Diabetic Macular EdemaPhase 3GLIMMERNCT04603937
A Study to Evaluate the Efficacy, Durability, and Safety of KSI-301 Compared to Aflibercept in Participants With Diabetic Macular Edema (DME)
A Phase 3 study testing KSI-301 and Aflibercept in people with Diabetic Macular Edema, run by Kodiak Sciences Inc at 72 sites in 8 countries.
Trial summary
This Phase 3 study will evaluate the efficacy, durability, and safety of KSI-301 compared to aflibercept in participants with treatment-naïve DME. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetic Macular Edema
- What is being tested?
- KSI-301 and Aflibercept
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 459 participants
- Where
- 72 sitesin 8 countries
- Study dates
- 30 Sep 2020to 31 Aug 2023
- 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
- Signed informed consent prior to participation in the study.
- Treatment-naïve diabetic macular edema, with vision loss and center involvement (if present) diagnosed within 9 months of screening.
- BCVA ETDRS letter score between 78 and 25 (-20/25 to 20/320 Snellen equivalent), inclusive, in the Study Eye.
- CST of ≥ 320 microns on SD-OCT (Heidelberg Spectralis or equivalent on other OCT instruments) as determined by the Reading Center.
- Decrease in vision determined by the Investigator to be primarily the result of DME.
- Type 1 or Type 2 diabetes mellitus and a HbA1c of ≤12%.
- Other protocol-specified inclusion criteria may apply.
Who cannot join
- Macular edema in the Study Eye considered to be secondary to a cause other than DME.
- Active iris or angle neovascularization or neovascular glaucoma in the Study Eye.
- High-risk proliferative diabetic retinopathy characteristics in the Study Eye.
- History of Pan-retinal Photocoagulation (PRP) laser in the Study Eye within 3 months of screening.
- Tractional retinal detachment in the Study Eye.
- Active retinal disease other than the condition under investigation in the Study Eye.
Show all 14Show fewer
- Any history or evidence of a concurrent ocular condition present, that in the opinion of the Investigator could require either medical or surgical intervention or affect macular edema or alter visual acuity during the study (e.g., vitreomacular traction, epiretinal membrane).
- Active or suspected ocular or periocular infection or inflammation in either eye at Day 1.
- Any prior use of an approved or investigational treatment for DME in the Study Eye (e.g., anti-VEGF, intraocular or periocular steroids, macular laser photocoagulation).
- Women who are pregnant or lactating or intending to become pregnant during the study.
- Uncontrolled blood pressure defined as a systolic value ≥ 180 mmHg or diastolic value ≥100 mmHg while at rest.
- Recent history (within the 6 months prior to screening) of myocardial infarction, stroke, transient ischemic attack, acute congestive heart failure or any acute coronary event.
- History of a medical condition that, in the judgment of the Investigator, would preclude scheduled study visits, completion of the study, or a safe administration of investigational product.
- Other protocol-specified exclusion criteria may apply.
Trial locations and contacts
72 sites in 8 countries.
72 sites in 8 countries
United States40 sites
Retina Consultants of Hawaii, Inc
‘Aiea, Hawaii, 96701
Retina Research Institute of Texas
Abilene, Texas, 79606
Asheville Eye Associates
Asheville, North Carolina, 28803
Southeast Retina Center
Augusta, Georgia, 30909
Austin Research Center for Retina
Austin, Texas, 78705
Retina Vitreous Associates
Beverly Hills, California, 90211
Retina Specialists of Idaho
Boise, Idaho, 83713
Florida Eye Microsurgical Institute
Boynton Beach, Florida, 33426
Cleveland Clinic Foundation, Cole Eye Institute
Cleveland, Ohio, 44195
Rand Eye Institute
Deerfield Beach, Florida, 33064
Talley Eye
Evansville, Indiana, 47710
National Ophthalmic Research Institute
Fort Myers, Florida, 33912
Texas Retina Associates
Fort Worth, Texas, 76108
Retina Consultants of Orange County
Fullerton, California, 92835
Vitreo Retinal Consultants
Hauppauge, New York, 11788
Retina Consultants of NV
Henderson, Nevada, 89052
Retina Consultants of Houston-(Katy)
Katy, Texas, 77494
Southeastern Retina Associates PC
Knoxville, Tennessee, 37922
Retina-Vitreous Surgeons of Central NY
Liverpool, New York, 13088
Georgia Retina, P.C.
Marietta, Georgia, 30060
Vitreoretinal Surgery PA
Minneapolis, Minnesota, 55435
Northern California Retina Vitreous Associates
Mountain View, California, 94040
Ophthalmic Consultants of Long Island
Oceanside, New York, 11572
Retinal Research Institute, LLC
Phoenix, Arizona, 85014
Texas Retina Associates
Plano, Texas, 75075
Fort Lauderdale Eye Institute
Plantation, Florida, 33324
Maine Eye Center
Portland, Maine, 04101
Retina Consultants of San Diego
Poway, California, 92064
Sierra Eye Associates
Reno, Nevada, 89502
Retina Institute of Virginia
Richmond, Virginia, 23235
Retina Associates of Western NY
Rochester, New York, 14620
Austin Retina Associates (Round Rock)
Round Rock, Texas, 78681
Associated Retinal Consultants PC
Royal Oak, Michigan, 48073
Retinal Consultants Medical Group Inc
Sacramento, California, 95825
Retina Consultants, LLC
Salem, Oregon, 97302
Medical Center Ophthalmology Associates
San Antonio, Texas, 78240
Retina Vitreous Associates of Florida
St. Petersburg, Florida, 33703
Southern Vitreoretinal Associates
Tallahassee, Florida, 32308
Retina Consultants of Houston - (Woodlands)
The Woodlands, Texas, 77384
Retina Group of New England
Waterford, Connecticut, 06385
Israel9 sites
Bnai Zion
Haifa, 31048
Rambam MC
Haifa, 31096
Hadassah University Hospital
Jerusalem, 91120
Meir MC
Kfar Saba, 44281
Rabin Medical Center
Petah Tikva, 49100
Kaplan MC
Rehovot, 76100
Tel Aviv Sourasky Medical Center
Tel Aviv, 6423906
Assuta HaShalom
Tel Aviv, 6789140
Shamir Medical Center Assaf Harofeh
Tzrifin, 70300
France6 sites
Centre Hospitalier Intercommunal de Créteil
Créteil, 94000
CHRU Dijon Complexe Du Bocage
Dijon, Côte-d'Or, 21079
Hôpital de La Croix Rousse
Lyon, Rhône, 69317
Centre Paradis Monticelli
Marseille, 13008
Hôpital Lariboisière - Service Pharmacie , Essais cliniques - Aude Jacob
Paris, 75 010
Fondation Rothschild
Paris, 75019
Poland6 sites
Oftalmika Sp. z o.o.
Bydgoszcz, 85-631
Optimum Profesorskie Centrum Okulistyki
Gdansk, Pomeranian Voivodeship, 80-809
Uniwersyteckie Centrum Kliniczne Im. Prof. K. Gibinskiego Slaskiego Uniwersytetu Medycznego w Katowi
Katowice, Silesian Voivodeship, 40-514
Specjalistyczny Szpital im. Alfreda Sokolowskiego
Wałbrzych, 58-309
Dr Nowosielska Okulistyka i Chirurgia Oka
Warsaw, 01-249
Uniwersytecki Szpital Kliniczny im. Jana Mikulicza Radeckiego we Wroclawiu
Wroclaw, 50-556
Hungary4 sites
Semmelweis Egyetem
Budapest, 1085
Bajcsy-Zsilinszky Korhaz es Rendelointezet
Budapest, 1106
Budapest Retina Associates Kft
Budapest, 1133
Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktatokorhaz , Josa Andras Oktatókórház
Nyíregyháza, Szabolcs-Szatmár-Bereg, H-4400
Czechia3 sites
OFTEX s.r.o.
Pardubice, 53002
Vseobecna Fakultni
Prague, 128 08
Lekarna BENU
Prague, 150 00
Italy3 sites
Ospedale San Raffaele S.r.l. - PPDS
Milan, Lombardy, 20132
AOU dell'Università degli Studi della Campania Luigi Vanvitelli
Naples, 80131
Fondazione Policlinico Universitario A Gemelli
Rome, Lazio, 00168
Puerto Rico1 site
Emanuelli Research & Development Center LLC
Arecibo, 00612
About this study
Official title: A Prospective, Randomized, Double-masked, Active Comparator-controlled, Multi-center, Two-arm, Phase 3 Study to Evaluate the Efficacy and Safety of Intravitreal KSI-301 Compared With Intravitreal Aflibercept in Participants With Visual Impairment Secondary to Treatment-naïve Diabetic Macular Edema (DME)
This Phase 3 study will evaluate the efficacy, durability, and safety of KSI-301 compared to aflibercept in participants with treatment-naïve DME.
Read the detailed description
This is a Phase 3, prospective, randomized, double-masked, two-arm, multi-center non-inferiority study evaluating the efficacy and safety of repeated intravitreal dosing of KSI-301 5 mg in participants with treatment-naïve DME.
The primary endpoint will be assessed at Year 1; additional secondary endpoints for efficacy will be assessed at Years 1 and 2.
- Conditions
- Diabetic Macular Edema
- Being tested
- KSI-301, Aflibercept, Sham Procedure
- Keywords
- DME, Kodiak, Vascular endothelial growth factor, Anti-VEGF, VEGF, Antibody biopolymer conjugate, Retinal Degeneration, Retinal Diseases, Eye Diseases, Vision Disorders, Vision, low, Aflibercept, Eylea, Diabetes mellitus, Diabetes, Diabetic retinopathy, Diabetic macular edema, Macular edema, KSI-301
- Medical subject headings
- Retinal Degeneration, Retinal Diseases, Eye Diseases, Vision Disorders, Vision, Low, Diabetes Mellitus, Diabetic Retinopathy, Macular Edema
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
KSI-301Drug
Intravitreal Injection
AfliberceptDrug
Also called Eylea
Intravitreal Injection
Sham ProcedureOther
The sham is a procedure that mimics an intravitreal injection. It involves pressing the blunt end of an empty syringe (without a needle) against the anesthetized eye. It will be administered to participants in both treatments arms at applicable visits to maintain masking.
| Study group | Role | What they receive |
|---|---|---|
| KSI-301 (Arm A) | Experimental | Intravitreal injection of KSI-301 (5 mg) once every 4 weeks for 3 monthly doses followed by an individualized dosing regimen (every 8 to 24 weeks) via intravitreal injection from Week 16 to Week 100. Receives: Drug: KSI-301; Other: Sham Procedure |
| Aflibercept (Arm B) | Active comparator | Intravitreal injection of aflibercept (2 mg) once every 4 weeks for 5 monthly doses followed by aflibercept (2 mg) once every 8 weeks via intravitreal injection from Week 24 to 100. Receives: Drug: Aflibercept; Other: Sham Procedure |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Change in BCVA
Mean change in best-corrected visual acuity (BCVA) from baseline to the average of Weeks 60 and 64 (using Early Treatment Diabetic Retinopathy Study (ETDRS) Letters). Best Corrected Visual Acuity (BCVA) was measured on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters. The BCVA letter score ranges from 0 to 100 (best score), and a gain in BCVA letter score from baseline indicates an improvement in visual acuity.
Measured: Day 1 to Week 64
Secondary outcomes (5)
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Studies KS301P104 and KS301P105 Combined
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Studies KS301P104 and KS301P105 combined. 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).
Measured: Day 1 to Week 52
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Study KS301P105
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Study KS301P105. 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).
Measured: Day 1 to Week 52
Percentage of Patients in the KSI-301 Arm on a Q8W, Q12W, Q16W, Q20W, or Q24W Treatment Interval
Percentage of patients in the KSI-301 arm on a Q8W, Q12W, Q16W, Q20W, or Q24W treatment interval at the primary endpoint. Analyses include KSI-301 patients who completed a treatment interval from Week 56 onwards.
Measured: Week 56
Mean Number of Intravitreal Injections
Mean number of intravitreal injections from Day 1 to Week 60
Measured: Day 1 to Week 60
Mean Change in OCT CST
Mean change in Optical Coherence Tomography (OCT) central subfield retinal thickness (CST) baseline to the average of Weeks 60 and 64
Measured: Day 1 to Week 64
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Oct 2020
- Study start30 Sep 2020
- Primary completion27 Apr 2023
- Study completion31 Aug 2023
Why it stopped: Study did not meet primary endpoint
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized 1:1 into one of two treatment arms: KSI-301 or aflibercept.
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 459 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kodiak Sciences Inc
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Pablo Velazquez-Martin, MD, Study director, Kodiak Sciences Inc
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04603937
- Sponsor's protocol ID
- KS301P105
- Other IDs
- 2020-001063-82
- Acronym
- GLIMMER
- Status last verified
- Aug 2024
- First submitted
- 21 Oct 2020
- Last updated
- 22 Aug 2024
- Results posted
- Yes, on ClinicalTrials.gov
- 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 Aug 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective, Randomized, Double-masked, Active Comparator-controlled, Multi-center, Two-arm, Phase 3 Study to Evaluate the Efficacy and Safety of Intravitreal KSI-301 Compared With Intravitreal Aflibercept in Participants With Visual Impairment Secondary to Treatment-naïve Diabetic Macular Edema (DME)
- ClinicalTrials.gov ID
- NCT04603937
- Acronym / sponsor ID
- GLIMMER / KS301P105
- Conditions
- Diabetic Macular Edema
- Keywords
- DME, Kodiak, Vascular endothelial growth factor, Anti-VEGF, VEGF, Antibody biopolymer conjugate, Retinal Degeneration, Retinal Diseases
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Study did not meet primary endpoint
- Enrolment
- 459 participants (actual)
- Lead sponsor
- Kodiak Sciences IncIndustry (pharma, biotech, devices)
- Study start
- 30 Sep 2020 (actual)
- Primary completion
- 27 Apr 2023 (actual)
- Study completion
- 31 Aug 2023 (actual)
- First posted
- 27 Oct 2020 (actual)
- Results
- Posted 22 Aug 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This Phase 3 study will evaluate the efficacy, durability, and safety of KSI-301 compared to aflibercept in participants with treatment-naïve DME.
Detailed description
This is a Phase 3, prospective, randomized, double-masked, two-arm, multi-center non-inferiority study evaluating the efficacy and safety of repeated intravitreal dosing of KSI-301 5 mg in participants with treatment-naïve DME.
The primary endpoint will be assessed at Year 1; additional secondary endpoints for efficacy will be assessed at Years 1 and 2.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomized 1:1 into one of two treatment arms: KSI-301 or aflibercept.
| Arm | Type | Receives |
|---|---|---|
| KSI-301 (Arm A) | Experimental | Drug: KSI-301, Other: Sham ProcedureIntravitreal injection of KSI-301 (5 mg) once every 4 weeks for 3 monthly doses followed by an individualized dosing regimen (every 8 to 24 weeks) via intravitreal injection from Week 16 to Week 100. |
| Aflibercept (Arm B) | Active comparator | Drug: Aflibercept, Other: Sham ProcedureIntravitreal injection of aflibercept (2 mg) once every 4 weeks for 5 monthly doses followed by aflibercept (2 mg) once every 8 weeks via intravitreal injection from Week 24 to 100. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Signed informed consent prior to participation in the study.
- Treatment-naïve diabetic macular edema, with vision loss and center involvement (if present) diagnosed within 9 months of screening.
- BCVA ETDRS letter score between 78 and 25 (-20/25 to 20/320 Snellen equivalent), inclusive, in the Study Eye.
- CST of ≥ 320 microns on SD-OCT (Heidelberg Spectralis or equivalent on other OCT instruments) as determined by the Reading Center.
- Decrease in vision determined by the Investigator to be primarily the result of DME.
Key exclusion criteria (14 listed)
- Macular edema in the Study Eye considered to be secondary to a cause other than DME.
- Active iris or angle neovascularization or neovascular glaucoma in the Study Eye.
- High-risk proliferative diabetic retinopathy characteristics in the Study Eye.
- History of Pan-retinal Photocoagulation (PRP) laser in the Study Eye within 3 months of screening.
- Tractional retinal detachment in the Study Eye.
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 |
|---|---|---|
| KSI-301Intravitreal Injection | Drug | KSI-301 (Arm A) |
| AfliberceptAlso: EyleaIntravitreal Injection | Drug | Aflibercept (Arm B) |
| Sham ProcedureThe sham is a procedure that mimics an intravitreal injection. It involves pressing the blunt end of an empty syringe (without a needle) against the anesthetized eye. It will be administered to participants in both treatments arms at applicable visits to maintain masking. | Other | Aflibercept (Arm B), KSI-301 (Arm A) |
Primary outcome
Mean Change in BCVA
Time frame: Day 1 to Week 64
Mean change in best-corrected visual acuity (BCVA) from baseline to the average of Weeks 60 and 64 (using Early Treatment Diabetic Retinopathy Study (ETDRS) Letters). Best Corrected Visual Acuity (BCVA) was measured on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters. The BCVA letter score ranges from 0 to 100 (best score), and a gain in BCVA letter score from baseline indicates an improvement in visual acuity.
5 secondary outcomes
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Studies KS301P104 and KS301P105 Combined
Time frame: Day 1 to Week 52
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Study KS301P105
Time frame: Day 1 to Week 52
Percentage of Patients in the KSI-301 Arm on a Q8W, Q12W, Q16W, Q20W, or Q24W Treatment Interval
Time frame: Week 56
Mean Number of Intravitreal Injections
Time frame: Day 1 to Week 60
Mean Change in OCT CST
Time frame: Day 1 to Week 64
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Aug 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
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A Clinical Trial of MK-8748 Compared to Aflibercept in Participants With Diabetic Macular Edema (MK-8748-004)
Diabetic Retinopathy, Macular Edema
Not yet recruitingPhase 2
Study of CU06-1004 in Patients With Daibetic Macular Edema
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A Clinical Trial of MK-8748 Compared to Aflibercept in Participants With Diabetic Macular Edema (MK-8748-005)
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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.
Pablo Velazquez-Martin, MD study director
Kodiak Sciences Inc
72 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing KSI-301 and Aflibercept in people with Diabetic Macular Edema, run by Kodiak Sciences Inc at 72 sites in 8 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 7 inclusion and 14 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: stopped early, as of the sponsor's last update on 22 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 72 sites in United States, Israel, France, Poland, Hungary and 3 more countries. 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 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 22 Aug 2024). 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?
Mean Change in BCVA (time frame: Day 1 to Week 64). 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 Aug 2024.