VIBRANT: Study to Assess the Clinical Efficacy and Safety of Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321) in Patients With Branch Retinal Vein Occlusion (BRVO)

Sponsor
Regeneron Pharmaceuticals (Industry)
Overall Status
Completed
CT.gov ID
NCT01521559
Collaborator
Bayer (Industry)
183
56
2
23
3.3
0.1

Study Details

Study Description

Brief Summary

This is a phase III, double-masked, randomized, active-controlled, parallel-group, 52-week study to assess the efficacy and safety of Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321) compared to laser treatment in patients with macular edema secondary to BRVO.

Condition or Disease Intervention/Treatment Phase
  • Procedure: Macular Laser Photocoagulation
  • Drug: Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
183 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Participant, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Double-Masked, Randomized, Active-Controlled Study of the Efficacy, Safety, and Tolerability of Intravitreal Administration of VEGF Trap-Eye (Intravitreal Aflibercept Injection [IAI]) in Patients With Macular Edema Secondary to Branch Retinal Vein Occlusion
Study Start Date :
Apr 1, 2012
Actual Primary Completion Date :
Aug 1, 2013
Actual Study Completion Date :
Mar 1, 2014

Arms and Interventions

Arm Intervention/Treatment
Sham Comparator: Macular Laser Photocoagulation Treatment (Control)

Participants will receive macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants will receive treatment with Intravitreal Aflibercept Injection (IAI) starting at week 24 if they met rescue criteria. Treatment with IAI once initiated was 3 initial monthly doses followed by Q8 week dosing.

Procedure: Macular Laser Photocoagulation

Experimental: Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321) 2Q4

Participants will receive 2 milligrams (mg) Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24 followed by injections every 8 weeks (2Q8) through week 48. Participants in this group may receive laser rescue at week 36.

Drug: Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)

Outcome Measures

Primary Outcome Measures

  1. Participants Who Gained at Least 15 Letters in Best Corrected Visual Acuity (BCVA) at Week 24 - LOCF [Baseline to week 24]

    Best corrected visual acuity (BCVA) was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol at every visit from baseline through week 24. Last observation carried forward (LOCF) method was used to impute missing data.

Secondary Outcome Measures

  1. Change From Baseline to Week 24 in BCVA Score - LOCF [Baseline to Week 24]

    Best corrected visual acuity (BCVA) was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol at every visit from baseline through week 24 - Last observation carried forward (LOCF) method was used to impute missing data.

  2. Change From Baseline in Central Retinal Thickness (CRT) at Week 24 - LOCF [Baseline to week 24]

    CRT was evaluated at every visit from baseline through week 24 using spectral domain Optical Coherence Tomography (OCT).

  3. Change From Baseline in the National Eye Institute Visual Function Questionnaire - 25 (NEI VFQ-25) Questionnaire Total Score at Week 24 - LOCF [Baseline to week 24]

    The NEI VFQ-25 total score ranges from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. The NEI VFQ questionnaire is organized as a collection of subscales that are all scored from 0-100. Near activities are defined as reading ordinary print in newspapers, performing work or hobbies requiring near vision, or finding something on a crowded shelf.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
The following inclusion criteria include, but are not limited to:
  1. Adults ≥ 18 years of age with foveal center-involved macular edema (ME) secondary to BRVO diagnosed within 12 months before the screening visit

  2. ETDRS BCVA: letter score of 73 to 24 (20/40 to 20/320) in the study eye at screening and at day 1

  3. Provide signed informed consent

Exclusion Criteria:
The following exclusion criteria include, but are not limited to:
  1. Current bilateral manifestation of BRVO

  2. Uncontrolled glaucoma defined as ≥ 25 mmHg on optimal medical regimen, or previous filtration surgery in either the study eye or the fellow eye

  3. Insufficient clearing of macular hemorrhage that would prevent the patient from receiving laser treatment safely on day 1 (patients that meet this criterion may be rescreened once the macular hemorrhage resolves)

  4. Uncontrolled diabetes mellitus (DM)

  5. Previous use of intraocular corticosteroids or anti-angiogenic drugs in the study eye

  6. Use of periocular corticosteroids in the study eye within 3 months before day 1

  7. Use of intraocular or periocular corticosteroids or anti-angiogenic drugs in the fellow eye within 3 months before day 1

