ARIES: Managing Neovascular (Known as "Wet") Age-related Macular Degeneration Over 2 Years Using Different Treatment Schedules of 2 mg Intravitreal Aflibercept Injected in the Eye

Sponsor
Bayer (Industry)
Overall Status
Completed
CT.gov ID
NCT02581891
Collaborator
Regeneron Pharmaceuticals (Industry)
287
39
2
41.2
7.4
0.2

Study Details

Study Description

Brief Summary

This study aims to evaluate the optimal use, efficacy, and safety of a Treat-and-Extend regimen with aflibercept in subjects with nAMD.

Condition or Disease Intervention/Treatment Phase
  • Drug: Eylea (Intravitreal Aflibercept, VEGF Trap-Eye, BAY86-5321)
  • Drug: Eylea (Intravitreal Aflibercept, VEGF Trap-Eye, BAY86-5321)
Phase 4

Detailed Description

The T&E dosing regimen for nAMD has emerged as a preferred regimen for many treating physicians aiming at maximizing outcomes by proactively treating the subject at each visit and by extending the treatment interval (if extension criteria are met), thus limiting visits, monitoring, and injections.

To this day, there is limited evidence available addressing the question of what are useful intervals for treating and monitoring, how do they differ among subjects, and how are retreatment criteria applied to achieve long-term desirable outcomes in real-life practice. This study is designed to evaluate the optimal use, efficacy, and safety of the T&E regimen with intravitreal aflibercept in subjects with nAMD.

Study Design

Study Type:
Interventional
Actual Enrollment :
287 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Managing Neovascular Age-related Macular Degeneration (nAMD) Over 2 Years With a Treat and Extend (T&E) Regimen of 2 mg Intravitreal Aflibercept - a Randomized, Open-label, Active-controlled, Parallel-group Phase IV/IIIb Study (ARIES)
Actual Study Start Date :
Nov 19, 2015
Actual Primary Completion Date :
Apr 26, 2019
Actual Study Completion Date :
Apr 26, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Early-start T&E / Arm 1

Early-start T&E arm: test group, early treatment individualization

Drug: Eylea (Intravitreal Aflibercept, VEGF Trap-Eye, BAY86-5321)
3 monthly doses followed by individualized treatment intervals of between 8 to16 weeks based on protocol-defined anatomical criteria

Active Comparator: Late-start T&E / Arm 2

Late-start T&E arm; per label, control group, treatment individualization after Year 1

Drug: Eylea (Intravitreal Aflibercept, VEGF Trap-Eye, BAY86-5321)
3 monthly doses followed by five 8-weekly doses (5 x 2Q8), then by individualized treatment intervals of between 8 to 16 weeks based on protocol-defined anatomical criteria

Outcome Measures

Primary Outcome Measures

  1. Change in BCVA as Measured by the ETDRS Letter Score [From Week 16 to Week 104]

    BCVA (best corrected visual acuity) was measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter score of 73 to 25 (= Acuity of 20/40 to 20/320) in the study eye at 4 meters; a higher score represents better functioning.

Secondary Outcome Measures

  1. Percentage of Participants Maintaining Vision (<3 Lines Loss) at Week 104 Compared With Baseline [at Week 104]

    Participants maintained 3 lines (15 letters) vision loss in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.

  2. Change in BCVA From Baseline to Week 52, Baseline to Week 104, and Week 16 to Week 52 [from baseline to Week 52, baseline to Week 104, and Week 16 to Week 52]

    BCVA (best corrected visual acuity) was measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter score of 73 to 25 (= Acuity of 20/40 to 20/320) in the study eye at 4 meters; a higher score represents better functioning.

  3. Percentage of Participants Maintaining Vision (<3 Lines Loss) at Week 52 Compared With Baseline [At week 52]

    Participants maintained 3 lines (15 letters) vision loss in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.

  4. Percentage of Participants Gained 3-line at Week 52 and Week 104 Compared With Baseline [At Week 52 and Week 104]

    Participants gained 3 lines (15 letters) in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.

  5. Change in Central Retinal Thickness (CRT) [From baseline to Week 52, baseline to Week 104, Week 16 to Week 52, and Week 16 to Week 104]

    CRT were evaluated using spectral domain Optical coherence tomograph (OCT).

