Macular Degeneration Clinical Trial
Official title:
Systemic Bevacizumab (Avastin) Therapy for Exudative Neovascular Age-Related Macular Degeneration
Choroidal neovascularisation (CNV) in age-related macular degeneration is one of the major causes of blindness in the western world. It is already known that the vascular endothelial growth factor (VEGF) plays a major role in the development of CNV. Photodynamic therapy (PDT), subretinal surgery, and intravitreal injection of VEGF- inhibitors are the common treatments. These methods are either very invasive or need to be repeated several times over long periods of time in order show some effect. Furthermore PDT can only be performed in eyes with pigment epithelium detachments (PED) of maximum 50% of the avascular zone, while intravitreal injections can lead to endophthalmitis and acute glaucoma. A systemic treatment, which would only need to be administered 3 times within 6 weeks would be a major effort in macular degeneration therapy.
Bevacizumab (Avastin®, Genentech Inc.) is a new anti-vascular endothelial growth factor
(anti-VEGF) which has shown promising results as a combination therapy with 5-fluorouracil,
leucovorin, and oxaliplatin in first-line treatment of metastatic colorectal cancer14,15.
Since intraocular anti-VEGF therapies for CNV in AMD have already shown promising results,
the idea of this study is to administer the anti-VEGF bevacizumab intravenously, as a
systemic therapy, in AMD-patients.
The rationale of the present study is to determine the effect of systemic bevacizumab
therapy in patients with fibrovascular pigment epithelium detachment (PED), involving the
geometric center of the foveal avascular zone, in comparison to placebo treatment with
sodium chloride 0,9%.
The patients will receive 3 intravenous infusions of 5mg/kg bevacizumab at 2 weeks intervals
or 3 intravenous infusions of 100ml sodium chloride 0,9% at 2 weeks intervals. Medical
internal reviews, ETDRS and Radner visual acuity assessment, ophthalmologic examinations,
ocular imaging with OCT 3, multifocal ERG, fluorescein angiography, and indocyanine
angiography will be performed. The follow-up time is 6 months.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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