search
Back to results

Trial of Switching Between Intravitreal Bevacizumab (Avastin®)& Intravitreal Dexamethasone (Ozurdex™) for Persistent Diabetic Macular Oedema (SwitchDMO)

Primary Purpose

Diabetes, Diabetic Macular Oedema, Diabetic Macular Edema

Status
Completed
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
Avastin (Bevacizumab)
Ozurdex (dexamethasone)
Sponsored by
University of Sydney
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes focused on measuring diabetic macular oedema, diabetic macular edema, diabetic retinopathy, dexamethasone, Ozurdex, Avastin, bevacizumab, DME, DMO

Eligibility Criteria

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

Inclusion Criteria:

Eyes Previously Treated with bevacizumab:

  1. Diabetic macular oedema affecting the fovea that has persisted despite ongoing, monthly intravitreal injections of bevacizumab over at least 6 months, the last being 2 to 3 months prior to the screening visit.
  2. There must be an historical OCT available from 1-4 weeks after the last bevacizumab injection with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT to show the lack of complete response to bevacizumab.
  3. At screening, the bevacizumab treated eye must have DMO with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT

    Eyes Previously Treated with dexamethasone:

  4. Diabetic macular oedema affecting the fovea that has persisted despite two dexamethasone implants 5 or fewer months apart, the last being 5-8 months prior to the screening visit.
  5. There must be an historical OCT available from 8-14 weeks after the last dexamethasone implant with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT to show the lack of complete response to the dexamethasone implant.
  6. At screening, the dexamethasone treated eye must have DMO with retinal thickness > 300 microns in central 1mm subfield on Spectral domain OCT
  7. Age >= 18 years
  8. Diagnosis of diabetes mellitus
  9. Best corrected visual acuity of 20-78 letters (approx 6/120 -6/7.5)
  10. Previous macular laser treatment, or the investigator believes laser treatment is unlikely to be helpful
  11. Intraocular pressure <22mmHg
  12. Women of childbearing potential must have a negative urine pregnancy test at the screening visit and prior to treatment. A woman is considered of childbearing potential unless she is postmenopausal and without menses for 12 months or is surgically sterilised
  13. Written informed consent has been obtained.

Exclusion Criteria:

  • Treatment with intravitreal triamcinolone acetonide (IVTA) within the last 6 months or peribulbar TA within the last 3 months, or anti vascular endothelial growth factor (VEGF) drugs: ranibizumab and aflibercept, within the last 2 months.
  • Cataract surgery within the last 3 months
  • Retinal laser treatment within the last 3 months
  • For eyes to be switched to Dexamethasone: Patient considered, at the judgement of the investigator, to be at-risk for syphilis, tuberculosis or other potentially infective chorioretinopathies. Patients considered at-risk may be assessed at the investigators discretion to reasonably exclude these conditions. Should these conditions be excluded, the patient may be considered for enrolment.

Sites / Locations

  • Sydney Eye Hospital
  • Centre for Eye Research Australia (Royal Victorian Eye & Ear Hospital)
  • Lions Eye Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Avastin (bevacizumab)

Ozurdex (dexamethasone)

Arm Description

Intravitreal Avastin loading doses followed by as prn for remainder of 6 months according to defined retreatment criteria

single dose at baseline and repeat dose when required according to defined re-treatment criteria

Outcomes

Primary Outcome Measures

Proportion of eyes that have central macular thickness <300 microns 6 months after switching

Secondary Outcome Measures

Mean change in central macular thickness (CMT) as measured by OCT.
Mean change in central macular thickness (CMT) as measured by OCT.

Full Information

First Posted
February 6, 2013
Last Updated
November 9, 2018
Sponsor
University of Sydney
Collaborators
Allergan
search

1. Study Identification

Unique Protocol Identification Number
NCT01787669
Brief Title
Trial of Switching Between Intravitreal Bevacizumab (Avastin®)& Intravitreal Dexamethasone (Ozurdex™) for Persistent Diabetic Macular Oedema
Acronym
SwitchDMO
Official Title
A Multicentre Clinical Trial of Switching Between Intravitreal Bevacizumab (Avastin®) and Intravitreal Dexamethasone (Ozurdex™) for Persistent Diabetic Macular Oedema (SwitchDMO)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
June 2013 (undefined)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
October 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Sydney
Collaborators
Allergan