  6. Number of Study Drug Injections From Baseline to Week 52 and Baseline to Week 104 [At Week 52 and Week 104]

  7. Duration of Last Treatment Interval [Early-Start T&E: from week 16 up to Week 104 or early termination; Late-Start T&E: From end of Year 1 up to Week 104 or early termination]

  8. Percentage of Participants Requiring Retreatment at 8 Weeks, 10 Weeks, 12 Weeks, 14 Weeks, and 16 Weeks as the Last Treatment Interval [at 8 weeks, 10 weeks, 12 weeks, 14 weeks, and 16 weeks]

Eligibility Criteria

Criteria

Ages Eligible for Study:
50 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Men and women ≥ 50 years of age.

  • Active primary subfoveal CNV lesions secondary to nAMD, including juxtafoveal lesions that affect the fovea as evidenced by FA in the study eye. Patients with polypoidal choroidal vasculopathy or retinal angiomatous proliferation are eligible to participate in the study, and their condition should be captured in the eCRF.

  • ETDRS BCVA of 73 to 25 letters (20/40 to 20/320 Snellen equivalent) in the study eye.

  • The area of CNV must occupy at least 50% of the total lesion.

Exclusion Criteria:
  • Any prior ocular (in the study eye) or systemic treatment or surgery for nAMD, except dietary supplements or vitamins.

  • Any prior or concomitant therapy with another investigational agent to treat nAMD in the study eye.

  • Prior treatment with anti-VEGF agents as follows:

  • Prior treatment with anti-VEGF therapy in the study eye is not allowed

  • Prior treatment with anti-VEGF therapy in the fellow eye with an investigational agent (not approved, e.g. bevacizumab) within the last 3 months before the first dose in the study. Such treatment will also not be allowed during the study. Prior treatment with an approved anti-VEGF therapy in the fellow eye is allowed.

  • Prior systemic anti-VEGF therapy, investigational or approved, within the last 3 months before the first dose in the study, and such treatment will not be allowed during the study.

  • Total lesion size >12 disc areas (30.5 mm2, including blood, scars and neovascularization) as assessed by FA in the study eye.

  • Subretinal hemorrhages that are either 50% or more of the total lesion area, or if the blood is under the fovea and is 1 or more disc areas in size in the study eye. (If the blood is under the fovea, then the fovea must be surrounded by 270 degrees by visible CNV).

  • Scar or fibrosis making up >50% of the total lesion in the study eye.

  • Scar, fibrosis, or atrophy involving the center of the fovea in the study eye.

  • Presence of retinal pigment epithelial tears or rips involving the macula in the study eye.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Strathfield New South Wales Australia 2135
2 Sydney New South Wales Australia 2000
3 Westmead New South Wales Australia 2145
4 East Melbourne Victoria Australia 3002
5 Launceston Australia 7249
6 Hamilton Ontario Canada L8G 5E4
7 Ottawa Ontario Canada K2B 7E9
8 Boisbriand Quebec Canada J7H 1S6
9 Creteil Cedex France 94010
10 Nice cedex 1 France 06006
11 Freiburg Baden-Württemberg Germany 79106
12 Tübingen Baden-Württemberg Germany 72076
13 Hannover Niedersachsen Germany 30625
14 Bonn Nordrhein-Westfalen Germany 53105
15 Köln Nordrhein-Westfalen Germany 50924
16 Sulzbach Saarland Germany 66280
17 Chemnitz Sachsen Germany 09116
18 Berlin Germany 10713
19 Budapest Hungary 1062
20 Budapest Hungary 1085
21 Budapest Hungary 1106
22 Budapest Hungary 1115
23 Budapest Hungary 1125
24 Budapest Hungary 1133
25 Debrecen Hungary 4032
26 Pecs Hungary 7621
27 Szombathely Hungary 9700
28 Roma Lazio Italy 00198
29 Milano Lombardia Italy 20132
30 Milano Lombardia Italy 20157
31 Padova Veneto Italy 35128
32 Oviedo Asturias Spain 33012
33 Madrid Spain
34 Zaragoza Spain 50009
35 Canterbury Kent United Kingdom CT1 3NG
36 Bristol United Kingdom BS1 2LX
37 Liverpool United Kingdom L7 8XP
38 London United Kingdom EC1V 2PD
39 Oxford United Kingdom OX3 9DU

Sponsors and Collaborators

  • Bayer
  • Regeneron Pharmaceuticals

Investigators

  • Study Director: Bayer Study Director, Bayer

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Bayer
ClinicalTrials.gov Identifier:
NCT02581891
Other Study ID Numbers:
  • 17508
  • 2014-003132-39
First Posted:
Oct 21, 2015
Last Update Posted:
May 21, 2020
Last Verified:
May 1, 2020
Studies a U.S. FDA-regulated Drug Product:
Yes
Studies a U.S. FDA-regulated Device Product:
No
Product Manufactured in and Exported from the U.S.:
Yes
Keywords provided by Bayer
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details This study was conducted from 19-Nov-2015 (First Patient First Visit) to 26-Apr-2019 (Last Patient Last Visit).
Pre-assignment Detail A total of 443 participants were screened in this study. Of these, 156 participants were screening failures and did not enter the treatment period. Of the 287 treated participants, 16 were treated during the initiation phase, but were not randomized to a treatment arm after the initiation phase.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Period Title: Overall Study
STARTED 135 136
Completed Treatment 120 117
COMPLETED 119 117
NOT COMPLETED 16 19

Baseline Characteristics

Arm/Group Title Early-start T&E Arm Late-start T&E Arm Total
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. Total of all reporting groups
Overall Participants 135 136 271
Age (Years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [Years]
76
(8.8)
76.9
(8.2)
76.5
(8.5)
Sex: Female, Male (Count of Participants)
Female
81
60%
73
53.7%
154
56.8%
Male
54
40%
63
46.3%
117
43.2%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino
3
2.2%
7
5.1%
10
3.7%
Not Hispanic or Latino
126
93.3%
122
89.7%
248
91.5%
Unknown or Not Reported
6
4.4%
7
5.1%
13
4.8%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
0
0%
0
0%
0
0%
Asian
2
1.5%
1
0.7%
3
1.1%
Native Hawaiian or Other Pacific Islander
0
0%
0
0%
0
0%
Black or African American
1
0.7%
0
0%
1
0.4%
White
131
97%
127
93.4%
258
95.2%
More than one race
0
0%
0
0%
0
0%
Unknown or Not Reported
1
0.7%
8
5.9%
9
3.3%
Baseline BCVA letters scores (study eye) (letters) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [letters]
60.2
(12.1)
61.3
(10.8)
60.8
(11.4)
Baseline CRT (μm) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [μm]
443.7
(120.0)
448.3
(133.1)
446.0
(126.4)

Outcome Measures

1. Primary Outcome
Title Change in BCVA as Measured by the ETDRS Letter Score
Description BCVA (best corrected visual acuity) was measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter score of 73 to 25 (= Acuity of 20/40 to 20/320) in the study eye at 4 meters; a higher score represents better functioning.
Time Frame From Week 16 to Week 104

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Mean (Standard Deviation) [Letters correctly read]
-2.1
(11.4)
-0.4
(8.4)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Early-start T&E Arm, Late-start T&E Arm
Comments
Type of Statistical Test Non-Inferiority
Comments The non-inferiority margin is set to 5 letters.
Statistical Test of Hypothesis p-Value 0.0162
Comments
Method ANCOVA
Comments
Method of Estimation Estimation Parameter LS mean difference
Estimated Value -2.0199
Confidence Interval (2-Sided) 95%
-4.7470 to 0.7073
Parameter Dispersion Type: Standard Error of the Mean
Value: 1.3833
Estimation Comments
2. Secondary Outcome
Title Percentage of Participants Maintaining Vision (<3 Lines Loss) at Week 104 Compared With Baseline
Description Participants maintained 3 lines (15 letters) vision loss in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.
Time Frame at Week 104

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Number [Percentage]
93.4
96.2
3. Secondary Outcome
Title Change in BCVA From Baseline to Week 52, Baseline to Week 104, and Week 16 to Week 52
Description BCVA (best corrected visual acuity) was measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter score of 73 to 25 (= Acuity of 20/40 to 20/320) in the study eye at 4 meters; a higher score represents better functioning.
Time Frame from baseline to Week 52, baseline to Week 104, and Week 16 to Week 52

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
From baseline to Week 52
7.8
(9.4)
10.2
(9.3)
From baseline to Week 104
4.3
(13.4)
7.9
(11.9)
Week 16
66.7
(13.0)
69.6
(11.6)
From Week 16 to Week 52
1.3
(6.4)
2.0
(5.3)
4. Secondary Outcome
Title Percentage of Participants Maintaining Vision (<3 Lines Loss) at Week 52 Compared With Baseline
Description Participants maintained 3 lines (15 letters) vision loss in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.
Time Frame At week 52

