Clinical trial NCT04976244: Brolucizumab for CNV Associated With Pathologic Myopia
Official title: Collaborative Ocular Antiangiogenic Study of Ukraine. Multicentral, Open-label, Randomized, Prospective Study of Antiangiogenic Therapy of Choroidal Neovascularisation Associated With Pathologic Myopia
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Pathologic Myopia
Keywords: fundus diseases
antiangiogenic therapy
choroidal neovascularization
pathologyc myopia
intravitreal injection
anti-VEGF
brolucizumab
aflibercept
Lead sponsor: The Filatov Institute of Eye Diseases and Tissue Therapy
Sponsor class: OTHER
Collaborators: name: Odessa National Medical University
name: Mykolaiv Region Ophthalmogical Hospital
name: Central Polyclinic of Internal Affairs of Ukraine
name: Lesya Ukrainka Volyn National University
First posted: 2021-07-26
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.

Detailed description: The purpose of this study is to determine the effectiveness of antiangiogenic therapy to choroidal neovascularization secondary to pathologic myopia.

This study is planned as a randomized, multicenter, open-label, comperative, interventional. Patients with myopia included in it will receive brolucizumab or aflibercept.

The treatment proposed in this study is based on the world experience and scientific developments of the Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine". Therefore, it is expected that the benefit/risk ratio in relation to the participation in this study should not be different from that described in the scientific literature and the benefits outweigh the risk. It is known that the absence of treatment in these diseases leads to an irreparable loss of central vision.

Patients with a pathologic myopia with CNV (native) will be treated with antiangiogenic drugs according to the regimen pro re nata.

Eligibility criteria: Inclusion Criteria:

* Able to read (or, if unable to read due to visual impairment, be read to verbatim by the person administering the informed consent form or a family member) and understand the informed consent form and willing to sign the informed consent form.
* Signed informed consent form.
* Men and women ≥ 18 years of age.
* Willing, committed, and able to return for all clinic visits and complete all study-related procedures.
* Myopia of greater than or equal to -6 D OR axial length of greater than (if the spherical myopic equivalent is \<6.0 diopters, then the patient should have myopic changes in the macula: lacquer cracks, focal chorioretinal atrophy, posterior staphyloma) or equal to 26.5 mm.
* Active subfoveal or juxtafoveal (within 1 to 199 μm of the center of the fovea) CNV secondary to pathologic myopia as defined by leakage on FA.
* Transparent optical media and possibility to mydriasis.
* Best corrected visual acuity at least 20/200 Equivalent of Snellen (ETDRS).

Exclusion Criteria:

* Ocular media of insufficient quality to obtain fundus and OCT images in the study eye
* Recurrent mCNV in the study eye
* History or presence of CNV with an origin other than pathologic myopia in the study eye
* Ocular inflammation or external ocular inflammation in the study eye
* Concurrent disease in the study eye that would compromise BCVA or require medical or surgical intervention during the study period
* Any ocular disorder in the study eye that, in the opinion of the investigator, may confound interpretation of the study results
* Significant scarring or atrophy in the fovea that indicates substantial irreversible vision loss in the study eye
* History of idiopathic or autoimmune-associated uveitis in either eye
* Evidence at examination of infectious blepharitis, keratitis, scleritis, or conjunctivitis in either eye or current treatment for serious systemic infection
* Vitreomacular traction or traction retinal detachment, epiretinal membrane in either eye
* Any iris neovascularization and/or vitreous hemorrhage in either eye
* Uncontrolled glaucoma, or previous filtration surgery in either eye
* Prior and concomitant treatments
* Any prior or concomitant treatment with another investigational agent for mCNV in the study eye.
* Any previous panretinal photocoagulation or subfoveal thermal laser therapy in the study eye.
* Any prior treatment with photodynamic therapy in the study eye.
* Cataract surgery within 3 months prior to Day 1 in the study eye.
* Yttrium-aluminum-garnet laser capsulotomy within 2 months prior to Day 1 in the study eye.
* Any other intraocular surgery within 3 months prior to Day 1 in the study eye.
* History of vitreoretinal surgery and/or scleral buckle surgery in the study eye.
* Any prior treatment with anti-VEGF agents
* Previous use of intraocular or periocular corticosteroids in either eye within 3 months prior to Day 1
* Previous assignment to treatment during this study
* Uncontrolled hypertension
* History of cerebrovascular disease or myocardial infarction within 6 months prior to Baseline/Day 1
* History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, may affect interpretation of the results of the study, or renders the subject at high risk from treatment complications
* Women of childbearing potential without contraception, women who intend to breastfeed during the study. All subjects (both men and women) of childbearing potential who are unwilling to use adequate birth control measures during the course of the study.
* Renal failure requiring dialysis or renal transplant
* Participation in an investigational study within 30 days prior to Screening/Visit 1 that involved treatment with any drug (excluding vitamins and minerals) or device
* Known serious allergy to the fluorescein sodium for injection in angiography or Verteporfin
* Inability to obtain fundus photographs or fluorescein angiograms of sufficient quality

Primary outcomes:
measure: Mean Change in Best Corrected Visual Acuity (BCVA) as Measured by ETDRS Chart
timeFrame: Baseline-Month 12
Secondary outcomes:
measure: Mean Change in Central Retinal Thickness (CRT) as Assessed by Optical Coherence Tomography (OCT)
timeFrame: Baseline-Month 12
measure: Average Number of Intravitreal Injections
timeFrame: Baseline-Month 12
measure: Number of Inflamations after Intravitreal Injections
timeFrame: Baseline-Month 12
Other outcomes:
Locations:
city: Lutsk
country: Ukraine
facility: Lesya Ukrainka Volyn National University
city: Mykolaiv
country: Ukraine
facility: Mykolaiv Region Ophthalmogical Hospital
city: Odesa
country: Ukraine
facility: Odessa National Medical University
city: Odesa
country: Ukraine
facility: The Filatov Institute of Eye Diseases and Tissue Therapy
Study officials:
affiliation: The Filatov Institute of Eye Diseases and Tissue Therapy
name: Andrii MD Korol, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Korol AR, Zadorozhnyy OS, Naumenko VO, Kustryn TB, Pasyechnikova NV. Intravitreal aflibercept for the treatment of choroidal neovascularization associated with pathologic myopia: a pilot study. Clin Ophthalmol. 2016 Nov 4;10:2223-2229. doi: 10.2147/OPTH.S117791. eCollection 2016.