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The purpose of this global, multicenter, open-label, Phase 4 clinical extension study is to evaluate the long-term safety and efficacy of revakinagene taroretcel-lwey (Enceltoâ„¢; hereinafter referred to as NT-501), in participants with macular telangiectasia type 2 (MacTel) who previously received the intraocular implant in a Phase 1, Phase 2, or Phase 3 clinical study. In addition, this study will evaluate the safety and efficacy of NT501 in participants who previously underwent the sham procedure in a Phase 3 MacTel clinical study and elect to have NT-501 implanted intraocularly in this Phase 4 study.
This extension study consists of 3 arms:
Arms 1 and 2 are noninterventional and observational studies. Participants who received NT-501 in both eyes (ie, participated in study NTMT-02B) will be enrolled in either Arm 1 or Arm 2 based on the study in which the first NT-501 was implanted (ie, participants who received the first implant in a Phase 3 study will be enrolled in Arm 1 and those who received the first implant in the Phase 1 study or Phase 2 study will be enrolled in Arm 2).
Only Arm 3 is an interventional study where participants will receive an NT-501 implant. A participant can receive NT-501 in either eye that meets eligibility criteria according to investigator assessment, and in accordance with participant choice.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 (Phase 3 Long-term Follow-up) | Other | For participants who received NT-501 (ENCELTO) in a previous Phase 3 study (NTMT-03-A or NTMT-03-B), or for participants who received NT-501 (ENCELTO) in both eyes (i.e. participated in study NTMT-02B) but received the first NT-501 (ENCELTO) implant in a Phase 3 study. No new treatment intervention will be administered. Arm 2 is focused on long term follow-up for participant who already has the ENCELTO implant at time of study screening and enrollment. |
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| Arm 2 (Phase 1 and Phase 2 Long-term Follow-up) | Other | For participants who received NT-501 (ENCELTO) in a previous Phase 1 study (NTMT-01), Phase 2 study (NTMT-02), in the sub study of Phase 1 and Phase 2 extension study (NTMT-01/02E), or for participants who received NT-501 (ENCELTO) in both eyes (i.e. participated in study NTMT-02B) but received the first NT-501 (ENCELTO) implant in a Phase 1 or Phase 2 study. No new treatment intervention will be administered. Arm 2 is focused on long term follow-up for participant who already has the ENCELTO implant at time of study screening and enrollment. |
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| Arm 3 (Phase 3 Sham to Implant Crossover) | Experimental | For participants who underwent Sham procedure in either Phase 3 study (NTMT-03-A or NTMT-03-B) and will receive NT-501 in this study. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NT-501/revakinagene taroretcel-lwey | Combination Product | NT-501 is surgically implanted into the vitreous cavity to continuously release recombinant human ciliary neurotrophic factor (CNTF). |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of ocular and nonocular adverse events (AEs) and serious adverse events (SAEs) | Incidence of ocular and nonocular adverse events (AEs) and serious adverse events (SAEs) | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Percentage of participants with a loss of 15 letters or more in best corrected visual acuity (BCVA) compared to presurgery baseline BCVA | Percentage of participants with a loss of 15 letters or more in best corrected visual acuity (BCVA) compared to presurgery baseline BCVA using the Early Treatment Diabetic Retinopathy Study (ETDRS) distance chart | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Measure | Description | Time Frame |
|---|---|---|
| Change from presurgery baseline in ellipsoid zone (EZ) area loss | Change from presurgery baseline in ellipsoid zone (EZ) area loss as measured by en face spectral domain optical coherence tomography (SD-OCT) for both eyes | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
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Inclusion Criteria
To be eligible to participate in this study, an individual participant must meet all the following criteria:
Male or female adult participants who previously completed an NT-501 MacTel clinical study and:
Arm 1: received NT-501 intraocular implant in either Phase 3 study (NTMT-03-A or NTMT-03-B)
Arm 2: received NT-501 intraocular implant in the Phase 1 study (NTMT-01), Phase 2 study (NTMT-02), or in the substudy of the Phase 1 and Phase 2 extension study (NTMT-01/02E)
Note: participants who received NT-501 in both eyes (ie, participated in study NTMT-02B) will be enrolled in either Arm 1 or Arm 2 based on the study in which the first NT 501 was implanted (ie, participants who received the first implant in a Phase 3 study will be enrolled in Arm 1 and those who received the first implant in the Phase 1 study or Phase 2 study will be enrolled in Arm 2).