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Number [Percentage]
100.0
100.0
5. Secondary Outcome
Title Percentage of Participants Gained 3-line at Week 52 and Week 104 Compared With Baseline
Description Participants gained 3 lines (15 letters) in BCVA (Best-corrected visual acuity) as measured by the ETDRS (Early Treatment Diabetic Retinopathy Study) letter.
Time Frame At Week 52 and Week 104

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Week 52
19.8
27.9
Week 104
18.9
22.1
6. Secondary Outcome
Title Change in Central Retinal Thickness (CRT)
Description CRT were evaluated using spectral domain Optical coherence tomograph (OCT).
Time Frame From baseline to Week 52, baseline to Week 104, Week 16 to Week 52, and Week 16 to Week 104

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
From baseline to Week 52
-164.9
(117.3)
-167.1
(117.1)
From baseline to Week 104
-161.6
(135.6)
-158.6
(125.1)
Week 16
321.4
(93.4)
322.5
(104.0)
From Week 16 to Week 52
-28.5
(56.3)
-28.7
(54.0)
From Week 16 to Week 104
-25.1
(68.9)
-20.2
(70.0)
7. Secondary Outcome
Title Number of Study Drug Injections From Baseline to Week 52 and Baseline to Week 104
Description
Time Frame At Week 52 and Week 104

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Week 52
7.1
(0.8)
8.0
(0.2)
Week 104
12.0
(2.3)
13.0
(1.8)
8. Secondary Outcome
Title Duration of Last Treatment Interval
Description
Time Frame Early-Start T&E: from week 16 up to Week 104 or early termination; Late-Start T&E: From end of Year 1 up to Week 104 or early termination

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
Mean (Standard Deviation) [Weeks]
11.5
(3.7)
11.4
(3.7)
9. Secondary Outcome
Title Percentage of Participants Requiring Retreatment at 8 Weeks, 10 Weeks, 12 Weeks, 14 Weeks, and 16 Weeks as the Last Treatment Interval
Description
Time Frame at 8 weeks, 10 weeks, 12 weeks, 14 weeks, and 16 weeks

Outcome Measure Data

Analysis Population Description
PPS (Per-protocol set): all participants in the FAS (full analysis set) without any major protocol deviation.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria.
Measure Participants 106 104
<8 weeks
5.7
7.7
8 weeks
27.4
29.8
10 weeks
19.8
10.6
12 weeks
8.5
13.5
14 weeks
8.5
11.5
16 weeks
25.5
25.0
>16 weeks
4.7
1.9

Adverse Events

Time Frame Treatment-emergent adverse events (TEAEs) were AEs that started after the first application of aflibercept up to 30 days after last study drug Injection in the study. TEAEs were collected from Week 0 till End of study/Week 104 or early termination.
Adverse Event Reporting Description Below adverse events were reported based on Safety Analysis Set (SAF), which included all participants who received any study drug in this study. The participants who dropped out after start of treatment before randomization were not allocated to a treatment arm, but were included in this SAF.
Arm/Group Title Early-start T&E Arm Late-start T&E Arm Treated, But Not Randomized
Arm/Group Description All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 to Week 104 participants randomized to Early-start T&E arm (Treat and Extend arm) received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. All participants during the initiation phase received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4, and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks) at Week 16. From Week 16 participants randomized to Late-start T&E arm received four 2Q8 injections. In Year 2 starting at Week 48, participants received treatment in individualized intervals of between 8 to16 weeks based on anatomical criteria. Participants were treated during the initiation phase, received Aflibercept (Eylea, BAY86-5321) 3 doses at Weeks 0, 4 and 8 followed by one dose 2Q8 (2 mg administered every 8 weeks)at Week 16, but were not randomized to a treatment arm after the initiation phase.
All Cause Mortality
Early-start T&E Arm Late-start T&E Arm Treated, But Not Randomized
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 3/135 (2.2%) 4/136 (2.9%) 0/16 (0%)
Serious Adverse Events
Early-start T&E Arm Late-start T&E Arm Treated, But Not Randomized
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 29/135 (21.5%) 35/136 (25.7%) 3/16 (18.8%)
Cardiac disorders
Acute myocardial infarction 0/135 (0%) 0 1/136 (0.7%) 1 1/16 (6.3%) 1
Atrial fibrillation 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Atrial flutter 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Atrioventricular block 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Atrioventricular block second degree 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Cardiac arrest 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Cardiac failure congestive 2/135 (1.5%) 2 0/136 (0%) 0 0/16 (0%) 0
Cor pulmonale acute 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Coronary artery stenosis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Myocardial infarction 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Pericardial haemorrhage 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Ventricular tachycardia 1/135 (0.7%) 2 0/136 (0%) 0 0/16 (0%) 0
Congestive cardiomyopathy 0/135 (0%) 0 1/136 (0.7%) 2 0/16 (0%) 0
Cardiac valve disease 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Eye disorders
Eye inflammation 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Retinal artery embolism 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Visual acuity reduced 0/135 (0%) 0 2/136 (1.5%) 2 0/16 (0%) 0
Visual impairment 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Eyelid cyst 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Gastrointestinal disorders
Abdominal pain 2/135 (1.5%) 2 0/136 (0%) 0 0/16 (0%) 0
Constipation 1/135 (0.7%) 2 0/136 (0%) 0 0/16 (0%) 0
Duodenal ulcer perforation 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Gastritis 1/135 (0.7%) 1 1/136 (0.7%) 1 0/16 (0%) 0
Gastrointestinal haemorrhage 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Haematochezia 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Ileus 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Inguinal hernia 2/135 (1.5%) 2 1/136 (0.7%) 1 0/16 (0%) 0
Intestinal perforation 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Pancreatitis acute 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Small intestinal obstruction 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Upper gastrointestinal haemorrhage 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Large intestine polyp 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Noninfective sialoadenitis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
General disorders
Hernia 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Pyrexia 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Multiple organ dysfunction syndrome 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Hepatobiliary disorders
Acute hepatic failure 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Biliary colic 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Cholangitis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Cholecystitis 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Cholecystitis acute 2/135 (1.5%) 2 2/136 (1.5%) 2 0/16 (0%) 0
Cholelithiasis 1/135 (0.7%) 1 1/136 (0.7%) 1 0/16 (0%) 0
Infections and infestations
Bronchitis 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Cystitis 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Influenza 2/135 (1.5%) 2 0/136 (0%) 0 0/16 (0%) 0
Pneumonia 3/135 (2.2%) 4 5/136 (3.7%) 5 0/16 (0%) 0
Pneumonia pseudomonal 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Sepsis 1/135 (0.7%) 1 1/136 (0.7%) 1 0/16 (0%) 0
Enterococcal sepsis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Infective exacerbation of chronic obstructive airways disease 3/135 (2.2%) 4 0/136 (0%) 0 0/16 (0%) 0
Adenovirus infection 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Injury, poisoning and procedural complications
Concussion 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Facial bones fracture 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Hip fracture 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Rib fracture 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Splenic rupture 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Traumatic fracture 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Inflammation of wound 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Pelvic fracture 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Metabolism and nutrition disorders
Fluid overload 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Intervertebral disc disorder 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Fracture pain 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Adenocarcinoma of colon 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Basal cell carcinoma 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Bladder neoplasm 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Breast cancer 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Chronic myeloid leukaemia 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Lung neoplasm malignant 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Lung neoplasm 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Epithelioid mesothelioma 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Papillary renal cell carcinoma 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Nervous system disorders
Carotid artery stenosis 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Cerebral infarction 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Cerebrovascular accident 1/135 (0.7%) 1 0/136 (0%) 0 2/16 (12.5%) 2
Haemorrhagic stroke 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Hemiplegia 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Vertebrobasilar insufficiency 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Psychiatric disorders
Suicide attempt 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Renal and urinary disorders
Acute kidney injury 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
End stage renal disease 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease 1/135 (0.7%) 2 0/136 (0%) 0 0/16 (0%) 0
Cough 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Dyspnoea 0/135 (0%) 0 2/136 (1.5%) 3 0/16 (0%) 0
Pleural effusion 0/135 (0%) 0 1/136 (0.7%) 2 0/16 (0%) 0
Pulmonary embolism 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Surgical and medical procedures
Implantable defibrillator replacement 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Vascular disorders
Aortic aneurysm 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Aortic dissection 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Haematoma 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Hypovolaemic shock 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Intermittent claudication 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Deep vein thrombosis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Extremity necrosis 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Peripheral arterial occlusive disease 1/135 (0.7%) 1 0/136 (0%) 0 0/16 (0%) 0
Peripheral artery stenosis 0/135 (0%) 0 1/136 (0.7%) 1 0/16 (0%) 0
Other (Not Including Serious) Adverse Events
Early-start T&E Arm Late-start T&E Arm Treated, But Not Randomized
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 93/135 (68.9%) 80/136 (58.8%) 10/16 (62.5%)
Eye disorders
Blepharitis 2/135 (1.5%) 6 11/136 (8.1%) 25 0/16 (0%) 0
Cataract 9/135 (6.7%) 14 8/136 (5.9%) 13 0/16 (0%) 0
Cataract nuclear 2/135 (1.5%) 4 7/136 (5.1%) 16 0/16 (0%) 0
Conjunctival haemorrhage 20/135 (14.8%) 26 18/136 (13.2%) 20 0/16 (0%) 0
Corneal erosion 5/135 (3.7%) 6 2/136 (1.5%) 3 1/16 (6.3%) 1
Dry eye 6/135 (4.4%) 11 11/136 (8.1%) 18 0/16 (0%) 0
Erythema of eyelid 0/135 (0%) 0 0/136 (0%) 0 1/16 (6.3%) 2
Macular degeneration 6/135 (4.4%) 6 5/136 (3.7%) 5 1/16 (6.3%) 1
Punctate keratitis 10/135 (7.4%) 23 5/136 (3.7%) 9 1/16 (6.3%) 1
Retinal haemorrhage 4/135 (3%) 4 6/136 (4.4%) 7 2/16 (12.5%) 2
Swelling of eyelid 0/135 (0%) 0 0/136 (0%) 0 1/16 (6.3%) 2
Visual acuity reduced 21/135 (15.6%) 24 17/136 (12.5%) 19 1/16 (6.3%) 1
Visual impairment 8/135 (5.9%) 11 4/136 (2.9%) 4 0/16 (0%) 0
Vitreous floaters 8/135 (5.9%) 8 4/136 (2.9%) 5 0/16 (0%) 0
Vitreous adhesions 1/135 (0.7%) 1 2/136 (1.5%) 2 1/16 (6.3%) 1
Choroidal neovascularisation 7/135 (5.2%) 7 5/136 (3.7%) 5 0/16 (0%) 0
Retinal pigment epithelial tear 3/135 (2.2%) 3 2/136 (1.5%) 2 1/16 (6.3%) 1
Neovascular age-related macular degeneration 15/135 (11.1%) 15 14/136 (10.3%) 14 1/16 (6.3%) 1
Macular fibrosis 2/135 (1.5%) 2 6/136 (4.4%) 6 1/16 (6.3%) 1
Infections and infestations
Gastroenteritis 0/135 (0%) 0 3/136 (2.2%) 3 1/16 (6.3%) 1
Influenza 11/135 (8.1%) 12 12/136 (8.8%) 13 0/16 (0%) 0
Nasopharyngitis 18/135 (13.3%) 21 17/136 (12.5%) 22 0/16 (0%) 0
Injury, poisoning and procedural complications
Foreign body in eye 0/135 (0%) 0 0/136 (0%) 0 1/16 (6.3%) 1
Post procedural swelling 0/135 (0%) 0 0/136 (0%) 0 1/16 (6.3%) 1
Metabolism and nutrition disorders
Dyslipidaemia 0/135 (0%) 0 0/136 (0%) 0 1/16 (6.3%) 1
Musculoskeletal and connective tissue disorders
Back pain 8/135 (5.9%) 9 1/136 (0.7%) 1 0/16 (0%) 0
Musculoskeletal pain 1/135 (0.7%) 1 2/136 (1.5%) 2 1/16 (6.3%) 1
Vascular disorders
Hypertension 13/135 (9.6%) 15 11/136 (8.1%) 11 0/16 (0%) 0

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

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

Results Point of Contact

Name/Title Therapeutic Area Head
Organization Bayer
Phone (+) 1-888-8422937
Email clinical-trials-contact@bayer.com
Responsible Party:
Bayer
ClinicalTrials.gov Identifier:
NCT02581891
Other Study ID Numbers:
  • 17508
  • 2014-003132-39
First Posted:
Oct 21, 2015
Last Update Posted:
May 21, 2020
Last Verified:
May 1, 2020