Trial Outcomes & Findings for Comparative Effectiveness Study of Intravitreal Aflibercept, Bevacizumab, and Ranibizumab for Diabetic Macular Edema (NCT NCT01627249)

NCT ID: NCT01627249

Last Updated: 2020-08-10

Results Overview

Visual Acuity was measured with the Electronic Early Treatment Study (E-ETDRS) visual acuity test. Unit of measure is based on the E-ETDRS letter score scale, 0-97, where 0 = worst and 97 = best.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

660 participants

Primary outcome timeframe

Baseline to 1-year

Results posted on

2020-08-10

Participant Flow

Participant milestones

Participant milestones
Measure
Aflibercept
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Overall Study
STARTED
224
218
218
Overall Study
COMPLETED
208
206
206
Overall Study
NOT COMPLETED
16
12
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Aflibercept
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Overall Study
Death
3
5
3
Overall Study
Withdrawal by Subject
12
6
9
Overall Study
Missed Visit
1
1
0

Baseline Characteristics

Comparative Effectiveness Study of Intravitreal Aflibercept, Bevacizumab, and Ranibizumab for Diabetic Macular Edema

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Aflibercept
n=224 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=218 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=218 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Total
n=660 Participants
Total of all reporting groups
Age, Customized
60 years
STANDARD_DEVIATION 10 • n=5 Participants
62 years
STANDARD_DEVIATION 10 • n=7 Participants
60 years
STANDARD_DEVIATION 11 • n=5 Participants
61 years
STANDARD_DEVIATION 10 • n=4 Participants
Sex/Gender, Customized
Women
110 participants
n=5 Participants
103 participants
n=7 Participants
94 participants
n=5 Participants
307 participants
n=4 Participants
Sex/Gender, Customized
Men
114 participants
n=5 Participants
115 participants
n=7 Participants
124 participants
n=5 Participants
353 participants
n=4 Participants
Race/Ethnicity, Customized
White
145 participants
n=5 Participants
139 participants
n=7 Participants
146 participants
n=5 Participants
430 participants
n=4 Participants
Race/Ethnicity, Customized
Black/African American
32 participants
n=5 Participants
37 participants
n=7 Participants
36 participants
n=5 Participants
105 participants
n=4 Participants
Race/Ethnicity, Customized
Hispanic
37 participants
n=5 Participants
36 participants
n=7 Participants
30 participants
n=5 Participants
103 participants
n=4 Participants
Race/Ethnicity, Customized
Native Hawaiian/other Pacific Islander
2 participants
n=5 Participants
2 participants
n=7 Participants
0 participants
n=5 Participants
4 participants
n=4 Participants
Race/Ethnicity, Customized
American Indian/Alaskin Native
1 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
1 participants
n=4 Participants
Race/Ethnicity, Customized
More than one race
4 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
6 participants
n=4 Participants
Race/Ethnicity, Customized
Unknown/not reported
1 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
3 participants
n=4 Participants
Race/Ethnicity, Customized
Asian
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
8 participants
n=4 Participants
Diabetes Type
Type 1
22 participants
n=5 Participants
12 participants
n=7 Participants
16 participants
n=5 Participants
50 participants
n=4 Participants
Diabetes Type
Type 2
196 participants
n=5 Participants
205 participants
n=7 Participants
196 participants
n=5 Participants
597 participants
n=4 Participants
Diabetes Type
Uncertain
6 participants
n=5 Participants
1 participants
n=7 Participants
6 participants
n=5 Participants
13 participants
n=4 Participants
Prior Myocardial Infarction
13 participants
n=5 Participants
14 participants
n=7 Participants
16 participants
n=5 Participants
43 participants
n=4 Participants
Prior Coronary Artery Disease
22 participants
n=5 Participants
27 participants
n=7 Participants
34 participants
n=5 Participants
83 participants
n=4 Participants
Prior Stroke
8 participants
n=5 Participants
13 participants
n=7 Participants
10 participants
n=5 Participants
31 participants
n=4 Participants
Prior Transient Ischemic attacks
6 participants
n=5 Participants
8 participants
n=7 Participants
10 participants
n=5 Participants
24 participants
n=4 Participants
Prior Hypertension
177 participants
n=5 Participants
181 participants
n=7 Participants
175 participants
n=5 Participants
533 participants
n=4 Participants
Visual Acuity Letter Score
69 units on a scale
n=5 Participants
69 units on a scale
n=7 Participants
68 units on a scale
n=5 Participants
69 units on a scale
n=4 Participants
OCT Central Subfield
387 Microns
n=5 Participants
376 Microns
n=7 Participants
390 Microns
n=5 Participants
387 Microns
n=4 Participants
Lens Status
Phakic
166 participants
n=5 Participants
160 participants
n=7 Participants
173 participants
n=5 Participants
499 participants
n=4 Participants
Lens Status
Pseudophakic
58 participants
n=5 Participants
58 participants
n=7 Participants
45 participants
n=5 Participants
161 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Absent of minimal NPDR
7 participants
n=5 Participants
6 participants
n=7 Participants
5 participants
n=5 Participants
18 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Mild to moderately severe NPDR
150 participants
n=5 Participants
131 participants
n=7 Participants
145 participants
n=5 Participants
426 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Severe NPDR
17 participants
n=5 Participants
15 participants
n=7 Participants
18 participants
n=5 Participants
50 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Prior PRP; without current PDR
17 participants
n=5 Participants
21 participants
n=7 Participants
16 participants
n=5 Participants
54 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Mild to moderate PDR
28 participants
n=5 Participants
31 participants
n=7 Participants
23 participants
n=5 Participants
82 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
High risk PDR
2 participants
n=5 Participants
7 participants
n=7 Participants
9 participants
n=5 Participants
18 participants
n=4 Participants
Diabetic Retinopathy Severity (ETDRS Level)
Missing
3 participants
n=5 Participants
7 participants
n=7 Participants
2 participants
n=5 Participants
12 participants
n=4 Participants
Prior Focal/Grid Laser for DME
80 participants
n=5 Participants
84 participants
n=7 Participants
80 participants
n=5 Participants
244 participants
n=4 Participants
Prior Anti-VEGF for DME
24 participants
n=5 Participants
31 participants
n=7 Participants
29 participants
n=5 Participants
84 participants
n=4 Participants
Prior other treatment for DME
14 participants
n=5 Participants
12 participants
n=7 Participants
11 participants
n=5 Participants
37 participants
n=4 Participants
Prior PRP
32 participants
n=5 Participants
40 participants
n=7 Participants
35 participants
n=5 Participants
107 participants
n=4 Participants

