Treat & Extend Versus Fixed Dosing with Faricimab for Management of Diabetic Macular Edema: a Pragmatic, Multi-center, Open-label, Randomized, Controlled Trial

NCT ID: NCT05610319

Last Updated: 2025-01-08

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

446 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2026-12-31

Brief Summary

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This study will assess a pragmatic, treat and extend regimen of faricimab against the standard of a fixed dosing regimen.

Detailed Description

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Conditions

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Diabetic Macular Edema

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two-armed, parallel, non-inferiority randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Treat and Extend

Participants randomized to the T\&E Arm will initially receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), with treatment intervals increased/extended, reduced, or maintained based on CST assessments, until week 100.

Group Type EXPERIMENTAL

Faricimab

Intervention Type DRUG

Faricimab will be administered via intravitreal injection.

Control/Usual Care Arm

Participants in the control arm will receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), for 6 treatments. Afterwards, participants will continue to receive 6mg faricimab IVT every 8 weeks until week 100.

Group Type OTHER

Faricimab

Intervention Type DRUG

Faricimab will be administered via intravitreal injection.

Interventions

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Faricimab

Faricimab will be administered via intravitreal injection.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years
2. Diagnosis of diabetes mellitus (type 1 or type 2).
3. Macular thickening secondary to DME (CI-DME) involving the center of the fovea on Optical Coherence Tomography - Central subfield thickness (CST) ≥ 325 μm on Spectralis at screening.\*\*\*
4. Visual impairment due to DME, with best corrected visual acuity of 80 to 20 letters (Snellen VA 20/25 - 20/400).
5. Media clarity, pupillary dilation, and individual cooperation sufficient for adequate OCT and fundus photographs.
6. Hemoglobin A1c must be \<10% within 2 months prior to 1st study treatment.
7. Provide signed informed consent.

Exclusion Criteria

1. Active or history of ocular inflammation or suspected/active ocular infection in either eye.
2. High-risk proliferative diabetic retinopathy in the study eye.\*\*
3. Tractional retinal detachment, preretinal fibrosis or visually significant epiretinal membrane involving the macula.
4. Uncontrolled glaucoma (intraocular pressure \>30 with or without medications).
5. Any intravitreal, periocular or implant corticosteroids within 26 weeks (6 months) before day 1 or any use of Iluvien implants.
6. Treatment with Panretinal photocoagulation (PRP) within 12 weeks before day 1.
7. Treatment with macular laser.
8. Any cataract surgery or any other intraocular surgery within 12 weeks before day 1.
9. Macular edema in study eye due to a cause other than DME.
10. If clinical exam and/or OCT and/or wide-field fluorescein angiography (WF-FA) suggest that (a) macular edema is considered to be related to ocular surgery such as cataract extraction or (b) if primary cause for macular edema is vitreoretinal interface abnormalities (e.g. a taut posterior hyaloid or epiretinal membrane).
11. Any ocular condition is present such that visual acuity loss would not improve from resolution of macular edema in opinion of the investigator (e.g. foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, nonretinal condition)
12. Any history of ocular conditions that might affect macular edema (e.g. vein occlusion, idiopathic or infectious or non-infectious uveitis, ocular inflammatory disease, neovascular glaucoma etc.)
13. Women of child-bearing potential who are lactating, pregnant, or intending to become pregnant within the next 100 weeks.
14. Current or anticipated incarceration.
15. Terminal illness with expected survival less than 100 weeks.
16. Known hypersensitivity to faricimab or any of the excipients in the faricimab injection.
17. Currently enrolled in a study that does not permit co-enrollment.
18. Unable to obtain informed consent due to language or other operational barriers.
19. Anticipated problems, in the judgment of the site investigator, maintaining compliance with the protocol, including attending study visits, completing assessments or procedures.
20. Prior enrollment in this trial.
21. Other reason to exclude the patient, as approved by the sponsor and site investigator.
22. Previous treatment with anti-VEGF and:

* \<12 weeks prior to day 1 (washout period).\*or,
* Diagnosis of DME is \> 2 years of enrollment or,
* Do not have a demonstrated response to anti-VEGF treatment based on clinical discretion.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hoffmann-La Roche

INDUSTRY

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dr. Varun Chaudhary, MD, FRCS(C)

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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Retinal Consultants Medical Group Inc.

