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Phase 2 clinical trial, single site, randomized, subject-masked study to determine safety and efficacy of intravitreal injections of Sirolimus in subjects with wet Age-Related Macular Degeneration (wet AMD) with persistent intraretinal or subretinal edema due to neovascular AMD despite previous AntiVEGF treatment.
Forty subjects will be randomized to receive intravitreal Sirolimus or standard of care treatment in a 1:1 ratio. Over the course of the six month trial plus a 6 month optional extension, subjects will be evaluated monthly. Treatment with Sirolimus will be given at baseline, month 2 and month 4 with sham injections given at months 1, 3 and 5. For subjects in the extension Sirolimus will also be given at months 6, 8 and 10 with sham at month 7, 9, and 11. Subjects in the standard of care group will receive anti-VEGF injections or sham monthly. Retreatment criteria will be based upon continued subretinal edema, intraretinal edema or active chorioretinal neovascularization (CNV)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sirolimus | Experimental | Intravitreal Sirolimus |
|
| Standard of Care intravitreal anti-VEGF | Active Comparator | anti-VEGF intravitreal injections |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sirolimus | Drug | intravitreal injection |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Edema From Baseline to Month 6 Central Subfield Thickness ) on Heidelberg Optical Coherence Topography | Change in edema from baseline to month 6 as measured by mean difference in microns of central subfield thickness on Heidelberg optical coherence topography in each treatment group | Baseline to 6 months |
| Visual Acuity | number of subjects with gain of 0-4 letters of visual acuity | Baseline to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Acuity (Best Corrected Visual Acuity) | number of subjects with gain of 5 or more letters of visual acuity | baseline to 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Raj K Maturi, MD | Raj K. Maturi, MD, PC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Raj K Maturi MD PC | Indianapolis | Indiana | 46290 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33593448 | Derived | Minturn RJ, Bracha P, Klein MJ, Chhablani J, Harless AM, Maturi RK. Intravitreal sirolimus for persistent, exudative age-related macular degeneration: a Pilot Study. Int J Retina Vitreous. 2021 Feb 16;7(1):11. doi: 10.1186/s40942-021-00281-0. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Sirolimus | Intravitreal Sirolimus Sirolimus: intravitreal injection at baseline, month 2 and month 4. Sham injections at months 1, 3 and 5 |
| FG001 | Standard of Care Intravitreal Anti-VEGF | Standard of Care intravitreal injections of either bevacizumab (1.25mg/0.05ml) or aflibercept (2mg/0.05ml). Bevacizumab injections were repeated at monthly intervals and aflibercept was given at baseline, month 2 and 4 and sham injections at months 1, 3 and 5. Subjects in this group continued the same drug they were on prior to joining the study. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First 6 Months |
|
| ||||||||||||||||||
| Extension Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Sirolimus | Intravitreal Sirolimus Sirolimus: intravitreal injection |
| BG001 | Standard of Care Intravitreal antiVEGF | antiVEGF intravitreal injections Standard of Care intravitreal injections of antiVEGF: intravitreal injections of antiVEGF |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 in Edema From Baseline to Month 6 Central Subfield Thickness ) on Heidelberg Optical Coherence Topography | Change in edema from baseline to month 6 as measured by mean difference in microns of central subfield thickness on Heidelberg optical coherence topography in each treatment group | Posted | Mean | Full Range | microns | Baseline to 6 months |
|
On or after baseline visit (Day 0) to on or before month 12 visit.
