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Completed

NCT Number: NCT02543229

Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 With or Without Lucentis™ in Patients With Wet AMD

The purpose of this first-in-human study is to evaluate the safety, pharmacokinetics (PK) and pharmacodynamics of OPT-302 administered as monthly intravitreal injections for 3 months with and without Lucentis™ in patients with wet age related macular degeneration (AMD). This study will be conducted in two parts: Part 1 will comprise an open label, sequential dose escalation and Part 2 a randomized dose expansion.

OPT-302 is a soluble form of VEGFR-3 comprising the extracellular domains 1-3 of human vascular endothelial growth factor receptor (VEGFR)-3 and the Fc fragment of human IgG1. It functions by binding and neutralizing the activity of vascular endothelial growth factor (VEGF)-C and VEGF-D on endogenous VEGFR-2 and VEGFR-3.

VEGF-C and VEGF-D promote blood vessel development (angiogenesis) by binding and activating VEGFR-2 and VEGFR-3. VEGF-C is also a potent inducer of vascular permeability or leakage. Angiogenesis and vascular leakage are key hallmarks of wet AMD. Approved therapies for wet AMD include Eylea™ and Lucentis™ which block the activity of VEGF-A, but not VEGF-C or VEGF-D which are alternate members of the same family of molecules.

VEGF-C and VEGF-D can stimulate blood vessel growth and leakage through the same pathway as VEGF-A (via VEGFR-2), as well as through pathways that are independent of VEGF-A (via VEGFR-3). Published studies have also indicated that VEGF-C and VEGF-D play an important role in mediating resistance to therapies that block VEGF-A such as Lucentis™ and Eylea™.

Combination therapy with OPT-302 an anti-VEGF-A agent provides a more complete blockade of the VEGF family. This strategy targets functional redundancy in the VEGF pathway and mechanisms of 'resistance' or sub-response to VEGF-A inhibition.

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Key information

Age range

50 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Opthea Investigative Site, Phoenix, Arizona, United States

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Able and willing to provide written informed consent
  • Age ≥ 50 years of either gender
  • Active CNV lesions secondary to AMD (i.e., subretinal or intraretinal fluid on SD-OCT and / or leakage on fluorescein angiography)
  • Either no previous treatment in the study eye with IVT anti-VEGF-A therapy (treatment naïve) or prior IVT anti-VEGF-A therapy (previously treated) with sub-optimal response to treatment and the need for additional treatment
  • Best corrected visual acuity in the study eye, using ETDRS testing, of 20/320 or better (Snellen equivalent) in Part 1 (dose escalation) and between 20/40 and 20/320 (Snellen equivalent), inclusive, in Part 2 (dose expansion).
  • Women of child bearing potential and male subjects with female partners of child bearing potential must be practicing effective contraception during the trial and for at least 3 months following the last dose of study medication

Exclusion criteria

  • Previous or concurrent use of systemic anti-VEGF-A agents
  • Most recent IVT injection of bevacizumab or ranibizumab <28 days prior to screening or aflibercept <42 days prior to screening
  • Previous treatment with photodynamic therapy, thermal laser or external beam radiation in the study eye
  • Concurrent treatment in either eye for any ocular condition with an investigational drug or device that has not received regulatory approval
  • Anatomic damage to the center of the fovea including fibrosis and scarring making up >50% of total lesion area including the CNV in the study eye
  • Geographic atrophy involving the center of the fovea in the study eye
  • History or presence of a retinal pigment epithelial tear
  • Presence of polypoidal choroidal vasculopathy (if in the opinion of the investigator, anti-VEGF treatment would not be of benefit) or retinal angiomatous proliferation
  • Active or recent (within 4 weeks) intraocular inflammation (grade trace or above) in the study eye
  • History of rhegmatogenous retinal detachment or macular hole in the study eye
  • History of vitrectomy
  • Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye
  • History of vitreous hemorrhage within 4 weeks prior to screening in the study eye
  • History of major ocular surgery within prior 6 months or anticipated within next 3 months following dosing on day 1
  • Uncontrolled glaucoma in the study eye (defined as intraocular pressure of >25 mmHg despite treatment with maximal medical therapy)
  • Uncontrolled hypertension ≥180 mmHg systolic or ≥110 mmHg diastolic at baseline
  • Uncontrolled diabetes mellitus (Disease must be controlled with hemoglobin A1c (HgbA1c) < 9.0%)
  • Clinical evidence of diabetic retinopathies, diabetic macular edema or any other vascular disease affecting the retina, other than AMD, in either eye that, in the opinion of the investigator, would be likely to limit improvement in the macular anatomy and/or function
  • Pregnancy or lactation

Treatment and study plan

OPT-302

Drug

OPT-302 will be administered by intravitreal injection once every month for 3 months

Lucentis™

Drug

Lucentis™ (0.5 mg) will be administered by intravitreal injection once every month for 3 months

Other names: Ranibizumab

Primary outcomes

  1. Safety (Adverse Events)

    Time frame: Up to 1 month after the last dose

    Subject incidences of ophthalmic and systemic Adverse Events during study and follow-up period

Secondary outcomes

  1. Mean change in Best Corrected Visual Acuity (BCVA) from baseline

    Time frame: 6 months

    Mean change in Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA from baseline

  2. Mean change in central retinal thickness from baseline

    Time frame: 6 months

    Changes in intra- or sub-retinal fluid measured as mean change in central retinal thickness or macula volume by Spectral Domain Optical Coherence Tomography (SD-OCT)

  3. Mean change in Choroidal Neovascularization (CNV) lesion area from baseline

    Time frame: 6 months

    Change in CNV size according to fluorescein angiogram

  4. Mean number of retreatment injections of anti-VEGF-A therapy during long term follow-up (week 12 to 24)

    Time frame: 3 months

  5. Need for 'rescue therapy' with ranibizumab in subjects receiving OPT-302 monotherapy

    Time frame: 3 months

  6. Assess the Pharmacokinetic profile of OPT-302 alone and in combination with ranibizumab following intravitreal administration

    Time frame: Up to 28 days post-dose

    Mean systemic OPT-302 Concentration-Time profile

  7. Anti-OPT-302 antibody formation

    Time frame: Pre-dose and up to 3 months post-dose

    Incidence of anti-OPT-302 antibody formation

Other outcomes

  1. Exploratory: Changes in the systemic blood levels of angiogenesis-related biomarkers

    Time frame: 3 months

    Change in systemic blood levels of angiogenesis-related biomarkers including, but not limited to: Vascular Endothelial Growth Factor A (VEGF-A), VEGF-C, VEGF-D, soluble VEGFR-2 and soluble VEGFR-3.

Sponsors and collaborators

Lead sponsor

Opthea Limited

Industry

Registry information

Official study title

A Phase 1 Dose Escalation Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of OPT-302 in Combination With Ranibizumab in Subjects With Wet AMD

Important dates

Study start
2015
Primary completion
2017
Study completion
2017
First posted
Sep 7, 2015
Registry last updated
Nov 6, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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