Efficacy and Safety Study of iSONEP With and Without Lucentis/Avastin to Treat Age-related Macular Degeneration (AMD) (Nexus)

This study is currently recruiting participants.
Verified August 2012 by Lpath, Inc.
Sponsor:
Collaborator:
Pfizer
Information provided by (Responsible Party):
Lpath, Inc.
ClinicalTrials.gov Identifier:
NCT01414153
First received: August 9, 2011
Last updated: April 17, 2013
Last verified: August 2012
  Purpose

The purpose of the study is to determine the safety and efficacy of 4 monthly injections of iSONEP given alone or in combination with Lucentis or Avastin in subjects with wet Age-related Macular Degeneration (AMD). iSONEP not only has an anti-permeability effect, but also has anti-angiogenic, anti-inflammatory, and anti-fibrotic properties. The drug may therefore have the ability to achieve better visual outcomes than Lucentis (or Avastin), particularly in those subjects who do not demonstrate a robust response to Lucentis (or Avastin) after several monthly injections. Further, the combination of Lucentis (or Avastin) and iSONEP may be additive or synergistic. By inhibiting the multiple mechanisms that contribute to exudative-AMD-related vision loss, better visual outcomes may be possible than with Lucentis or Avastin alone.


Condition Intervention Phase
Exudative Age-related Macular Degeneration
Drug: iSONEP
Drug: 0.5 mg iSONEP with ranibizumab or bevacizumab
Drug: 4.0 mg iSONEP with ranibizumab or bevacizumab
Drug: ranibizumab or bevacizumab
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2a, Multi-center, Masked, Randomized, Comparator Controlled Study Evaluating iSONEP™ as Monotherapy or Adjunctive Therapy to Lucentis®/Avastin® Versus Lucentis/Avastin Alone for the Treatment of Subjects With CNV Secondary to AMD

Resource links provided by NLM:


Further study details as provided by Lpath, Inc.:

Primary Outcome Measures:
  • Mean change in Best Corrected Visual Acuity (BCVA) by ETDRS from Day 0 to Day 120. [ Time Frame: 120 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Mean change in central subfield retinal thickness from Day 0 to Day 120. [ Time Frame: 120 days ] [ Designated as safety issue: No ]
  • Mean change in CNV lesion area from Day 0 to Day 120 as determined by FA. [ Time Frame: 120 days ] [ Designated as safety issue: No ]
  • Proportion of subjects gaining greater than or equal to 0, 5, 10 and 15 letters on the ETDRS chart. [ Time Frame: 120 days ] [ Designated as safety issue: No ]
  • Proportion of subjects losing 3 lines or more in ETDRS BCVA. [ Time Frame: 120 days ] [ Designated as safety issue: No ]
  • Proportion of subjects with ETDRS BCVA of 20/50 or better. [ Time Frame: 120 days ] [ Designated as safety issue: No ]
  • Proportion of subjects with adverse events. [ Time Frame: 9 months ] [ Designated as safety issue: Yes ]
  • Single and multiple-dose pharmacokinetics [ Time Frame: Pre-dose on dosing days (Days 0, 30, 60 and 90) and during non-dosing study visits on Days 7, 14, 67, 74, 120 and Month 5 ] [ Designated as safety issue: Yes ]
  • Changes in anti-drug antibodies (ADA) during study and follow-up period [ Time Frame: Pre-dose on dosing days (Days 0, 30, 60 and 90) and during non-dosing study visits on Days 67, 74, 120, Months 5 and 9 ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 160
Study Start Date: August 2012
Estimated Study Completion Date: March 2014
Estimated Primary Completion Date: September 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Monotherapy
4.0 mg iSONEP followed by sham injection; given monthly intravitreously for 4 months
Drug: iSONEP
4.0 mg iSONEP followed by a sham injection; given monthly intravitreously for 4 months
Other Name: sonepcizumab
Experimental: 0.5 mg iSONEP with ranibizumab or bevacizumab
0.5 mg iSONEP followed by 0.5 mg ranibizumab or 1.25 mg bevacizumab; given monthly intravitreously for 4 months
Drug: 0.5 mg iSONEP with ranibizumab or bevacizumab
0.5 mg iSONEP with 0.5 mg ranibizumab or 1.25 mg bevacizumab; given monthly intravitreously for 4 months
Other Names:
  • Lucentis
  • Avastin
  • sonepcizumab
Experimental: 4.0 mg iSONEP with ranibizumab or bevacizumab
4.0 mg iSONEP followed by 0.5 mg ranibizumab or 1.25 mg bevacizumab; given monthly intravitreously for 4 months
Drug: 4.0 mg iSONEP with ranibizumab or bevacizumab
4.0 mg iSONEP followed by 0.5 mg ranibizumab or 1.25 mg bevacizumab; given monthly intravitreously for 4 months
Other Names:
  • Lucentis
  • Avastin
  • sonepcizumab
Active Comparator: ranibizumab or bevacizumab
0.5 mg ranibizumab or 1.25 mg bevacizumab followed by a sham injection; given monthly intravitreously for 4 months
Drug: ranibizumab or bevacizumab
0.5 mg ranibizumab or 1.25 mg bevacizumab followed by a sham injection; given monthly intravitreously for 4 months
Other Names:
  • Lucentis
  • Avastin

Detailed Description:

The study will be conducted in subjects who qualify as "sub-responders" to Lucentis or Avastin meaning that each subject has (i) residual subretinal or intra-retinal fluid observed on Cirrus or Spectralis SDOCT, (ii) leakage on FA, and (iii) an average central subfield thickness of ≥250 μm. Additionally, each subject will have previously received a total of 3-10 IVT injections of Lucentis or Avastin within a 12-month period prior to screening. Screening must occur between 28 and 65 days from the subject's last Lucentis or Avastin treatment. Subjects must be dosed within 14 days of screening, and as of the day of initial study treatment (Day 0), meet the following criteria: (i) ETDRS BCVA of ≥25 and ≤73 letters (approximately 20/320 and 20/40 on the Snellen scale), (ii) residual subretinal or intra-retinal fluid observed on Cirrus or Spectralis SDOCT, and (iii) leakage on FA.

  Eligibility

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

Inclusion Criteria:

  • ≥50 years of age with a diagnosis of wet AMD
  • Subjects who have received 3-10 IVT injections of Lucentis or Avastin within 12 months prior to screening
  • Active subfoveal CNV secondary to AMD (leakage on FA)
  • Presence of residual subretinal or intraretinal fluid on Cirrus or Spectralis SDOCT
  • SDOCT in the 1 mm central macular subfield on the retinal map analysis of ≥250 μm at screening
  • ETDRS BCVA of ≥25 and ≤73 letters (approximately 20/320 and 20/40 on the Snellen scale) at screening and on Day 0
  • In the fellow eye, ETDRS BCVA of 20/400 or better
  • Subject with serous PED (any part of which may be subfoveal) with intraretinal and/or subretinal fluid may be included

Exclusion Criteria:

  • Most recent IVT injection of Lucentis or Avastin fewer than 28 days and more than 65 days prior to screening
  • Previous PDT or Macugen® at any time point
  • Focal thermal laser or grid laser within 3 months prior to Day 0
  • Use of IVT, subtenon or subconjunctival steroids within 3 months prior to Day 0
  • Use of topical ophthalmic corticosteroids 2 weeks prior to Day 0
  • Intraocular surgery, including cataract surgery, and / or laser of any type within 3 months prior to Day 0 or anticipated need for ocular surgery or ophthalmic laser treatment during the study period
  • Subjects previously treated with, or are currently receiving treatment with another investigational agent or device for neovascular AMD in the study eye
  • Retinal total lesion size >12 disc areas (30.5 mm2), including blood, scars and neovascularization as assessed by FA in the study eye
  • Presence of a fibrovascular PED extending underneath the center of the fovea
  • Presence of RAP (retinal angiomatous proliferation) lesions
  • Presence of PCV (if suspected, ICG should be performed at the discretion of the Investigator)
  • Subretinal hemorrhage in the study eye if any of the following is true: (i) the subretinal hemorrhage represents 50% or more of the total lesion area; (ii) subfoveal blood is 1 or more disc areas in size (iii) subfoveal blood where the fovea is surrounded by less than 270 degrees of visible CNV on FA
  • Scar or fibrosis making up >50% of total lesion area in the study eye
  • Anatomic damage to the center of the fovea including fibrosis, scarring or atrophy
  • History of a retinal pigment epithelial tear
  • History of vitreous hemorrhage within 4 weeks prior to screening in the study eye
  • Clinical evidence of diabetic retinopathy, diabetic macular edema or any other vascular disease affecting the retina, other than AMD, in either eye
  • Uncontrolled glaucoma defined as: (i) as intraocular pressure ≥25 mmHg despite treatment with anti glaucoma medication in the study eye or (ii) by the Investigator
  • Prior trabeculectomy or other filtration surgery in the study eye (prior laser trabeculoplasty is allowed)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01414153

  Hide Study Locations
Locations
United States, Arizona
Retina Consultants of Arizona Recruiting
Peoria, Arizona, United States, 85381
Contact: Jaime Gaitan, MD     623-972-1173        
Associated Retina Consultants Recruiting
Phoenix, Arizona, United States, 85020
Contact: Clive Sell, MD     602-242-4928     Lindan@associatedretina.com    
Retina Consultants of Arizona Recruiting
Phoenix, Arizona, United States, 85014
Contact: Jaime Gaitan, MD     602-222-2221        
Retina Centers, P.C. Recruiting
Tucson, Arizona, United States, 85704
Contact: Henry Hudson, MD     520-742-0236     clinicatrials@retinacenterspc.com    
United States, California
Retina-Vitreous Associates Medical Group Recruiting
Beverly Hills, California, United States, 90211
Contact: Firas Rahhal, MD     310-289-2478     tgasparyan@laretina.com    
Retinal Diagnostic Center Recruiting
Campbell, California, United States, 95008
Contact: Amr Dessouki, MD     408-559-0666     tweetie@retinaldiagnostic.com    
Retina Associates of Orange County Recruiting
Laguna Hills, California, United States, 92653
Contact: Charles Eifrig, MD     949-707-5125     ceifrig@yahoo.com    
Northern California Retina Vitreous Associates Recruiting
Mountain View, California, United States, 94040
Contact: James Palmer, MD     408-272-7480        
Retinal Consultants Medical Group, Inc. Recruiting
Sacramento, California, United States, 95819
Contact: Robert Equi, MD     916-453-5452     robequi@gmail.com    
Orange County Retina Medical Group Recruiting
Santa Ana,, California, United States, 92705
Contact: Sanford Chen, MD     714-972-8432     sfdchen@pol.net    
Miramar Eye Specialists Recruiting
Ventura, California, United States, 93003
Contact: Adam Martidis, MD     805-648-3085     aamartidis@yahoo.com    
United States, Florida
Florida Eye Microsurgical Institute Recruiting
Boynton Beach, Florida, United States, 33426
Contact: Randy Katz, MD     561-737-5500     retinadoc1@aol.com    
Retina Health Center Recruiting
Ft. Myers, Florida, United States, 33907
Contact: Alexander Eaton, MD     239-337-3337     ame@retinahealthcenter.com    
Magruder Eye Institute Recruiting
Orlando, Florida, United States, 32803
Contact: John Lehr, MD     407-893-8200     JLehr@magrudereye.com    
Retina Specialty Institute Recruiting
Pensacola, Florida, United States, 32503
Contact: Sunil Gupta, MD     850-476-6759     sgupta@retinaspecialty.com    
Fort Lauderdale Eye Institute Recruiting
Plantation, Florida, United States, 33324
Contact: Stuart Burgess, MD     954-741-5555     Cindyf@flei.com    
East Florida Eye Institute Recruiting
Stuart, Florida, United States, 34994
Contact: Ronald Frenkel, MD     772-287-9000     efleye@aol.com    
Center for Retina & Macular Disease Recruiting
Winter Haven, Florida, United States, 33880
Contact: Michael Tolentino, MD     863-297-5400     miket@crmd.net    
United States, Georgia
Southeast Retina Center Recruiting
Augusta, Georgia, United States, 30909
Contact: Dennis Marcus, MD     706-650-0061     dmarcus@southeastretina.com    
United States, Illinois
University of Chicago Medica Center Recruiting
Chicago, Illinois, United States, 60637
Contact: Seenu Hariprasad, MD     312-799-0360     retina@uchicago.edu    
United States, Indiana
Midwest Eye Institute Recruiting
Indianapolis, Indiana, United States, 46290
Contact: Thomas Ciulla, MD     317-805-2150     thomasciulla@yahoo.com    
United States, Iowa
Wolfe Eye Clinic Recruiting
West Des Moines, Iowa, United States, 50323
Contact: Jared Nielsen, MD     515-306-6599     jnielsen@wolfeclinic.com    
United States, Kansas
Central Plains Eye MDs Recruiting
Wichita, Kansas, United States, 67226
Contact: C. Joseph Beck, MD     316-712-4970     kdarden@centralplainseye.com    
United States, Kentucky
Bennett & Bloom Eye Centers Recruiting
Louisville, Kentucky, United States, 40207
Contact: Steven Bloom, MD     800-477-0055     smbloo01@gmail.com    
United States, Maryland
Retina Specialists Recruiting
Towson, Maryland, United States, 21204
Contact: Raymond Sjaarda, MD     410-296-9748     rnsresearch@me.com    
United States, Michigan
Henry Ford Health System Recruiting
Detroit, Michigan, United States, 48202
Contact: Hua Gao, MD     313-916-3627     HGAO1@hfhs.org    
TLC Eye Care and Laser Center Recruiting
Jackson, Michigan, United States, 49202
Contact: Carmelina Gordon, MD     517-782-5026     Carmelina.gordon@tlcmi.com    
William Beaumont Hospital Medical Office Bldg. Not yet recruiting
Royal Oak, Michigan, United States, 48073
Contact: George Williams, MD     248-551-4603     gwilliams@beaumont.edu    
Retina Consultants of Michigan Recruiting
Southfield, Michigan, United States, 48034
Contact: Michael Ober, MD     248-356-8610     obermike@gmail.com    
United States, New Jersey
Delaware Valley Retina Associates Recruiting
Lawrenceville, New Jersey, United States, 08648
Contact: Darmakusuma le, MD     609-896-1414     delawarevalleyretina@att.net    
Retina Vitreous Center Recruiting
New Brunswick, New Jersey, United States, 08901
Contact: Daniel Roth, MD     732-220-1600        
United States, New York
Island Retina Recruiting
Shirley, New York, United States, 11967
Contact: Pamela Weber, MD     631-924-4300     drpamelaweber@hotmail.com    
United States, North Carolina
Charlotte Eye Ear Nose & Throat Associates Recruiting
Charlotte, North Carolina, United States, 28210
Contact: Andrew Antoszyk, MD     704-295-3180     ana@ceenta.com    
United States, Oregon
Retina & Vitreous Center SO Recruiting
Ashland, Oregon, United States, 97520
Contact: Christine Gonzales, MD     541-488-3192     cgonzales@retinaandvitreous.com    
United States, Pennsylvania
Pennsylvania Retina Specialists Recruiting
Camp Hill, Pennsylvania, United States, 17011
Contact: Jay Prensky, MD     717-761-8688     jprensky@gmail.com    
Associates in Ophthalmology Recruiting
West Mifflin, Pennsylvania, United States, 15122
Contact: Miguel Busquets, MD     412-653-3080     mbusquets@aioeyesurgeons.com    
United States, South Carolina
Palmetto Retina Center Recruiting
West Columbia, South Carolina, United States, 29169
Contact: John Wells, MD     803-931-0077     jackwells@palmettoretina.com    
United States, South Dakota
Black Hills Regional Eye Institute Recruiting
Rapid City, South Dakota, United States, 57701
Contact: Prema Abraham, MD     605-719-3307     retina@bhrei.com    
United States, Texas
Retina Research Institute of Texas Recruiting
Abilene, Texas, United States, 79606
Contact: Sunil S Patel, MD     325-690-4451     research@westtexasretina.com    
Retina Research Center Recruiting
Austin, Texas, United States, 78705
Contact: Brian Berger, MD     512-454-0138     bberger@e-retina.net    
Austin Retina Associates Recruiting
Austin, Texas, United States, 78705
Contact: Jose Martinez, MD     572-451-0103     japepemartinez@hotmail.com    
Texas Retina Associates Recruiting
Dallas, Texas, United States, 75231
Contact: Gary Fish, MD     800-695-6941        
Valley Retina Institute Recruiting
Harlingen, Texas, United States, 78550
Contact: Victor Gonzalez, MD     956-423-2100     research@vritx.com    
Medical Center Ophthalmology Associates Recruiting
San Antonio, Texas, United States, 78240
Contact: Michael Singer, MD     210-697-2006     msinger1@earthlink.net    
Retina Associates of South Texas Recruiting
San Antonio, Texas, United States, 78240
Contact: Timothy Cleland, MD     210-615-7600     timcleland@hotmail.com    
United States, Utah
Rocky Mountain Retina Consultants Recruiting
Salt Lake City, Utah, United States, 84107
Contact: David Faber, MD     801-264-4444     fabermd@rockymountainretina.com    
Sponsors and Collaborators
Lpath, Inc.
Pfizer
Investigators
Study Chair: Glenn Stoller, MD Lpath, Inc.
  More Information

No publications provided

Responsible Party: Lpath, Inc.
ClinicalTrials.gov Identifier: NCT01414153     History of Changes
Other Study ID Numbers: LT1009-Oph-003
Study First Received: August 9, 2011
Last Updated: April 17, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Lpath, Inc.:
choroidal neovascularization
age-related macular degeneration
iSONEP
sonepcizumab
Lucentis
ranibizumab
Avastin
bevacizumab

Additional relevant MeSH terms:
Macular Degeneration
Wet Macular Degeneration
Retinal Degeneration
Retinal Diseases
Eye Diseases
Bevacizumab
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Pharmacologic Actions
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on May 16, 2013