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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 | Sirolimus | Intravitreal Sirolimus Sirolimus: intravitreal injection at baseline, month 2 and month 4. Sham injections at months 1, 3 and 5 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| pulmonary embolism | Vascular disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| photopsia | Eye disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Raj K. Maturi, MD | Raj K. Maturi, MD, PC | 317-817-1414 | rmaturi@gmail.com |
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| ID | Term |
|---|---|
| D008268 | Macular Degeneration |
| ID | Term |
|---|---|
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
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| ID | Term |
|---|---|
| D020123 | Sirolimus |
| D000068258 | Bevacizumab |
| C533178 | aflibercept |
| ID | Term |
|---|---|
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D061067 | Antibodies, Monoclonal, Humanized |
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| Standard of Care intravitreal injections of anti-VEGF | Drug | intravitreal injections of anti-VEGF |
|
|
| NOT COMPLETED |
|
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Primary | Visual Acuity | number of subjects with gain of 0-4 letters of visual acuity | Posted | Count of Participants | Participants | Baseline to 6 months |
|
|
|
| Secondary | Visual Acuity (Best Corrected Visual Acuity) | number of subjects with gain of 5 or more letters of visual acuity | Posted | Number | 100% Confidence Interval | participants | baseline to 6 months |
|
|
|
| 2 |
| 20 |
| 1 |
| 20 |
| 14 |
| 20 |
| EG001 | Standard of Care Intravitreal Anti-VEGF | Standard of Care intravitreal injections of either bevacizumab (1.25mg/0.05ml) or aflibercept (2mg/0.05ml). Bevacizumab injections were repeated at monthly intervals and aflibercept was given at baseline, month 2 and 4 and sham injections at months 1, 3 and 5. Subjects in this group continued the same drug they were on prior to joining the study. | 0 | 20 | 1 | 20 | 15 | 20 |
| myocardial infarction | Cardiac disorders | Systematic Assessment |
|
| pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| subretinal hemorrhage | Eye disorders | Systematic Assessment |
|
| central retinal artery occlusion | Eye disorders | Systematic Assessment |
|
| anterior chamber inflammation | Eye disorders | Systematic Assessment |
|
| underactive thyroid | Endocrine disorders | Systematic Assessment |
|
| unexplained vision Loss | Eye disorders | Systematic Assessment |
|
| intraretinal hemorrhage | Eye disorders | Systematic Assessment |
|
| hypothyroidism | Endocrine disorders | Systematic Assessment |
|
| decreased visual acuity | Eye disorders | Systematic Assessment |
|
| angular blepharitis | Eye disorders | Systematic Assessment |
|
| pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| pre-cancerous lesion | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| urinary tract infection | Renal and urinary disorders | Systematic Assessment |
|
| basal cell carcinoma | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| dot hemorrhage | Eye disorders | Systematic Assessment |
|
| corneal irritation | Eye disorders | Systematic Assessment |
|
| hypokalemia | Metabolism and nutrition disorders | Systematic Assessment |
|
| Bradycardia | Cardiac disorders | Systematic Assessment |
|
| vitamin B12 deficiency | Metabolism and nutrition disorders | Systematic Assessment |
|
| Right radial artery hematoma | Blood and lymphatic system disorders | Systematic Assessment |
|
| Acute Hypotic Respiratory failure | Reproductive system and breast disorders | Systematic Assessment |
|
| shingles | Nervous system disorders | Systematic Assessment |
|
| increased intraocular pressure | Eye disorders | Systematic Assessment |
|
| progressed posterior subcapsular cataract | Eye disorders | Systematic Assessment |
|
| progressed nuclear sclerotic cataract | Eye disorders | Systematic Assessment |
|
| Serous Retinal Detachment | Eye disorders | Systematic Assessment |
|
| vitreous hemorrhage | Eye disorders | Systematic Assessment |
|
| Subretinal Hemorrhage | Eye disorders | Systematic Assessment |
|
| choroidal neovascular membrane | Eye disorders | Systematic Assessment |
|
| intraretinal and subretinal fluid | Eye disorders | Systematic Assessment |
|
| Sinusitis | Infections and infestations | Systematic Assessment |
|
| Worsening hypertension | Vascular disorders | Systematic Assessment |
|
| PRES syndrome | Nervous system disorders | Systematic Assessment |
|
| arthritis, left sholder | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Anemia | Metabolism and nutrition disorders | Systematic Assessment |
|
| fatigue | General disorders | Systematic Assessment |
|
| Acute Chronic Hypoxic Respitory Failure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Diastolic Dysfunction | Cardiac disorders | Systematic Assessment |
|
| Acute Kidney Inury | Renal and urinary disorders | Systematic Assessment |
|
| Acute Encephalopathy | Nervous system disorders | Systematic Assessment |
|
| uveitis | Eye disorders | Systematic Assessment |
|
| Posterior Synechiae | Eye disorders | Systematic Assessment |
|
| Endothelial Pigment | Eye disorders | Systematic Assessment |
|
| corneal edema | Eye disorders | Systematic Assessment |
|
| worsening anemia | Blood and lymphatic system disorders | Systematic Assessment |
|
| floaters | Eye disorders | Systematic Assessment |
|
| subconjunctival hemorrhage | Eye disorders | Systematic Assessment |
|
| recurrent subretinal hemorrhage | Eye disorders | Systematic Assessment |
|
| headache (right side of head) | General disorders | Systematic Assessment |
|
| eye pain following injection | Eye disorders | Systematic Assessment |
|
| bronchitis | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| parkinsons disease | Nervous system disorders | Systematic Assessment |
|
| pigment on lens surface | Eye disorders | Systematic Assessment |
|
| hemorrhage on optic nerve | Eye disorders | Systematic Assessment |
|
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| D000911 |
| Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |