Immediate Effects of Lucentis® in Conjunction With Photodynamic Therapy With Visudyne® in Exudative AMD(IECOMB)

This study has been completed.
Sponsor:
Collaborator:
Novartis
Information provided by:
University Hospital Inselspital, Berne
ClinicalTrials.gov Identifier:
NCT00413829
First received: December 19, 2006
Last updated: January 13, 2010
Last verified: January 2010
  Purpose

This study is an evaluation of the short term effects on CNV perfusion of a same-day administration of photodynamic therapy (PDT) with Visudyne® and an intravitreal injection of Lucentis® (ranibizumab, 0.3 mg). An evaluation of the short term effects on CNV perfusion of this combined treatment is needed for better understanding of treatment effects.


Condition Intervention Phase
Age Related Macular Degeneration
Drug: Intravitreal ranibizumab with photodynamic therapy
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Open-label, Phase II Study Assessing Immediate Effects of Lucentis®(Ranibizumab) Administered in Conjunction With Photodynamic Therapy With Visudyne® in Patients With Choroidal Neovascularization Secondary to AMD

Resource links provided by NLM:


Further study details as provided by University Hospital Inselspital, Berne:

Primary Outcome Measures:
  • incidence of CNV closure one week after combined therapy as assessed with high speed ICG angiography [ Time Frame: 24 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • retinal thickness as measured by OCT over time [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  • change of total lesion area, area of CNV and area of leakage over time as assessed by FA [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  • mean change of VA from baseline over time [ Time Frame: 24 months ] [ Designated as safety issue: No ]

Enrollment: 20
Study Start Date: October 2006
Study Completion Date: March 2008
Primary Completion Date: May 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1 Drug: Intravitreal ranibizumab with photodynamic therapy
Intravitreal injection, photodynamic therapy

Detailed Description:

The primary objective is to quantify the short term effects on CNV perfusion of the same-day administration of photodynamic therapy with Visudyne® and an intravitreal injection of ranibizumab. These short term effects will be assessed with visual acuity measurements and ophthalmic examinations including indocyanine green (ICG) and fluorescein angiography (FA) as well as Optical Coherence Tomography (OCT) measurements. The primary variable for this assessment is the incidence of CNV closure one week after combined therapy as assessed with high speed ICG angiography. Fluorescein and ICG angiography will be performed using a scanning laser ophthalmoscope (HRA). All angiographic studies and OCT examinations will be evaluated by the Bern Photographic Reading Center in a masked fashion. Visual acuity assessments will be performed with Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity testing charts.

A secondary objective is to explore the effect of the same-day administration of photodynamic therapy with Visudyne® and an intravitreal injection of ranibizumab:

  • on retinal thickness as measured by OCT over time
  • in change of total lesion area, area of CNV assessed by FA
  • in mean change of VA from baseline over time
  Eligibility

Ages Eligible for Study:   50 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients 50 years of age or greater
  • Patients with subfoveal choroidal neovascularization lesions secondary to AMD, either predominantly classic, occult, or minimally classic.
  • CNV lesion in the study eye is ≤5400 microns in greatest linear dimension
  • Patients who have a best corrected visual acuity (BCVA) score between 73 and 24 letters, inclusively, in the study eye using ETDRS-like grading charts (approximately 20/40 to 20/320) measured at 4 meters
  • Willing to return for follow up scheduled visits for a 6 months period
  • Only one eye will be assessed in the study. If both eyes are eligible, the one with the worse visual acuity will be selected for treatment and study unless, based on medical reasons, the investigator deems the other eye the more appropriate candidate for treatment and study

Exclusion Criteria:

  • Patients who have a BCVA of < 33 letters (approximately 20/200) in both eyes
  • Prior treatment in the study eye with verteporfin, external-beam radiation therapy, vitrectomy, submacular surgery, other surgical intervention for AMD, or transpupillary thermotherapy
  • Previous or current intravitreal drug delivery (e.g., intravitreal corticosteroid injection or device implantation) in the study eye
  • Focal laser photocoagulation (juxta-, extra- or subfoveal ) in the study eye
  • Concomitant use of chronic NSAIDs or steroids (by any route) for the duration of study participation (chronic use is defined as multiple doses taken daily for three or more consecutive days at any time during the study). Note that ASA (aspirin) taken as "low dose" up to 100 mg daily (qd) for prophylaxis of myocardial infarction (MI) and/or stroke is permitted during study
  • Current use or likely need for systemic medications known to be toxic to the lens, retina or optic nerve, including Deferoxamine, Chloroquine/ hydroxychloroquine (Plaquenil), Tamoxifen, Phenothiazines and Ethambutol is excluded
  • History of glaucoma filtration surgery, corneal transplant surgery or extracapsular extraction of cataract with phacoemulsification within six months preceding Day One, or a history of post-operative complications within the last 12 months preceding Day One in the study eye (uveitis, cyclitis etc.)
  • History of uncontrolled glaucoma in the study eye (defined as intraocular pressure ≥ 25 mmHg despite treatment with topical anti-glaucomatous medication).
  • Aphakia or absence of the posterior capsule in the study eye
  • Previous violation of the posterior capsule in the study eye is also excluded unless it occurred as a result of YAG posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
  • Spherical equivalent of the refractive error in the study eye demonstrating more than -8 diopters of myopia
  • Presence of a retinal pigment epithelial tear involving the macula in the study eye
  • Angioid streaks or precursors of CNV in either eye due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
  • Active intraocular inflammation (grade trace or above) in the study eye
  • Any active infection involving an eyeball adnexa
  • Vitreous hemorrhage or history of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the study eye
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00413829

Locations
Switzerland
Klinik und Poliklinik fuer Augenheilkunde, Inselspital
Bern, Switzerland
Sponsors and Collaborators
University Hospital Inselspital, Berne
Novartis
Investigators
Study Chair: Sebastian Wolf, MD PhD Klinik und Poliklinik fuer Augenheilkunde, Inselspital
Principal Investigator: Ute Wolf-Schnurrbusch, MD Klinik und Polklinik fuer Augenheilkunde, Inselspital
  More Information

Publications:
Responsible Party: S. Wolf, University Hospital Inselspital, Berne
ClinicalTrials.gov Identifier: NCT00413829     History of Changes
Other Study ID Numbers: Aug1202
Study First Received: December 19, 2006
Last Updated: January 13, 2010
Health Authority: Switzerland: Swissmedic

Keywords provided by University Hospital Inselspital, Berne:
age related macular degeneration
anti-VEGF therapy

Additional relevant MeSH terms:
Macular Degeneration
Choroidal Neovascularization
Retinal Degeneration
Retinal Diseases
Eye Diseases
Choroid Diseases
Uveal Diseases
Neovascularization, Pathologic
Metaplasia
Pathologic Processes
Verteporfin
Photosensitizing Agents
Dermatologic Agents
Therapeutic Uses
Pharmacologic Actions
Radiation-Sensitizing Agents

ClinicalTrials.gov processed this record on August 26, 2014