Modesto, California, United States

Site Status

Vitreo-Retina Medical Group

Sacramento, California, United States

Site Status

University Retina and Macula Associates

Oak Forest, Illinois, United States

Site Status

Eye Associates of Northeast Louisiana Dba Haik Humble Eye Center

West Monroe, Louisiana, United States

Site Status

Mississippi Retina Associates

Jackson, Mississippi, United States

Site Status

Austin Retina Associates

Austin, Texas, United States

Site Status

Retina Consultants of Texas

Beaumont, Texas, United States

Site Status

Retina & Vitreous of Texas

Bellaire, Texas, United States

Site Status

Retina Consultants of Houston, dba Retina Consultants of Texas

Bellaire, Texas, United States

Site Status

Valley Retina Institute

McAllen, Texas, United States

Site Status

Retina Consultants of Houston, dba Retina Consultants of Texas

San Antonio, Texas, United States

Site Status

Eye Clinic Albury Wodonga

Albury, New South Wales, Australia

Site Status

Nexus Eyecare Blacktown

Blacktown, New South Wales, Australia

Site Status

Eastern Suburbs Eye Specialists

Bondi Junction, New South Wales, Australia

Site Status

Retina and Eye Consultants

Hurstville, New South Wales, Australia

Site Status

Lane Cove Eye

Lane Cove, New South Wales, Australia

Site Status

South West Retina

Liverpool, New South Wales, Australia

Site Status

Marsden Eye Specialists

Parramatta, New South Wales, Australia

Site Status

Strathfield Retina Clinic

Strathfield, New South Wales, Australia

Site Status

South Eastern Sydney Health

Sydney, New South Wales, Australia

Site Status

Sydney Retina

Sydney, New South Wales, Australia

Site Status

Queensland Eye Institute

Woolloongabba, Queensland, Australia

Site Status

Adelaide Eye & Retina Centre

Adelaide, South Australia, Australia

Site Status

Hobart Eye Surgeons

Hobart, Tasmania, Australia

Site Status

Centre for Eye Research Australia

East Melbourne, Victoria, Australia

Site Status

Retina Specialists Victoria

Rowville, Victoria, Australia

Site Status

Lions Eye Institute Limited

Nedlands, Western Australia, Australia

Site Status

Calgary Retina Consultants

Calgary, Alberta, Canada

Site Status

Alberta Retina Consultants

Calgary, Alberta, Canada

Site Status

Retina Surgical Associates

New Westminster, British Columbia, Canada

Site Status

West Coast Retina

Vancouver, British Columbia, Canada

Site Status

UBC Eye Centre, Vancouver General Hospital

Vancouver, British Columbia, Canada

Site Status

The Research Institute of St. Joe's Hamilton

Hamilton, Ontario, Canada

Site Status

St. Joseph's Healthcare London

London, Ontario, Canada

Site Status

Retina Institute of Ottawa

Ottawa, Ontario, Canada

Site Status

Toronto Retina Institute

Toronto, Ontario, Canada

Site Status

Vitreous Retina Macula Specialists of Toronto

Toronto, Ontario, Canada

Site Status

Maisonneuve-Rosemont Hospital

Montreal, Quebec, Canada

Site Status

Bradford Royal Infirmary

Bradford, England, United Kingdom

Site Status

University Hospitals Bristol-Weston

Bristol, England, United Kingdom

Site Status

Frimley Health

Frimley, England, United Kingdom

Site Status

Liverpool University Hospitals

Liverpool, England, United Kingdom

Site Status

King's College Hospital

London, England, United Kingdom

Site Status

London North West University

London, England, United Kingdom

Site Status

Moorfields Eye Hospital

London, England, United Kingdom

Site Status

The Royal Wolverhampton

Wolverhampton, England, United Kingdom

Site Status

Countries

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United States Australia Canada United Kingdom

Other Identifiers

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MR44143

Identifier Type: OTHER

Identifier Source: secondary_id

2022-01

Identifier Type: -

Identifier Source: org_study_id

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