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Nonproliferative Diabetic RetinopathyPhase 3PANORAMANCT02718326

Study of the Efficacy and Safety of Intravitreal (IVT) Aflibercept for the Improvement of Moderately Severe to Severe Nonproliferative Diabetic Retinopathy (NPDR)

A Phase 3 study testing Intravitreal aflibercept injection [IAI] in people with Nonproliferative Diabetic Retinopathy, run by Regeneron Pharmaceuticals at 89 sites in 6 countries.

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

The primary objective of the study is to assess the efficacy of intravitreal (IVT) aflibercept compared to sham treatment in the improvement of moderately severe to severe nonproliferative diabetic retinopathy (NPDR). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Nonproliferative Diabetic Retinopathy
What is being tested?
Intravitreal aflibercept injection [IAI]
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
402 participants
Where
89 sitesin 6 countries
Study dates
29 Mar 2016to 16 Jul 2019
Phase
Phase 3
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

  • Men or women ≥18 years of age with type 1 or 2 diabetes mellitus who have moderately severe to severe nonproliferative diabetic retinopathy (NPDR) [(diabetic retinopathy severity scale (DRSS) levels 47 or 53)], confirmed by the central reading center, in whom panretinal photocoagulation (PRP) can be safely deferred for at least 6 months per the investigator
  • Best corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) letter score in the study eye of ≥69 letters (approximate Snellen equivalent of 20/40 or better)

Who cannot join

  • Presence of diabetic macular edema (DME) threatening the center of the macula in the study eye
  • Evidence of retinal neovascularization on clinical examination or Fluorescein Angiography (FA)
  • Any prior focal or grid laser photocoagulation or any prior PRP in the study eye
  • Any prior systemic anti-vascular endothelial growth factor (VEGF) treatment or intravitreal (IVT) anti-VEGF treatment in the study eye
  • Any prior intraocular steroid injection in the study eye
  • Current anterior segment neovascularization (ASNV), vitreous hemorrhage, or tractional retinal detachment visible at the screening assessments in the study eye
  • Note: Other inclusion/ exclusion criteria apply

Trial locations and contacts

89 sites in 6 countries.

