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| Name | Class |
|---|---|
| Greater Houston Retina Research | OTHER |
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The purpose of this Phase 4 study is to evaluate the safety of aflibercept 8mg in patients with proliferative diabetic retinopathy without center-involved diabetic macular edema.
Subjects will be administered intravitreal aflibercept 8mg every 4 weeks, starting at week 0 for 8 weeks, then may be extended by 4-week intervals with no maximum between treatments with an end of study visit at week 96. At any visit, it will be determined if supplemental treatment is needed as determined by disease activity assessment until there is no regression of disease is noted and the extension intervals will begin again.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| All subjects | Experimental | Subjects will receive 8mg aflibercept at week 0, 4, and 8. At week 12, subjects will enter a variable treatment and extension approach where they may be extended by 4-week intervals with no maximum interval between treatments until the end of study visit at week 96. Supplemental: Disease activity will be assessed at every 4-week visit and supplemental treatment with panretinal photocoagulation (PRP) as needed and/or intravitreal (IVT) 8mg aflibercept injections as determined by the regression patterns listed below. No regression: administer IVT aflibercept 8mg at 4-week intervals. If NV is not assessable due to VH, continue IVT and reassess; PRP is deferred. Supplemental PRP permitted ONLY if NV is assessable AND "No Regression" persists after prespecified treatment thresholds. Partial regression: Continue IVT aflibercept 8mg. Continue monthly observation. PRP not permitted. Total Regression: Without IVT aflibercept 8mg. Continue monthly observation. PRP not permitted. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aflibercept 8mg | Drug | Solution in Vial, intravitreal (IVT) injection |
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| Measure | Description | Time Frame |
|---|---|---|
| Primary Endpoint - DRSS step improvement | Proportion of eyes with ≥ 2 step improvement in diabetic retinopathy severity scale (DRSS), as assessed by the central reading center | Baseline through weeks 48 and 96 |
| Measure | Description | Time Frame |
|---|---|---|
| DRSS Step Improvement | Proportion of eyes with ≥ 2 step improvement in diabetic retinopathy severity scale (DRSS), as assessed by the central reading center | Baseline to week 24 and 96 |
| Mean change in BCVA |
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Inclusion Criteria:
Exclusion Criteria:
Any known hypersensitivity to any of the components of aflibercept 8 mg injection
Any known hypersensitivity to any contrast media (e.g., fluorescein), dilating eye drops, disinfectants (e.g., iodine), or any of the anesthetics and antimicrobial preparations used bye the site during the study
Prior systemic anti-VEGF or IVT anti-VEGF treatment in the study eye within 3 months of enrollment. (i.e., 3-month (90 days) wash-out period for anti-VEGF allowed)
Any intra- or periocular corticosteroid treatment in the study eye within 3 months (90 days) of baseline
Any intraocular sustained-release treatment or implantable device in the study eye
Any gene therapy in the study eye
SD-OCT central subfield thickness measurement of > 320 µm, in the study eye
Evidence of ocular infection, in the study eye, at time of screening
IOP >/= 25 mmHg in the study eye
Any intraocular inflammation/ infection in either eye within 12 weeks (84 days) of the screening visit
History of vitreoretinal surgery in the study eye
Any prior Panretinal laser photocoagulation (PRP) in the study eye
Current vitreous hemorrhage obscuring clear view of the macula in the study eye (precluding baseline imaging and DRSS grading)
Presence of any tractional retinal detachment (macular or peripheral) or pre-retinal fibrovascular proliferation (macular or peripheral) causing definite retinal traction or elevation (e.g. retinal tenting/peaking, tractional folds, or OCT-confirmed tractional distortion) in the study eye. Pre-retinal fibrovascular tissue without evidence of retinal traction or elevation (macular or peripheral) is permitted
Cataract surgery in the study eye within 4 weeks prior to Screening/ Day 0
Blood pressure > /=180/100 mmHg systolic/ diastolic, while seated
Pregnant or breastfeeding women
Sexually active men* or women of childbearing potential** who are unwilling to practice adequate contraception during the study (adequate contraceptive measures include stable use of oral contraceptives or other prescription pharmaceutical contraceptives for 2 or more menstrual cycles prior to screening/ baseline; intrauterine device [IUD]; bilateral tubal ligation; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm plus contraceptive sponge, foam, or jelly, or total abstinence).
Contraception is not required for men with documented vasectomy
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| Name | Affiliation | Role |
|---|---|---|
| Edward Wood, MD | Retina Consultants of Texas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Retina Consultants of Texas - Austin Retina Associates | Austin | Texas | 78705 | United States | ||
| Retina Consultants of Texas |
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| ID | Term |
|---|---|
| C533178 | aflibercept |
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Evaluate the mean change in the best corrected visual acuity (BCVA)
| Baseline through weeks 24, 48, 72, and 96 |
| Conversion from PDR to NPDR | Proportion of eyes converting from proliferative diabetic retinopathy (PDR) to non-proliferative diabetic retinopathy (NPDR) | Baseline to weeks 24, 48, 72, 96. |
| DRSS Step Improvement | Proportion of eyes with >= 3 step improvement in diabetic retinopathy severity scale (DRSS) | Baseline to weeks 24, 48, 72, 96 |
| Retinal non-perfusion change | Mean change (quantitative area) in retinal vascular non-perfusion (RNP) based on ultrawide-field fluorescein angiography (UWFA) | Baseline to weeks 24, 48, 72, 96. |
| Changes in visual function on HVF | Mean change in Humphrey visual field 30-2 total point score | Baseline to weeks 48, 96. |
| CST change | Mean change in CST | Baseline to weeks 24, 48, 72, 96 |
| Number of supplemental treatments | Mean and median number of intravitreal (IVT) 8mg aflibercept injections (with and without intravitreal 8 mg aflibercept injections given for DME) as well as annualized injection frequencies | Baseline through week 96 |
| Worsening PDR | Time to first worsening of proliferative diabetic retinopathy associated event(s), including PDR-related vitrectomy, new or worsening preretinal or vitreous hemorrhage, retinal detachment, panretinal photocoagulation (time-to-event analysis) | Baseline to week 96 |
| CI-DME development | ·Time to first development of central-involved DME (CI-DME) defined as > 320 µm in the study eye (time-to-event analysis) | Baseline to week 96 |
| AEs notated | Incidence and severity of ocular and systemic adverse events | Baseline to week 96 |
| Bellaire |
| Texas |
| 77401 |
| United States |
| Retina Consultants of Texas - San Antonio | San Antonio | Texas | 78240 | United States |