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Treatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study (ACT)

Primary Purpose

Proliferative Diabetic Retinopathy

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Intravitreal Aflibercept Injection (IAI)
Sponsored by
Ophthalmic Consultants of Long Island
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Proliferative Diabetic Retinopathy

Eligibility Criteria

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

Inclusion Criteria:

Subjects will be enrolled if the following criteria are met:

  • Ability to provide written informed consent and comply with study assessments for the full duration of the study
  • Age 18 years and older
  • Retinal neovascularization secondary to diabetic retinopathy
  • Best corrected visual acuity in the study eye better than 20/320 using an ETDRS chart
  • In the event that either eye of a potential subject meets enrollment criteria, the worse sighted eye will be enrolled into the study. Only one eye can be enrolled in the study.

Exclusion Criteria:

  • Pregnant or breast-feeding women Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study and for at least 30 days after the last administration of study drug for women and at least 90 days after the last administration for men (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD];; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly)

    *Contraception is not required for men with documented vasectomy.

    ** Pregnancy testing and contraception are not required for women with documented hysterectomy.

  • HbA1C >10 within approximately 90 days of Screening visit
  • Participation in a study of an investigational drug or device within 30 days prior to potential enrollment into the study
  • Prior treatment with systemic anti-VEGF agents
  • Presence of any substantial ocular disease (other than diabetic retinopathy) that may compromise vision in the study eye and /or confound interpretation of the data; e.g. substantial cataracts, advanced glaucoma, optic neuritis, optic neuropathy or atrophy, marked macular atrophy, ocular vascular occlusion, history of retinal detachment, uveitis, viral or other forms of chorioretinitis, etc.
  • Prior treatment with anti-VEGF therapy in the study eye within 90 days of baseline
  • Prior treatment with PRP within 60 days
  • Prior treatment with IAI.
  • Prior treatment with triamcinolone in the study eye within 180 days of baseline.
  • Prior treatment with dexamethasone in the study eye within 30 days prior to baseline.
  • Intraocular surgery (including cataract surgery) in the study eye within 60 days preceding baseline
  • History of vitrectomy surgery in the study eye.
  • Active intraocular inflammation (grade trace or above) in the study eye
  • History of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the study eye
  • Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye
  • Uncontrolled glaucoma in the study eye (defined as IOP ≥ 25 mmHg despite treatment with anti-glaucoma medication)
  • History of cerebral vascular accident, myocardial infarction, transient ischemic attacks within 180 days of study enrollment.
  • History of allergy to fluorescein, topical antibiotic, povidone iodine (Betadine) or aflibercept.
  • Presence of vitreous hemorrhage that completely obstructs the view of the optic nerve (amount of vitreous hemorrhage will also be gated by 20/320 criteria)
  • Presence of TRD in the study eye.
  • Presence of pre-retinal fibrosis (not including epiretinal membrane)
  • Unwilling to discontinue sperm bank donation for any period of time after IAI treatment

Sites / Locations

  • Ophthalmic Consultants of Long Island

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group A - IAI every 4 weeks

Group B - IAI every 8 weeks

Arm Description

Receives 5 injections of Intravitreal Aflibercept Injection (IAI) beginning Day 1, and then at weeks 4, 8, 12, and 16. Following the 5 initial injections, this group will continue to receive IAI every 4 weeks, beginning week 20, through week 48.

Receives 5 injections of Intravitreal Aflibercept Injection (IAI) beginning Day 1, and then at weeks 4, 8, 12, and 16. Following the 5 initial injections, this group will receive IAI every 8 weeks, beginning week 24, through week 48.

Outcomes

Primary Outcome Measures

Incidence and severity of adverse events of intravitreal aflibercept injection in the treatment of PDR.

Secondary Outcome Measures

Mean change in the area of fluorescein leakage in mm2 (area of neovascularization) compared to baseline.
Proportion of subjects with complete regression of neovascularization
Mean change in ETDRS BCVA from baseline
Proportion of subjects gaining > 5 letters, > 10 letters and > 15 letters from baseline
Proportion of subjects losing > 5 letters from baseline
Mean change in retinal thickness from baseline as demonstrated by Spectral Domain OCT Imaging
Proportion of subjects without vitreous hemorrhage or pre-retinal hemorrhage
Proportion of subjects with complete avoidance of panretinal laser photocoagulation (PRP)/ additional PRP
Proportion of subjects with avoidance of vitrectomy

Full Information

First Posted
February 25, 2013
Last Updated
June 3, 2016
Sponsor
Ophthalmic Consultants of Long Island
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01813773
Brief Title
Treatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study
Acronym
ACT
Official Title
Treatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study
Study Type
Interventional

2. Study Status

Record Verification Date
June 2016
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ophthalmic Consultants of Long Island
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To assess the safety of intravitreal aflibercept injection in the treatment of proliferative diabetic retinopathy (PDR) by evaluating the incidence and severity of adverse events.
Detailed Description
Single center, open label pilot study using 2.0mg intravitreal aflibercept injection. (IAI) 20 subjects with active PDR to be randomized into 2 groups, i.e. groups A and B. Subjects in both arms will be followed-up every 4 weeks until week 52. The primary endpoint of the study will be at week 52.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Proliferative Diabetic Retinopathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A - IAI every 4 weeks
Arm Type
Experimental
Arm Description
Receives 5 injections of Intravitreal Aflibercept Injection (IAI) beginning Day 1, and then at weeks 4, 8, 12, and 16. Following the 5 initial injections, this group will continue to receive IAI every 4 weeks, beginning week 20, through week 48.
Arm Title
Group B - IAI every 8 weeks
Arm Type
Experimental
Arm Description
Receives 5 injections of Intravitreal Aflibercept Injection (IAI) beginning Day 1, and then at weeks 4, 8, 12, and 16. Following the 5 initial injections, this group will receive IAI every 8 weeks, beginning week 24, through week 48.
Intervention Type
Drug
Intervention Name(s)
Intravitreal Aflibercept Injection (IAI)
Other Intervention Name(s)
Eylea
Intervention Description
EYLEA (aflibercept) is a recombinant fusion protein consisting of portions of human VEGF receptors 1 and 2 extracellular domains fused to the Fc portion of human IgG1 formulated as an iso-osmotic solution for intravitreal administration. Aflibercept is a dimeric glycoprotein with a protein molecular weight of 97 kilodaltons (kDa) and contains glycosylation, constituting an additional 15% of the total molecular mass, resulting in a total molecular weight of 115 kDa. Aflibercept is produced in recombinant Chinese hamster ovary (CHO) cells.
Primary Outcome Measure Information:
Title
Incidence and severity of adverse events of intravitreal aflibercept injection in the treatment of PDR.
Time Frame
The primary endpoint of the study will be at week 52.
Secondary Outcome Measure Information:
Title
Mean change in the area of fluorescein leakage in mm2 (area of neovascularization) compared to baseline.
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects with complete regression of neovascularization
Time Frame
At Weeks 24 and 52
Title
Mean change in ETDRS BCVA from baseline
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects gaining > 5 letters, > 10 letters and > 15 letters from baseline
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects losing > 5 letters from baseline
Time Frame
At Weeks 24 and 52
Title
Mean change in retinal thickness from baseline as demonstrated by Spectral Domain OCT Imaging
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects without vitreous hemorrhage or pre-retinal hemorrhage
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects with complete avoidance of panretinal laser photocoagulation (PRP)/ additional PRP
Time Frame
At Weeks 24 and 52
Title
Proportion of subjects with avoidance of vitrectomy
Time Frame
At Weeks 24 and 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects will be enrolled if the following criteria are met: Ability to provide written informed consent and comply with study assessments for the full duration of the study Age 18 years and older Retinal neovascularization secondary to diabetic retinopathy Best corrected visual acuity in the study eye better than 20/320 using an ETDRS chart In the event that either eye of a potential subject meets enrollment criteria, the worse sighted eye will be enrolled into the study. Only one eye can be enrolled in the study. Exclusion Criteria: Pregnant or breast-feeding women Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study and for at least 30 days after the last administration of study drug for women and at least 90 days after the last administration for men (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD];; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly) *Contraception is not required for men with documented vasectomy. ** Pregnancy testing and contraception are not required for women with documented hysterectomy. HbA1C >10 within approximately 90 days of Screening visit Participation in a study of an investigational drug or device within 30 days prior to potential enrollment into the study Prior treatment with systemic anti-VEGF agents Presence of any substantial ocular disease (other than diabetic retinopathy) that may compromise vision in the study eye and /or confound interpretation of the data; e.g. substantial cataracts, advanced glaucoma, optic neuritis, optic neuropathy or atrophy, marked macular atrophy, ocular vascular occlusion, history of retinal detachment, uveitis, viral or other forms of chorioretinitis, etc. Prior treatment with anti-VEGF therapy in the study eye within 90 days of baseline Prior treatment with PRP within 60 days Prior treatment with IAI. Prior treatment with triamcinolone in the study eye within 180 days of baseline. Prior treatment with dexamethasone in the study eye within 30 days prior to baseline. Intraocular surgery (including cataract surgery) in the study eye within 60 days preceding baseline History of vitrectomy surgery in the study eye. Active intraocular inflammation (grade trace or above) in the study eye History of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the study eye Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye Uncontrolled glaucoma in the study eye (defined as IOP ≥ 25 mmHg despite treatment with anti-glaucoma medication) History of cerebral vascular accident, myocardial infarction, transient ischemic attacks within 180 days of study enrollment. History of allergy to fluorescein, topical antibiotic, povidone iodine (Betadine) or aflibercept. Presence of vitreous hemorrhage that completely obstructs the view of the optic nerve (amount of vitreous hemorrhage will also be gated by 20/320 criteria) Presence of TRD in the study eye. Presence of pre-retinal fibrosis (not including epiretinal membrane) Unwilling to discontinue sperm bank donation for any period of time after IAI treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Glenn L Stoller, MD
Organizational Affiliation
Ophthalmic Consultants of Long Island
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ophthalmic Consultants of Long Island
City
Lynbrook
State/Province
New York
ZIP/Postal Code
11563
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Treatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study

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