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出境医 / 临床实验 / Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Myopia (COAST_UAmCNV)

Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Myopia (COAST_UAmCNV)

Study Description
Brief Summary:
The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.

Condition or disease Intervention/treatment Phase
Pathologic Myopia Procedure: Intravitreal injection Not Applicable

Detailed Description:

The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.

This study is planned as a follow-up. Patients with myopia included in it will receive antiangiogenic therapy in accordance with the approved indications for use indicated in the instructions for the use of drugs in Ukraine.

The treatment proposed in this study is based on the world experience and scientific developments of the Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine ". Therefore, it is expected that the benefit / risk ratio in relation to the participation in this study should not be different from that described in the scientific literature and the benefits outweigh the risk. It is known that the absence of treatment in these diseases leads to an irreparable loss of central vision.

Patients with a pathologic myopia with CNV (native) will be treated with antiangiogenic drugs according to the regimen pro re nata.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 200 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Collaborative Ocular Antiangiogenic Study of Ukraine. Multicentral, Open-label, Randomized, Prospective Study of Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Myopia
Actual Study Start Date : March 27, 2018
Estimated Primary Completion Date : July 1, 2020
Estimated Study Completion Date : December 31, 2020
Arms and Interventions
Arm Intervention/treatment
Active Comparator: Ranibizumab
Arm 1
Procedure: Intravitreal injection
Intravitreal injection to the regimen pro re nata.
Other Name: Patients after general ophthalmic examination (visometry, refractometry, biomicroscopy, ophthalmoscopy, OCT, fluorescence angiography) receive an injection according to the regimen pro re nata.

Active Comparator: Aflibercept
Arm 2
Procedure: Intravitreal injection
Intravitreal injection to the regimen pro re nata.
Other Name: Patients after general ophthalmic examination (visometry, refractometry, biomicroscopy, ophthalmoscopy, OCT, fluorescence angiography) receive an injection according to the regimen pro re nata.

Outcome Measures
Primary Outcome Measures :
  1. Mean Change in Best Corrected Visual Acuity (BCVA) as Measured by ETDRS Chart [ Time Frame: Baseline-Month 12 ]
    Defined study baseline range of ETDRS equivalent of 20/200 to 20/20) in the study eye; a higher score represents better functioning.


Secondary Outcome Measures :
  1. Mean Change in Central Retinal Thickness (CRT) as Assessed by Optical Coherence Tomography (OCT) [ Time Frame: Baseline-Month 12 ]
    A negative number indicates improvement (reduced thickness).

  2. Average Number of Intravitreal Injections [ Time Frame: Baseline-Month 12 ]
    The number of intravitreal injections administered

  3. Number of Endophthalmitis after Intravitreal Injections [ Time Frame: Baseline-Month 12 ]
    The number of endophthalmitis registered in patients after intravitreal injections


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Able to read (or, if unable to read due to visual impairment, be read to verbatim by the person administering the informed consent form or a family member) and understand the informed consent form and willing to sign the informed consent form.
  2. Signed informed consent form.
  3. Men and women ≥ 18 years of age.
  4. Willing, committed, and able to return for all clinic visits and complete all study-related procedures.
  5. Myopia of greater than or equal to -6 D OR axial length of greater than (if the spherical myopic equivalent is <6.0 diopters, then the patient should have myopic changes in the macula: lacquer cracks, focal chorioretinal atrophy, posterior staphyloma) or equal to 26.5 mm.
  6. Active subfoveal or juxtafoveal (within 1 to 199 μm of the center of the fovea) CNV secondary to pathologic myopia as defined by leakage on FA.
  7. Transparent optical media and possibility to mydriasis.
  8. Best corrected visual acuity at least 20/200 Equivalent of Snellen (ETDRS). -

Exclusion Criteria:

  1. Ocular media of insufficient quality to obtain fundus and OCT images in the study eye
  2. Recurrent mCNV in the study eye
  3. History or presence of CNV with an origin other than pathologic myopia in the study eye
  4. Ocular inflammation or external ocular inflammation in the study eye
  5. Concurrent disease in the study eye that would compromise BCVA or require medical or surgical intervention during the study period
  6. Any ocular disorder in the study eye that, in the opinion of the investigator, may confound interpretation of the study results
  7. Significant scarring or atrophy in the fovea that indicates substantial irreversible vision loss in the study eye
  8. History of idiopathic or autoimmune-associated uveitis in either eye
  9. Evidence at examination of infectious blepharitis, keratitis, scleritis, or conjunctivitis in either eye or current treatment for serious systemic infection
  10. Vitreomacular traction or traction retinal detachment, epiretinal membrane in either eye
  11. Any iris neovascularization and/or vitreous hemorrhage in either eye
  12. Uncontrolled glaucoma, or previous filtration surgery in either eye
  13. Prior and concomitant treatments
  14. Any prior or concomitant treatment with another investigational agent for mCNV in the study eye.
  15. Any previous panretinal photocoagulation or subfoveal thermal laser therapy in the study eye.