Arm 3: underwent the sham procedure in either Phase 3 study (NTMT-03-A or NTMT-03-B)
Participants must have steady fixation in the foveal or parafoveal area and sufficiently clear media for good quality retinal imaging.
Participant or their legally authorized representative must be able to provide written informed consent to participate in the study, in accordance with the International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guidelines, and local regulations, before initiating any clinical study related procedures.
Arm 3: female participants of childbearing potential must agree to use highly effective contraception. Highly effective forms of contraception (generally a first-year typical use pregnancy risk of 1% or less) include the following: contraceptive implants; an intrauterine device; permanent contraceptive procedures (vasectomy, bilateral salpingectomy, bilateral tubal occlusion, or partial salpingectomy); abstinence. A combination of male condom with either cap, diaphragm, or sponge with spermicide (ie, double barrier methods) is also considered an acceptable, but not highly effective, method of birth control.
Note: Participants enrolled at investigator sites in France or Germany must agree to use 2 forms of contraception listed above during study participation.
Exclusion Criteria
To participate in this study, the potential participant must not meet any of the following criteria. (Note that the ocular exclusion criteria are relevant to the study eye[s], unless indicated for both eyes):
Exclusion Criteria Applicable to Arms 1, 2, and 3:
Participant is medically unable to comply with clinical study procedures or visits.
Participant has, in the opinion of the investigator, any physical or mental condition that would increase the risk of participation in the study or may interfere with the study procedures, evaluations, and outcome assessments.
Exclusion Criteria Applicable to Arm 3 Only:
Participant has significant corneal or media opacities in the study eye to be implanted.
Participant has evidence of pathologic myopia in the study eye to be implanted.
Participant has any of the following lens opacities in the study eye to be implanted: cortical opacity > standard 3, posterior subcapsular opacity > standard 2, or a nuclear opacity > standard 3 as measured on the Age- Related Eye Disease Study (AREDS) clinical lens grading system. Note: the participant can be reconsidered for enrollment 90 days after undergoing cataract surgery.
Participant has undergone lens removal in the study eye to be implanted in the previous 3 months or YAG laser within 4 weeks of the screening/baseline visit.
Participant has evidence of ocular disease in the study eye to be implanted other than MacTel that, in the judgment of the examining physician, may confound the diagnosis, procedures, or outcome of the study (eg. glaucoma, severe nonproliferative or proliferative diabetic retinopathy, uveitis).
Received intravitreal steroid therapy in the study eye to be implanted within the last year.
Received intravitreal anti-vascular endothelial growth factor therapy in the study eye to be implanted within the last 6 months.
Evidence of active exudative intraretinal neovascularization or subretinal neovascularization in the study eye to be implanted, as evidenced by hemorrhage, hard exudate, subretinal fluid, or intraretinal fluid.
Evidence of central serous chorioretinopathy in the study eye to be implanted.
Participant underwent vitrectomy, penetrating keratoplasty, trabeculectomy, or trabeculoplasty in the study eye to be implanted.
A history of ocular herpes virus in the study eye to be implanted.
Participant is on chemotherapy.
Participant is pregnant or breastfeeding.
Participation in any other clinical study of an intervention (drug or device) within 6 months prior to the screening/baseline visit.
A history of malignancy that would compromise survival during the clinical study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Patricia Davis | Contact | 401-333-3880 | p.davis@neurotechusa.com |
| Name | Affiliation | Role |
|---|---|---|
| Thomas Aaberg, Jr, MD | Neurotech Pharmaceuticals | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Scripps Health | Not yet recruiting | La Jolla | California | 92037 | United States |
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Arms 1 and 2: For participants who previously received a single NT-501, the implanted eye is designated the study eye. For participants who received an NT-501 implant in both eyes (ie. the first implant received in NTMT-01, NTMT-02, NTMT 01/02E, NTMT-03-A, or NTMT-03-B, and the second implant received in NTMT-02B), both eyes will be designated as study eyes (the eye in which NT-501 was originally implanted will be study eye 1 and the other implanted eye will be study eye 2).
