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The objective of this study is to evaluate the safety and preliminary biologic activity/efficacy of X-82 in patients with wet Age-related Macular Degeneration (AMD). Preliminary efficacy will be assessed by change from baseline in visual acuity, fluorescein leakage, retinal thickness and fibrosis, if detectable, based on fundus examination, fundus photography, fluorescein angiography and optical coherence tomography (OCT).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 50 mg X-82 oral alternate days | Experimental | 50 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity develops |
|
| 50 mg X-82 oral QD | Experimental | 50 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria.for 24 weeks or until unacceptable toxicity develops |
|
| 100 mg X-82 oral alternate days | Experimental | 100 mg X-82 oral on alternate days with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria.for 24 weeks or until unacceptable toxicty develops |
|
| 100 mg X-82 oral QD | Experimental | 100 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs |
|
| 200 mg X-82 oral QD | Experimental | 200 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| X-82 oral | Drug | X-82 oral for 24 weeks or until unacceptable toxicity develops |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline Visual Acuity at 6 Months | The best corrected visual acuity by the Early Treatment Diabetic Retinopathy Study (ETDRS) method was determined at baseline and at various times during the study. The ETDRS method records the number of letters of decreasing size on a chart that a subject can read from a defiend distance. During the study the ETDRS visual acuity was used to monitor the need for rescue therapy. The primary endpoint of the study was the change from baseline visual ETDRS visual acuity at 6 months. It was calculated by subtracting the baseline visual acuity from the visual acuity at 6 months for each individual subject. A positive change from baseline indicates improvement in visual acuity. | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Retina Vitreous Associates Medical Group | Beverly Hills | California | 90211 | United States | ||
| New England Retina Associates |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28570723 | Result | Jackson TL, Boyer D, Brown DM, Chaudhry N, Elman M, Liang C, O'Shaughnessy D, Parsons EC, Patel S, Slakter JS, Rosenfeld PJ. Oral Tyrosine Kinase Inhibitor for Neovascular Age-Related Macular Degeneration: A Phase 1 Dose-Escalation Study. JAMA Ophthalmol. 2017 Jul 1;135(7):761-767. doi: 10.1001/jamaophthalmol.2017.1571. |
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110 subjects were screened for entry into the study. 52 did not meet inclusion criteria, 19 declined to participate and 4 were excluded for other reasons
Subjects with wet age related macular degeneration were enrolled at 5 US retinal clinics between November 2012 and March 2015
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| ID | Title | Description |
|---|---|---|
| FG000 | 50 mg X82 Alternate Days | Participants were assigned to 50 mg X-82 on alternate days for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| FG001 | 50 mg X82 QD | Participants were assigned to 50 mg X-82 QD for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| FG002 | 100 mg X82 on Alternate Days | Participants were assigned to 100 mg X-82 on alternate days for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| FG003 | 100 mg X82 QD | Participants were assigned to 100 mg X-82 QD for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| FG004 | 200 mg X82 QD | Participants were assigned to 200 mg X-82 QD for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| FG005 | 300 mg X82 QD | Participants were assigned to 300 mg X-82 QD for 24 weeks. After treatment discontinuation subjects were followed for an additional 4 weeks. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Dose Escalation of X-82 and Ranibizumab Rescue | Groups of participants were assigned to 1 of 6 X-82 doses over 24weeks,with an additional 4 weeks for follow-up. The dose escalated from one level to the next in the absence of any dose-limiting toxicity (DLT) defined as a drug-related safety event during the first 2 weeks of treatment that was severe enough to require removal of the participant from the study. The escalating X82 oral dose regimens were 50 mg alternate days, 50 mg daily, 100 mg alternate days, 100mg daily, 200mg daily, and 300mg daily. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline Visual Acuity at 6 Months | The best corrected visual acuity by the Early Treatment Diabetic Retinopathy Study (ETDRS) method was determined at baseline and at various times during the study. The ETDRS method records the number of letters of decreasing size on a chart that a subject can read from a defiend distance. During the study the ETDRS visual acuity was used to monitor the need for rescue therapy. The primary endpoint of the study was the change from baseline visual ETDRS visual acuity at 6 months. It was calculated by subtracting the baseline visual acuity from the visual acuity at 6 months for each individual subject. A positive change from baseline indicates improvement in visual acuity. | The mean and standard deviation was calculated for all subjects who completed 6 months of treatment with oral X82 | Posted | Mean | Standard Deviation | number of letters | 6 months |
|
Adverse events were recorded for the duration of the study beginning at participant randomization and continuing till participant completion of the study. The participation of individual subjects in the study ranged from 1-7 months.
