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Use of Immune Globulin Intravenous (Human) To Treat Age-Related Macular Degeneration

Primary Purpose

Macular Degeneration

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Immune Globulin Intravenous [Human], 10% Caprylate/Chromatography Purified
Albumin (Human) 25%, United States Pharmacopeia (USP)
Sponsored by
Grifols Therapeutics LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Macular Degeneration

Eligibility Criteria

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

Inclusion Criteria: The best corrected visual acuity must be in the range of 20/40 to 20/200 on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart (0.5 - 0.1). Patient complaint of visual loss within the last three months prior to study entry. Documented visual loss on a visual acuity chart in the 3-month period prior to the beginning of the run-in period. Signed written informed consent prior to initiation of any study-related procedures. Exclusion Criteria: Treatment with IGIV within the last 3 months prior to the run-in. Previous photodynamic therapy (PDT) or vitrectomy or transpupillary thermotherapy (TTT) or any specific pre-treatment of CNV Subfoveal blood in the study eye if ≥ 1/2 disc diameter as measured by slit lamp during run-in period. History of anaphylaxis or severe systemic response to immunoglobulin or with a blood product. Cardiac insufficiency (NYHA III/IV), cardiomyopathy, significant cardiac dysrhythmia requiring treatment, unstable or advanced ischemic heart disease, or severe or uncontrolled hypertension (diastolic > 95 mmHg or systolic >170 mmHg) Females, who are pregnant, breast feeding, or if of childbearing potential, unwilling to practice adequate contraception throughout the study. History of renal insufficiency or serum creatinine levels > 221 µmol/L (2.5 mg/dL). Known selective immunoglobulin A (IgA) deficiency Other investigational drugs received within the past 3 months. Conditions whose symptoms and effects could alter protein catabolism and/or immunoglobulin (IgG) utilization (e.g. protein-losing enteropathies, nephrotic syndrome). Known hypercoagulable state. Patients on continuous systemic steroid treatment Mentally challenged adult subjects who cannot give independent informed consent. History of thromboembolic events. Diabetes mellitus requiring drug treatment. Known severe hypersensitivity to sodium fluorescein. Acute or known ocular diseases such as glaucoma, arterial or venous occlusions, acute ischemic optic-neuropathy, impairment of visual acuity due to opacities in the lens (LOCSIII: NO 5-6 or C: 4-5 or P 4-5) or vitreous which may influence the evaluation of the therapeutic effect.

Sites / Locations

  • Universitatsklinikum Aachen, Augenklinik
  • Augenklinik Tausendfensterhaus
  • St. Martinus-Krankenhaus, Augenabteilung
  • Medizinische Eirnrichtungen der Universitat Essen, Klinik fur Erkrankungen des hinteren Augenabschnittes
  • Kliniken und Polikliniken der Albert Ludwigs Universität
  • Medizinische Einrichtungen der Universitat zu Koln, Centrum fur Augenheilkunde
  • Klininkum der Eberhard-Karls-Universitat Tubingen, Universitats-Augenklinik

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Group 1

Group 2

Arm Description

Outcomes

Primary Outcome Measures

Mean Change in Visual Acuity (Logarithm of the Minimum Angle of Resolution [LogMAR]) Score From Baseline for IGIV-C, 10% Compared to Placebo at Week 12 or at Last LogMAR Assessment (Conducted at or After Week 8 of the Treatment Period)
Using the LogMAR score, lower values correspond to higher visual acuity. For example, a visual acuity of 20/20 corresponds to a LogMAR value of zero (0), and a visual acuity of 20/100 corresponds to a LogMAR value of 0.7.

