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UveitisNCT00790803

Pegaptanib Therapy in Non-Infectious Uveitic Cystoid Macular Edema

A study testing Pegaptanib in people with Uveitis and Cystoid Macular Edema, run by Wake Forest University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

According to a recent estimate more than 280,000 people in the United States are affected by uveitis each year. This report, also estimated that uveitis is the reason for 30,000 new cases of blindness/year and up to 10 percent of all cases of blindness. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Uveitis, Cystoid Macular Edema
What is being tested?
Pegaptanib
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteUnited States
Study dates
Mar 2009to Mar 2012
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female adults (>18 years of age) with non infectious uveitis.
  • Demonstrable (FA and/or OCT) bilateral or unilateral CME associated with uveitis of greater than 3 months but less than 1 years duration that is documented by two independent qualified observers.
  • Best corrected VA between 20/40 and 20/200 as measured by the ETDRS chart attributable to CME in the study eye.
  • Patients may be receiving systemic therapy for the treatment of their intraocular inflammation or cystoid macular edema, or may have been treated for the cystoid macular edema in the past.
  • Anterior chamber inflammation equal to or greater than 1+ and vitreous inflammation equal to or greater than 1+ cell and 1+ haze as per the 'Standardization of Uveitis' working group definition.
  • Females of child bearing potential must agree to utilize effective contraception during the study and two months after the last dose of study medication.
  • Male study patients will agree to use effective contraception.
  • Ability to give informed consent.

Who cannot join

  • Allergy to pegaptanib or any of its components
  • Diabetic retinopathy, macular degeneration or any other ocular condition affecting the study eye that may cause vision loss or in the opinion of the study investigator would interfere with the evaluation of the efficacy of Macugen for the treatment of uveitis associated CME.
  • Refusal to try the therapeutic alternative pegaptanib
  • Lack of understanding of the consent or protocol
  • Suspicion/proved history or current diagnosis, (clinical or otherwise) of infectious uveitis.
  • Need for intraocular surgery within 30 weeks of study duration.
Show all 19Show fewer
  • Periocular steroids to the study eye less than 6 weeks prior to study enrollment
  • History of any prior intravitreal injections in study eye
  • Systemic immunomodulatory agent(s) added or increased in dosage (>20%) within the last two months prior to study enrollment, or potential need for any increase during the study.
  • Requirement for systemic corticosteroids in the equivalent of oral prednisone > 30mg/day
  • Topical prostaglandin analog use
  • Severe debilitating disease or medical problems that make consistent follow-up over the treatment period unlikely (e.g. liver impairment, stroke, severe myocardial infarction, terminal cancer).
  • History of hypersensitivity to fluorescein or multiple drug allergies that may increase the chance of a drug reaction to Macugen.
  • Unclear media that precludes assessment of cystoid macular edema in eligible eye(s), such as a cataract or vitreal opacity.
  • Evidence of a macular hole in the study eye.
  • Prior or current retinal detachment in the study eye.
  • Concurrent treatment with any new investigational drug.
  • Pregnant or lactating women (Pregnant and lactating women are excluded since pregnancy may have some effect on CME).
  • Inability to comply with the study requirements.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Wake Forest University Eye Center

    Winston-Salem, North Carolina, 27157

Other trials in United States

About this study

Official title: Vascular Endothelial Growth Factor (VEGF)Blockade With Intravitreal Pegaptnib in Non-Infectious Uveitic Cystoid Macular Edema (CME)

According to a recent estimate more than 280,000 people in the United States are affected by uveitis each year. This report, also estimated that uveitis is the reason for 30,000 new cases of blindness/year and up to 10 percent of all cases of blindness. The purpose of this trial is to determine the effectiveness of VEGF blockade with intravitreal pegaptanib in patients with uveitic CME.

Read the detailed description
  1. Cystoid macular edema is a common complication of uveitic intraocular inflammatory diseases and is characterized by intraretinal edema involving the outer plexiform layer. Intraocular inflammation or uveitis may be associated with non infectious or infectious etiologies. The early symptoms of CME include a decrease or blurry central vision. With long standing CME there is a substantial risk of photoreceptor degeneration and ensuing long term decrease in the quality and level of visual acuity (VA). Furthermore it has been shown that in patients with uveitis, the morphologic features of macular edema and macular thickness correlated with final VA. Current therapeutic interventions have had at best modest results in patients with CME who have had decreased VA. This may the case with systemic interventions also.
  2. Vascular endothelial growth factor is a very strong inducer of blood vessel permeability and has been linked to the ocular manifestations of uveitis including CME by experienced researchers both in experimental and clinical settings. In animal tests, VEGF has been shown to be 50,000 times more potent than histamine, the molecule commonly associated with blood vessel leakage related to allergies. Also in animal tests, it has been shown that VEGF is required for the blood vessel permeability associated with neovascular AMD and diabetic retinopathy that have been shown to have an inflammatory component. In addition to its anti-angiogenic property of inhibiting abnormal blood vessel growth, pegaptanib has been shown in animal tests to inhibit blood vessels from leaking into the retina. Uveitis has been shown to be associated with ocular neovascularization both clinically and well as in the clinical studies. Thus, by preventing blood vessel leakage as well as abnormal blood vessel growth pegaptanib may be a viable approach for the treatment of CME. Although pegaptanib use has been associated with mild transient anterior segment inflammation CME itself has not been linked to its use. Besides, pegaptanib has been demonstrated to effect a sustainable decrease the macular edema in maculopathies, both age related and diabetic.
  3. There is currently a need for considering alternative forms of local (ocular) therapy for CME to triamcinolone (sub tenon and intraocular). The serious adverse effects with intraocular corticosteroid use are well documented and include cataracts (nuclear and subcapsular), glaucoma, endophthalmitis (may be significantly higher than pegaptanib in patients who are treated exactly as per protocol) as well as sterile inflammatory reactions.
Being tested
Pegaptanib
Keywords
uveitis, cystoid macular edema
Medical subject headings
Uveitis, Macular Edema

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PegaptanibDrug

    Also called Macugen

    Five patients will receive intravitreous injections of Macugen 0.3 mg every 6 weeks as needed for a total of no more than five.

Study groups in NCT00790803
Study groupRoleWhat they receive
Pegaptanib (Macugen)OtherOpen label, non randomized, interventional controlled injection of 0.3mg of Pegaptanib (Macugen) every 6weeks with max of 5 injections over 30weeks.
Receives: Drug: Pegaptanib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Improvement in VA ETDRS >/= 15 Letters

    The primary outcome was an improvement in VA greater than or equal to fifteen letters on the EDTRS chart.

    Measured: 32 weeks

Secondary outcomes (4)
  1. Proportion of Patients Experiencing > 0 Letter Vision Gain and a < 15 Loss

    Patients best corrected visual acuity was measured at each visit to monitor gain or loss of letters on the EDTRS chart.

    Measured: 32 weeks

  2. Decrease in CME as Evidenced by Imaging (Fluorescein Angiography and 50 Micron Change in OCT)

    Patients retinal thickness was measured at each visit bu imaging to monitor increase or decrease in thickness.

    Measured: 32 weeks

  3. A Decrease in Anterior Chamber Cells or Vitreous Cells or Haze in Injected Eye

    The degree of cell and flare was recorded at each visit during the course of the trial in the injected eye.

    In uveitis, severely inflamed vessels leak protein which clouds the normally clear aqueous. This looks hazy with the slit lamp. If severe, it disperses the light beam, causing flare.

    White or red blood cells may be observed: the presence of inflammatory cells in the anterior chamber suggests inflammation of the iris and ciliary body.

    Blood cells: grading of blood cells in the anterior chamber is as follows:

    • 0 - None.
    • 1+ - faint (barely detectable).
    • 2+ - moderate (clear iris and lens details).
    • 3+ - moderate (hazy iris and lens details).
    • 4+ - intense (fibrin deposits, coagulated aqueous).

    Measured: 32 weeks

  4. Change in Immunomodulatory Medications (Topical, Periocular or Systemic) After the Initiation of Macugen Therapy

    No changes were to be made in immunodulatory medications of the patients unless needed for safety after in initiation of Macugen therapy.

    Measured: 32 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Nov 2008 (estimated)
  2. Study startMar 2009
  3. Primary completionNov 2011
  4. Study completionMar 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00790803
Sponsor's protocol ID
4499 Pegaptanib in uveitis
Status last verified
Feb 2017
First submitted
12 Nov 2008
Last updated
15 Mar 2022
Data monitoring committee
No

Publications

  • Gritz DC, Wong IG. Incidence and prevalence of uveitis in Northern California; the Northern California Epidemiology of Uveitis Study. Ophthalmology. 2004 Mar;111(3):491-500; discussion 500. doi: 10.1016/j.ophtha.2003.06.014.

    PubMed 15019324
  • Okhravi N, Lightman S. Cystoid macular edema in uveitis. Ocul Immunol Inflamm. 2003 Mar;11(1):29-38. doi: 10.1076/ocii.11.1.29.15582.

