Safety and Effectiveness Investigation for Dry, Non-Exudative Age Related Macular Degeneration (AMD) Using Rheopheresis

NCT ID: NCT00460967

Last Updated: 2007-11-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Clinical Phase

PHASE3

Total Enrollment

325 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2009-12-31

Brief Summary

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SUMMARY

Age-related macular degeneration (AMD) is the leading cause of late onset visual impairment and legal blindness in people 65 years of age or older in the United States. It is a heterogeneous clinical entity in which retinal degeneration occurs predominantly in the macula in the context of aging and leads to impairment primarily of central visual acuity. The degenerative retinal eye disease occurs in two forms - a non-exudative "dry" form and an exudative "wet" form which in an individual patient may also represent stages of the disease. Non-exudative AMD accounts for 80-90% of AMD cases and it involves a constellation of clinical features that can include drusen, pigment clumping and/or retinal pigment epithelium (RPE) dropout, and geographic atrophy. Because of the overwhelming numbers of "dry" AMD subjects, the cumulative impact of this vision loss is significant.

There is no effective therapy for maintaining or improving vision associated with dry AMD. The only therapy for persons with dry AMD is an oral supplement containing high doses of antioxidants and zinc, which was tested by the National Eye Institute in a large, multi-center, double-masked, sham-controlled clinical trial1. This antioxidant therapy was shown to modestly retard the progression of dry AMD from an intermediate stage to the advanced stages and confirmed the benefit of antioxidant therapy in this disease. There is currently no FDA-approved therapy for the treatment of subjects with dry AMD.

Recently, the MIRA-1 modified per protocol population showed the effectiveness of Rheopheresis which is an application of selective therapeutic apheresis, namely double filtration plasmapheresis (DFPP) using a specifically designed filter for plasma filtration in subjects with non-exudative AMD. At one year the study reported with statistical significance (1) approximately a one line vision improvement in the Rheopheresis group versus no change in the Sham group and (2) 28% of subjects randomized to the active treatment gaining at least one line vision versus only 9% of subjects randomized to the sham treatment.

With a total of 300 subjects with dry AMD and visual acuity of 20/40-20/100 inclusive, the current investigation plans to prove the effectiveness of the Rheopheresis treatment on a larger scale. Each subject will receive a series of 8 treatments (either active treatment or sham treatment in a 2:1 ratio) for a period of approximately 2.5 months. In addition, a post-treatment ophthalmic evaluation will be performed 2 weeks after the 8th treatment (approximately 3 months after the baseline visit) and at the 6, 9 and 12 month visits. Comparing the one-year proportions of at least a 10-letter gain in ETDRS LogMar BCVA from baseline, the current investigation will show the effectiveness of Rheopheresis treatment (compared to sham treatment) for treating dry AMD subjects. Other secondary effectiveness endpoints, including mean changes and proportions of BCVA better than 20/40 at one year, will be analyzed to support the main investigation.

Detailed Description

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Conditions

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Age-Related Maculopathy

Keywords

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non-Exudative (Dry) Age-Related Macular Degeneration

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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1

Rheopheresis treatment

Group Type EXPERIMENTAL

Rheopheresis

Intervention Type DEVICE

8 rheopheresis treatments over 10 wks.

2

Sham treatment

Group Type SHAM_COMPARATOR

Rheopheresis

Intervention Type DEVICE

Sham treatment

Interventions

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Rheopheresis

8 rheopheresis treatments over 10 wks.

Intervention Type DEVICE

Rheopheresis

Sham treatment

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Study eye must have a diagnosis of non-exudative, "Dry", AMD with equivalent drusen surface area of approximately 31,000 µm2 \[e.g. at least 10 soft, semi-soft intermediate size ≥63µm or at least 3 drusen size ≥125 µm within 3,000 µm of the fovea documented on macular exam, retinal angiography and fundus photographs as determined by the reading center. ETDRS BCVA of 20/40 - 20/100 inclusive

Exclusion Criteria

* Either eye with previous or active sub-retinal neovascularization (SRNV) or choroidal neovascularization (CNV)
* Pigment epithelial detachment (PED) within 500 µm of the fovea
* Either eye with a diagnosis of exudative (wet) AMD
* Subjects having undergone cataract surgery less than 3 months prior to enrollment without an open posterior capsule
* Uncontrolled hypertension and/or diabetes
* Subjects with prolonged PT/PTT (unless the subject is taking warfarin), hematocrit \<35%, evidence of active bleeding, platelet count \<100,000/ml
Minimum Eligible Age

50 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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OccuLogix

INDUSTRY

Sponsor Role lead

Principal Investigators

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Nozhat Choudry, PhD

Role: STUDY_DIRECTOR

OccuLogix, Inc.

Locations

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Retinal Consultants of Arizona

Phoenix, Arizona, United States

Site Status

Associated Retina Consultants, LTD.

Phoenix, Arizona, United States

Site Status

Mayo Clinic Hospital

Phoenix, Arizona, United States

Site Status

Mayo Clinic, Department of Ophthalmology

Scottsdale, Arizona, United States

Site Status

Southwest Kidney Institute, PLC, 2149 East Warner Rd. Ste. 109 & 110

Tempe, Arizona, United States

Site Status

Retina-Vitreous Associates Medical Group

Beverly Hills, California, United States

Site Status

Good Samaritan Hospital

Los Angeles, California, United States

Site Status

DSI

Brandon, Florida, United States

Site Status

Center for Retina and Macular Disease

Winter Haven, Florida, United States

Site Status

University of Illinois at Chicago

Chicago, Illinois, United States

Site Status

University of Illinois at Chicago

Chicago, Illinois, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

Retina Group of Washington

Chevy Chase, Maryland, United States

Site Status

Vitreo-Retinal Associates

Worcester, Massachusetts, United States

Site Status

University of Massachuesettes Medical Health Center

Worcester, Massachusetts, United States

Site Status

Retinovitreous Associates, Ltd.

Cherry Hill, New Jersey, United States

Site Status

Ophthalmic Consultants of Long Island

Lynbrook, New York, United States

Site Status

New York Blood Center

New York, New York, United States

Site Status

Macula Care

New York, New York, United States

Site Status

Vitreous Retina Macula Consultants

New York, New York, United States

Site Status

Columbia University

New York, New York, United States

Site Status

Retina Associates of Cleveland

Beachwood, Ohio, United States

Site Status

Cleveland Clinic Foundation, Cole Eye Institute

Cleveland, Ohio, United States

Site Status

The Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Retina Associates of Cleveland

Lakewood, Ohio, United States

Site Status

University of Pennsylvannia Medical Center

Philadelphia, Pennsylvania, United States

Site Status

Texas Retina Associates

Dallas, Texas, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

Memorial Hermann University of Texas Health Science Center

Houston, Texas, United States

Site Status

The Methodist Hospital System

Houston, Texas, United States

Site Status

Vitreoretinal Consultants

Houston, Texas, United States

Site Status

Fairfax Pathology Associates, Ltd.

Annadale, Virginia, United States

Site Status

Retina Group of Washington

Fairfax, Virginia, United States

Site Status

Capital Health Systems, Ophthalmology & Visual Sciences

Halifax, Nova Scotia, Canada

Site Status

Victoria General Hospital

Halifax, Nova Scotia, Canada

Site Status

eyeMD Institute

Brampton, Ontario, Canada

Site Status

Dr. Sapir

Oakville, Ontario, Canada

Site Status

Rheopheresis Center Cologne

Cologne, , Germany

Site Status

University of Cologne

Cologne, , Germany

Site Status

Countries

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United States Canada Germany

Other Identifiers

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RHEO-AMD 01-06

Identifier Type: -

Identifier Source: org_study_id