Title

Phase 2 Randomized Clinical Trial of Luminate® as Compared to Avastin® in the Treatment of Diabetic Macular Edema
A Phase 2 Randomized, Controlled, Double-Masked, Multicenter Clinical Trial Designed to Evaluate the Safety and Exploratory Efficacy of Luminate® (ALG-1001) as Compared to Avastin® in the Treatment of Diabetic Macular Edema (DME)
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    bevacizumab risuteganib ...
  • Study Participants

    218
A Phase 2 Multi center, Randomized, Controlled, Double-Masked Clinical Trial Designed To Evaluate The Safety And Exploratory Efficacy Of Luminate® (Alg-1001) As Compared To Avastin® In The Treatment Of Diabetic Macular Edema
To evaluate the safety and efficacy of Luminate® (ALG-1001) as compared to Avastin® in patients with diabetic macular edema

- Stage 1: 120 eligible subjects with DME will be enrolled and randomized to one of 4 treatment groups at an allocation ratio of 1:1:1:1, i.e., one of three doses (1.0 mg, 2.0 mg and 3.0 mg) of Luminate intravitreal injection or Avastin intravitreal injection. Subjects will be followed monthly for 24 weeks (6 months).

Stage 2 (select sites): 75 eligible subjects with DME will be enrolled and randomized to one of 5 treatment groups at an allocation ratio of 1:1:1:1:1; i.e., one of 2 doses of Luminate intravitreal injection or Avastin intravitreal injection (0.5 mg and 1.0 mg). Subjects will be followed monthly for 20 weeks (5 months).
Study Started
Oct 13
2014
Primary Completion
May 16
2017
Study Completion
Jun 13
2017
Results Posted
Dec 07
2018
Last Update
Dec 07
2018

Drug Luminate 1.0mg

  • Other names: ALG-1001

Drug Luminate 2.0mg

  • Other names: ALG-1001

Drug Luminate 3.0mg

  • Other names: ALG-1001

Drug Avastin

  • Other names: bevacizumab

Drug Luminate 0.5mg

  • Other names: ALG-1001

Luminate 1.0mg group Active Comparator

Stage 1- Luminate 1.0 mg intravitreal injection administered at baseline (Day 0), 4 weeks and 8 weeks with prn Luminate injection at week 20 for a total of at least 3 and no more than 4 Luminate injections. Sham injections will be performed at weeks 12 and 16 and may also be performed at week 20 if prn Luminate is not required; sham laser treatment will be administered at baseline and at 16 weeks.

Luminate 2.0mg group Active Comparator

Stage 1 -Luminate 2.0 mg intravitreal injection administered at baseline (Day 0), 4 weeks and 8 weeks with prn Luminate injection at week 20 for a total of at least 3 and no more than 4 Luminate injections. Sham injections will be performed at weeks 12 and 16 and may also be performed at week 20 if prn Luminate is not required; sham laser treatment will be administered at baseline and at 16 weeks.

Luminate 3.0mg group Active Comparator

Stage 1- Luminate 3.0 mg intravitreal injection administered at baseline (Day 0), 4 weeks and 8 weeks with prn Luminate injection at week20 for a total of at least 3 and no more than 4 Luminate injections. Sham injections will be performed at weeks 12 and 16 and may also be performed at week 20 if prn Luminate is not required; sham laser treatment will be administered at baseline and at 16 weeks.

Avastin® group Active Comparator

Stage 1- Avastin 1.25 mg intravitreal injection administered at baseline (Day 0), 4 weeks and 8 weeks with prn Avastin injection at weeks 12, 16, or 20 for a total of at least 3 and up to 6 Avastin injections. Sham injections may be performed at weeks 12, 16, and 20 if prn Avastin is not required.

Avastin then Luminate 1.0 mg IVT + sham injection Active Comparator

Stage 2 - Week 0 (Baseline): Avastin 1.25 mg IVT Weeks 1, 4 and 8: Luminate 1.0 mg IVT + sham injection Weeks 12 and 16: Sham IVT

Avastin then Luminate 0.5 mg IVT + sham injection Active Comparator

Stage 2- Week 0 (Baseline); Avastin 1.25 mg IVT Weeks 1, 4 and 8: Luminate 0.5 mg IVT + sham injection Weeks 12 and 16: Sham IVT

Sham then Luminate 1.0 mg + Avastin 1.25 mg IVT Active Comparator

Stage 2 : Week 0 (Baseline): Sham IVT Weeks 1, 4 and 8: Luminate 1.0 mg + Avastin 1.25 mg IVT Weeks 12 and 16: Sham IVT

Sham then Luminate 0.5 mg IVT + Avastin 1.25 mg IVT Active Comparator

Stage 2 : Week 0: Sham IVT Weeks 1, 4 and 8: Luminate 0.5 mg IVT + Avastin 1.25 mg IVT Weeks 12 and 16: Sham IVT

Avastin 1.25 mg + Sham IVT Active Comparator

Stage 2 : Week 0 (Baseline): Sham IVT Weeks 1, 4 and 8: Avastin 1.25 mg + Sham IVT Weeks 12 and 16: Avastin PRN

Criteria

Inclusion Criteria:

Male or female, 18 years of age or older.
Study eye with clinically significant diabetic macular edema (DME) with central subfield thickness ≥ 350µm on spectral domain OCT
Best corrected visual acuity (BCVA) of 20/50 to 20/320 ETDRS equivalent (65 letters to 23 letters) in the study eye, with BCVA decrement primarily attributable to DME.
Treatment naïve, i.e., no previous anti-VEGF treatment in the study eye or no anti-VEGF treatment in the 45 days prior to study enrollment.
In the investigator's opinion, the subject still has significant intraretinal fluid with room for improvement in both macular edema and BCVA.

