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Clinical Trial Details — Status: Withdrawn

Administrative data

NCT number NCT00676559
Other study ID # NA 00015499
Secondary ID
Status Withdrawn
Phase Phase 1
First received May 8, 2008
Last updated August 25, 2016
Start date April 2008
Est. completion date April 2010

Study information

Verified date August 2016
Source Johns Hopkins University
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

This study looks to continue the study of anti-vegf therapy in patients with macular edema, and compare it to an anti-inflammatory therapy and a combined Anti-vegf and anti-inflammatory.


Description:

Cell adhesion molecules are key mediators of inflammatory processes, which have been shown to play a role in the pathogenesis of diabetic retinopathy . Efalizumab inhibits the binding of leukocyte function-associated antigen-1 (LFA-1) to intercellular adhesion molecule-1 (ICAM-1) thereby inhibiting the adhesion of leukocytes to other cell types.

Clinical studies have demonstrated the bioactivities of intravitreal ranibizumab, a Vascular endothelial growth factor (VEGF) antagonist, in reducing retinal thickness and improving visual acuity in patients with diabetic macular edema (DME).

The objective of the CAPTURE Study is to assess the safety and tolerability of efalizumab, administered subcutaneously as a weekly (1 mg/kg) dose, compared to and in combination with ranibizumab, administered intravitreally (0.5 mg), in the treatment of DME.


Recruitment information / eligibility

Status Withdrawn
Enrollment 0
Est. completion date April 2010
Est. primary completion date April 2009
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Signed informed consent and authorization of use and disclosure of protected health information

- 18 years of Age

- Diagnosis of diabetes mellitus (type 1 or type 2)

- Serum HbA1c 5.5% within 12 months of randomization

- Retinal thickening (diabetic macular edema) involving the center of the fovea

- Diagnosis must be confirmed by fluorescein angiography and OCT images over 250

- Best corrected visual acuity score in the study eye of 20/40 to 20/320

- If a female of childbearing potential, a negative pregnancy test and commitment to the use of at least two forms of effective contraception.

- If a non-sterile male, commitment to the use of two forms of effective contraception.

- Demonstrate understanding of and ability to perform weekly self sub-cutaneous injections.

Exclusion Criteria:

- Panretinal or macular photocoagulation within 3 months of study entry in the study eye

- Use of intraocular or periocular injection of steroids in the study eye within 3 months of study entry

- Previous participation in a study and receipt of anti-angiogenic drugs (pegaptanib sodium, ranibizumab, bevacizumab, anecortave acetate, protein kinase C inhibitor, etc.) within 2 months of study entry

- Current or history of prior treatment of psoriasis with subcutaneous efalizumab within 6 months of study entry

- Proliferative diabetic retinopathy in the study eye, with the exceptions of

- inactive, fibrotic proliferative diabetic retinopathy that has regressed following pan-retinal laser photocoagulation OR

- tufts of neovascularization elsewhere (NVE) less than one disc area with no vitreous hemorrhage

- Vitreomacular traction or epiretinal membrane in the study eye

- Structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema.

- Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the first 6-months.

- Cataract surgery in the study eye within 3 months of study entry; (YAG) laser capsulotomy within 1 month of study entry; or any other intraocular surgery within 3 months preceding Day 0.

- History of vitreoretinal surgery in the study eye within 3 months of study entry

- Uncontrolled glaucoma .

- Blood pressure exceeding 180/100 (sitting) during the screening period

- Uncontrolled diabetes mellitus, as evidenced by glycosylated hemoglobin > or = 13%(HbA1c) value

- Renal failure requiring dialysis or renal transplant

- Premenopausal women unwilling to commit to adequate contraception

- History of other diseases or finding giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications

- International Normalized Ratio (INR) > or = 3.0 (e.g. due to current treatment with warfarin).

- History of cerebral vascular accident, myocardial infarction, transient ischemic attacks within 6 months of study enrollment.

- Have a history of hypersensitivity to efalizumab

- Have a history of ongoing uncontrolled serious bacterial, viral, fungal, or atypical mycobacterial infection. Have a history of opportunistic infections.

- Have the presence or history of malignancy, including lymphoproliferative disorders.

- Have a history of thrombocytopenia, clinically significant hemolytic anemia, or unexplained anemia

- Have a platelet count < 100,000 cells/microliter (uL)

- Inability to comply

- Patients receiving immunosuppressive agents

- All acellular, live and live-attenuated vaccines are excluded from 14 days prior to the first dose of efalizumab until a minimum of 4 weeks after the last dose of efalizumab

- Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated.

- Participation in another simultaneous medical investigation or trial

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
Efalizumab
Efalizumab 1 mg/kg weekly subcutaneous self-administered injections for 48 weeks.
Ranibizumab
Ranibizumab 0.5 mg intravitreal injections monthly for three months followed by criteria-guided monthly injections through Month 11 (inclusive).

Locations

Country Name City State
United States Texas Retina Associates Arlington Texas
United States Wilmer Eye Institute at the Johns Hopkins University Baltimore Maryland
United States Retina Associates of Maine Bangor Maine
United States Ophthalmic Consultants of Boston Boston Massachusetts
United States Eye Care Specialists Kingston Pennsylvania
United States University of Utah Salt Lake City Utah
United States Sharp Rees-Stealy Medical Group San Diego California
United States Retina Center of Maine South Portland Maine
United States Retina Macula Institute Torrance California
United States Diego H. Calonje, M.D., P.C. Tucson Arizona

Sponsors (3)

Lead Sponsor Collaborator
Johns Hopkins University Genentech, Inc., Juvenile Diabetes Research Foundation

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary To assess the safety and tolerability of efalizumab, compared to and in combination with ranibizumab, measuring the frequency and severity of adverse events. 6 mos Yes
Secondary To measure the mean change from Baseline to Month 6 and Month 12 in Best correct visual acuity (BCVA) 6 and 12 mos. No
Secondary To evaluate the anatomic retinal changes as assessed by color fundus photography, fluorescein angiography, and Optical Coherence Tomography (OCT) 6 mos and 12 mos Yes
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