    PubMed 12854025
  • Kurup SK, Chan CC. Immunotherapeutic approaches in ocular inflammatory diseases. Arch Immunol Ther Exp (Warsz). 2005 Nov-Dec;53(6):484-96.

    PubMed 16407781
  • Vinores SA, Chan CC, Vinores MA, Matteson DM, Chen YS, Klein DA, Shi A, Ozaki H, Campochiaro PA. Increased vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGFbeta) in experimental autoimmune uveoretinitis: upregulation of VEGF without neovascularization. J Neuroimmunol. 1998 Aug 14;89(1-2):43-50. doi: 10.1016/s0165-5728(98)00075-7.

    PubMed 9726824
  • Kurup SK, Chan CC. Mycobacterium-related ocular inflammatory disease: diagnosis and management. Ann Acad Med Singap. 2006 Mar;35(3):203-9.

    PubMed 16625271
  • Rothova A. Medical treatment of cystoid macular edema. Ocul Immunol Inflamm. 2002 Dec;10(4):239-46. doi: 10.1076/ocii.10.4.239.15589.

    PubMed 12854032
  • Markomichelakis NN, Halkiadakis I, Pantelia E, Peponis V, Patelis A, Theodossiadis P, Theodossiadis G. Patterns of macular edema in patients with uveitis: qualitative and quantitative assessment using optical coherence tomography. Ophthalmology. 2004 May;111(5):946-53. doi: 10.1016/j.ophtha.2003.08.037.

    PubMed 15121373
  • Fine HF, Baffi J, Reed GF, Csaky KG, Nussenblatt RB. Aqueous humor and plasma vascular endothelial growth factor in uveitis-associated cystoid macular edema. Am J Ophthalmol. 2001 Nov;132(5):794-6. doi: 10.1016/s0002-9394(01)01103-5.

    PubMed 11704050
  • Krzystolik MG, Filippopoulos T, Ducharme JF, Loewenstein JI. Pegaptanib as an adjunctive treatment for complicated neovascular diabetic retinopathy. Arch Ophthalmol. 2006 Jun;124(6):920-1. doi: 10.1001/archopht.124.6.920. No abstract available.

    PubMed 16769855
  • Kourlas H, Schiller DS. Pegaptanib sodium for the treatment of neovascular age-related macular degeneration: a review. Clin Ther. 2006 Jan;28(1):36-44. doi: 10.1016/j.clinthera.2006.01.009.

    PubMed 16490578
  • Cunningham ET Jr, Adamis AP, Altaweel M, Aiello LP, Bressler NM, D'Amico DJ, Goldbaum M, Guyer DR, Katz B, Patel M, Schwartz SD; Macugen Diabetic Retinopathy Study Group. A phase II randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology. 2005 Oct;112(10):1747-57. doi: 10.1016/j.ophtha.2005.06.007.

    PubMed 16154196
  • VEGF Inhibition Study in Ocular Neovascularization (V.I.S.I.O.N.) Clinical Trial Group; D'Amico DJ, Masonson HN, Patel M, Adamis AP, Cunningham ET Jr, Guyer DR, Katz B. Pegaptanib sodium for neovascular age-related macular degeneration: two-year safety results of the two prospective, multicenter, controlled clinical trials. Ophthalmology. 2006 Jun;113(6):992-1001.e6. doi: 10.1016/j.ophtha.2006.02.027. Epub 2006 Apr 27.

    PubMed 16647134
  • Amato JE, Lee DH, Santos BA, Akduman L. Steroid hypopyon following intravitreal triamcinolone acetonide injection in a pseudophakic patient. Ocul Immunol Inflamm. 2005 Apr-Jun;13(2-3):245-7. doi: 10.1080/09273940590928562.

    PubMed 16019686
  • Konstantopoulos A, Williams CP, Newsom RS, Luff AJ. Ocular morbidity associated with intravitreal triamcinolone acetonide. Eye (Lond). 2007 Mar;21(3):317-20. doi: 10.1038/sj.eye.6702416. Epub 2006 May 19.

    PubMed 16710433

Questions about this trial

What is this clinical trial studying?

A study testing Pegaptanib in people with Uveitis and Cystoid Macular Edema, run by Wake Forest University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Sep 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Improvement in VA ETDRS >/= 15 Letters (time frame: 32 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00790803, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Mar 2022; AzTrials last refreshed its copy on 7 Nov 2026.

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