  8. Previous administration of systemic anti-angiogenic medications

  9. Panretinal scatter photocoagulation, sector laser photocoagulation, or macular grid photocoagulation in the study eye

Contacts and Locations

Locations

Site City State Country Postal Code
1 Phoenix Arizona United States
2 Tucson Arizona United States
3 Beverly Hills California United States
4 La Jolla California United States
5 Mountain View California United States
6 Palm Desert California United States
7 Sacramento California United States
8 Colorado Springs Colorado United States
9 Fort Myers Florida United States
10 Miami Florida United States
11 Plantation Florida United States
12 Stuart Florida United States
13 Tampa Florida United States
14 Winter Haven Florida United States
15 Augusta Georgia United States
16 Chicago Illinois United States
17 Baltimore (2 locations) Maryland United States
18 Hagerstown Maryland United States
19 Boston (2 locations) Massachusetts United States
20 Grand Rapids Michigan United States
21 Jackson Michigan United States
22 Southfield Michigan United States
23 Florissant Missouri United States
24 Lincoln Nebraska United States
25 Las Vegas Nevada United States
26 Teaneck New Jersey United States
27 Orchard Park New York United States
28 Syracuse New York United States
29 Charlotte North Carolina United States
30 Oklahoma City Oklahoma United States
31 Portland Oregon United States
32 Kingston Pennsylvania United States
33 West Mifflin Pennsylvania United States
34 Florence South Carolina United States
35 Ladson South Carolina United States
36 West Columbia South Carolina United States
37 Rapid City South Dakota United States
38 Nashville Tennessee United States
39 Abilene Texas United States
40 Ft. Worth Texas United States
41 Harlingen Texas United States
42 Houston Texas United States
43 San Antonio Texas United States
44 Seattle Washington United States
45 Milwaukee Wisconsin United States
46 Vancouver British Columbia Canada
47 Victoria British Columbia Canada
48 Mississauga Ontario Canada
49 Toronto Ontario Canada
50 Urayasu-shi Chiba Japan
51 Amagasaki Hyogo Japan
52 Kagoshima-shi Kagoshima Japan
53 Hamamatsu-shi Shizuoka Japan
54 Fukushima Japan
55 Kyoto Japan
56 Osaka Japan

Sponsors and Collaborators

  • Regeneron Pharmaceuticals
  • Bayer

Investigators

  • Study Director: Clinical Trial Management, Regeneron Pharmaceuticals

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Regeneron Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT01521559
Other Study ID Numbers:
  • VGFTe-RVO-1027
First Posted:
Jan 30, 2012
Last Update Posted:
Nov 13, 2014
Last Verified:
Nov 1, 2014
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details Participants with macular edema secondary to branch retinal vein occlusion (BRVO) involving the center of the macula in the study eye were eligible to participate in the study.
Pre-assignment Detail Of 281 participants who were screened for inclusion in the study, 183 were enrolled (started) and 183 received treatment.
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received treatment with Intravitreal Aflibercept Injection (IAI) starting at week 24 if they met rescue criteria. Treatment with IAI once initiated was 3 initial monthly doses followed by Q8 week dosing. Participants received 2 milligrams (mg) Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24 followed by injections every 8 weeks (2Q8) through week 48. Participants in this group could receive laser rescue at week 36.
Period Title: Overall Study
STARTED 92 91
Completed Week 24 83 85
Completed Week 52 77 73
COMPLETED 77 73
NOT COMPLETED 15 18

Baseline Characteristics

Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321) Total
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received treatment with Intravitreal Aflibercept Injection (IAI) starting at week 24 if they met rescue criteria. Treatment with IAI once initiated was 3 initial monthly doses followed by Q8 week dosing. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24 followed by injections every 8 weeks (2Q8) through week 48. Participants in this group could receive laser rescue at week 36. Total of all reporting groups
Overall Participants 90 91 181
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
63.9
(11.37)
67.0
(10.41)
65.5
(10.98)
Sex: Female, Male (Count of Participants)
Female
36
40%
47
51.6%
83
45.9%
Male
54
60%
44
48.4%
98
54.1%

Outcome Measures

1. Primary Outcome
Title Participants Who Gained at Least 15 Letters in Best Corrected Visual Acuity (BCVA) at Week 24 - LOCF
Description Best corrected visual acuity (BCVA) was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol at every visit from baseline through week 24. Last observation carried forward (LOCF) method was used to impute missing data.
Time Frame Baseline to week 24

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24.
Measure Participants 90 91
Number [participants]
24
26.7%
48
52.7%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Macular Laser Photocoagulation Treatment (Control), Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0003
Comments P-value was calculated using 2-sided Cochran-Mantel-Haenszel test adjusted by regions (Japan vs North America) and baseline Best Corrected Visual Acuity (BCVA ≤20/200 and BCVA >20/200).
Method Cochran-Mantel-Haenszel
Comments
Method of Estimation Estimation Parameter Mean Difference (Net)
Estimated Value 26.6
Confidence Interval (2-Sided) 95%
13.0 to 40.1
Parameter Dispersion Type:
Value:
Estimation Comments Difference was IAI group minus laser group; Difference and confidence interval were calculated using Mantel-Haenszel weighting scheme adjusted by regions (Japan vs North America) and baseline BCVA (BCVA ≤20/200 and BCVA >20/200).
2. Secondary Outcome
Title Change From Baseline to Week 24 in BCVA Score - LOCF
Description Best corrected visual acuity (BCVA) was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol at every visit from baseline through week 24 - Last observation carried forward (LOCF) method was used to impute missing data.
Time Frame Baseline to Week 24

