Efficacy/Safety of Verteporfin Photodynamic Therapy and Ranibizumab Compared With Ranibizumab in Patients With Subfoveal Choroidal Neovascularization

NCT ID: NCT00436553

Last Updated: 2011-04-19

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

321 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-02-28

Study Completion Date

2009-10-31

Brief Summary

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This study evaluated the effect of combination therapy with verteporfin photodynamic therapy and ranibizumab on visual acuity and anatomic outcomes compared to ranibizumab monotherapy and the durability of response observed in patients with choroidal neovascularization secondary to age-related macular degeneration.

Detailed Description

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Conditions

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Macular Degeneration Choroidal Neovascularization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Verteporfin With Standard Fluence Rate Plus Ranibizumab

Patients received three consecutive monthly ranibizumab injections on Day 1 and at Months 1 and 2, and thereafter as needed at intervals of at least 30 days based on retreatment criteria. These patients also received verteporfin photodynamic therapy (PDT) with standard fluence (SF) rate on Day 1 and then as needed from Month 3 at intervals of at least 90 days based on the retreatment criteria. From month 3 onward, retreatments were determined based on study-specific retreatment criteria that included retinal thickness by Optical Coherence Tomography (OCT), sub-retinal hemorrhage evaluated by ophthalmoscopic examination, visual acuity assessed using Early treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart and choroidal neovascularization (CNV) leakage assessed by fluorescein angiography (FA). Patients received sham intravitreal injections for the first 12 months if retreatment with ranibizumab was not warranted based on the retreatment criteria.

Group Type EXPERIMENTAL

Verteporfin Photodynamic Therapy

Intervention Type DRUG

After a 10-minute intravenous infusion of verteporfin at a dose of 6 mg/m\^2 body surface area, verteporfin was activated by light application of 50 J/cm\^2 (Standard Fluence rate) or 25 J/cm\^2 (Reduced Fluence rate) to the study eye, begun 15 minutes after the start of the infusion.

Ranibizumab

Intervention Type DRUG

Ranibizumab 0.5 mg administered as an intravitreal injection.

Ranibizumab Placebo

Intervention Type DRUG

To maintain masking, patients in the combination groups received sham intravitreal injections whenever retreatment with active Ranibizumab was not warranted based on the retreatment algorithm.

Ranibizumab Monotherapy

Patients received monthly ranibizumab injections for 12 months and thereafter as needed based on the retreatment criteria. These patients were also administered verteporfin placebo infusion with sham PDT on Day 1 and then as needed from Month 3 at intervals of at least 90 days based on the retreatment criteria. Retreatments were determined based on study specific retreatment criteria that included retinal thickness by Optical Coherence Tomography (OCT), sub-retinal hemorrhage evaluated by ophthalmoscopic examination, visual acuity assessed using Early treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart and choroidal neovascularization (CNV) leakage assessed by fluorescein angiography (FA).

Group Type ACTIVE_COMPARATOR

Ranibizumab

Intervention Type DRUG

Ranibizumab 0.5 mg administered as an intravitreal injection.

Verteporfin Placebo

Intervention Type DRUG

To maintain masking, as a placebo for verteporfin photodynamic therapy, patients were administered a 10-minute intravenous infusion of 5% dextrose solution, followed by light application of 50 J/cm\^2 to the study eye, begun 15 minutes after the start of infusion.

Verteporfin With Reduced Fluence Rate Plus Ranibizumab

Patients received three consecutive monthly ranibizumab injections on Day 1 and at Months 1 and 2, and thereafter as needed at intervals of at least 30 days based on retreatment criteria. These patients also received verteporfin PDT with reduced fluence (RF) rate on Day 1 and then as needed from Month 3 at intervals of at least 90 days based on the retreatment criteria. From month 3 onward, retreatments were determined based on study-specific retreatment criteria that included retinal thickness by Optical Coherence Tomography (OCT), sub-retinal hemorrhage evaluated by ophthalmoscopic examination, visual acuity assessed using Early treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart and choroidal neovascularization (CNV) leakage assessed by fluorescein angiography (FA). Patients received sham intravitreal injections for the first 12 months if retreatment with ranibizumab was not warranted based on the retreatment criteria.

Group Type EXPERIMENTAL

Verteporfin Photodynamic Therapy

Intervention Type DRUG

After a 10-minute intravenous infusion of verteporfin at a dose of 6 mg/m\^2 body surface area, verteporfin was activated by light application of 50 J/cm\^2 (Standard Fluence rate) or 25 J/cm\^2 (Reduced Fluence rate) to the study eye, begun 15 minutes after the start of the infusion.

Ranibizumab

Intervention Type DRUG

Ranibizumab 0.5 mg administered as an intravitreal injection.

Ranibizumab Placebo

Intervention Type DRUG

To maintain masking, patients in the combination groups received sham intravitreal injections whenever retreatment with active Ranibizumab was not warranted based on the retreatment algorithm.

Interventions

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Verteporfin Photodynamic Therapy

After a 10-minute intravenous infusion of verteporfin at a dose of 6 mg/m\^2 body surface area, verteporfin was activated by light application of 50 J/cm\^2 (Standard Fluence rate) or 25 J/cm\^2 (Reduced Fluence rate) to the study eye, begun 15 minutes after the start of the infusion.

Intervention Type DRUG

Ranibizumab

Ranibizumab 0.5 mg administered as an intravitreal injection.

Intervention Type DRUG

Verteporfin Placebo

To maintain masking, as a placebo for verteporfin photodynamic therapy, patients were administered a 10-minute intravenous infusion of 5% dextrose solution, followed by light application of 50 J/cm\^2 to the study eye, begun 15 minutes after the start of infusion.

Intervention Type DRUG

Ranibizumab Placebo

To maintain masking, patients in the combination groups received sham intravitreal injections whenever retreatment with active Ranibizumab was not warranted based on the retreatment algorithm.

Intervention Type DRUG

Other Intervention Names

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Visudyne Lucentis

Eligibility Criteria

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Inclusion Criteria

* Subjects of either gender age 50 years or older
* Subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD)

Exclusion Criteria

* Choroidal neovascularization due to causes other than AMD
* Prior treatment for neovascular AMD in the study eye
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novartis

INDUSTRY

Sponsor Role lead

Responsible Party

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Novartis

Principal Investigators

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Novartis

Role: STUDY_CHAIR

Novartis

Locations

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Novartis Investigative Site

Tucson, Arizona, United States

Site Status

Novartis Investigative Site

Beverly Hills, California, United States

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Novartis Investigative Site

Oakland, California, United States

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Novartis Investigative Site

Pasadena, California, United States

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Novartis Investigative Site

Sacramento, California, United States

Site Status

West Coast Retina Medical Group Inc. - 185 Berry St. Suite 130

San Francisco, California, United States

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Novartis Investigative Site

Santa Ana, California, United States

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Novartis Investigative Site

Denver, Colorado, United States

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Novartis Investigative Site

‘Aiea, Hawaii, United States

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Novartis Investigative Site

Iowa City, Iowa, United States

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Novartis Investigative Site

Wichita, Kansas, United States

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Novartis Investigative Site

Lexington, Kentucky, United States

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Novartis Investigative Site

Paducah, Kentucky, United States

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Novartis Investigative Site

Baltimore, Maryland, United States

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Novartis Investigative Site

Grand Rapids, Michigan, United States

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Novartis Investigative SIte

Royal Oak, Michigan, United States

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Novartis Investigative Site

Williamsburg, Michigan, United States

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Novartis Investigative Site

Independence, Missouri, United States

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Novartis Investigative Site

St Louis, Missouri, United States

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Novartis Investigative Site

Toms River, New Jersey, United States

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Novartis Investigative Site

Lynbrook, New York, United States

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Novartis Investigative Site

Rochester, New York, United States

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Novartis Investigative Site

Beachwood, Ohio, United States

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Novartis Investigative Site

Cincinnati, Ohio, United States

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Novartis Investigative Site

Cleveland, Ohio, United States

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Novartis Investigative Site

Pittsburgh, Pennsylvania, United States

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Novartis Investigative Site

West Mifflin, Pennsylvania, United States

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Novartis Investigative Site

West Columbia, South Carolina, United States

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Novartis Investigative Site

Rapid City, South Dakota, United States

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Novartis Investigative Site

Kingsport, Tennessee, United States

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Novartis Investigative Site

Knoxville, Tennessee, United States

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Novartis Investigative Site

Austin, Texas, United States

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Novartis Investigative Site

Houston, Texas, United States

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Novartis Investigative Site

Fairfax, Virginia, United States

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Novartis Investigative Site

Richmond, Virginia, United States

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Novartis Investigative Site

Milwaukee, Wisconsin, United States

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Novartis Investigative Site

Edmonton, Alberta, Canada

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Novartis Investigative Site

Vancouver, British Columbia, Canada

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Novartis Investigative Site

Halifax, Nova Scotia, Canada

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Ivey Eye Institute, Dr. Thomas Sheidow

London, Ontario, Canada

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Novartis Investigative Site

London, Ontario, Canada

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Novartis Investigative Site

Ottawa, Ontario, Canada

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Novartis Investigative Site

Montreal, Quebec, Canada

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Countries

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United States Canada

References

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Kaiser PK, Boyer DS, Cruess AF, Slakter JS, Pilz S, Weisberger A; DENALI Study Group. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month results of the DENALI study. Ophthalmology. 2012 May;119(5):1001-10. doi: 10.1016/j.ophtha.2012.02.003. Epub 2012 Mar 22.

Reference Type DERIVED
PMID: 22444829 (View on PubMed)

Other Identifiers

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CBPD952A2308

Identifier Type: -

Identifier Source: org_study_id

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