PRIMARY outcome

Timeframe: Baseline to 1-year

Population: Visual acuity change truncated to +/- 3SD (-22 and +44) to minimize the effects of outliers for 6 eyes in the aflibercept group (4 on the positive end, 2 on the negative end) and 2 eyes in the bevacizumab group (both on the negative end).

Visual Acuity was measured with the Electronic Early Treatment Study (E-ETDRS) visual acuity test. Unit of measure is based on the E-ETDRS letter score scale, 0-97, where 0 = worst and 97 = best.

Outcome measures

Outcome measures
Measure
Aflibercept
n=208 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=206 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=206 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Overall Change in Electronic Early Treatment Diabetic Retinopathy Study Visual Acuity Letter Score From Baseline to 1-year
13.3 units on a scale
Standard Deviation 11.1
9.7 units on a scale
Standard Deviation 10.1
11.2 units on a scale
Standard Deviation 9.4

PRIMARY outcome

Timeframe: Baseline to 1-year

Population: Visual acuity change truncated to +/- 3SD (-22 and +44) to minimize the effects of outliers for 6 eyes in the aflibercept group (4 on the positive end, 2 on the negative end) and 2 eyes in the bevacizumab group (both on the negative end).

Visual Acuity was measured with the Electronic Early Treatment Study (E-ETDRS) visual acuity test. Unit of measure is based on the E-ETDRS letter score scale, 0-97, where 0 = worst and 97 = best.

Outcome measures

Outcome measures
Measure
Aflibercept
n=102 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=102 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=101 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Change in Electronic Early Treatment Diabetic Retinopathy Study Visual Acuity Letter Score From Baseline to 1-year: Baseline Visual Acuity Letter Score <69
18.9 units on a scale
Standard Deviation 11.5
11.8 units on a scale
Standard Deviation 12.0
14.2 units on a scale
Standard Deviation 10.6

PRIMARY outcome

Timeframe: Baseline to 1-year

Population: Visual acuity change truncated to +/- 3SD (-22 and +44) to minimize the effects of outliers for 6 eyes in the aflibercept group (4 on the positive end, 2 on the negative end) and 2 eyes in the bevacizumab group (both on the negative end).

Visual Acuity was measured with the Electronic Early Treatment Study (E-ETDRS) visual acuity test. Unit of measure is based on the E-ETDRS letter score scale, 0-97, where 0 = worst and 97 = best.

Outcome measures

Outcome measures
Measure
Aflibercept
n=106 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=104 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=105 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Change in Electronic Early Treatment Diabetic Retinopathy Study Visual Acuity Letter Score From Baseline to 1-year: Baseline Visual Acuity Letter Score 78-69
8.0 units on a scale
Standard Deviation 7.6
7.5 units on a scale
Standard Deviation 7.4
8.3 units on a scale
Standard Deviation 6.8

SECONDARY outcome

Timeframe: baseline to 1-year

Population: In addition to participants missing the 1-year visit, 3 in the aflibercept group, 3 in the bevacizumab group, and 5 in the ranibizumab group had 1-year visits but unusable OCT data to compute change due to the scan being missing or ungradable at either baseline or 1 year.

All baseline and 1-year optical coherence tomography (OCT) scans were graded by Duke Reading Center. In addition, a random sample of OCT images from other visits and images for which the investigator believed central grading was needed also were graded by Duke Reading Center. Baseline CSF values were converted from the thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 583 scans. One-year CSF values were converted from a thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 604 scans. When calculating change in CSF thickness, measurements taken on the same machine at both visits were not converted, since the conversion equation slope is nearly 1 and the constant difference does not affect the change calculation. Therefore, change in CSF thickness was calculated after converting either the baseline and/or follow-up thickness value from Spectralis or Cirrus to a Stratus equivalent value in 26 eyes.

Outcome measures

Outcome measures
Measure
Aflibercept
n=205 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=203 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=201 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Overall Change in Optical Coherence Tomography Central Subfield Thickness
-169 microns
Standard Deviation 138
-101 microns
Standard Deviation 121
-147 microns
Standard Deviation 137

SECONDARY outcome

Timeframe: baseline to 1-year

Population: In addition to participants missing the 1-year visit, 3 in the aflibercept group, 3 in the bevacizumab group, and 5 in the ranibizumab group had 1-year visits but unusable OCT data to compute change due to the scan being missing or ungradable at either baseline or 1 year.

All baseline and 1-year optical coherence tomography (OCT) scans were graded by Duke Reading Center. In addition, a random sample of OCT images from other visits and images for which the investigator believed central grading was needed also were graded by Duke Reading Center. Baseline CSF values were converted from the thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 583 scans. One-year CSF values were converted from a thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 604 scans. When calculating change in CSF thickness, measurements taken on the same machine at both visits were not converted, since the conversion equation slope is nearly 1 and the constant difference does not affect the change calculation. Therefore, change in CSF thickness was calculated after converting either the baseline and/or follow-up thickness value from Spectralis or Cirrus to a Stratus equivalent value in 26 eyes.

Outcome measures

Outcome measures
Measure
Aflibercept
n=101 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=100 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=99 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Change in Optical Coherence Tomography Central Subfield Thickness: Baseline Visual Acuity Letter Score <69
-210 microns
Standard Deviation 151
-135 microns
Standard Deviation 152
-176 microns
Standard Deviation 151

SECONDARY outcome

Timeframe: baseline to 1-year

Population: In addition to participants missing the 1-year visit, 3 in the aflibercept group, 3 in the bevacizumab group, and 5 in the ranibizumab group had 1-year visits but unusable OCT data to compute change due to the scan being missing or ungradable at either baseline or 1 year.

All baseline and 1-year optical coherence tomography (OCT) scans were graded by Duke Reading Center. In addition, a random sample of OCT images from other visits and images for which the investigator believed central grading was needed also were graded by Duke Reading Center. Baseline CSF values were converted from the thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 583 scans. One-year CSF values were converted from a thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 604 scans. When calculating change in CSF thickness, measurements taken on the same machine at both visits were not converted, since the conversion equation slope is nearly 1 and the constant difference does not affect the change calculation. Therefore, change in CSF thickness was calculated after converting either the baseline and/or follow-up thickness value from Spectralis or Cirrus to a Stratus equivalent value in 26 eyes.

Outcome measures

Outcome measures
Measure
Aflibercept
n=104 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=103 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=102 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Change in Optical Coherence Tomography Central Subfield Thickness: Baseline Visual Acuity Letter Score 78-69
-129 microns
Standard Deviation 110
-67 microns
Standard Deviation 65
-119 microns
Standard Deviation 109

SECONDARY outcome

Timeframe: Baseline to 1-year

Population: In addition to participants missing the 1-year visit, 46 in the aflibercept group, 53 in the bevacizumab group, and 44 in the ranibizumab group had 1-year visits but unusable OCT data to compute change due to the scan being missing or ungradable at either baseline or 1 year.

Baseline volume values were converted from the thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 459 scans. One-year volume values were converted from a thickness value measured on a Spectralis or Cirrus OCT machine to a Stratus equivalent value for 472 scans. When calculating change in volume, measurements taken on the same machine at both visits were not converted, because the conversion equation slope is nearly 1 and the constant difference does not affect the change calculation. Therefore, change in volume was calculated after converting either the baseline and/or follow-up value from Spectralis or Cirrus to a Stratus equivalent value in 17 eyes.

Outcome measures

Outcome measures
Measure
Aflibercept
n=162 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=153 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=162 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Overall Change in Retinal Volume
-1.7 mm^3
Standard Deviation 1.6
-1.0 mm^3
Standard Deviation 1.2
-1.7 mm^3
Standard Deviation 1.5

SECONDARY outcome

Timeframe: Baseline to 1-year

Population: Seven study eyes received 1 injection and 2 eyes received 2 injections of 0.5 mg of ranibizumab prior to the FDA approving a 0.3 mg dosage of ranibizumab for diabetic macular edema treatment.

Only includes participants that completed the 1 year visit

Outcome measures

Outcome measures
Measure
Aflibercept
n=208 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=206 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=206 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Total Number of Injections Prior to 1 Year
9.2 Injections
Standard Deviation 2.0
9.7 Injections
Standard Deviation 2.3
9.4 Injections
Standard Deviation 2.1

SECONDARY outcome

Timeframe: between 24 weeks and 1 year

Only includes participants that completed the 1 year visit.

Outcome measures

Outcome measures
Measure
Aflibercept
n=208 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=206 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=206 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Total Number of Laser Treatments
0
132 participants
91 participants
111 participants
Total Number of Laser Treatments
1
57 participants
85 participants
77 participants
Total Number of Laser Treatments
2
19 participants
30 participants
18 participants

SECONDARY outcome

Timeframe: Baseline to 1-year

Outcome measures

Outcome measures
Measure
Aflibercept
n=208 Participants
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=206 Participants
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Ranibizumab
n=206 Participants
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab (Lucentis™) at baseline and up to every 4 weeks using defined retreatment criteria.
Eyes Receiving 1 or More Alternative Treatments for DME Other Than Laser
2 Eyes
4 Eyes
1 Eyes

Adverse Events

Ranibizumab

Serious events: 57 serious events
Other events: 144 other events
Deaths: 0 deaths

Aflibercept

Serious events: 61 serious events
Other events: 152 other events
Deaths: 0 deaths

Bevacizumab

Serious events: 46 serious events
Other events: 151 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Ranibizumab
n=218 participants at risk
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Aflibercept
n=224 participants at risk
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=218 participants at risk
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Blood and lymphatic system disorders
anaemia
0.46%
1/218
1.3%
3/224
0.00%
0/218
Blood and lymphatic system disorders
anaemia of chronic disease
0.00%
0/218
0.00%
0/224
0.46%
1/218
Cardiac disorders
arrhythmia
0.00%
0/218
0.45%
1/224
0.00%
0/218
Cardiac disorders
arteriosclerosis coronary artery
0.46%
1/218
0.00%
0/224
0.00%
0/218
Cardiac disorders
Atrial Fibrillation
0.00%
0/218
0.45%
1/224
0.00%
0/218
Cardiac disorders
Atrioventricular block second degree
0.92%
2/218
0.00%
0/224
0.00%
0/218
Cardiac disorders
Cardiac arrest
0.00%
0/218
0.45%
1/224
0.46%
1/218
Cardiac disorders
cardiac failure
0.92%
2/218
0.00%
0/224
0.46%
1/218
Cardiac disorders
cardiac failure congestive
2.8%
6/218
0.45%
1/224
1.4%
3/218
Cardiac disorders
cardiomegaly
0.00%
0/218
0.45%
1/224
0.00%
0/218
Cardiac disorders
coronary artery disease
1.4%
3/218
0.89%
2/224
0.92%
2/218
Cardiac disorders
diastolic dysfunction
0.00%
0/218
0.45%
1/224
0.00%
0/218
Cardiac disorders
hypertensive heart disease
0.46%
1/218
0.89%
2/224
0.00%
0/218
Cardiac disorders
myocardial infarction
1.4%
3/218
1.3%
3/224
0.46%
1/218
Cardiac disorders
palpitations
0.46%
1/218
0.00%
0/224
0.00%
0/218
Cardiac disorders
pericardial effusion
0.46%
1/218
0.00%
0/224
0.00%
0/218
Cardiac disorders
ventricular tachycardia
0.46%
1/218
0.00%
0/224
0.00%
0/218
Endocrine disorders
Diabetic ketoacidosis
0.46%
1/218
0.89%
2/224
0.46%
1/218
Endocrine disorders
Glucocorticoid deficiency
0.00%
0/218
0.45%
1/224
0.00%
0/218
Endocrine disorders
Hyperglycaemia
0.00%
0/218
0.45%
1/224
0.00%
0/218
Endocrine disorders
Hypoglycaemia
0.46%
1/218
0.89%
2/224
0.00%
0/218
Eye disorders
Cataract
0.00%
0/218
0.45%
1/224
0.00%
0/218
Eye disorders
Endophthalmitis
0.46%
1/218
0.45%
1/224
0.00%
0/218
Eye disorders
Glaucoma
0.46%
1/218
0.00%
0/224
0.00%
0/218
Eye disorders
Visual acuity reduced
0.00%
0/218
0.45%
1/224
0.00%
0/218
Gastrointestinal disorders
Abdominal pain
0.46%
1/218
0.00%
0/224
1.4%
3/218
Gastrointestinal disorders
Clostridium difficile colitis
0.46%
1/218
0.45%
1/224
0.00%
0/218
Gastrointestinal disorders
Colon cancer
0.46%
1/218
0.00%
0/224
0.46%
1/218
Gastrointestinal disorders
Diabetic gastroparesis
0.46%
1/218
0.89%
2/224
0.00%
0/218
Gastrointestinal disorders
Gastric cancer stage I
0.46%
1/218
0.00%
0/224
0.00%
0/218
Gastrointestinal disorders
Gastritis
0.00%
0/218
0.00%
0/224
0.92%
2/218
Gastrointestinal disorders
Gastroenteritis
0.46%
1/218
0.00%
0/224
0.46%
1/218
Gastrointestinal disorders
Gastroenteritis viral
0.00%
0/218
0.45%
1/224
0.00%
0/218
Gastrointestinal disorders
Gastrointestinal haemorrhage
0.46%
1/218
0.00%
0/224
0.00%
0/218
Gastrointestinal disorders
Gastrointestinal stoma complication
0.46%
1/218
0.00%
0/224
0.00%
0/218
Gastrointestinal disorders
Impaired gastric emptying
1.4%
3/218
0.00%
0/224
0.00%
0/218
Gastrointestinal disorders
Intestinal perforation
0.00%
0/218
0.00%
0/224
0.46%
1/218
Gastrointestinal disorders
Nausea
0.00%
0/218
0.45%
1/224
0.46%
1/218
Gastrointestinal disorders
Pancreatitis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Gastrointestinal disorders
Peptic ulcer
0.00%
0/218
0.00%
0/224
0.46%
1/218
Gastrointestinal disorders
Rectal haemorrhage
0.00%
0/218
0.45%
1/224
0.00%
0/218
Gastrointestinal disorders
Vomiting
0.46%
1/218
2.2%
5/224
1.8%
4/218
General disorders
Chest pain
0.92%
2/218
1.3%
3/224
1.8%
4/218
General disorders
Death
0.00%
0/218
0.45%
1/224
0.46%
1/218
General disorders
Device related infection
0.00%
0/218
0.00%
0/224
0.46%
1/218
General disorders
Fatigue
0.00%
0/218
0.45%
1/224
0.00%
0/218
General disorders
Oedema peripheral
0.00%
0/218
0.45%
1/224
0.46%
1/218
General disorders
Pain
0.00%
0/218
0.00%
0/224
0.46%
1/218
General disorders
Pyrexia
0.46%
1/218
0.00%
0/224
0.00%
0/218
Hepatobiliary disorders
Cholecystitis acute
0.46%
1/218
0.00%
0/224
0.00%
0/218
Hepatobiliary disorders
Cholelithiasis
0.00%
0/218
0.00%
0/224
0.46%
1/218
Immune system disorders
Drug hypersensitivity
0.46%
1/218
0.00%
0/224
0.00%
0/218
Infections and infestations
Abscess
0.00%
0/218
0.45%
1/224
0.00%
0/218
Infections and infestations
Escherichia infection
0.46%
1/218
0.00%
0/224
0.00%
0/218
Infections and infestations
Infection
0.46%
1/218
0.45%
1/224
0.92%
2/218
Infections and infestations
Influenza
0.00%
0/218
0.45%
1/224
0.00%
0/218
Infections and infestations
Localised infection
1.4%
3/218
0.89%
2/224
0.92%
2/218
Infections and infestations
Sepsis
0.46%
1/218
1.3%
3/224
0.46%
1/218
Infections and infestations
Septic shock
0.00%
0/218
0.00%
0/224
0.46%
1/218
Infections and infestations
Staphylococcal infection
0.46%
1/218
0.00%
0/224
0.00%
0/218
Injury, poisoning and procedural complications
Fall
0.00%
0/218
0.45%
1/224
0.46%
1/218
Injury, poisoning and procedural complications
Limb injury
0.46%
1/218
0.00%
0/224
0.00%
0/218
Injury, poisoning and procedural complications
Subgaleal haematoma
0.00%
0/218
0.45%
1/224
0.00%
0/218
Investigations
International normalised ratio increased
0.00%
0/218
0.45%
1/224
0.00%
0/218
Metabolism and nutrition disorders
Dehydration
0.92%
2/218
0.00%
0/224
0.46%
1/218
Metabolism and nutrition disorders
Fluid overload
0.46%
1/218
0.00%
0/224
0.00%
0/218
Metabolism and nutrition disorders
Hyperkalaemia
0.46%
1/218
0.00%
0/224
0.00%
0/218
Metabolism and nutrition disorders
Hyperlipidaemia
0.92%
2/218
0.00%
0/224
0.00%
0/218
Metabolism and nutrition disorders
Hypokalaemia
0.00%
0/218
0.00%
0/224
0.46%
1/218
Metabolism and nutrition disorders
Obesity
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Ankle fracture
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Arthritis
0.00%
0/218
0.00%
0/224
0.46%
1/218
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Femur fracture
0.00%
0/218
0.00%
0/224
0.46%
1/218
Musculoskeletal and connective tissue disorders
Inclusion body myositis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
0.00%
0/218
0.00%
0/224
0.92%
2/218
Musculoskeletal and connective tissue disorders
Lower limb fracture
0.00%
0/218
0.00%
0/224
0.46%
1/218
Musculoskeletal and connective tissue disorders
Multiple fractures
0.46%
1/218
0.00%
0/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Muscular weakness
0.46%
1/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Osteoarthritis
0.00%
0/218
0.00%
0/224
0.92%
2/218
Musculoskeletal and connective tissue disorders
Osteomyelitis
0.92%
2/218
0.89%
2/224
0.92%
2/218
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Pelvic fracture
0.00%
0/218
0.45%
1/224
0.00%
0/218
Musculoskeletal and connective tissue disorders
Upper limb fracture
0.46%
1/218
0.00%
0/224
0.46%
1/218
Musculoskeletal and connective tissue disorders
Wrist fracture
0.00%
0/218
0.45%
1/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasm malignant
0.00%
0/218
0.00%
0/224
0.46%
1/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Polyp
0.46%
1/218
0.00%
0/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Brain neoplasm
0.92%
2/218
0.00%
0/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Convulsion
0.46%
1/218
0.00%
0/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Dizziness
0.92%
2/218
0.00%
0/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Dysarthria
0.00%
0/218
0.45%
1/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Encephalopathy
0.46%
1/218
0.45%
1/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Headache
0.46%
1/218
0.00%
0/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Hypoaesthesia
0.00%
0/218
0.00%
0/224
0.46%
1/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neuropathy peripheral
0.00%
0/218
0.00%
0/224
0.46%
1/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Presyncope
0.00%
0/218
0.45%
1/224
0.46%
1/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Somnolence
0.00%
0/218
0.45%
1/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Syncope
0.92%
2/218
0.00%
0/224
0.46%
1/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
