Trial Condition(s):

新生血管(湿性)年龄相关性黄斑变性

A study to learn how well aflibercept injected into the eye works and how safe it is when given in customized treatment intervals in patients with an eye disease called neovascular age-related macular degeneration after start of treatment (XPAND)

Bayer Identifier:

21912

ClinicalTrials.gov Identifier:

NCT05473715

EudraCT Number:

2022-000690-73

EU CT Number:

Not Available

终止/撤回

试验目的

研究人员正在寻找一种更好的方法来治疗患有新生血管(湿性)年龄相关性黄斑变性(nAMD 或湿性 AMD)的患者。在患有湿性 AMD 的人中,身体会产生过多名为血管内皮生长因子 (VEGF) 的蛋白质。这会导致过多的血管在眼睛中视力最敏锐的部位(称为黄斑)生长。由于这些血管渗漏导致的液体积聚会损坏黄斑,导致视力问题,例如阅读或识别面部或驾驶汽车所需的中心(正前方)视力模糊或盲点。湿性 AMD 在 50 岁及以上的人中十分常见。

研究药物玻璃体内阿柏西普(也称为 BAY865321)被注射到眼睛中。它通过阻断 VEGF 蛋白,从而减少血管生长发挥作用。它已经被批准用于湿性 AMD 患者,最初每月一次玻璃体内注射,然后每 8 周或更长时间一次。反复注射阿柏西普可防止视力恶化,但会给患者带来负担。

在常规临床实践中,医生会根据患者的个体需求尝试延长两次注射之间的时间(治疗间隔)。这称为治疗和延长 (T&E)。根据治疗效果,治疗间隔会逐步延长或缩短。这通过光学相干断层扫描 (OCT) 进行检查,OCT 是一种用于观察眼睛相关变化的成像技术。

本研究的主要目的是了解如果治疗间隔加快延长(两个治疗组的延长时间点相同),与治疗开始后没有液体的湿性 AMD 预选患者群体的常规 T&E 方案相比,阿柏西普的效果如何。
为回答这个问题,研究人员将评估研究开始和 36 周后称为最佳矫正视力 (BCVA) 的视力变化。然后将比较提前延长治疗间隔的参与者和采用常规 T&E 方案的参与者之间的变化。
所有参与者将接受 2 毫克阿柏西普玻璃体内注射,最多 52 周,间隔为每 4 至 16 周一次。
每位参与者将参与研究长达 56 周。在此期间,为所有参与者设定了 4 次对研究中心访视。其他访视单独设定。计划在研究治疗结束后 3 天进行最后一次通话。

在研究期间,医生及研究团队将:
•    check patients’ eye health using various eye examination techniques (slit lamp microscopy, OCT, and ophthalmoscopy) that may necessitate eye drops to widen the pupil)
•    measure patients’ eye vision (BCVA)
•    do physical examinations
•    check vital signs
•    ask the participants questions about how they are feeling and what adverse events they are having.

不良事件是参与者在研究期间遇到的任何医疗问题。医生会跟踪研究中发生的所有不良事件,即使他们认为不良事件可能与研究治疗药物无关。
此外,快速延长小组的参与者将获得一台家庭监控 OCT 设备。

入选标准
- Written informed consent and able to read (or if unable to read due to visual impairment, be read to verbatim by the person administering the informed consent or a family member), understand, and willing to sign the informed consent form (ICF).
- Men and women ≥50 years of age.
- At treatment initiation, active macular neovascular lesions secondary to nAMD (Patients with polypoidal choroidal vasculopathy or retinal angiomatous proliferation are eligible to participate in the study, and their condition should be captured in the electronic case report form [eCRF]).
- Treatment initiation with 3 × monthly IVT aflibercept injections (Weeks -16, -12, and -8 to planned study baseline visit) resulting in absence of any fluid at week -8.
- ETDRS BCVA of at least 25 letters (20/320 Snellen equivalent) in the study eye at screening visit.
- Willing, committed, and able to return for all clinic visits and complete all study-related procedures.
- Able to use the provided monitoring device and willing to perform 5 × weekly self-assessments in the Investigator’s opinion.
- Women and men of reproductive potential must agree to use adequate contraception when sexually active. This applies for the time period between signing of the ICF and 3 months after the last administration of study drug.
排除标准
- Any contraindication to IVT anti-vascular endothelial growth factor (VEGF) treatment or treatment with Eylea® as detailed in the Summary of Product Characteristics (SmPC).
- Any prior ocular (in the study eye) or systemic treatment (including investigational agents) or surgery for nAMD, except the 3 × monthly IVT aflibercept injections required for treatment initiation and dietary supplements or vitamins.
- Any presence of intraretinal and subretinal fluid.
- Any ocular or systemic condition expected to interfere with study outcomes and procedures, including but not limited to:
-- Scar, fibrosis or other lesions (e.g., retinal pigment epithelium [RPE] tears, macular hole stage 2 or above and others) involving the center of the macula in the study eye.
-- Clinically relevant opacities or conditions involving the optic media including cataract, corneal dystrophies or s.p. corneal transplant in the study eye.
-- Uncontrolled glaucoma (defined as IOP ≥25 mm Hg despite treatment with antiglaucoma medication) in the study eye or prior trabeculectomy or other filtration surgery in the study eye.
-- Intraocular surgery, periocular surgery, or cataract surgery within 90 days before Day 1 in the study eye, except the IVT aflibercept injections required for treatment initiation and any history of vitrectomy, retinal radiation therapy, retinal detachment or treatment or surgery for retinal detachment in the study eye.
-- Aphakia or pseudophakia with absence of posterior capsule (unless as a result of an yttrium aluminum garnet posterior capsulotomy) in the study eye.
- Participation as a patient in any clinical study within 12 weeks before screening.
- Close affiliation with the investigational site; e.g., a close relative of the Investigator, dependent person (e.g., employee or student of the investigational site).
- Previously screen failed patients for this study.

试验总结

Enrollment Goal
3
Trial Dates
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Phase
4
是否有安慰剂?
Products
Eylea(阿柏西普,VEGF Trap-Eye,BAY86-5321)
Accepts Healthy Volunteers

在哪里参加

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Bristol Eye Hospital

Bristol, United Kingdom, BS12LX

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GOGiunta ophtalmologie

Sherbrooke, Canada, J1J 2B8

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Retina Center of Ottawa

Ottawa, Canada, K2B7E9

试验设计