEGF-D, soluble VEGFR-2 and soluble VEGFR-3.
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to provide written informed consent Age ≥ 50 years of either gender Active CNV lesions secondary to AMD (i.e., subretinal or intraretinal fluid on SD-OCT and / or leakage on fluorescein angiography) Either no previous treatment in the study eye with IVT anti-VEGF-A therapy (treatment naïve) or prior IVT anti-VEGF-A therapy (previously treated) with sub-optimal response to treatment and the need for additional treatment Best corrected visual acuity in the study eye, using ETDRS testing, of 20/320 or better (Snellen equivalent) in Part 1 (dose escalation) and between 20/40 and 20/320 (Snellen equivalent), inclusive, in Part 2 (dose expansion). Women of child bearing potential and male subjects with female partners of child bearing potential must be practicing effective contraception during the trial and for at least 3 months following the last dose of study medication Exclusion Criteria: Previous or concurrent use of systemic anti-VEGF-A agents Most recent IVT injection of bevacizumab or ranibizumab <28 days prior to screening or aflibercept <42 days prior to screening Previous treatment with photodynamic therapy, thermal laser or external beam radiation in the study eye Concurrent treatment in either eye for any ocular condition with an investigational drug or device that has not received regulatory approval Anatomic damage to the center of the fovea including fibrosis and scarring making up >50% of total lesion area including the CNV in the study eye Geographic atrophy involving the center of the fovea in the study eye History or presence of a retinal pigment epithelial tear Presence of polypoidal choroidal vasculopathy (if in the opinion of the investigator, anti-VEGF treatment would not be of benefit) or retinal angiomatous proliferation Active or recent (within 4 weeks) intraocular inflammation (grade trace or above) in the study eye History of rhegmatogenous retinal detachment or macular hole in the study eye History of vitrectomy Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye History of vitreous hemorrhage within 4 weeks prior to screening in the study eye History of major ocular surgery within prior 6 months or anticipated within next 3 months following dosing on day 1 Uncontrolled glaucoma in the study eye (defined as intraocular pressure of >25 mmHg despite treatment with maximal medical therapy) Uncontrolled hypertension ≥180 mmHg systolic or ≥110 mmHg diastolic at baseline Uncontrolled diabetes mellitus (Disease must be controlled with hemoglobin A1c (HgbA1c) < 9.0%) Clinical evidence of diabetic retinopathies, diabetic macular edema or any other vascular disease affecting the retina, other than AMD, in either eye that, in the opinion of the investigator, would be likely to limit improvement in the macular anatomy and/or function Pregnancy or lactation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Research
Organizational Affiliation
Opthea Limited
Official's Role
Study Director
Facility Information:
Facility Name
Opthea Investigative Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85014
Country
United States
Facility Name
Opthea Investigative Site
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
Opthea Investigative Site
City
Sacramento
State/Province
California
ZIP/Postal Code
95819
Country
United States
Facility Name
Opthea Investigative Site
City
Santa Maria
State/Province
California
ZIP/Postal Code
93454
Country
United States
Facility Name
Opthea Investigative Site
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33912
Country
United States
Facility Name
Opthea Investigative Site
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32503
Country
United States
Facility Name
Opthea Investigative Site
City
Winter Haven
State/Province
Florida
ZIP/Postal Code
33800
Country
United States
Facility Name
Opthea Investigative Site
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
Opthea Investigative Site
City
Bloomfield
State/Province
New Jersey
ZIP/Postal Code
07003
Country
United States
Facility Name
Opthea Investigative Site
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28210
Country
United States
Facility Name
Opthea Investigative Site
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
Facility Name
Opthea Investigative Site
City
West Columbia
State/Province
South Carolina
ZIP/Postal Code
29169
Country
United States
Facility Name
Opthea Investigative Site
City
Abilene
State/Province
Texas
ZIP/Postal Code
79606
Country
United States
Facility Name
Opthea Investigative Site
City
Willow Park
State/Province
Texas
ZIP/Postal Code
76087
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 With or Without Lucentis™ in Patients With Wet AMD

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