Efficacy and Safety Study of iSONEP With & Without Lucentis/Avastin/Eylea to Treat Wet AMD (Nexus)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Pfizer
Information provided by (Responsible Party):
Lpath, Inc.
ClinicalTrials.gov Identifier:
NCT01414153
First received: August 9, 2011
Last updated: January 5, 2015
Last verified: January 2015
  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, Avastin or Eylea 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, Avastin or Eylea, particularly in those subjects who do not demonstrate a robust response to Lucentis, Avastin or Eylea after several monthly injections. Further, the combination of Lucentis, Avastin or Eylea 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, Avastin or Eylea alone.


Condition Intervention Phase
Exudative Age-related Macular Degeneration
Drug: 4.0 mg iSONEP
Drug: 0.5 mg iSONEP
Drug: 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea
Drug: sham injection
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: Phase 2a, Multicenter, Masked, Randomized, Comparator Controlled Study Evaluating iSONEP™ as Monotherapy or Adjunctive Therapy to Lucentis/Avastin/Eylea Versus Lucentis/Avastin/Eylea Alone for 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: October 2015
Estimated Primary Completion Date: June 2015 (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: 4.0 mg iSONEP
4.0 mg iSONEP given monthly intravitreously for 4 months
Other Name: sonepcizumab
Drug: sham injection
administered monthly for 4 months
Other Name: placebo
Experimental: 0.5 mg iSONEP & Lucentis/Avastin/Eylea
0.5 mg iSONEP and 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea; given monthly intravitreously for 4 months
Drug: 0.5 mg iSONEP
0.5 mg iSONEP given monthly intravitreously for 4 months
Other Name: sonepcizumab
Drug: 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea
0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea given monthly intravitreously for 4 months
Other Names:
  • ranibizumab
  • bevacizumab
  • aflibercept
Experimental: 4.0 mg iSONEP & Lucentis/Avastin/Eylea
4.0 mg iSONEP followed by 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea; given monthly intravitreously for 4 months
Drug: 4.0 mg iSONEP
4.0 mg iSONEP given monthly intravitreously for 4 months
Other Name: sonepcizumab
Drug: 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea
0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea given monthly intravitreously for 4 months
Other Names:
  • ranibizumab
  • bevacizumab
  • aflibercept
Active Comparator: Lucentis or Avastin or Eylea
0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea followed by a sham injection; given monthly intravitreously for 4 months
Drug: 0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea
0.5 mg Lucentis or 1.25 mg Avastin or 2 mg Eylea given monthly intravitreously for 4 months
Other Names:
  • ranibizumab
  • bevacizumab
  • aflibercept
Drug: sham injection
administered monthly for 4 months
Other Name: placebo

Detailed Description:

The study will be conducted in subjects who qualify as "sub-responders" to Lucentis, Avastin or Eylea 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 minimum of 3 IVT injections of Lucentis, Avastin or Eylea within the 12-month period prior to screening. Screening must occur between 28 and 65 days from the subject's last Lucentis or Avastin treatment or between 42 and 79 days from the subject's last Eylea 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 injections of Lucentis or Avastin or Eylea 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
  • Most recent IVT injection of Eylea fewer than 42 days and more than 79 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
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: NCT01414153

  Hide Study Locations
Locations
United States, Arizona
Retina Consultants of Arizona
Peoria, Arizona, United States, 85381
Associated Retina Consultants
Phoenix, Arizona, United States, 85020
Retina Consultants of Arizona
Phoenix, Arizona, United States, 85014
Retina Centers, P.C.
Tucson, Arizona, United States, 85704
United States, California
Retina-Vitreous Associates Medical Group
Beverly Hills, California, United States, 90211
Retinal Diagnostic Center
Campbell, California, United States, 95008
Specialty Eye Care Medical Center
Glendale, California, United States, 91203
Retina Associates of Orange County
Laguna Hills, California, United States, 92653
Northern California Retina Vitreous Associates
Mountain View, California, United States, 94040
Sagar Kenyon American Eye Institute
New Albany, California, United States, 47150
Retinal Consultants Medical Group, Inc.
Sacramento, California, United States, 95819
Orange County Retina Medical Group
Santa Ana,, California, United States, 92705
Miramar Eye Specialists
Ventura, California, United States, 93003
United States, Florida
Florida Eye Microsurgical Institute
Boynton Beach, Florida, United States, 33426
Retina Health Center
Ft. Myers, Florida, United States, 33907
Retina Specialty Institute
Pensacola, Florida, United States, 32503
Fort Lauderdale Eye Institute
Plantation, Florida, United States, 33324
East Florida Eye Institute
Stuart, Florida, United States, 34994
Center for Retina & Macular Disease
Winter Haven, Florida, United States, 33880
United States, Hawaii
Retina Consultants of Hawaii
Aiea, Hawaii, United States, 96701
United States, Illinois
University of Chicago Medica Center
Chicago, Illinois, United States, 60637
United States, Indiana
Midwest Eye Institute
Indianapolis, Indiana, United States, 46290
United States, Kansas
Central Plains Eye MDs
Wichita, Kansas, United States, 67226
United States, Kentucky
Bennett & Bloom Eye Centers
Louisville, Kentucky, United States, 40207
United States, Maryland
Retina Group of Washington
Chevy Chase, Maryland, United States, 20815
Retina Specialists
Towson, Maryland, United States, 21204
United States, Massachusetts
Ophthalmic Consultants of Boston
Boston, Massachusetts, United States, 02114
United States, Michigan
Henry Ford Health System
Detroit, Michigan, United States, 48202
TLC Eye Care and Laser Center
Jackson, Michigan, United States, 49202
Retina Consultants of Michigan
Southfield, Michigan, United States, 48034
United States, New York
Island Retina
Shirley, New York, United States, 11967
United States, North Carolina
Charlotte Eye Ear Nose & Throat Associates
Charlotte, North Carolina, United States, 28210
United States, Oregon
Retina & Vitreous Center SO
Ashland, Oregon, United States, 97520
United States, Pennsylvania
Associates in Ophthalmology
West Mifflin, Pennsylvania, United States, 15122
United States, South Carolina
Palmetto Retina Center
West Columbia, South Carolina, United States, 29169
United States, Texas
Retina Research Institute of Texas
Abilene, Texas, United States, 79606
Austin Retina Associates
Austin, Texas, United States, 78705
Retina Research Center
Austin, Texas, United States, 78705
Texas Retina Associates
Dallas, Texas, United States, 75231
Valley Retina Institute
Harlingen, Texas, United States, 78550
Alkek Eye Center - Baylor College of Medicine
Houston, Texas, United States, 77039
Medical Center Ophthalmology Associates
San Antonio, Texas, United States, 78240
Retina Associates of South Texas
San Antonio, Texas, United States, 78240
United States, Utah
Rocky Mountain Retina Consultants
Salt Lake City, Utah, United States, 84107
United States, Virginia
Retina Group of Washington
Fairfax, Virginia, United States, 22031
United States, Washington
Spokane Eye Clinical Research
Spokane, Washington, United States, 99204
Sponsors and Collaborators
Lpath, Inc.
Pfizer
Investigators
Study Director: Susan Hazel 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: January 5, 2015
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
Eylea
aflibercept

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

ClinicalTrials.gov processed this record on March 26, 2015