89 sites in 6 countries

United States71 sites
  • Regeneron Study Site

    Abilene, Texas, 79606

  • Regeneron Study Site

    Albuquerque, New Mexico, 87109

  • Regeneron Study Site

    Altamonte Springs, Florida, 32701

  • Regeneron Study Site

    Arcadia, California, 91007

  • Regeneron Study Site

    Asheville, North Carolina, 28803

  • Regeneron Study Site 1

    Austin, Texas, 78705

  • Regeneron Study Site 2

    Austin, Texas, 78705

  • Regeneron Study Site

    Baltimore, Maryland, 21204

  • Regeneron Study Siste

    Baltimore, Maryland, 21209

  • Regeneron Study Site

    Baltimore, Maryland, 21287

  • Regeneron Study Site

    Beverly Hills, California, 90211

  • Regeneron Study Site

    Bloomfield, New Jersey, 07003

  • Regeneron Study Site

    Boston, Massachusetts, 02114

  • Regeneron Study Site

    Burlington, Vermont, 05401

  • Regeneron Study Site

    Charlotte, North Carolina, 28210

  • Regeneron Study Site

    Chattanooga, Tennessee, 37421

  • Regeneron Study Site

    Chicago, Illinois, 60612

  • Regeneron Study Site

    Colorado Springs, Colorado, 80909

  • Regeneron Study Site

    Columbus, Ohio, 43212

  • Regeneron Study Site

    Dallas, Texas, 75231

  • Regeneron Study Site

    Deerfield Beach, Florida, 33064

  • Regeneron Study Site

    Encino, California, 91436

  • Regeneron Study Site

    Fairfax, Virginia, 22031

  • Regeneron Study Site

    Florence, South Carolina, 29501

  • Regeneron Study Site

    Fort Myers, Florida, 33912

  • Regeneron Study Site

    Fullerton, California, 92835

  • Regeneron Study Site

    Germantown, Tennessee, 38138

  • Regeneron Study Site

    Golden, Colorado, 80401

  • Regeneron Study Site

    Hagerstown, Maryland, 21740

  • Regeneron Study Site

    Harlingen, Texas, 78559

  • Regeneron Study Site

    Henderson, Nevada, 89052

  • Regeneron Study Site

    Houston, Texas, 77030

  • Regeneron Study Site

    Indianapolis, Indiana, 46290

  • Regeneron Study Site

    Kingston, Pennsylvania, 18704

  • Regeneron Study Site

    La Jolla, California, 92093

  • Regeneron Study Site

    Ladson, South Carolina, 29456

  • Regeneron Study Site

    Lakeland, Florida, 33805

  • Regeneron Study Site

    Largo, Florida, 33770

  • Regeneron Study Site

    Lexington, Kentucky, 40509

  • Regeneron Study Ssites

    Marietta, Georgia, 30060

  • Regeneron Study Site

    Medford, Oregon, 97504

  • Regeneron Study Site

    Melbourne, Florida, 32901

  • Regeneron Study Site

    Miami, Florida, 33126

  • Regeneron Study Site

    Miami, Florida, 33143

  • Regeneron Study Site

    Morgantown, West Virginia, 26506

  • Regeneron Study Site

    Mountain View, California, 94040

  • Regeneron Study Site

    Nashville, Tennessee, 37203

  • Regeneron Study Site

    Nashville, Tennessee, 37232

  • Regeneron Study Site

    New Albany, Indiana, 47150

  • Regeneron Study Site

    New London, Connecticut, 06320

  • Regeneron Study Site

    Oak Forest, Illinois, 60452

  • Regeneron Study Site

    Oakland, California, 94609

  • Regeneron Study Site

    Oceanside, California, 92056

  • Regeneron Study Site

    Oklahoma City, Oklahoma, 73104

  • Regeneron Study Site

    Orlando, Florida, 32806

  • Regeneron Study Site

    Philadelphia, Pennsylvania, 19107

  • Regeneron Study Site

    Phoenix, Arizona, 85020

  • Regeneron Study Site

    Plantation, Florida, 33324

  • Regeneron Study Site

    Rapid City, South Dakota, 57701

  • Regeneron Study Site

    Sacramento, California, 95841

  • Regeneron Study Site

    Salt Lake City, Utah, 84132

  • Regeneron Study Site

    San Antonio, Texas, 78240

  • Regeneron Study Site

    Spokane, Washington, 99204

  • Regeneron Study Site

    Tallahassee, Florida, 32308

  • Regeneron Study Site

    Tampa, Florida, 33612

  • Regeneron Study Site

    The Woodlands, Texas, 77384

  • Regeneron study Site

    Tucker, Georgia, 30084

  • Regeneron Study Site

    Tucson, Arizona, 85704

  • Regeneron Study Site

    West Columbia, South Carolina, 29169

  • Regeneron Study Site

    Willow Park, Texas, 76087

  • Regeneron Study Site

    Winter Haven, Florida, 33880

Other trials in United States

Japan6 sites
  • Regeneron Study Site

    Amagasaki, Hyōgo, 660-8550

  • Regeneron Study Site

    Asahikawa, Hokkaido, 078-8510

  • Regeneron Study Site

    Chiyoda City, Tokyo, 101-8309

  • Regeneron Study Site

    Kagoshima, 890-8520

  • Regeneron Study Site

    Matsumoto, Nagano, 390-8621

  • Regeneron Study Site

    Nagasaki, 852-8501

Other trials in Japan

Hungary5 sites
  • Regeneron Study Site

    Budapest, Pest County, 1062

  • Regeneron Study Site

    Budapest, Pest County, 1106

  • Regeneron Study Site

    Debrecen, Hajdú-Bihar, 4032

  • Regeneron Study Site

    Szeged, Csongrád megye, 6720

  • Regeneron Study Site

    Zalaegerszeg, Zala County, 8900

Other trials in Hungary

Germany3 sites
  • Regeneron Study Site

    Leipzig, Saxony, 04103

  • Regeneron Study Site

    Marburg, Hesse, 35043

  • Regeneron Study Site

    Münster, North Rhine-Westphalia, 48145

Other trials in Germany

Puerto Rico2 sites
  • Regeneron Study Site

    Arecibo, 00613

  • Regeneron Study Site

    San Juan, 00907

Other trials in Puerto Rico

United Kingdom2 sites
  • Regeneron Study Site

    Camberley, Surrey, GU16 7UJ

  • Regeneron Study Site

    London, EC1V 2PD

Other trials in United Kingdom

About this study

Official title: A Phase 3, Double-Masked, Randomized Study of the Efficacy and Safety of Intravitreal Aflibercept Injection in Patients With Moderately Severe to Severe Nonproliferative Diabetic Retinopathy

The primary objective of the study is to assess the efficacy of intravitreal (IVT) aflibercept compared to sham treatment in the improvement of moderately severe to severe nonproliferative diabetic retinopathy (NPDR).

The secondary objectives of the study are:

  • To characterize the safety of IVT aflibercept in patients with moderately severe to severe NPDR
  • To determine if IVT aflibercept will prevent the worsening of diabetic retinopathy and reduce the incidence of DME
  • To determine the anatomic effects of IVT aflibercept in patients with moderately severe to severe NPDR
Being tested
Intravitreal aflibercept injection [IAI], Sham

What participants receive

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

  • Intravitreal aflibercept injection [IAI]Drug

    Also called EYLEA® (aflibercept) Injection, BAY86-5321

  • ShamDrug

Study groups in NCT02718326
Study groupRoleWhat they receive
Dosing regimen 1ExperimentalParticipants will receive IVT aflibercept dosing regimen 1
Receives: Drug: Intravitreal aflibercept injection [IAI]
Dosing regimen 2ExperimentalParticipants will receive IVT aflibercept dosing regimen 2
Receives: Drug: Intravitreal aflibercept injection [IAI]
Dosing regimen 3Sham comparatorParticipants will receive matching sham injections
Receives: Drug: Sham

What is being measured

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

  1. Percentage of Participants Who Improved by ≥2 Steps From Baseline in the Diabetic Retinopathy Disease Severity Scale (DRSS) Score at Week 24 in the Combined 2Q16 and 2Q8 Groups

    The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached). Here, DRSS describes severity level 47 (moderately severe NPDR) and level 53 (severe NPDR) at week 24 from baseline.

    Measured: At Week 24

  2. Percentage of Participants With a ≥ 2-step Change at Week 52 in Diabetic Retinopathy Severity Scale (DRSS) From Baseline

    The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached). Here, DRSS describes severity level 47 (moderately severe NPDR) and level 53 (severe NPDR) at week 52 from baseline.

    Measured: At Week 52

Secondary outcomes (6)
  1. Percentage of Participants Who Developed a Vision-Threatening Complication Due to Diabetic Retinopathy at Week 52

    Vision-threatening complications are defined as the composite outcome of proliferative diabetic retinopathy (PDR) (inclusive of participants who have vitreous hemorrhage or tractional retinal detachment believed to be due to PDR) and anterior segment neovascularization (ASNV) (participants with neovascularization of the iris [at least 2 cumulative clock hours], and/or definitive neovascularization of the iridocorneal angle).

    Measured: At Week 52

  2. Percentage of Participants Who Developed Central Involved-Diabetic Macular Edema (CI-DME) at Week 52

    The percentage of participants who developed CI-DME at week 52 were reported.

    Measured: At Week 52

  3. Time to Development of Any Neovascular Vision Threatening Complication (PDR/ASNV) Through Week 52

    Vision-threatening complication (VTC) is defined as the composite outcome of proliferative diabetic retinopathy (PDR) (inclusive of participants who have vitreous hemorrhage or tractional retinal detachment believed to be due to PDR) and anterior segment neovascularization (ASNV) (participants with neovascularization of the iris [at least 2 cumulative clock hours], and/or definitive neovascularization of the iridocorneal angle). Vision Threatening Complications include PDR/ASNV identified by investigators and Diabetic Retinopathy Scale Score (DRSS) >61.

    Measured: Baseline through week 52 (day 365)

  4. Time to Development of Central Involved-Diabetic Macular Edema (CI-DME) Through Week 52

    Time to develop Central Involved-Diabetic Macular Edema (CI-DME) through week 52 reported.

    Measured: Baseline through week 52 (day 365)

  5. Percentage of Participants Who Received Panretinal Photocoagulation (PRP), Inclusive of Participants Undergoing Vitrectomy With Endolaser, at Week 52

    The percentage of participants who received panretinal photocoagulation (PRP), inclusive of participants undergoing vitrectomy with endolaser, at week 52 were reported.

    Measured: At Week 52

  6. Area Under the Curve (AUC) for Change From Baseline in Best Corrected Visual Acuity (BCVA) at Week 52

    The area under the curve (AUC) is the area under the best corrected visual acuity (BCVA) versus time curve from baseline to week 52. Visual function of the study eye was assessed at a distance of 4 meters at every study visit using the Early Treatment Diabetic Retinopathy Study (ETDRS) Best Corrected Visual Acuity (BCVA) letter score. BCVA scale range is 0 (worst) to 100 (best).

    Measured: At week 52

Timeline

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

  1. First posted24 Mar 2016 (estimated)
  2. Study start29 Mar 2016
  3. Primary completion6 Aug 2018
  4. Study completion16 Jul 2019

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
402 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02718326
Sponsor's protocol ID
VGFTe-OD-1411
Other IDs
2016-002639-14, 2016
Acronym
PANORAMA
Status last verified
Jul 2020
First submitted
20 Mar 2016
Last updated
30 Jul 2020
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Brown DM, Wykoff CC, Boyer D, Heier JS, Clark WL, Emanuelli A, Higgins PM, Singer M, Weinreich DM, Yancopoulos GD, Berliner AJ, Chu K, Reed K, Cheng Y, Vitti R. Evaluation of Intravitreal Aflibercept for the Treatment of Severe Nonproliferative Diabetic Retinopathy: Results From the PANORAMA Randomized Clinical Trial. JAMA Ophthalmol. 2021 Sep 1;139(9):946-955. doi: 10.1001/jamaophthalmol.2021.2809.

    PubMed 34351414

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Intravitreal aflibercept injection [IAI] in people with Nonproliferative Diabetic Retinopathy, run by Regeneron Pharmaceuticals at 89 sites in 6 countries.

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 2 inclusion and 7 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 30 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 89 sites in United States, Japan, Hungary, Germany, Puerto Rico and 1 more country. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Nov 2019). 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?

Percentage of Participants Who Improved by ≥2 Steps From Baseline in the Diabetic Retinopathy Disease Severity Scale (DRSS) Score at Week 24 in the Combined 2Q16 and 2Q8 Groups (time frame: At Week 24). The study lists 2 primary outcomes in all. 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 NCT02718326, which also lists 1 linked publication.

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 30 Jul 2020.

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