Intra-Ocular Pressure (IOP) is under control (i.e., IOP

≤ 25 mm in the study eye) and study eye is not receiving any IOP lowering drops.

Willing and able to return for all study visits.
Able to meet the extensive post-op evaluation regimen.
Understands and signs the informed consent form.

Exclusion Criteria:

Active proliferative diabetic retinopathy (PDR) in the study eye such as NVE, NVD, vitreous hemorrhage, or neovascular glaucoma.
Uncontrolled hypertension defined as systolic >180 mmHg or > 160 mmHg on 2 consecutive measurements or diastolic > 100 mmHg on optimal medical regimen
Screening HgA1c blood test > 10.0
Focal laser photocoagulation or intravitreal/periocular steroids of any type in the study eye within the last 90 days prior to study enrollment.
A history of intravitreal anti-VEGF injection of any type in the study eye within the last 45 days prior to study enrollment.
History of rhegmatogenous retinal detachment, retinal tear(s), or traction retinal detachments in the study eye.
Epiretinal membrane and/or vitreomacular traction in the study eye as determined by the central reading center.
Previous pars plana vitrectomy in the study eye
Any intraocular surgery in the study eye within the last 90 days prior to study enrollment.
YAG laser treatment in the study eye in last 30 days prior to study enrollment.
High myopia in the study eye, with a spherical equivalent of >8.00D at screening
Other ocular pathologies that in the investigator's opinion would interfere with the subject's vision in the study eye.
Chronic or recurrent uveitis.
Ongoing ocular infection or inflammation in either eye.
A history of cataract surgery complications/vitreous loss in the study eye.
Congenital eye malformations in the study eye.
A history of penetrating ocular trauma in the study eye.
Mentally handicapped.
Pregnant female, as determined for women less than 60 years old by a positive urine pregnancy test during the screening window.
Nursing female.
Currently participating in any other clinical research study.
Contraindication to the study medication.

Summary

Luminate 1.0mg Group

Luminate 2.0mg Group

Luminate 3.0mg Group

Avastin® Group

Avastin Then Luminate 1.0 mg IVT + Sham Injection

Avastin Then Luminate 0.5 mg IVT + Sham Injection

Sham Then Luminate 1.0 mg + Avastin 1.25 mg IVT

Sham Then Luminate 0.5 mg IVT + Avastin 1.25 mg IVT

Avastin 1.25 mg + Sham IVT

All Events

Event Type Organ System Event Term Luminate 1.0mg Group Luminate 2.0mg Group Luminate 3.0mg Group Avastin® Group Avastin Then Luminate 1.0 mg IVT + Sham Injection Avastin Then Luminate 0.5 mg IVT + Sham Injection Sham Then Luminate 1.0 mg + Avastin 1.25 mg IVT Sham Then Luminate 0.5 mg IVT + Avastin 1.25 mg IVT Avastin 1.25 mg + Sham IVT

Change in BCVA at Week 24

Primary efficacy outcome is BCVA changes at Week 24 as compared to baseline

Luminate 1.0mg Group

5.2
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Luminate 2.0mg Group

2.7
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Luminate 3.0mg Group

-1.5
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Avastin® Group

7.0
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Avastin Then Luminate 1.0 mg IVT + Sham Injection

7.1
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Avastin Then Luminate 0.5 mg IVT + Sham Injection

4.6
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Sham Then Luminate 1.0 mg + Avastin 1.25 mg IVT

1.4
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Sham Then Luminate 0.5 mg IVT + Avastin 1.25 mg IVT

3.9
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Avastin 1.25 mg + Sham IVT

6.7
Letters on ETDRS eye chart (Mean)
Standard Error: 3

Total

218
Participants

Age, Continuous

62.3
years (Mean)
Standard Deviation: 9.35

Age, Categorical

Race/Ethnicity, Customized

Region of Enrollment

Sex: Female, Male

Overall Study

Luminate 1.0mg Group

Luminate 2.0mg Group

Luminate 3.0mg Group

Avastin® Group

Avastin Then Luminate 1.0 mg IVT + Sham Injection

Avastin Then Luminate 0.5 mg IVT + Sham Injection

Sham Then Luminate 1.0 mg + Avastin 1.25 mg IVT

Sham Then Luminate 0.5 mg IVT + Avastin 1.25 mg IVT

Avastin 1.25 mg + Sham IVT