randomized study for efficacy and safety of ranibizumab 0.5mg in treat-extend and monthly regimens in patients with namd

Conditions: Age-related Macular Degeneration; Choroidal Neovascularization

Summary: this study was designed to evaluate the efficacy and safety of two different regimens of 0.5 mg ranibizumab given as intravitreal injection in patients with neovascular age-related macular degeneration

this was a 12-month, phase iiib, randomized, visual acuity assessor-masked, multi-center, interventional study assessing the efficacy and safety of the ter vs monthly regimens of 0.5 mg ranibizumab intravitreal (ivt) injections in patients with newly diagnosed namd. patients will be randomized 1:1 into one of two treatment arms, treat and extend or monthly regimens. there will be 3 periods in this study: screening period (up to 14days), treatment period (11 months), follow-up period (1 month). at randomization visit patients will be randomized into one of the 2 treatment groups group i ranibizumab 0.5 mg based on monthly treatment or group ii ranibizumab 0.5 mg based on ter (randomization ratio of 1:1) and will receive the first dose of investigational treatment. patients in group i the following visits will perform on monthly intervals. for patients in group ii the investigator will evaluate disease activity (i.e., signs of exudation) based on sd-oct, and in case of absence of disease activity every next visit will be 2 weeks), with a maximum of a 12-week interval.

Eligibility criteria:
key inclusion criteria: * male or female patients, ≥50 years of age with signed informed consent before study procedures * visual impairment predominantly due to namd. * active cnv secondary to amd confirmed by presence of active leakage from cnv seen by fluorescein angiography (fa) and/or color fundus photography * presence of intra- or subretinal fluid/hemorrhage seen by sd-oct * bcva score must be ≤ 78 and ≥ 23 letters at 4 meters starting distance using early treatment diabetic retinopathy study (etdrs)-like visual acuity charts (approximate snellen equivalent of 20/32 and 20/320) key exclusion criteria: * any type of advanced, severe or unstable disease, including any medical condition (controlled or uncontrolled) that could be expected to progress, recur, or change to such an extent that it may bias the assessment of the clinical status of the patient to a significant degree or put the patient at special risk. * stroke or myocardial infarction within 3 months prior to screening. * any active periocular or ocular infection or inflammation in both eyes. * ocular disorders in the study eye at the time of enrollment that may confound interpretation of study results and compromise visual acuity. * presence of amblyopia or amaurosis in the fellow eye. * history of treatment with any anti-angiogenic drugs (including any anti- vascular endothelial growth factor (anti-vegf) agents) e.g., bevacizumab \[avastin®\], aflibercept \[eylea®\]) or vpdt in the study eye. * history of intravitreal treatment with corticosteroids within 6 months and history of intra-ocular surgery within 3 months in the study eye prior to the screening. * pregnant or nursing (lactating) women. women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using effective methods of contraception during dosing of study treatment.

Keywords: ranibizumab, lucentis, choroidal neovascularization, age-related macular degeneration, treat and extend regimen