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The specific aim of the study is to test the following hypothesis: That switching between treatments from bevacizumab to Ozurdex or vice versa in eyes with diabetic macular oedema with no or incomplete response from one therapy is beneficial.
Detailed Description
A Multicentre Clinical Trial of Switching Between Intravitreal Bevacizumab (Avastin®) and Intravitreal Dexamethasone (Ozurdex™) for Persistent Diabetic Macular Oedema (SwitchDMO)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes, Diabetic Macular Oedema, Diabetic Macular Edema, Diabetic Retinopathy
Keywords
diabetic macular oedema, diabetic macular edema, diabetic retinopathy, dexamethasone, Ozurdex, Avastin, bevacizumab, DME, DMO

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Non-Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Avastin (bevacizumab)
Arm Type
Active Comparator
Arm Description
Intravitreal Avastin loading doses followed by as prn for remainder of 6 months according to defined retreatment criteria
Arm Title
Ozurdex (dexamethasone)
Arm Type
Active Comparator
Arm Description
single dose at baseline and repeat dose when required according to defined re-treatment criteria
Intervention Type
Drug
Intervention Name(s)
Avastin (Bevacizumab)
Intervention Description
Avastin (Bevacizumab) administered intravitreally
Intervention Type
Drug
Intervention Name(s)
Ozurdex (dexamethasone)
Intervention Description
Ozurdex (dexamethasone) given intravitreally
Primary Outcome Measure Information:
Title
Proportion of eyes that have central macular thickness <300 microns 6 months after switching
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Mean change in central macular thickness (CMT) as measured by OCT.
Description
Mean change in central macular thickness (CMT) as measured by OCT.
Time Frame
6 months
Other Pre-specified Outcome Measures:
Title
Mean change in BCVA (best corrected visual acuity)
Description
Proportion of eyes with a gain of 15 LogMAR letters or more Proportion of eyes with a loss of less than 15 LogMAR letters Proportion of eyes with gain of 5 LogMAR letters or more Proportion of eyes with gain of 10 LogMAR letters or more
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Eyes Previously Treated with bevacizumab: Diabetic macular oedema affecting the fovea that has persisted despite ongoing, monthly intravitreal injections of bevacizumab over at least 6 months, the last being 2 to 3 months prior to the screening visit. There must be an historical OCT available from 1-4 weeks after the last bevacizumab injection with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT to show the lack of complete response to bevacizumab. At screening, the bevacizumab treated eye must have DMO with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT Eyes Previously Treated with dexamethasone: Diabetic macular oedema affecting the fovea that has persisted despite two dexamethasone implants 5 or fewer months apart, the last being 5-8 months prior to the screening visit. There must be an historical OCT available from 8-14 weeks after the last dexamethasone implant with retinal thickness > 300 microns in the central 1mm subfield on Spectral domain OCT to show the lack of complete response to the dexamethasone implant. At screening, the dexamethasone treated eye must have DMO with retinal thickness > 300 microns in central 1mm subfield on Spectral domain OCT Age >= 18 years Diagnosis of diabetes mellitus Best corrected visual acuity of 20-78 letters (approx 6/120 -6/7.5) Previous macular laser treatment, or the investigator believes laser treatment is unlikely to be helpful Intraocular pressure <22mmHg Women of childbearing potential must have a negative urine pregnancy test at the screening visit and prior to treatment. A woman is considered of childbearing potential unless she is postmenopausal and without menses for 12 months or is surgically sterilised Written informed consent has been obtained. Exclusion Criteria: Treatment with intravitreal triamcinolone acetonide (IVTA) within the last 6 months or peribulbar TA within the last 3 months, or anti vascular endothelial growth factor (VEGF) drugs: ranibizumab and aflibercept, within the last 2 months. Cataract surgery within the last 3 months Retinal laser treatment within the last 3 months For eyes to be switched to Dexamethasone: Patient considered, at the judgement of the investigator, to be at-risk for syphilis, tuberculosis or other potentially infective chorioretinopathies. Patients considered at-risk may be assessed at the investigators discretion to reasonably exclude these conditions. Should these conditions be excluded, the patient may be considered for enrolment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Samantha FRASER-BELL
Organizational Affiliation
SAVE SIGHT INSTITUTE, UNIVERSITY OF SYDNEY, SYDNEY EYE HOSPITAL
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sydney Eye Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2000
Country
Australia
Facility Name
Centre for Eye Research Australia (Royal Victorian Eye & Ear Hospital)
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3002
Country
Australia
Facility Name
Lions Eye Institute
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia

12. IPD Sharing Statement

Learn more about this trial

Trial of Switching Between Intravitreal Bevacizumab (Avastin®)& Intravitreal Dexamethasone (Ozurdex™) for Persistent Diabetic Macular Oedema

We'll reach out to this number within 24 hrs