A Phase III Study to Evaluate the Port Delivery System With Ranibizumab Compared With Monthly Ranibizumab Injections in Participants With Wet Age-Related Macular Degeneration

Overview

Study GR40548 is a Phase III, randomized, multicenter, open-label (visual assessor [VA]-masked), active-comparator study designed to assess the efficacy, safety, and pharmacokinetics (PK) of 100mg/ml delivered via the Port Delivery System with ranibizumab (PDS) compared with ranibizumab intravitreal injections at 0.5 mg (10 mg/mL) in participants with neovascular age-related macular degeneration (nAMD).

Full Title of Study: “Phase III, Multicenter, Randomized, Visual Assessor-Masked, Active-Comparator Study of the Efficacy, Safety, and Pharmacokinetics of the Port Delivery System With Ranibizumab in Patients With Neovascular Age-Related Macular Degeneration”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: May 22, 2020

Interventions

  • Drug: PDS Implant filled with 100 mg/mL Ranibizumab
    • Will be administered as per the schedule described in individual arm.
  • Drug: Intravitreal Injections of 10 mg/mL Ranibizumab
    • Will be administered as per the schedule described in individual arm.

Arms, Groups and Cohorts

  • Experimental: PDS Implant Arm
    • Participants will receive ranibizumab delivered through the PDS implant with 100 mg/mL in the study eye on Day 1 and receive refill-exchanges at fixed 24-week intervals
  • Active Comparator: Intravitreal Arm
    • Participants will receive ranibizumab 0.5 mg monthly intravitreal injections of 10 mg/mL formulation at Day 1 and every month thereafter.

Clinical Trial Outcome Measures

Primary Measures

  • Change From Baseline in Best-Corrected Visual Acuity (BCVA) Score at the Average of Week 36 and Week 40, as Assessed Using the ETDRS Visual Acuity Chart at a Starting Distance of 4 Meters
    • Time Frame: Baseline, and the average of Week 36 and Week 40
    • The primary efficacy endpoint is the change in BCVA score from baseline averaged over Weeks 36 and 40 with BCVA assessed using the ETDRS chart at a starting distance of 4 meters. ETDRS = Early Treatment Diabetic Retinopathy Study. The primary objective is to determine the NI and equivalence between the two treatment groups, as measured by the primary efficacy endpoint with a NI margin of 4.5 letters and equivalence margins of ± 4.5 letters. A vision score of 20/20 vision is considered normal. A score of 20/200 is considered being legally blind.