16 Any prior treatment with photodynamic therapy in the study eye. 17. Cataract surgery within 3 months prior to Day 1 in the study eye. 18. Yttrium-aluminum-garnet laser capsulotomy within 2 months prior to Day 1 in the study eye.

19. Any other intraocular surgery within 3 months prior to Day 1 in the study eye.

20. History of vitreoretinal surgery and/or scleral buckle surgery in the study eye.

21. Any prior treatment with anti-VEGF agents 22. Previous use of intraocular or periocular corticosteroids in either eye within 3 months prior to Day 1 23. Previous assignment to treatment during this study 24. Uncontrolled hypertension 25. History of cerebrovascular disease or myocardial infarction within 6 months prior to Baseline/Day 1 26. History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, may affect interpretation of the results of the study, or renders the subject at high risk from treatment complications 27. Women of childbearing potential without contraception, women who intend to breastfeed during the study. All subjects (both men and women) of childbearing potential who are unwilling to use adequate birth control measures during the course of the study.

28. Renal failure requiring dialysis or renal transplant 29. Participation in an investigational study within 30 days prior to Screening/Visit 1 that involved treatment with any drug (excluding vitamins and minerals) or device 30. Known serious allergy to the fluorescein sodium for injection in angiography or Verteporfin 31. Inability to obtain fundus photographs or fluorescein angiograms of sufficient quality

-

Contacts and Locations

Contacts
Layout table for location contacts
Contact: Andrii MD Korol, PhD +380936327266 andrii.r.korol@gmail.com
Contact: Viktoriia MD Rostel +380976126589 rostelviktoria@gmail.com

Locations
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Ukraine
Mykolaiv Region Ophthalmogical Hospital Recruiting
Mykolaiv, Ukraine, 54000
Contact: Krasymira Rylkovа, PhD         
Odessa National Medical University Recruiting
Odessa, Ukraine, 65028
Contact: Nadiia Ulianova, PhD         
The Filatov Institute of Eye Diseases and Tissue Therapy Recruiting
Odessa, Ukraine, 65061
Sponsors and Collaborators
The Filatov Institute of Eye Diseases and Tissue Therapy
Odessa National Medical University
Mykolaiv Region Ophthalmogical Hospital
Central Polyclinic of Internal Affairs of Ukraine
Investigators
Layout table for investigator information
Principal Investigator: Andrii MD Korol, PhD The Filatov Institute of Eye Diseases and Tissue Therapy
Tracking Information
First Submitted Date  ICMJE May 21, 2019
First Posted Date  ICMJE May 24, 2019
Last Update Posted Date April 27, 2020
Actual Study Start Date  ICMJE March 27, 2018
Estimated Primary Completion Date July 1, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 23, 2019)
Mean Change in Best Corrected Visual Acuity (BCVA) as Measured by ETDRS Chart [ Time Frame: Baseline-Month 12 ]
Defined study baseline range of ETDRS equivalent of 20/200 to 20/20) in the study eye; a higher score represents better functioning.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 23, 2019)
  • Mean Change in Central Retinal Thickness (CRT) as Assessed by Optical Coherence Tomography (OCT) [ Time Frame: Baseline-Month 12 ]
    A negative number indicates improvement (reduced thickness).
  • Average Number of Intravitreal Injections [ Time Frame: Baseline-Month 12 ]
    The number of intravitreal injections administered
  • Number of Endophthalmitis after Intravitreal Injections [ Time Frame: Baseline-Month 12 ]
    The number of endophthalmitis registered in patients after intravitreal injections
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Myopia
Official Title  ICMJE Collaborative Ocular Antiangiogenic Study of Ukraine. Multicentral, Open-label, Randomized, Prospective Study of Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Myopia
Brief Summary The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.
Detailed Description

The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.

This study is planned as a follow-up. Patients with myopia included in it will receive antiangiogenic therapy in accordance with the approved indications for use indicated in the instructions for the use of drugs in Ukraine.

The treatment proposed in this study is based on the world experience and scientific developments of the Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine ". Therefore, it is expected that the benefit / risk ratio in relation to the participation in this study should not be different from that described in the scientific literature and the benefits outweigh the risk. It is known that the absence of treatment in these diseases leads to an irreparable loss of central vision.

Patients with a pathologic myopia with CNV (native) will be treated with antiangiogenic drugs according to the regimen pro re nata.

Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Pathologic Myopia
Intervention  ICMJE Procedure: Intravitreal injection
Intravitreal injection to the regimen pro re nata.
Other Name: Patients after general ophthalmic examination (visometry, refractometry, biomicroscopy, ophthalmoscopy, OCT, fluorescence angiography) receive an injection according to the regimen pro re nata.
Study Arms  ICMJE
  • Active Comparator: Ranibizumab
    Arm 1
    Intervention: Procedure: Intravitreal injection
  • Active Comparator: Aflibercept
    Arm 2
    Intervention: Procedure: Intravitreal injection
Publications * Korol AR, Zadorozhnyy OS, Naumenko VO, Kustryn TB, Pasyechnikova NV. Intravitreal aflibercept for the treatment of choroidal neovascularization associated with pathologic myopia: a pilot study. Clin Ophthalmol. 2016 Nov 4;10:2223-2229. eCollection 2016.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: May 23, 2019)
200
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE December 31, 2020
Estimated Primary Completion Date July 1, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Able to read (or, if unable to read due to visual impairment, be read to verbatim by the person administering the informed consent form or a family member) and understand the informed consent form and willing to sign the informed consent form.
  2. Signed informed consent form.
  3. Men and women ≥ 18 years of age.
  4. Willing, committed, and able to return for all clinic visits and complete all study-related procedures.
  5. Myopia of greater than or equal to -6 D OR axial length of greater than (if the spherical myopic equivalent is <6.0 diopters, then the patient should have myopic changes in the macula: lacquer cracks, focal chorioretinal atrophy, posterior staphyloma) or equal to 26.5 mm.
  6. Active subfoveal or juxtafoveal (within 1 to 199 μm of the center of the fovea) CNV secondary to pathologic myopia as defined by leakage on FA.
  7. Transparent optical media and possibility to mydriasis.
  8. Best corrected visual acuity at least 20/200 Equivalent of Snellen (ETDRS). -

Exclusion Criteria:

  1. Ocular media of insufficient quality to obtain fundus and OCT images in the study eye
  2. Recurrent mCNV in the study eye
  3. History or presence of CNV with an origin other than pathologic myopia in the study eye
  4. Ocular inflammation or external ocular inflammation in the study eye
  5. Concurrent disease in the study eye that would compromise BCVA or require medical or surgical intervention during the study period
  6. Any ocular disorder in the study eye that, in the opinion of the investigator, may confound interpretation of the study results
  7. Significant scarring or atrophy in the fovea that indicates substantial irreversible vision loss in the study eye
  8. History of idiopathic or autoimmune-associated uveitis in either eye
  9. Evidence at examination of infectious blepharitis, keratitis, scleritis, or conjunctivitis in either eye or current treatment for serious systemic infection
  10. Vitreomacular traction or traction retinal detachment, epiretinal membrane in either eye
  11. Any iris neovascularization and/or vitreous hemorrhage in either eye
  12. Uncontrolled glaucoma, or previous filtration surgery in either eye
  13. Prior and concomitant treatments
  14. Any prior or concomitant treatment with another investigational agent for mCNV in the study eye.
  15. Any previous panretinal photocoagulation or subfoveal thermal laser therapy in the study eye.

16 Any prior treatment with photodynamic therapy in the study eye. 17. Cataract surgery within 3 months prior to Day 1 in the study eye. 18. Yttrium-aluminum-garnet laser capsulotomy within 2 months prior to Day 1 in the study eye.

19. Any other intraocular surgery within 3 months prior to Day 1 in the study eye.

20. History of vitreoretinal surgery and/or scleral buckle surgery in the study eye.

21. Any prior treatment with anti-VEGF agents 22. Previous use of intraocular or periocular corticosteroids in either eye within 3 months prior to Day 1 23. Previous assignment to treatment during this study 24. Uncontrolled hypertension 25. History of cerebrovascular disease or myocardial infarction within 6 months prior to Baseline/Day 1 26. History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, may affect interpretation of the results of the study, or renders the subject at high risk from treatment complications 27. Women of childbearing potential without contraception, women who intend to breastfeed during the study. All subjects (both men and women) of childbearing potential who are unwilling to use adequate birth control measures during the course of the study.

28. Renal failure requiring dialysis or renal transplant 29. Participation in an investigational study within 30 days prior to Screening/Visit 1 that involved treatment with any drug (excluding vitamins and minerals) or device 30. Known serious allergy to the fluorescein sodium for injection in angiography or Verteporfin 31. Inability to obtain fundus photographs or fluorescein angiograms of sufficient quality

-

Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 90 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Andrii MD Korol, PhD +380936327266 andrii.r.korol@gmail.com
Contact: Viktoriia MD Rostel +380976126589 rostelviktoria@gmail.com
Listed Location Countries  ICMJE Ukraine
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03963596
Other Study ID Numbers  ICMJE 0118U001612
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Andrii Korol, MD, PhD, The Filatov Institute of Eye Diseases and Tissue Therapy
Study Sponsor  ICMJE The Filatov Institute of Eye Diseases and Tissue Therapy
Collaborators  ICMJE
  • Odessa National Medical University
  • Mykolaiv Region Ophthalmogical Hospital
  • Central Polyclinic of Internal Affairs of Ukraine
Investigators  ICMJE
Principal Investigator: Andrii MD Korol, PhD The Filatov Institute of Eye Diseases and Tissue Therapy
PRS Account The Filatov Institute of Eye Diseases and Tissue Therapy
Verification Date April 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP