Diabetic Macular EdemaPhase 4NCT03197480
Diabetic Macular Edema Asian Response (DEAR) Study: Biomarkers for Response to Aflibercept in Asian Patients With Center Involving DME
A Phase 4 study testing Aflibercept Injection [Eylea] in people with Diabetic Macular Edema, run by Singapore National Eye Centre at 1 site in Singapore.
Trial summary
To investigate whether ocular imaging and proteomic biomarkers; and systemic biochemical, metabolomic, and genetic biomarkers predict treatment response to intravitreal aflibercept in a cohort of patients with DME. Read more about this study
- Who is it for?
- Ages 21 years and older
- Conditions the study is for
- Diabetic Macular Edema
- What is being tested?
- Aflibercept Injection [Eylea]
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 siteSingapore
- Study dates
- 17 Apr 2019to 1 Mar 2021
- Phase
- Phase 4
- Are there results?
- None posted in the registry
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 21 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participant
- Age >=21 years
- Diagnosis of Diabetes Mellitus (Type 1 or type 2)
- Current regular use of insulin or oral hypoglycemic agents for treatment of diabetes
- Documented diabetes by ADA and/or WHO criteria.
- Able and willing to provide informed consent.
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- Study Eye
- Best corrected ETDRS visual acuity score <= 78 (ie 20/32 or worse)
- On Clinical Examination, definite retinal thickening due to diabetic macular edema involving the center of the macula.
- Diabetic macular edema present on OCT (central subfield thickness on OCT >=300um with spectralis (Heidelberg)
- Media clarity, pupillary dilation and individual cooperation sufficient for study procedure including fundus photography.
Who cannot join
- Participant
- End stage renal failure requiring hemodialysis or peritoneal dialysis.
- Medical condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
- Participation in an investigational trial within 30 days of enrolment which involves treatment with unapproved investigational drug
- Known allergy to any component of the study drug.
- Blood pressure > 180/110 (systolic above 180 OR diastolic above 110 on repeated measurements). If blood pressure is brought below 180/110 by anti-hypertensive treatment, individual can become eligible.
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- Myocardial infarction, other acute cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 4 months prior to randomization.
- Systemic anti-VEGF or pro-VEGF treatment within three months prior to randomization or anticipated use during the study.
- For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 24 months. Women who are potential study participants should be questioned about the potential for pregnancy.
- Patient with non study eye VA: counting finger or worse (i.e. only one seeing eye) will be excluded.
- Study Eye
- Macular edema is considered to be due to a cause other than diabetic macular edema. An eye should not be considered eligible if: (1) the macular edema is considered to be related to ocular surgery such as cataract extraction or (2) clinical exam and/or OCT suggest that vitreoretinal interface abnormalities (e.g., a taut posterior hyaloid or epiretinal membrane) are the primary cause of the macular edema.
- An ocular condition is present such that, in the opinion of the investigator, visual acuity loss would not improve from resolution of macular edema (e.g., foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, nonretinal condition).
- An ocular condition is present (other than diabetes) that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the course of the study (e.g., vein occlusion, uveitis or other ocular inflammatory disease, neovascular glaucoma, etc.)
- Substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by more than three lines (i.e., cataract would be reducing acuity to worse than 20/40 if eye was otherwise normal).
- History of an anti-VEGF treatment for DME in the past 3 months or history of any other treatment for DME at any time in the past 3 months (such as focal/grid macular photocoagulation, intravitreal or peribulbar corticosteroids).
- History of pan-retinal photocoagulation within 3 months prior to randomization or anticipated need for immediate pan-retinal photocoagulation. (eg. Proliferative diabetic retinopathy. Cases with severe non-proliferative diabetic retinopathy will still be eligible)
- History of ocular anti-VEGF treatment for a disease other than DME in the past 3 months
- History of major ocular surgery (including vitrectomy, cataract extraction, scleral buckle, any intraocular surgery, etc.) within prior four months or anticipated within the next six months following randomization.
- History of YAG capsulotomy performed within two months prior to randomization.
- Aphakia.
- Exam evidence of external ocular infection, including conjunctivitis, chalazion, or significant blepharitis.
- History of intravitreal steroids within the last 6 months.
Trial locations and contacts
1 site in 1 country.
Singapore1 site, 1 recruiting
- Recruiting
Singapore National Eye Centre
Singapore
Gavin Tan, gavin.tan@singhealth.com.sg
About this study
Official title: Identifying Ocular and Systemic Biomarkers for Response to Aflibercept in Asian Patients With Centre Involving Diabetic Macular Edema: A Prospective Clinical Trial
To investigate whether ocular imaging and proteomic biomarkers; and systemic biochemical, metabolomic, and genetic biomarkers predict treatment response to intravitreal aflibercept in a cohort of patients with DME.
Read the detailed description
This is a prospective observational clinical trial with only the use of a standard care of drug, aflibercept. All study eyes will receive intravitreal aflibercept at the initial injection and x 4 monthly injections including at month 3.
- Conditions
- Diabetic Macular Edema
- Being tested
- Aflibercept Injection [Eylea]
- Keywords
- Anti-Vascular Endothelial Growth Factor, Aflibercept, Intravitreal injection, Diabetic Macular Edema
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Aflibercept Injection [Eylea]Drug
All subjects will receive 4 monthly intravitreal injections of aflibercept
| Study group | Role | What they receive |
|---|---|---|
| DME treatment group | Other | All patients will received 4 intravitreal injections of aflibercept.
Based on the OCT outcome they will be classified into 2 groups for assessment of biomarkers:
Less than 20% reduction in CRT on OCT or <5 letter improvement of VA (if VA<6/6 and CRT>=340) Rapid (Mac Dry at M4) Delayed: Persistent fluid at M4, but more than 20% reduction in CRT on OCT Receives: Drug: Aflibercept Injection [Eylea] |
What is being measured
The primary outcome is the main question the study is designed to answer.
CRT
Mean change in Central Retinal Thickness
Measured: 12 Months
Secondary outcomes (9)
BCVA
Mean change in Best Corrected Visual Acuity
Measured: 12 Months
Change in vascular density by OCTA
Change in vascular density by OCTA in different layer
Measured: Baseline, Month 12
Percentage of patients with a BCVA improvement of 15 letters or more
Percentage of patients with a BCVA improvement of 15 letters or more
Measured: Baseline, Month 12
Percentage of patients with a BCVA improvement of 10 letters or more
Percentage of patients with a BCVA improvement of 10 letters or more
Measured: Baseline, Month 12
Mean BCVA at each injection number
Mean BCVA at each injection number
Measured: 12 Months
Mean change in BCVA across all the study injection numbers
Mean change in BCVA across all the study injection numbers
Measured: Baseline, Month 12
Percentage of patients with BCVA improvement
Percentage of patients with BCVA improvement
Measured: Baseline, Month 12
Percentage of BCVA losers
Percentage of BCVA losers
Measured: Baseline, Month 12
Percentage of patients improving to 20/40 or better
Percentage of patients improving to 20/40 or better
Measured: Baseline, Month 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jun 2017
- Study start17 Apr 2019
- Primary completion31 Dec 2020 (estimated)
- Study completion1 Mar 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Diabetic Macular EdemaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 4
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- This is a prospective observational clinical trial with only the use of a standard care of drug, aflibercept. All study eyes will receive intravitreal aflibercept at the initial injection and x 4 monthly injections including at month 3.
- Masking
- None (open label)
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Singapore National Eye Centre
- Sponsor type
- Other government
- Collaborators
- Santen Pharmaceutical Co., Ltd., Singapore Eye Research Institute
- Responsible party
- Sponsor
- Investigators
- Gavin Tan, Study director, Singapore National Eye Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03197480
- Sponsor's protocol ID
- R1436/19/2017
- Status last verified
- Apr 2019
- First submitted
- 5 Jun 2017
- Last updated
- 22 Apr 2019
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Apr 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Identifying Ocular and Systemic Biomarkers for Response to Aflibercept in Asian Patients With Centre Involving Diabetic Macular Edema: A Prospective Clinical Trial
- ClinicalTrials.gov ID
- NCT03197480
- Acronym / sponsor ID
- R1436/19/2017
- Conditions
- Diabetic Macular Edema
- Keywords
- Anti-Vascular Endothelial Growth Factor, Aflibercept, Intravitreal injection, Diabetic Macular Edema
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Singapore National Eye CentreOther government
- Collaborators
- Santen Pharmaceutical Co., Ltd., Singapore Eye Research Institute
- Study start
- 17 Apr 2019 (actual)
- Primary completion
- 31 Dec 2020 (estimated)
- Study completion
- 1 Mar 2021 (estimated)
- First posted
- 23 Jun 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To investigate whether ocular imaging and proteomic biomarkers; and systemic biochemical, metabolomic, and genetic biomarkers predict treatment response to intravitreal aflibercept in a cohort of patients with DME.
Detailed description
This is a prospective observational clinical trial with only the use of a standard care of drug, aflibercept. All study eyes will receive intravitreal aflibercept at the initial injection and x 4 monthly injections including at month 3.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- This is a prospective observational clinical trial with only the use of a standard care of drug, aflibercept. All study eyes will receive intravitreal aflibercept at the initial injection and x 4 monthly injections including at month 3.
| Arm | Type | Receives |
|---|---|---|
| DME treatment group | Other | Drug: Aflibercept Injection [Eylea]All patients will received 4 intravitreal injections of aflibercept. Based on the OCT outcome they will be classified into 2 groups for assessment of biomarkers: Less than 20% reduction in CRT on OCT or <5 letter improvement of VA (if VA<6/6 and CRT>=340) Rapid (Mac Dry at M4) Delayed: Persistent fluid at M4, but more than 20% reduction in CRT on OCT |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Participant
- Age >=21 years
- Diagnosis of Diabetes Mellitus (Type 1 or type 2)
- Able and willing to provide informed consent.
- Study Eye
Key exclusion criteria (23 listed)
- Participant
- End stage renal failure requiring hemodialysis or peritoneal dialysis.
- Medical condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
- Participation in an investigational trial within 30 days of enrolment which involves treatment with unapproved investigational drug
- Known allergy to any component of the study drug.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Aflibercept Injection [Eylea]All subjects will receive 4 monthly intravitreal injections of aflibercept | Drug | DME treatment group |
Primary outcome
CRT
Time frame: 12 Months
Mean change in Central Retinal Thickness
9 secondary outcomes
BCVA
Time frame: 12 Months
Change in vascular density by OCTA
Time frame: Baseline, Month 12
Percentage of patients with a BCVA improvement of 15 letters or more
Time frame: Baseline, Month 12
Percentage of patients with a BCVA improvement of 10 letters or more
Time frame: Baseline, Month 12
Mean BCVA at each injection number
Time frame: 12 Months
Mean change in BCVA across all the study injection numbers
Time frame: Baseline, Month 12
Percentage of patients with BCVA improvement
Time frame: Baseline, Month 12
Percentage of BCVA losers
Time frame: Baseline, Month 12
Percentage of patients improving to 20/40 or better
Time frame: Baseline, Month 12
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Apr 2019.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gavin Tan study director
Singapore National Eye Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Aflibercept Injection [Eylea] in people with Diabetic Macular Edema, run by Singapore National Eye Centre at 1 site in Singapore.
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 11 inclusion and 23 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: status not confirmed, as of the sponsor's last update on 22 Apr 2019. 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 Singapore. 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.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Gavin Tan (6322 7433, gavin.tan@singhealth.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
CRT (time frame: 12 Months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 22 Apr 2019.