A Randomized, Multi-center, Phase II Study of the Safety, Tolerability and Bioactivity of Repeated Intravitreal Injections of iCo-007 as Monotherapy or in Combination With Ranibizumab or Laser Photocoagulation in the Treatment of Diabetic Macular Edema (the iDEAL Study)

Diabetic Macular Edema Clinical Trial

— iDEAL  

Official title:

A Randomized, Multi-center, Phase II Study of the Safety, Tolerability, and Bioactivity of Repeated Intravitreal Injections of iCo-007 as Monotherapy or in Combination With Ranibizumab or Laser Photocoagulation in the Treatment of Diabetic Macular Edema With Involvement of the FoveAL Center (the iDEAL Study)

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01565148
• Other study ID #: 2010-007-03-DME
• Status: Active, not recruiting
• Phase: Phase 2
• First received: March 15, 2012
• Last updated: June 24, 2013
• Start date: February 2012
• Est. completion date: December 2013

Study information

• Verified date: June 2013
• 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

• To assess the safety of repeated iCo-007 intravitreal injections in treatment of subjects with diabetic macular edema as monotherapy and in combination with ranibizumab or laser photocoagulation

• To assess the change in visual acuity and retinal thickness on OCT from baseline to month 8 and month 12

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 208
• Est. completion date: December 2013
• Est. primary completion date: September 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age =18 years

• Have diabetes mellitus type I or II (insulin or non-insulin dependent) with HbA1c =5.5% and HbA1c =13%; have non-proliferative diabetic retinopathy, or inactive proliferative diabetic retinopathy, or proliferative diabetic retinopathy with a reasonable expectation that panretinal photocoagulation will not be required during the study follow-up period

• Have diabetic macular edema with central subfield thickness of =250 microns (confirmed by Stratus TD OCT

• Have best corrected visual acuity (ETDRS) that is Snellen equivalent of

• 20/32 and =20/320, inclusive

• Be willing and able to sign an approved written informed consent. If a patient has a central nervous system disorder (i.e. dementia) that will not allow him/her to understand the consent independently, the patient will not be allowed to join the study

• Be able to attend all scheduled study visits

• Women who are not lactating or pregnant and are willing to use adequate contraception during the study period, if appropriate

Exclusion Criteria:

• Have macular or perimacular edema secondary to an etiology other than diabetes

• Have concurrent retinal diseases other than diabetic retinopathy

• Have additional ocular diseases compromising visual acuity and/or interfering with study assessments; patients who have glaucoma but deemed stable (intraocular pressure = 25 mmHg at screening) on medications or status post surgery, may participate in the study

• Participant has a history of prior pars plana vitrectomy

• Subjects with significant cataract or or posterior capsular opacification that may need intervention within one year or vitreous opacity that hinder study assessment (i.e.fundus examination) which requires intervention within a year

• Subjects who have DME with severe capillary non-perfusion (avascular zone diameter >1,000 microns)

• Have an allergy to fluorescein dye

• Have terminal renal disease (on active kidney dialysis), cerebral vascular accident(including TIA), myocardial infarction or congestive heart disease within 6 months of study enrollment, liver damage (2x upper limit of normal range for AST, ALT or total bilirubin). Patients who may have received renal transplant in the past and now have stable renal function, may participate in the study

• Subjects with systolic blood pressure higher than 180 mm Hg or diastolic above 100 mm Hg, with or without anti-hypertensive treatment

• Have a history of panretinal photocoagulation (PRP) in the study eye within 3 months of study entry or are likely to have PRP in the study eye during study participation

• Had macular photocoagulation or ocular surgery within 3 months of study entry in the study eye

• Received intraocular or periocular injection of steroids in the study eye (e.g., triamcinolone) within 3 months of study entry or anti-angiogenic drugs (pegaptanib sodium, ranibizumab, bevacizumab, VEGF-TRAP, protein kinase C inhibitor, etc.) within 2 months of study entry; history of usage of topical or systemic steroids within 3 months of study entry is not an exclusion

Study Design

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

Related Conditions & MeSH terms

• Diabetic Macular Edema
• Edema
• Macular Edema

Intervention

Drug:
• iCo-007 350 mcg
iCo-007 (350 µg) as an intravitreal injection at baseline followed by another iCo-007 dose (350 µg) at month 4
• iCo-007 700 mcg
iCo-007 (700 µg) as an intravitreal injection at baseline followed by another iCo-007 dose (700 µg) at month 4
• iCo-007 350 mcg Plus Laser
iCo-007 (350 µg) as an intravitreal injection at baseline followed 7 days later by laser photocoagulation. At M4, intravitreal injection of iCo-007 (350 µg) will be given as mandatory treatment. If the eye also meets retreatment criteria, it will also receive the second laser photocoagulation
• Ranibizumab Plus iCo-007 350 mcg
Ranibizumab (0.5 mg) intravitreal injection at baseline followed by iCo-007 (350 µg) intravitreal injection 2 weeks later; re-treatment with ranibizumab (0.5 mg) mandatory at M4 followed by iCo-007 (350 µg) 2 weeks later

Locations

Country	Name	City	State
United States	Stanley M Truhlsen Eye Institute	Omaha	Nebraska

Sponsors (3)

Lead Sponsor	Collaborator
Quan Dong Nguyen	iCo Therapeutics Inc., Juvenile Diabetes Research Foundation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in VA from baseline to month 8	The primary efficacy variable is the change in visual acuity (mean change in number of letters) from baseline to month 8	Baseline to month 8	No
Secondary	Number of participants in a given study arm experiencing the same drug-related serious adverse event as a measure of safety and tolerability	Safety of repeated iCo-007 intravitreal injections in treatment of subjects with DME as monotherapy and in combination with ranibizumab or laser photocoagulation. Serious consideration will be given if 2 or more patients in a particular treatment arm experience the same drug-related serious adverse event;	Baseline to month 12	Yes
Secondary	Change in VA from baseline to month 12		Baseline to month 12	No
Secondary	Change in retinal thickness measured by OCT from baseline to month 8		Baseline to month 8	No
Secondary	Change in retinal thickness measured by OCT from baseline to month 12		Baseline to month 12	No
Secondary	Duration of iCo-007 treatment effect during the 12 month follow-up period as measured by VA and OCt thickness		Baseline to month 12	No
Secondary	Peak plasma concentration (Cmax)of iCo-007 after multiple injections		Baseline to month 12	No