Secondary Outcome Measures

Proportion of Subjects Who Improve Visual Acuity From Baseline to Endpoint by ≥ 0.1 LogMAR
Proportion of Subjects Who Improve Visual Acuity From Baseline to Endpoint by ≥ 0.2 LogMAR
Mean Change in LogRAD Score From Baseline to Endpoint (RADNER Test)
The RADNER test gives not only information about the subject's reading performance, but also about the reading speed (life quality) and the faults while reading. The RADNER reading charts (1, 2, and 3) contain sentences in paragraphs having a range of print sizes starting with the largest print at the top.The subject was randomly assigned one of the RADNER charts, and the charts were different between consecutive visits. The reading distance was 25 cm. The subject's score was corrected for reading speed and errors. The range of possible logRAD scores was from 2.0 (could not read the first paragraph) to -0.2, with higher scores indicating lower reading acuity and lower scores indicating higher reading acuity.
Proportion of Subjects With an Increase ≥ 2 or More Points in Lens Opacity Classification System (LOCS III) for Nuclear Opalescence, Nuclear Color, Cortical Cataract or Posterior Subcapsular Cataract Categories
The LOCS III scale for cortical cataract and posterior subcapsular cataract opacity ranged from 1.0 to 5.0. The LOCS III scale for nuclear opalescence and for nuclear color was 1.0 to 6.0. For all scales, higher values indicate higher opacity, opalescence, or color.
Presence of Fibrosis and Location Assessed by Slit-lamp
Mean Change From Baseline to Endpoint in Size of Lesion (Largest Dimension Relative to Disk Diameter) Assessed by Central Fluorescein Angiogram Reading Center

Full Information

First Posted
September 14, 2005
Last Updated
February 22, 2016
Sponsor
Grifols Therapeutics LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00220805
Brief Title
Use of Immune Globulin Intravenous (Human) To Treat Age-Related Macular Degeneration
Official Title
Multicenter, Randomized, Double-blind, Placebo-controlled, Study to Evaluate the Efficacy and Safety of IGIV-C, 10% Treatment in Subjects With Pure Occult Choroidal Neovascularization Due to Age Related Macular Degeneration
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Completed
Study Start Date
January 2004 (undefined)
Primary Completion Date
May 2005 (Actual)
Study Completion Date
May 2005 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Grifols Therapeutics LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate visual improvement in patients treated with Immune Globulin Intravenous (Human), 10% Caprylate/Chromatography Purified (IGIV-C) or placebo who have Age-Related Macular Degeneration (AMD) with occult Choroidal Neovascularization (CNV).
Detailed Description
The purpose of this trial is to investigate the effect of IGIV-C in subjects suffering from AMD with occult CNV where fewer treatment options exist for patients with this disease form. This study is designed as a randomized, double-blind, parallel group, placebo-controlled prospective trial. Sixty patients, 30 per treatment group, with newly diagnosed pure occult CNV defined by angiography diagnostic criteria will be enrolled. If a subject has more than one eye affected with occult CNV, the eye with the better vision as measured by visual acuity ( Logarithm of the Minimum Angle of Resolution [LogMAR] score) will be entered as the study eye. Patients will be randomized to receive either IGIV-C at a dose of 2 g/kg body weight (bw) over 5 consecutive days or matching placebo. Additional 2 study drug treatment courses (IGIV-C or matching placebo) will be administered every 4 weeks at the same dose of 2 g/kg bw given over 5 days. Subjects' visual acuity will be measured and reported as LogMAR at screening, week 0 (baseline), day 5, week 4, week 8 and week 12. If at anytime during the study the subject's visual acuity worsens by ≥ 2 lines (0.2 on the LogMAR score), then a slit lamp examination will be performed and an angiogram will be conducted; the patient would be discontinued if the worsening is due to some other reason outside of the occult CNV or if the disease has changed from pure occult to the classic or mixed form. Subjects will be evaluated for efficacy (LogMAR score) at endpoint (at week 12 or at last LogMAR assessment at or after week 8, if the subject prematurely discontinues the trial). At the end of the treatment period (week 12), patients will be entered into a 3 month observation period with monthly visual acuity LogMAR score assessments.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
96 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Title
Group 2
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Immune Globulin Intravenous [Human], 10% Caprylate/Chromatography Purified
Other Intervention Name(s)
Gamunex®, IGIVnex®, Gaminex, IGIV-C, IGIV-C, 10%, Immune Globulin IV (Human), 10% (IGIV), Immune Globulin IV (Human), 10% by Chromatography Process, IGIV, IVIG, BAY 41-1000, TAL-05-00004, NDC 13533-645-12, NDC 13533-645-15, NDC 13533-645-20, NDC 13533-645-24, NDC 13533-645-71
Intervention Description
The dose per infusion cycle was 2 g/kg body weight over 5 consecutive days (= 4 mL/kg body weight/infusion). The infusion duration was approximately 1.5 - 2 h.
Intervention Type
Drug
Intervention Name(s)
Albumin (Human) 25%, United States Pharmacopeia (USP)
Other Intervention Name(s)
Plasbumin®-20, Plasbumin®-25, Plasbumin®-20 (Low Aluminum), Plasbumin®-25 (Low Aluminum), Albumin (Human) 20%, USP, TAL-05-00007, TAL-05-00008, TAL-05-00024, TAL-05-00025, BAY 34-9255, NDC 13533-683-20, NDC 13533-683-71, NDC 13533-684-16, NDC 13533-684-20, NDC 13533-684-71, NDC 13533-691-20, NDC 13533-691-71, NDC 13533-692-16, NDC 13533-692-20, NDC 13533-692-71
Intervention Description
Albumin (Human) 20% or 25% will be diluted with 5% glucose to a final concentration of 0.1%.
Primary Outcome Measure Information:
Title
Mean Change in Visual Acuity (Logarithm of the Minimum Angle of Resolution [LogMAR]) Score From Baseline for IGIV-C, 10% Compared to Placebo at Week 12 or at Last LogMAR Assessment (Conducted at or After Week 8 of the Treatment Period)
Description
Using the LogMAR score, lower values correspond to higher visual acuity. For example, a visual acuity of 20/20 corresponds to a LogMAR value of zero (0), and a visual acuity of 20/100 corresponds to a LogMAR value of 0.7.
Time Frame
At Week 12 or, if the Week 12 assessment is not available, at the last LogMAR assessment conducted at or after Week 8 of the Treatment Period
Secondary Outcome Measure Information:
Title
Proportion of Subjects Who Improve Visual Acuity From Baseline to Endpoint by ≥ 0.1 LogMAR
Time Frame
Last measurement at or later than Week 8
Title
Proportion of Subjects Who Improve Visual Acuity From Baseline to Endpoint by ≥ 0.2 LogMAR
Time Frame
Last measurement at or later than Week 8
Title
Mean Change in LogRAD Score From Baseline to Endpoint (RADNER Test)
Description