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24.
Measure Participants 90 91
Mean (Standard Deviation) [letters correctly read]
6.9
(12.91)
17.0
(11.88)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Macular Laser Photocoagulation Treatment (Control), Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Comments Difference was IAI group minus laser group. P-value, Point estimate and 95% confidence interval (CI) were based on an analysis of covariance (ANCOVA) model with baseline measurement as covariate and treatment group, region, and baseline Best Corrected Visual Acuity (BCVA ≤20/200 and BCVA >20/200) as fixed factors.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method ANCOVA
Comments
Method of Estimation Estimation Parameter Mean Difference (Net)
Estimated Value 10.5
Confidence Interval (2-Sided) 95%
7.1 to 14.0
Parameter Dispersion Type:
Value:
Estimation Comments
3. Secondary Outcome
Title Change From Baseline in Central Retinal Thickness (CRT) at Week 24 - LOCF
Description CRT was evaluated at every visit from baseline through week 24 using spectral domain Optical Coherence Tomography (OCT).
Time Frame Baseline to week 24

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24
Measure Participants 90 91
Mean (Standard Deviation) [microns]
-128.0
(195.02)
-280.5
(189.7)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Macular Laser Photocoagulation Treatment (Control), Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Comments Difference was IAI group minus laser group; P-value, Point estimate, and 95% CI, were based on an ANCOVA model with baseline measurement as covariate and treatment group, region, and baseline Best Corrected Visual Acuity (BCVA ≤20/200 and BCVA >20/200) as fixed factors.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method ANCOVA
Comments
Method of Estimation Estimation Parameter Mean Difference (Net)
Estimated Value -148.6
Confidence Interval (2-Sided) 95%
-179.8 to -117.4
Parameter Dispersion Type:
Value:
Estimation Comments
4. Secondary Outcome
Title Change From Baseline in the National Eye Institute Visual Function Questionnaire - 25 (NEI VFQ-25) Questionnaire Total Score at Week 24 - LOCF
Description The NEI VFQ-25 total score ranges from 0-100 with a score of 0 being the worst outcome and 100 being the best outcome. The NEI VFQ questionnaire is organized as a collection of subscales that are all scored from 0-100. Near activities are defined as reading ordinary print in newspapers, performing work or hobbies requiring near vision, or finding something on a crowded shelf.
Time Frame Baseline to week 24

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24.
Measure Participants 87 88
Mean (Standard Deviation) [scores on a scale]
6.3
(12.34)
7.7
(11.08)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Macular Laser Photocoagulation Treatment (Control), Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Comments Difference was IAI group minus laser group; P-value, Point estimate, and 95% CI, were based on an ANCOVA model with baseline measurement as covariate and treatment group, region, and baseline Best Corrected Visual Acuity (BCVA ≤20/200 and BCVA >20/200) as fixed factors.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0833
Comments
Method ANCOVA
Comments
Method of Estimation Estimation Parameter Mean Difference (Net)
Estimated Value 2.6
Confidence Interval (2-Sided) 95%
-0.3 to 5.5
Parameter Dispersion Type:
Value:
Estimation Comments

