Efficacy and Safety Study of iSONEP With and Without Lucentis/Avastin to Treat Age-related Macular Degeneration (AMD) (Nexus)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
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 |
- 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 ]
- 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:
|
|
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:
|
|
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:
|
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 |
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
Hide Study 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 | |
| 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