A Study to Compare the Efficacy and Safety of Intravitreal APL-2 Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration
Apellis Pharmaceuticals, Inc.
First Received: April 20, 2018 | Last Updated: September 16, 2020
Phase: Phase 3 | Start Date: August 30, 2018
Overall Status: Active, not recruiting | Estimated Enrollment: 600
This is a 30-month, Phase III, multicenter, randomized, double-masked, sham-injection
controlled study to assess the efficacy and safety of multiple IVT injections of APL-2 in
subjects with GA secondary to AMD.
Full Title of Study: “A Phase III, Multi-Center, Randomized, Double-Masked, Sham Controlled Study to Compare the Efficacy and Safety of Intravitreal APL-2 Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration (AMD)”
Study Type: Interventional
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Study Primary Completion Date: July 30, 2021
Complement (C3) Inhibitor
Complement (C3) Inhibitor
Other: Sham Procedure
Subjects will receive a Sham procedure every month
Other: Sham Procedure
Subjects will receive a Sham procedure every other month
Arms, Groups and Cohorts
Experimental: APL-2 15mg 0.1 mL Monthly for 24 months
A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every month
Experimental: APL-2 15mg 0.1 mL EOM for 24 months
A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every other month
Experimental: Sham Procedure Monthly for 24 months
Sham Procedure monthly for 24 months
Experimental: Sham Procedure Every Other Month for 24 months
Sham Procedure every other month for 24 months
Clinical Trial Outcome Measures
Change from Baseline to Month 12 in total area of GA lesion(s) in the study eye (in mm2 ) based on Fundus Autofluorescence (FAF)
Time Frame: 12 months
Incidence and severity of ocular and systemic treatment-emergent adverse events
Time Frame: 30 months
Participating in This Clinical Trial
The study eye must meet all inclusion criteria. If both eyes meet the inclusion criteria,
the eye with the worst visual acuity at the screening visit will be designated as the study
eye. If both eyes have the same visual acuity, the right eye will be selected as the study
Ocular- specific inclusion criteria apply to the study eye only, unless otherwise
Age ≥ 60 years.
– Normal Luminance best corrected visual acuity of 24 letters or better using Early
Treatment Diabetic Retinopathy Study (ETDRS) charts (approximately 20/320 Snellen
– Clinical diagnosis of GA of the macula secondary to AMD as determined by the
Investigator and confirmed by the Reading Center.
– The GA lesion must meet the following criteria as determined by the central reading
center's assessment of Fundus Autofluorescence (FAF) imaging at screening:
– Total GA area must be ≥ 2.5 and ≤ 17.5 mm2 (1 and 7 disk areas [DA] respectively)
– If GA is multifocal, at least one focal lesion must be ≥ 1.25 mm2 (0.5 DA), with
the overall aggregate area of GA, as specified above in 4a.
– The entire GA lesion must be completely visualized on the macula centered image
and must be able to be imaged in its entirety and not contiguous with any areas
of peripapillary atrophy.
– Presence of any pattern of hyperautofluorescence in the junctional zone of GA.
Absence of hyperautofluorescence (i.e. pattern = none) is exclusionary.
– Adequate clarity of ocular media, adequate pupillary dilation, and fixation to permit
the collection of good quality images as determined by the Investigator.
– Meets the following criteria related to microperimetry:
– Able to detect fixation target.
– Total elapsed time to complete the 10-2 68 point exam is ≤ 30 minutes in
– Reliability test ratio must be ≤ 20%.
– Subject is willing and able to undertake microperimetry assessment in the opinion
of the investigator.
– Female subjects must be:
– Women of non-child-bearing potential (WONCBP), or
– Women of child-bearing potential (WOCBP) with a negative pregnancy test at
screening and must agree to use protocol defined methods of contraception for the
duration of the study and refrain from breastfeeding for the duration of the
– Males with female partners of child-bearing potential must agree to use protocol
defined methods of contraception and agree to refrain from donating sperm for the
duration of the study.
– Willing and able to give informed consent and to comply with the study procedures and
Ocular specific exclusion criteria apply to the study eye only, unless otherwise specified.
GA secondary to a condition other than AMD such as Stargardt disease, cone rod
dystrophy or toxic maculopathies like plaquenil maculopathy in either eye.
– Spherical equivalent of the refractive error demonstrating > 6 diopters of myopia or
an axial length >26 mm.
– Any history or active choroidal neovascularization (CNV), associated with AMD or any
other cause, including any evidence of retinal pigment epithelium rips or evidence of
neovascularization anywhere based on SD-OCT imaging and/or fluorescein angiography as
assessed by the Reading Center.
– Presence of an active ocular disease that in the opinion of the Investigator
compromises or confounds visual function, including but not limited to, uveitis, other
macular diseases (e.g. clinically significant epiretinal membrane (ERM), full
thickness macular hole or uncontrolled glaucoma/ocular hypertension. Benign conditions
in the opinion of the investigator such as peripheral retina dystrophy are not
– Intraocular surgery (including lens replacement surgery) within 3 months prior to
– History of laser therapy in the macular region.
– Aphakia or absence of the posterior capsule. Note: YAG laser posterior capsulotomy for
posterior capsule opacification done at least 60 days prior to screening is not
– Any ocular condition other than GA secondary to AMD that may require surgery or
medical intervention during the study period or, in the opinion of the Investigator,
could compromise visual function during the study period.
– Any contraindication to IVT injection including current ocular or periocular
– History of prior intravitreal injection.
– Unable to perform microperimetry reliably in the opinion of the investigator
– Prior participation in another interventional clinical study for intravitreal
therapies in either eye (including subjects receiving sham).
– Prior participation in another interventional clinical study for geographic atrophy in
either eye including investigational oral medication and placebo.
– Participation in any systemic experimental treatment or any other systemic
investigational new drug within 6 weeks or 5 half-lives of the active ingredient
(whichever is longer) prior to the start of study treatment. Note: clinical trials
solely involving observation, over-the-counter vitamins, supplements, or diets are not
– Medical or psychiatric conditions that, in the opinion of the investigator, make
consistent follow-up over the 24-month treatment period unlikely, or would make the
subject an unsafe study candidate.
– Any screening laboratory value (hematology, serum chemistry or urinalysis) that in the
opinion of the Investigator is clinically significant and not suitable for study
– Known hypersensitivity to fluorescein sodium for injection or hypersensitivity to
APL-2 or any of the excipients in APL-2 solution.
Gender Eligibility: All
Minimum Age: 60 Years
Maximum Age: N/A
Are Healthy Volunteers Accepted: No
Apellis Pharmaceuticals, Inc.
Provider of Information About this Clinical Study
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