Study of the Efficacy and Safety of the Ranibizumab Port Delivery System for Sustained Delivery of Ranibizumab in Patients With Subfoveal Neovascular Age-Related Macular Degeneration (LADDER)
Macular Degeneration
About this trial
This is an interventional treatment trial for Macular Degeneration
Eligibility Criteria
Inclusion Criteria:
- Newly diagnosed with wet AMD within 9 months of screening visit
- Participant must have received at least 2 prior ITV anti-vascular endothelial growth factor (VEGF) injections. However, the most recent anti-VEGF injection must have been ranibizumab and must have occurred at least 7 days prior to the screening visit
- Demonstrated response to prior ITV anti-VEGF treatment
- Best Corrected Visual Acuity (BCVA) using Early Treatment Diabetic Retinopathy Study (ETDRS) charts of 20/20-20/200 Snellen equivalent
Exclusion Criteria:
- Treatment with ITV anti-VEGF agents other than ranibizumab within 1 month prior to the randomization visit in either eye
- Study eye treatment with ITV anti-VEGF agents other than ranibizumab within 1 month prior to the randomization visit
- History of laser photocoagulation, Visudyne®, ITV corticosteroid injection, vitrectomy surgery, submacular surgery, device implantation, or other surgical intervention for AMD in the study eye
- Prior participation in a clinical trial involving anti-angiogenic drugs, other than ranibizumab, in either eye within 2 months of the randomization visit
- Subretinal hemorrhage in the study eye that involves the center of the fovea
- Subfoveal fibrosis, or atrophy in the study eye
- Choroidal neovascularization (CNV) in either eye due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
- Uncontrolled ocular hypertension or glaucoma in the study eye
- History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery in the study eye
- Uncontrolled blood pressure
- Uncontrolled atrial fibrillation within 3 months of informed consent
- History of myocardial infarction or stroke within the last 3 months prior to informed consent
- History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the Implant, that might affect interpretation of the results of the study or renders the participant at high risk of treatment complications
- Use of oral corticosteroids
- Current treatment for any active systemic infection
- Use of anticoagulants, anti-platelets (other than aspirin), or medications known to exert similar effects
- Active malignancy within 12 months of randomization
- History of allergy to fluorescein
- Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month preceding the informed consent (excluding vitamins and minerals)
Sites / Locations
- Barnet Dulaney Perkins Eye Center
- Retinal Research Institute, LLC
- Associated Retina Consultants
- The Retina Partners
- Jacobs Retina center at the Shiley eye Institute UCSD
- Jules Stein Eye Institute/ UCLA
- N CA Retina Vitreous Assoc
- Retinal Consultants Med Group
- West Coast Retina Medical Group
- UCSF; Ophthalmology
- Orange County Retina Med Group
- California Retina Consultants
- Retina Consultants of Southern
- Colorado Retina Associates, PC
- Florida Eye Microsurgical Inst
- National Ophthalmic Research Institute
- Retina Specialty Institute
- Retina Vitreous Assoc of FL
- Retina Associates of Florida, LLC
- Southeast Retina Center
- Illinois Retina Associates
- Wolfe Eye Clinic
- Retina Associates of Kentucky
- Paducah Retinal Center
- Johns Hopkins Med; Wilmer Eye Inst
- Retina Group of Washington
- Retina Specialists
- Vitreo-Retinal Associates, PC
- Foundation for Vision Research
- Vitreoretinal Surgery
- Sierra Eye Associates
- Retina Center of New Jersey
- Mid Atlantic Retina - Wills Eye Hospital
- Eye Associates of New Mexico
- University of New Mexico; School of Med
- Retina Assoc of Western NY
- Char Eye Ear &Throat Assoc
- Cincinnati Eye Institute
- The Cleveland Clinic Foundation
- Retina Northwest
- Oregon HSU; Casey Eye Institute
- Palmetto Retina Center
- Charles Retina Institute
- Tennessee Retina PC.
- Texas Retina Associates
- Retina Research Center
- Retina Consultants of Texas
- Med Center Ophthalmology Assoc
- Retina Associates of Utah
- Wagner Macula & Retina Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Port Delivery System with Ranibizumab 10mg/mL
Port Delivery System with Ranibizumab 40mg/mL
Port Delivery System with Ranibizumab 100mg/mL
Intravitreal Injection with Ranibizumab 0.5mg
Participants had the Implant (prefilled with approximately 20 μL of 10-mg/mL ,approximately 0.2 mg dose, of ranibizumab) surgically inserted in the study eye at the Day 1 visit following their randomization visit. Starting at the Month 1 visit, participants were evaluated monthly for the need for Implant refill with the 10-mg/mL formulation of ranibizumab according to their randomization as per protocol-specified refill criteria.
Participants had the Implant (prefilled with approximately 20 μL of 40-mg/mL, approximately 0.8 mg dose, of ranibizumab) surgically inserted in the study eye at the Day 1 visit following their randomization visit. Starting at the Month 1 visit, participants were evaluated monthly for the need for Implant refill with the 40-mg/mL formulation of ranibizumab according to their randomization as per protocol-specified refill criteria.
Participants had the Implant (prefilled with approximately 20 μL of 100-mg/mL, approximately 2 mg dose, of ranibizumab) surgically inserted in the study eye at the Day 1 visit following their randomization visit. Starting at the Month 1 visit, participants were evaluated monthly for the need for Implant refill with the 100-mg/mL formulation of ranibizumab according to their randomization as per protocol-specified refill criteria.
Participants received ranibizumab 0.5 mg monthly ITV injections of 10 mg/mL formulation at Day 1 and every month thereafter.