VIIth nerve paralysis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Vestibular neuronitis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Psychiatric disorders
Bipolar disorder
0.92%
2/218
0.00%
0/224
0.00%
0/218
Psychiatric disorders
Mental disorder
0.00%
0/218
0.45%
1/224
0.00%
0/218
Psychiatric disorders
Psychotic disorder
0.46%
1/218
0.00%
0/224
0.00%
0/218
Renal and urinary disorders
Bladder prolapse
0.46%
1/218
0.00%
0/224
0.00%
0/218
Renal and urinary disorders
Cystitis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Renal and urinary disorders
Renal failure
4.1%
9/218
1.8%
4/224
2.8%
6/218
Renal and urinary disorders
Renal failure acute
0.46%
1/218
0.45%
1/224
0.46%
1/218
Renal and urinary disorders
Renal failure chronic
2.3%
5/218
2.2%
5/224
0.00%
0/218
Renal and urinary disorders
Renal impairment
0.00%
0/218
0.00%
0/224
0.46%
1/218
Renal and urinary disorders
Urinary tract infection
0.00%
0/218
1.3%
3/224
0.46%
1/218
Reproductive system and breast disorders
Breast cancer
0.00%
0/218
0.00%
0/224
0.46%
1/218
Reproductive system and breast disorders
Uterine prolapse
0.00%
0/218
0.00%
0/224
0.46%
1/218
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
1.4%
3/218
0.89%
2/224
0.46%
1/218
Respiratory, thoracic and mediastinal disorders
Asthma
0.00%
0/218
0.45%
1/224
0.00%
0/218
Respiratory, thoracic and mediastinal disorders
Bronchitis
0.00%
0/218
0.45%
1/224
0.46%
1/218
Respiratory, thoracic and mediastinal disorders
Cardio-respiratory arrest
0.00%
0/218
0.00%
0/224
0.46%
1/218
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.46%
1/218
0.00%
0/224
0.00%
0/218
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/218
0.89%
2/224
0.00%
0/218
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.46%
1/218
0.89%
2/224
0.46%
1/218
Respiratory, thoracic and mediastinal disorders
Nasal congestion
0.00%
0/218
0.45%
1/224
0.00%
0/218
Respiratory, thoracic and mediastinal disorders
Pneumonia
2.8%
6/218
1.3%
3/224
1.8%
4/218
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.46%
1/218
0.00%
0/224
0.00%
0/218
Skin and subcutaneous tissue disorders
Cellulitis
0.92%
2/218
0.89%
2/224
2.8%
6/218
Skin and subcutaneous tissue disorders
Cellulitis gangrenous
0.00%
0/218
0.00%
0/224
0.46%
1/218
Skin and subcutaneous tissue disorders
Diabetic foot
1.4%
3/218
0.45%
1/224
0.92%
2/218
Skin and subcutaneous tissue disorders
Furuncle
0.00%
0/218
0.45%
1/224
0.00%
0/218
Skin and subcutaneous tissue disorders
Skin ulcer
0.00%
0/218
0.45%
1/224
0.00%
0/218
Surgical and medical procedures
Cardiac pacemaker insertion
0.00%
0/218
0.00%
0/224
0.46%
1/218
Surgical and medical procedures
Foot amputation
0.00%
0/218
0.00%
0/224
0.46%
1/218
Surgical and medical procedures
Gastric bypass
0.00%
0/218
0.45%
1/224
0.00%
0/218
Surgical and medical procedures
Hip arthroplasty
0.46%
1/218
0.00%
0/224
0.00%
0/218
Surgical and medical procedures
Stent placement
0.00%
0/218
0.00%
0/224
0.92%
2/218
Surgical and medical procedures
Surgery
0.92%
2/218
0.45%
1/224
0.00%
0/218
Vascular disorders
Aortic stenosis
0.00%
0/218
0.45%
1/224
0.00%
0/218
Vascular disorders
Arteriovenous fistula
0.46%
1/218
0.45%
1/224
0.00%
0/218
Vascular disorders
Basilar artery occlusion
0.46%
1/218
0.00%
0/224
0.00%
0/218
Vascular disorders
Cerebrovascular accident
1.4%
3/218
0.00%
0/224
0.46%
1/218
Vascular disorders
Deep vein thrombosis
0.00%
0/218
0.00%
0/224
0.46%
1/218
Vascular disorders
Haematoma
0.00%
0/218
0.45%
1/224
0.00%
0/218
Vascular disorders
Haemorrhagic stroke
0.46%
1/218
0.00%
0/224
0.00%
0/218
Vascular disorders
Hypertension
1.4%
3/218
0.89%
2/224
0.92%
2/218
Vascular disorders
Hypotension
0.46%
1/218
0.45%
1/224
0.00%
0/218
Vascular disorders
Ischaemic stroke
1.4%
3/218
0.00%
0/224
0.46%
1/218
Vascular disorders
Orthostatic hypotension
0.00%
0/218
0.00%
0/224
0.46%
1/218
Vascular disorders
Peripheral vascular disorder
0.00%
0/218
0.89%
2/224
0.00%
0/218
Vascular disorders
Transient ischaemic attack
0.92%
2/218
0.00%
0/224
0.46%
1/218
Vascular disorders
Venous insufficiency
0.46%
1/218
0.00%
0/224
0.00%
0/218
Vascular disorders
Venous stenosis
0.46%
1/218
0.00%
0/224
0.00%
0/218

