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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01996826
Other study ID # 13-113H
Secondary ID
Status Completed
Phase Phase 1/Phase 2
First received
Last updated
Start date April 2014
Est. completion date April 2019

Study information

Verified date August 2020
Source Massachusetts Eye and Ear Infirmary
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The goal of this study is to investigate whether using bevacizumab (Avastin®) is both safe and effective at decreasing the likelihood of a high-risk corneal graft rejection. Patients who are "high-risk" for rejection have blood vessels growing from the white of the eye into the cornea (clear, front region of the eye). The medication is used at the time of surgery and in the weeks following surgery. Participants have a 50/50 chance at receiving the active study medication or a placebo medication.


Description:

The purpose of this study is to test the effectiveness of a drug, bevacizumab (Avastin), in preventing blood vessels that often occur after a corneal transplantation which are considered at "high-risk" for rejection. In many cases these blood vessels lead to the graft rejection and eventual failure of the corneal transplant. It is hoped that this treatment will increase the chances of corneal graft survival.

The medication used in this study is called bevacizumab or Avastin (Genentech, Inc). It works by inhibiting the action of a molecule called vascular endothelial growth factor (VEGF). VEGF is a substance molecule that binds to certain cells to stimulate new blood vessel formation. When VEGF is bound to the drug, it cannot stimulate the formation and growth of new blood vessels. Growth of blood vessels into the cornea is a complication which can worsen the prognosis of your corneal transplant and put the transplant at a higher risk for rejection.


Recruitment information / eligibility

Status Completed
Enrollment 75
Est. completion date April 2019
Est. primary completion date April 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Age > 18 years

- Participant willing and able to provide written informed consent

- Willing and able to comply with study assessments for the full duration of the study

- High-risk characteristics for penetrating keratoplasty:

1. Presence of corneal NV in one or more quadrants (= 3 clock hours NV = 2mm from the limbus) OR

2. Extension of corneal NV to graft-host junction in a previous failed graft

- In generally good stable overall health

Exclusion Criteria:

- History of Stevens-Johnson syndrome or ocular pemphigoid

- Ocular or periocular malignancy

- Non-healing epithelial defect of at least 0.5x0.5 mm in host corneal bed lasting =6 weeks preoperatively

- Uncontrolled glaucoma

- Currently on dialysis

- Has received treatment with anti-VEGF agents (intraocular or systemic) within 45 days of study entry

- Concurrent use of systemic anti-VEGF agents

- Change in topical corticosteroid regimen within 14 days of transplantation

- Use of systemic immunosuppressive for indication other than corneal graft rejection

- Pregnancy (positive pregnancy test) or lactating

- Pre-menopausal women not using adequate contraception (Reliable intrauterine devices, hormonal contraception or a spermicide in combination with a barrier method)

- Uncontrolled hypertension defined as systolic blood pressure (BP) =150 or diastolic BP =90 mmHg

- History of thromboembolic event within 12 months prior to study entry

- Participation in another simultaneous medical investigation or trial

Study Design


Intervention

Drug:
Avastin® (bevacizumab)
One time subconjunctival injection of 0.1 mL (2.5 mg) bevacizumab followed by topical treatment with 1% solution bevacizumab four times a day for four weeks.
0.9% NaCl & Refresh Liquigel
One-time subconjunctival injection of 0.1mL 0.9% NaCl followed by topical treatment with Refresh Liquigel four times a day for four weeks.

Locations

Country Name City State
United States Massachusetts Eye and Ear Infirmary Boston Massachusetts
United States Bascom Palmer Eye Institute Miami Florida
United States New York Presbyterian Hospital New York New York

Sponsors (4)

Lead Sponsor Collaborator
Reza Dana, MD Bascom Palmer Eye Institute, New York Presbyterian Hospital, United States Department of Defense

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Endothelial Rejection Rate Endothelial rejection rates in patients in the treatment group and the control group were calculated using the Kaplan-Meier survival curve. The Kaplan-Meier/product limit estimator is a non-parametric statistical test used to show the probability of an event occurring at a given time interval. The Kaplan-Meier estimator is used to show what the probability of corneal transplant rejection (and therefore transplant survival) after administration of the active treatment or control. 12 Months
Primary Number of Participants Experiencing Ocular Adverse Events Incidence and severity of ocular adverse events during the study (based on ophthalmic examination and subject self-reporting). 12 months
Primary Incidence of Systemic Adverse Events Incidence and severity of systemic adverse events during the study (based on physical examination, subject self-reporting, and changes in vital sign). 12 Months
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