Arm 3: The implanted eye will be designated as the study eye in Arm 3. Note, if NT-501 in not implanted in the Sham eye (ie. the eye that did not undergo intervention during the parent Phase 3 clinical study), then the sham eye will also be considered a study eye for long-term follow-up.
Regardless of study eye designation, both eyes of each participant in all 3 study arms will be evaluated during the study.
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| Change from presurgery baseline in BCVA | Change from presurgery baseline in BCVA using the ETDRS distance chart for both eyes | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Change from presurgery baseline in aggregate retinal sensitivity | Change from presurgery baseline in aggregate retinal sensitivity as measured by microperimetry within the EZ line break area for both eyes | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Change from presurgery baseline in monocular reading speed | Change from presurgery baseline in monocular reading speed for both eyes | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Change from presurgery baseline in the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) | Change from presurgery baseline in NEI-VFQ-25 near activities subscale score. All items are scored so that a high score represents better functioning. Each item is then converted to a 0 to 100 scale so that the lowest and highest possible scores are set at 0 and 100 points, respectively. | Baseline and annually for up to 5 yrs for Arms 1 and 2 and baseline, perioperative, and annually for up to 5 yrs for Arm 3 participants |
| Jules Stein Eye Institute/UCLA | Not yet recruiting | Los Angeles | California | 90085 | United States |
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| Stanford University School of Medicine | Not yet recruiting | Palo Alto | California | 94303 | United States |
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| Bay Area Retina Associates | Recruiting | Walnut Creek | California | 94598 | United States |
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| Colorado Retina | Recruiting | Lakewood | Colorado | 80228 | United States |
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| Bascom Palmer | Not yet recruiting | Miami | Florida | 33136 | United States |
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| Emory Eye Center | Recruiting | Atlanta | Georgia | 30322 | United States |
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| Northwestern University | Not yet recruiting | Chicago | Illinois | 60611 | United States |
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| National Eye Institute | Not yet recruiting | Bethesda | Maryland | 20892 | United States |
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| Cumberland Valley Retina Consultants | Not yet recruiting | Frederick | Maryland | 21702 | United States |
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| Massachusetts Eye and Ear Infirmary, Retina Service | Not yet recruiting | Boston | Massachusetts | 02114 | United States |
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| Foundation for Vision Research | Recruiting | Grand Rapids | Michigan | 49525 | United States |
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| Retina Consultants of Minnesota | Not yet recruiting | Minneapolis | Minnesota | 55435 | United States |
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| Envision Ocular, LLC | Recruiting | Bloomfield | New Jersey | 07003 | United States |
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| Cincinnati Eye Institute | Recruiting | Cincinnati | Ohio | 45242 | United States |
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| Retina Associates of Cleveland, Inc. | Recruiting | Cleveland | Ohio | 44126 | United States |
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| Retina Northwest, P.C. | Not yet recruiting | Portland | Oregon | 97221 | United States |
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| Scheie Eye Institute | Not yet recruiting | Philadelphia | Pennsylvania | 19104 | United States |
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| Southeastern Retina Associates, P.C. | Recruiting | Knoxville | Tennessee | 37922 | United States |
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| Texas Retina Associates | Recruiting | Dallas | Texas | 75231 | United States |
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| Retina Center of Texas | Recruiting | Dallas | Texas | 75251 | United States |
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| Retina Consultants of Texas | Recruiting | Houston | Texas | 77030 | United States |
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| University of Utah John A. Moran Center | Recruiting | Salt Lake City | Utah | 84132 | United States |
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| Cerulea | Recruiting | East Melbourne | Australia |
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| Lion's Eye Institute | Recruiting | Perth | Australia |
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| Sydney Eye Hospital | Recruiting | Sydney | Australia |
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