Since the sample size for each dose group of X82 was limited, the frequency of adverse events are reported for all patients enrolled in the study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Dose Escalation of X-82 and Ranibizumab Rescue | Groups of participants were assigned to 1 of 6 X-82 doses over 24 weeks,with an additional 4 weeks for follow-up. The dose escalated from one level to the next in the absence of any dose-limiting toxicity (DLT) defined as a drug-related safety event during the first 2 weeks of treatment that was severe enough to require removal of the participant from the study. The escalating X82 oral dose regimens were 50 mg alternate days, 50 mg daily, 100 mg alternate days, 100mg daily, 200mg daily, and 300mg daily. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest pain | Cardiac disorders | MedRA 17.1 | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | MedRA 17.1 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sr Vice President, Development | Tyrogenex, Inc | 240-403-7153 | Dan@tyrogenex.com |
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| ID | Term |
|---|---|
| D057135 | Wet Macular Degeneration |
| ID | Term |
|---|---|
| D008268 | Macular Degeneration |
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
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| ID | Term |
|---|---|
| D000069579 | Ranibizumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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|
| 300 mg X-82 oral QD | Experimental | 300 mg X-82 oral QD with intravitreous ranibizumab (Lucentis) therapy using predefined retreatment criteria for 24 weeks or until unacceptable toxicity occurs. |
|
| ranibizumab (Lucentis) | Drug | Rescue treatment with intravitreal ranibizumab (Lucentis) as needed |
|
| New London |
| Connecticut |
| 06320 |
| United States |
| Elman Retina Group | Baltimore | Maryland | 21237 | United States |
| Retina Research Institute of Texas | Abilene | Texas | 79606 | United States |
| Retina Consultants of Houston | Houston | Texas | 77030 | United States |
| Protocol Violation |
|
| Withdrawal by Subject |
|
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Best corrected visual acuity | Mean | Standard Deviation | Number of letters |
|
All subjects who successfully completed 6 months of treatment with oral X82
|
|
| 0 |
| 35 |
| 3 |
| 35 |
| 28 |
| 35 |
| Acute renal failure | Renal and urinary disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Congestive heart failure | Cardiac disorders | MedRA 17.1 | Non-systematic Assessment |
|
| multiple myeloma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedRA 17.1 | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Gastrointestinal reflux | Gastrointestinal disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedRA 17.1 | Non-systematic Assessment |
|
| Fatigue | General disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Sinusitis | Infections and infestations | MedRA 17.1 | Non-systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | MedRA 17.1 | Non-systematic Assessment |
|
| Alanine amino transferase elevation | Hepatobiliary disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Aspartate amino transferase elevation | Hepatobiliary disorders | MedRA 17.1 | Non-systematic Assessment |
|
| decrease body weight | General disorders | MedRA 17.1 | Non-systematic Assessment |
|
| muscle spasma | Musculoskeletal and connective tissue disorders | MedRA 17.1 | Non-systematic Assessment |
|
| arthritis | Musculoskeletal and connective tissue disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Headache | General disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Dizziness | General disorders | MedRA 17.1 | Non-systematic Assessment |
|
| Dysgeusia | Gastrointestinal disorders | MedRA 17.1 | Non-systematic Assessment |
|
| hypertension | Cardiac disorders | MedRA 17.1 | Non-systematic Assessment |
|
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| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |