Ranibizumab for Neovascularization in Sickle Cell Retinopathy

NCT ID: NCT00618644

Last Updated: 2012-09-27

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2011-06-30

Brief Summary

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The purpose of this study is to determine the ocular and non-ocular safety of a single dose of ranibizumab in treating neovascularization secondary to sickle cell retinopathy.

Detailed Description

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In the U.S., about 10% of African Americans have an abnormal hemoglobin gene. About 8% of African Americans are heterozygous for Hemoglobin S. In the United States, sickle cell anemia primarily occurs in the black population, with approximately 0.2% of African American children afflicted by this disease. It may be associated with other hemoglobinopathies as well. The prevalence in adults is lower because of the decrease in life expectancy. Systemically, the sickle cell anemia variation (SS) produces the most symptoms. With respect to the eye, the sickle cell disease mutation (SC) produces the most effects. Overall, the sickle cell trait expression (AS) produces the fewest complications.

* Among patients with SC or SThal, the incidence of proliferation sickle cell retinopathy is 33% and 14% respectively.
* Proliferative sickle cell retinopathy is the major cause of vision loss in sickle cell disease.

For sickle cell retinopathy, the commonly used therapeutic modalities include laser retinal photocoagulation, retinal cryotherapy, and vitrectomy/membranectomy depending on the severity of the disease. The most effective therapeutic modality with minimal postoperative complications appears to be scatter laser retinal photocoagulation.

A single case study of bevacizumab was found to effective in short term regression of neovascularization and improving vision after a single injection. Further study with ranibizumab is warranted.

Recent clinical trials (Marina and Anchor) have demonstrated that ranibizumab is effective in treating patients with CNV with age-related macular degeneration. Retinopathy in sickle cell disease has also been linked to VEGF. Therefore, patients with sickle cell retinopathy should respond to ranibizumab therapy.

This is an open-label single dose, phase I study of intravitreally administered ranibizumab in patients with sickle cell retinopathy.

Consented, enrolled subjects will receive a single open-label intravitreal injection of 0.5 mg ranibizumab.

Three subjects from one site in the United States will be enrolled.

Patients will receive one dose of 0.5 mg ranibizumab administered intravitreally.

Conditions

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Sickle Cell Anemia Retinopathy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1

Ranibizumab injection

Group Type EXPERIMENTAL

Ranibizumab

Intervention Type DRUG

Ranibizumab 0.5 mg intravitreal injection

Interventions

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Ranibizumab

Ranibizumab 0.5 mg intravitreal injection

Intervention Type DRUG

Other Intervention Names

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Lucentis (ranibizumab)

Eligibility Criteria

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Inclusion Criteria

* Patients with sickle cell anemia and retinopathy
* Over age 18 years
* Non-pregnant

Exclusion Criteria

* Pregnant
* Glaucoma
* Patients using anticoagulants (e.g., warfarin)
* Retinal detachment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wayne State University

OTHER

Sponsor Role collaborator

Genentech, Inc.

INDUSTRY

Sponsor Role collaborator

Kresge Eye Institute

OTHER

Sponsor Role lead

Responsible Party

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Kresge Eye Institute

Principal Investigators

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Vinay Shah, MD

Role: PRINCIPAL_INVESTIGATOR

Kresge Eye Institute

Locations

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Kresge Eye Institute

Detroit, Michigan, United States

Site Status

Countries

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United States

References

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Al-Abdulla NA, Haddock TA, Kerrison JB, Goldberg MF. Sickle cell disease presenting with extensive peri-macular arteriolar occlusions in a nine-year-old boy. Am J Ophthalmol. 2001 Feb;131(2):275-6. doi: 10.1016/s0002-9394(00)00778-9.

Reference Type BACKGROUND
PMID: 11228315 (View on PubMed)

McLeod DS, Merges C, Fukushima A, Goldberg MF, Lutty GA. Histopathologic features of neovascularization in sickle cell retinopathy. Am J Ophthalmol. 1997 Oct;124(4):455-72. doi: 10.1016/s0002-9394(14)70862-1.

Reference Type BACKGROUND
PMID: 9323937 (View on PubMed)

Witkin AJ, Rogers AH, Ko TH, Fujimoto JG, Schuman JS, Duker JS. Optical coherence tomography demonstration of macular infarction in sickle cell retinopathy. Arch Ophthalmol. 2006 May;124(5):746-7. doi: 10.1001/archopht.124.5.746. No abstract available.

Reference Type BACKGROUND
PMID: 16682603 (View on PubMed)

Chalam KV, Shah VA. Macular infarction a presentation of sickle cell crisis. Eye (Lond). 2004 Dec;18(12):1277-8. doi: 10.1038/sj.eye.6701409. No abstract available.

Reference Type BACKGROUND
PMID: 15105819 (View on PubMed)

Avery RL. Regression of retinal and iris neovascularization after intravitreal bevacizumab (Avastin) treatment. Retina. 2006 Mar;26(3):352-4. doi: 10.1097/00006982-200603000-00016. No abstract available.

Reference Type BACKGROUND
PMID: 16508438 (View on PubMed)

Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY; MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1419-31. doi: 10.1056/NEJMoa054481.

Reference Type BACKGROUND
PMID: 17021318 (View on PubMed)

Siqueira RC, Costa RA, Scott IU, Cintra LP, Jorge R. Intravitreal bevacizumab (Avastin) injection associated with regression of retinal neovascularization caused by sickle cell retinopathy. Acta Ophthalmol Scand. 2006 Dec;84(6):834-5. doi: 10.1111/j.1600-0420.2006.00779.x. No abstract available.

Reference Type BACKGROUND
PMID: 17083555 (View on PubMed)

Other Identifiers

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FVF4232s

Identifier Type: -

Identifier Source: secondary_id

08-08

Identifier Type: -

Identifier Source: org_study_id