Other adverse events

Other adverse events
Measure
Ranibizumab
n=218 participants at risk
0.3 mg intravitreal ranibizumab: Intravitreal injection of 0.3 mg ranibizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Aflibercept
n=224 participants at risk
2.0 mg intravitreal aflibercept: Intravitreal injection of 2.0 mg aflibercept at baseline and up to every 4 weeks using defined retreatment criteria.
Bevacizumab
n=218 participants at risk
1.25 mg intravitreal bevacizumab: Intravitreal injection of 1.25 mg bevacizumab at baseline and up to every 4 weeks using defined retreatment criteria.
Eye disorders
Cataract
6.4%
14/218 • Number of events 16
6.2%
14/224 • Number of events 17
5.0%
11/218 • Number of events 14
Eye disorders
Conjunctival haemorrhage
11.5%
25/218 • Number of events 55
13.4%
30/224 • Number of events 67
19.3%
42/218 • Number of events 83
Eye disorders
Dry eye
6.0%
13/218 • Number of events 18
6.2%
14/224 • Number of events 23
4.1%
9/218 • Number of events 15
Eye disorders
Eye irritation
6.4%
14/218 • Number of events 24
5.8%
13/224 • Number of events 28
7.3%
16/218 • Number of events 27
Eye disorders
Eye pain
9.6%
21/218 • Number of events 27
12.1%
27/224 • Number of events 45
17.0%
37/218 • Number of events 50
Eye disorders
Eye pruritus
5.0%
11/218 • Number of events 20
5.4%
12/224 • Number of events 15
4.6%
10/218 • Number of events 13
Eye disorders
Lacrimation increased
5.5%
12/218 • Number of events 14
7.1%
16/224 • Number of events 22
3.2%
7/218 • Number of events 10
Eye disorders
Vision blurred
20.6%
45/218 • Number of events 77
17.0%
38/224 • Number of events 55
17.9%
39/218 • Number of events 53
Eye disorders
Visual acuity reduced
7.8%
17/218 • Number of events 25
8.0%
18/224 • Number of events 24
10.1%
22/218 • Number of events 27
Eye disorders
Vitreous floaters
17.0%
37/218 • Number of events 62
18.3%
41/224 • Number of events 54
24.3%
53/218 • Number of events 70
Eye disorders
Vitreous haemorrhage
6.0%
13/218 • Number of events 15
6.2%
14/224 • Number of events 17
8.3%
18/218 • Number of events 25
Nervous system disorders
Headache
6.9%
15/218 • Number of events 15
6.7%
15/224 • Number of events 19
6.9%
15/218 • Number of events 19
Respiratory, thoracic and mediastinal disorders
Nasopharyngitis
7.3%
16/218 • Number of events 17
12.1%
27/224 • Number of events 31
9.2%
20/218 • Number of events 22
Respiratory, thoracic and mediastinal disorders
Sinusitis
6.0%
13/218 • Number of events 20
5.4%
12/224 • Number of events 13
3.7%
8/218 • Number of events 8
Vascular disorders
Hypertension
10.6%
23/218 • Number of events 24
10.7%
24/224 • Number of events 26
6.9%
15/218 • Number of events 16

Additional Information

Adam Glassman

Jaeb Center for Health Research

Phone: 813-975-8690

Results disclosure agreements

  • Principal investigator is a sponsor employee Trial results can not be discussed until they have been made available to the public.
  • Publication restrictions are in place

Restriction type: OTHER