The RADNER test gives not only information about the subject's reading performance, but also about the reading speed (life quality) and the faults while reading. The RADNER reading charts (1, 2, and 3) contain sentences in paragraphs having a range of print sizes starting with the largest print at the top.The subject was randomly assigned one of the RADNER charts, and the charts were different between consecutive visits. The reading distance was 25 cm. The subject's score was corrected for reading speed and errors. The range of possible logRAD scores was from 2.0 (could not read the first paragraph) to -0.2, with higher scores indicating lower reading acuity and lower scores indicating higher reading acuity.
Time Frame
Last measurement at or later than Week 8
Title
Proportion of Subjects With an Increase ≥ 2 or More Points in Lens Opacity Classification System (LOCS III) for Nuclear Opalescence, Nuclear Color, Cortical Cataract or Posterior Subcapsular Cataract Categories
Description
The LOCS III scale for cortical cataract and posterior subcapsular cataract opacity ranged from 1.0 to 5.0. The LOCS III scale for nuclear opalescence and for nuclear color was 1.0 to 6.0. For all scales, higher values indicate higher opacity, opalescence, or color.
Time Frame
Last measurement at or later than Week 8
Title
Presence of Fibrosis and Location Assessed by Slit-lamp
Time Frame
Last measurement at or later than Week 8
Title
Mean Change From Baseline to Endpoint in Size of Lesion (Largest Dimension Relative to Disk Diameter) Assessed by Central Fluorescein Angiogram Reading Center
Time Frame
At end of treatment (12 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
51 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The best corrected visual acuity must be in the range of 20/40 to 20/200 on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart (0.5 - 0.1). Patient complaint of visual loss within the last three months prior to study entry. Documented visual loss on a visual acuity chart in the 3-month period prior to the beginning of the run-in period. Signed written informed consent prior to initiation of any study-related procedures. Exclusion Criteria: Treatment with IGIV within the last 3 months prior to the run-in. Previous photodynamic therapy (PDT) or vitrectomy or transpupillary thermotherapy (TTT) or any specific pre-treatment of CNV Subfoveal blood in the study eye if ≥ 1/2 disc diameter as measured by slit lamp during run-in period. History of anaphylaxis or severe systemic response to immunoglobulin or with a blood product. Cardiac insufficiency (NYHA III/IV), cardiomyopathy, significant cardiac dysrhythmia requiring treatment, unstable or advanced ischemic heart disease, or severe or uncontrolled hypertension (diastolic > 95 mmHg or systolic >170 mmHg) Females, who are pregnant, breast feeding, or if of childbearing potential, unwilling to practice adequate contraception throughout the study. History of renal insufficiency or serum creatinine levels > 221 µmol/L (2.5 mg/dL). Known selective immunoglobulin A (IgA) deficiency Other investigational drugs received within the past 3 months. Conditions whose symptoms and effects could alter protein catabolism and/or immunoglobulin (IgG) utilization (e.g. protein-losing enteropathies, nephrotic syndrome). Known hypercoagulable state. Patients on continuous systemic steroid treatment Mentally challenged adult subjects who cannot give independent informed consent. History of thromboembolic events. Diabetes mellitus requiring drug treatment. Known severe hypersensitivity to sodium fluorescein. Acute or known ocular diseases such as glaucoma, arterial or venous occlusions, acute ischemic optic-neuropathy, impairment of visual acuity due to opacities in the lens (LOCSIII: NO 5-6 or C: 4-5 or P 4-5) or vitreous which may influence the evaluation of the therapeutic effect.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Brunner, MD
Organizational Affiliation
Center of Ophthalmology, University of Cologne, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitatsklinikum Aachen, Augenklinik
City
Aachen
ZIP/Postal Code
52074
Country
Germany
Facility Name
Augenklinik Tausendfensterhaus
City
Duisburg
ZIP/Postal Code
47119
Country
Germany
Facility Name
St. Martinus-Krankenhaus, Augenabteilung
City
Düsseldorf
ZIP/Postal Code
40219
Country
Germany
Facility Name
Medizinische Eirnrichtungen der Universitat Essen, Klinik fur Erkrankungen des hinteren Augenabschnittes
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Kliniken und Polikliniken der Albert Ludwigs Universität
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Medizinische Einrichtungen der Universitat zu Koln, Centrum fur Augenheilkunde
City
Koln
ZIP/Postal Code
50931
Country
Germany
Facility Name
Klininkum der Eberhard-Karls-Universitat Tubingen, Universitats-Augenklinik
City
Tubingen
ZIP/Postal Code
72076
Country
Germany

12. IPD Sharing Statement

Links:
URL
http://www.talecris-pi.info/inserts/gamunex.pdf
Description
FDA Approved Product Labeling Information - Gamunex®
URL
http://www.talecris-pi.info/inserts/plasbumin20la.pdf
Description
FDA Approved Product Labeling Information - Plasbumin®-20 (Low Aluminum)
URL
http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/FractionatedPlasmaProducts/ucm089390.htm
Description
FDA Product Approval
URL
http://www.talecris-pi.info/inserts/plasbumin25la.pdf
Description
FDA Approved Product Labeling Information - Plasbumin®-25 (Low Aluminum)

Learn more about this trial

Use of Immune Globulin Intravenous (Human) To Treat Age-Related Macular Degeneration

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