Adverse Events

Time Frame Through Week 52 (end of study)
Adverse Event Reporting Description The safety analysis set (SAF) included all enrolled participants who received any investigational product; it is based on the treatment received (as treated).
Arm/Group Title Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Arm/Group Description Participants received macular laser treatment at Baseline and then according to laser re-treatment criteria up to week 24. Participants received treatment with Intravitreal Aflibercept Injection (IAI) starting at week 24 if they met rescue criteria. Treatment with IAI once initiated was 3 initial monthly doses followed by Q8 week dosing. Participants received 2 mg Intravitreal Aflibercept Injection (IAI) every 4 weeks (2Q4) through week 24 followed by injections every 8 weeks (2Q8) through week 48. Participants in this group could receive laser rescue at week 36.
All Cause Mortality
Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN)
Serious Adverse Events
Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 10/92 (10.9%) 13/91 (14.3%)
Blood and lymphatic system disorders
Anaemia 0/92 (0%) 2/91 (2.2%)
Cardiac disorders
Atrial fibrillation 0/92 (0%) 1/91 (1.1%)
Atrial flutter 1/92 (1.1%) 0/91 (0%)
Atrioventricular block second degree 0/92 (0%) 1/91 (1.1%)
Bradycardia 0/92 (0%) 1/91 (1.1%)
Cardiac failure acute 1/92 (1.1%) 0/91 (0%)
Cardiomyopathy 0/92 (0%) 1/91 (1.1%)
Coronary artery disease 0/92 (0%) 1/91 (1.1%)
Myocardial infarction 1/92 (1.1%) 0/91 (0%)
Gastrointestinal disorders
Gastritis 0/92 (0%) 1/91 (1.1%)
Intestinal fistula 0/92 (0%) 1/91 (1.1%)
Large intestine polyp 0/92 (0%) 1/91 (1.1%)
Small intestinal obstruction 0/92 (0%) 1/91 (1.1%)
General disorders
Chest pain 0/92 (0%) 1/91 (1.1%)
Hernia 1/92 (1.1%) 0/91 (0%)
Non-cardiac chest pain 1/92 (1.1%) 0/91 (0%)
Infections and infestations
Gastroenteritis 0/92 (0%) 1/91 (1.1%)
Osteomyelitis 1/92 (1.1%) 0/91 (0%)
Pelvic abscess 0/92 (0%) 1/91 (1.1%)
Pneumonia 1/92 (1.1%) 2/91 (2.2%)
Pyelonephritis 0/92 (0%) 1/91 (1.1%)
Injury, poisoning and procedural complications
Cataract traumatic 0/92 (0%) 1/91 (1.1%)
Delayed haemolytic transfusion reaction 0/92 (0%) 1/91 (1.1%)
Road traffic accident 1/92 (1.1%) 0/91 (0%)
Investigations
Transaminases increased 0/92 (0%) 1/91 (1.1%)
Metabolism and nutrition disorders
Dehydration 2/92 (2.2%) 0/91 (0%)
Hypomagnesaemia 1/92 (1.1%) 0/91 (0%)
Musculoskeletal and connective tissue disorders
Cervical spinal stenosis 1/92 (1.1%) 0/91 (0%)
Osteonecrosis 1/92 (1.1%) 0/91 (0%)
Spinal column stenosis 1/92 (1.1%) 0/91 (0%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer metastatic 0/92 (0%) 1/91 (1.1%)
Lung adenocarcinoma 0/92 (0%) 1/91 (1.1%)
Squamous cell carcinoma 0/92 (0%) 1/91 (1.1%)
Nervous system disorders
Cerebrovascular accident 1/92 (1.1%) 0/91 (0%)
Hypoaesthesia 0/92 (0%) 1/91 (1.1%)
Presyncope 0/92 (0%) 1/91 (1.1%)
Subarachnoid haemorrhage 1/92 (1.1%) 0/91 (0%)
Syncope 1/92 (1.1%) 0/91 (0%)
Renal and urinary disorders
Hydronephrosis 0/92 (0%) 1/91 (1.1%)
Nephrolithiasis 0/92 (0%) 1/91 (1.1%)
Renal failure 1/92 (1.1%) 0/91 (0%)
Renal failure acute 1/92 (1.1%) 1/91 (1.1%)
Vascular disorders
Aortic stenosis 1/92 (1.1%) 0/91 (0%)
Hypertension 1/92 (1.1%) 1/91 (1.1%)
Other (Not Including Serious) Adverse Events
Macular Laser Photocoagulation Treatment (Control) Intravitreal Aflibercept Injection (IAI;EYLEA®;BAY86-5321)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 30/92 (32.6%) 25/91 (27.5%)
Eye disorders
Conjunctival haemorrhage 14/92 (15.2%) 22/91 (24.2%)
Eye irritation 1/92 (1.1%) 7/91 (7.7%)
Eye pain 7/92 (7.6%) 5/91 (5.5%)
Infections and infestations
Bronchitis 2/92 (2.2%) 6/91 (6.6%)
Nasopharyngitis 8/92 (8.7%) 8/91 (8.8%)
Urinary tract infection 7/92 (7.6%) 3/91 (3.3%)
Investigations
Blood pressure increased 5/92 (5.4%) 4/91 (4.4%)
Vascular disorders
Hypertension 15/92 (16.3%) 9/91 (9.9%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Without the prior written agreement of the Sponsor, the Institution (I) shall not publish, submit or present for publication, directly or indirectly, any Manuscript (M) prior to publication of an article in a peer-reviewed scientific journal summarizing data generated by all Study centers, unless no such article is so published before the first anniversary of the finalization of the clinical study report, in which case the (I) may publish or submit for publication a (M) without further delay.

Results Point of Contact

Name/Title Clinical Trials Administrator
Organization Regeneron
Phone 914 847 5385
Email clinicaltrials@regeneron.com
Responsible Party:
Regeneron Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT01521559
Other Study ID Numbers:
  • VGFTe-RVO-1027
First Posted:
Jan 30, 2012
Last Update Posted:
Nov 13, 2014
Last Verified:
Nov 1, 2014