Secondary Measures

  • Change From Baseline in BCVA Score Averaged Over Week 60 and Week 64
    • Time Frame: Baseline, Week60, Week 64
  • Change From Baseline in BCVA Score Over Time
    • Time Frame: Baseline up to Week 96
  • Percentage of Participants With BCVA Score of 38 Letters (20/200 Approximate Snellen Equivalent) or Worse at the Average Over Week 36 and Week 40
    • Time Frame: Baseline, and the average of Week 36 and Week 40
  • Percentage of Participants With BCVA Score of 38 Letters (20/200 Approximate Snellen Equivalent) or Worse Over Time
    • Time Frame: Baseline up to Week 96
  • Percentage of Participants With BCVA Score of 69 Letters (20/40 Approximate Snellen Equivalent) or Better at the Average Over Week 36 and Week 40
    • Time Frame: Baseline, and the average of Week 36 and Week 40
  • Percentage of Participants With BCVA Score of 69 Letters (20/40 Approximate Snellen Equivalent) or Better Over Time
    • Time Frame: Baseline up to Week 96
  • Percentage of Participants Who Lose <10 or <5 Letters in BCVA Score From Baseline to the Average Over Week 36 and Week 40
    • Time Frame: Baseline, and the average of Week 36 and Week 40
  • Percentage of Participants Who Lose <10 or <5 Letters in BCVA Score From Baseline Over Time
    • Time Frame: Baseline up to Week 96
  • Percentage of Participants Who Gain ≥0 Letters in BCVA Score From Baseline to the Average Over Week 36 and Week 40
    • Time Frame: Baseline up to Week 40
  • Percentage of Participants Who Gain ≥0 Letters in BCVA Score From Baseline Over Time
    • Time Frame: Baseline up to Week 96
  • Change From Baseline in Center Point Thickness (CPT) at Week 36
    • Time Frame: Baseline to Week 36
  • Change From Baseline in CPT Over Time
    • Time Frame: Baseline up to Week 96
  • Percentage of Participants in the PDS Implant Arm Who Undergo Supplemental Treatment With Intravitreal Ranibizumab 0.5 mg Before the First, Second, Third, and Fourth Fixed Refill-Exchange Intervals
    • Time Frame: Day 1 to Week 24, Week 25 to Week 48, Week 49 to Week 72, Week73 to Week 96
  • Percentage of Participants in the PDS Implant Arm Who Undergo a Supplemental Treatment That Requires Subsequent Additional Supplemental Treatments During the Study
    • Time Frame: Week 16 to Week 92
  • Percentage of Participants With Ocular and Systemic (Non-Ocular) AEs
    • Time Frame: Randomization to Week 96
  • Percentage of Participants With Adverse Events of Special Interest
    • Time Frame: Randomization to Week 96
    • Percentage of Participants with Adverse Events of Special Interest
  • Observed Serum Ranibizumab Concentrations at Specified Timepoints
    • Time Frame: Randomization to Week 96
  • Estimated PK Parameter Values AUC0-6M
    • Time Frame: Randomization to Week 96
    • AUC0-6M = Area Under the Concentration-Time Curve From 0 to 6 Months
  • Estimated PK Parameter Value t1/2 After PDS Implant Insertion
    • Time Frame: Randomization to Week 96
    • Apparent terminal half-life
  • Estimated PK Parameter Value Cmin
    • Time Frame: Randomization to Week 96
    • Cmin = Minimum Serum Concentration
  • Estimated PK Parameter Value Cmax
    • Time Frame: Randomization to Week 96
    • Cmax = Maximum Serum Concentration
  • Baseline Prevalence and Incidence of Treatment-Emergent ADA
    • Time Frame: Randomization to Week 96

Participating in This Clinical Trial

Inclusion Criteria

  • Age ≥50 years, at time of signing Informed Consent Form – Initial diagnosis of exudative neovascular age-related macular degeneration (nAMD) within 9 months prior to the screening visit – Previous treatment with at least three anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections for nAMD per standard of care within 6 months prior to the screening visit – Demonstrated response to prior anti-VEGF intravitreal treatment since diagnosis – Best-corrected visual acuity (BCVA) of 34 letters or better Exclusion Criteria:

  • Subfoveal fibrosis or subfoveal atrophy in study eye – Subretinal hemorrhage that involves the center of the fovea in study eye – History of vitrectomy surgery, submacular surgery, or other surgical intervention for AMD in study eye – Prior treatment with Visudyne®, external-beam radiation therapy, or transpupillary thermotherapy in study eye – Previous intraocular device implantation in study eye – Previous laser (any type) used for AMD treatment in study eye – Treatment with anti-VEGF agents other than ranibizumab within 1 month prior to the randomization visit in either eye – Prior participation in a clinical trial involving anti-VEGF drugs within 6 months prior to the randomization visit, other than ranibizumab in either eye – CNV due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia in either eye – Uncontrolled blood pressure – History of stroke within the last 3 months prior to informed consent – Uncontrolled atrial fibrillation within 3 months of informed consent – History of myocardial infarction within the last 3 months prior to informed consent – History of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the Implant and that might affect interpretation of the results of the study or renders the participant at high risk of treatment complications in the opinion of the investigator – Current systemic treatment for a confirmed active systemic infection – Chronic use of oral corticosteroids – Active cancer within 12 months of randomization – Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month preceding the informed consent (excluding vitamins and minerals)

Gender Eligibility: All

Minimum Age: 50 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Hoffmann-La Roche
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Clinical Trials, Study Director, Hoffmann-La Roche

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.