Clinical Trial Results:
EFFECT OF BEVACIZUMAB SUBCONJUNCTIVAL INJECTIONS ON CORNEAL NEWVESSELS
Summary
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EudraCT number |
2010-022858-16 |
Trial protocol |
FR |
Global end of trial date |
13 Apr 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
03 May 2021
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First version publication date |
03 May 2021
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Other versions |
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Summary report(s) |
Summary of the final report |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
I07034
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01501760 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
CHU de Limoges
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Sponsor organisation address |
2 Avenue MArtin Luther KING, Limoges, France, 87000
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Public contact |
DR A BENTALEB, CHU de Limoges, 33 0555058616, abdeslam.bentaleb@chu-limoges.fr
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Scientific contact |
Pr Pierre Yves ROBERT, CHU de Limoges, 33 05 55 05 62 31, pierre-yves.robert@unilim.fr-limoges.fr
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
17 Jun 2019
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
13 Apr 2018
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
To demonstrate Bevacizumab subconjunctival injections effectiveness on corneal neovascularisation reduction after 3 monthly injections
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Protection of trial subjects |
This study was conducted in conformance with Good Clinical Practice standards and applicable French statutes and regulations regarding ethical committee review,competent authority , informed consent, and the protection of human subjects participating in biomedical research.
Subjects were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time in language and terms appropriate for the subject .
During this pre-inclusion visit, investigator informs the patient and answers all his questions concerning the objective, the nature of the constraints, the foreseeable risks and the expected benefits of the research. It also specifies the patient's rights in the context of biomedical research. After this information session, the patient has a reflection period.
In addition, a DSMB has been set up to supervise the trial.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
01 Sep 2011
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
France: 38
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Worldwide total number of subjects |
38
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EEA total number of subjects |
38
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
23
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From 65 to 84 years |
14
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85 years and over |
1
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Recruitment
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Recruitment details |
The study was conducted at 6 study centers in FRance between 03/02/2012 (first subject first visit) and 12/09/2017 (last subject last visit). | |||||||||
Pre-assignment
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Screening details |
A total of 38 subjects were enrolled, received treatment and completed the study. | |||||||||
Period 1
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Period 1 title |
Overall trial (overall period)
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Is this the baseline period? |
Yes | |||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||
Roles blinded |
Subject, Investigator | |||||||||
Blinding implementation details |
The syringes prepared at the pharmacy (bevacizumab or placebo), will be presented in a strictly identical manner. The labeling of the syringes will ensure that the doctor and the patient are not aware of it.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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BEVACIZUMAB | |||||||||
Arm description |
Subjects received 1 subconjunctival injection of 0.2 ml of Bevacizumab (i.e. 5 mg) to be repeated twice, 1 month apart, i.e. 3 injections | |||||||||
Arm type |
Experimental | |||||||||
Investigational medicinal product name |
Bevacizumab
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Investigational medicinal product code |
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Other name |
Avastin*
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Conjunctival use
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Dosage and administration details |
1 subconjunctival injection of 0.2 ml of Bevacizumab (i.e. 5 mg)
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Arm title
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PLACEBO | |||||||||
Arm description |
Subjects received 1 subconjunctival injection of 0f 0.2 ml of 0.9% NaCl to be repeated twice, 1 month apart, i.e. 3 injections | |||||||||
Arm type |
Placebo | |||||||||
Investigational medicinal product name |
PLacebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Subconjunctival use
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Dosage and administration details |
Dosage: 1 subconjunctival injection of 0.2 ml of 0.9% NaCl
Ready-to-use pre-filled syringe prepared at the pharmacy of the investigating center
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Baseline characteristics reporting groups
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Reporting group title |
Overall trial
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
BEVACIZUMAB
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Reporting group description |
Subjects received 1 subconjunctival injection of 0.2 ml of Bevacizumab (i.e. 5 mg) to be repeated twice, 1 month apart, i.e. 3 injections | ||
Reporting group title |
PLACEBO
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Reporting group description |
Subjects received 1 subconjunctival injection of 0f 0.2 ml of 0.9% NaCl to be repeated twice, 1 month apart, i.e. 3 injections |
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End point title |
Subconjunctival injections effectiveness at month 3 | ||||||||||||
End point description |
The outcome measure associated with this primary objective is the efficacy of Bevacizumab administered by the subconjunctival route in reducing corneal neovascularization. It was evaluated by comparing in each group the proportion of responder patients defined by a percentage of corneal surface area occupied by neovessels at 3 months reduced by more than 30%, evaluated on photos by surface measurement software.
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End point type |
Primary
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End point timeframe |
After 3 injections (3 month)
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Statistical analysis title |
Treatment difference | ||||||||||||
Statistical analysis description |
This end point was evaluated by comparing in each group the proportion of responder patients defined by a percentage of corneal surface area occupied by neovessels at 3 months reduced by more than 30%, evaluated on photos by software for measuring surfaces according to a pre-established scale.
The statistical analysis associated with this primary objective consisted of a Fisher exact test
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Comparison groups |
PLACEBO v BEVACIZUMAB
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Number of subjects included in analysis |
33
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.5284 | ||||||||||||
Method |
Fisher exact | ||||||||||||
Confidence interval |
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End point title |
Effectiveness of Bevacizumab at Month 6 | ||||||||||||
End point description |
To evaluate the effectiveness of Bevacizumab, a on the proportion of responder patients compared to a placebo at 6 months .
The judgment criterion associated with this secondary objective was the patient's response at 6 months (the percentage of corneal surface area occupied by neovessels at 6 months is compared between the two groups)
The statistical analysis associated consisted of Fisher's exact test.
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End point type |
Secondary
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End point timeframe |
At month 6
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Statistical analysis title |
Treatment difference at month 6 | ||||||||||||
Comparison groups |
PLACEBO v BEVACIZUMAB
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Number of subjects included in analysis |
32
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.7625 | ||||||||||||
Method |
Fisher exact | ||||||||||||
Confidence interval |
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End point title |
The effectiveness of bevacizumab on reducing the use of corneal graft | |||||||||
End point description |
The outcome measure associated with this secondary objective was the proportion of patients with indication of keratoplasty at 6 months.
The statistical analysis associated with this secondary objective 2 consisted of a Chi² test.
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End point type |
Secondary
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End point timeframe |
At month 6
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
21.1
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Reporting groups
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Reporting group title |
BEVACIZUMAB
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Reporting group description |
Subjects received 1 subconjunctival injection of 0.2 ml of Bevacizumab (i.e. 5 mg) to be repeated twice, 1 month apart, i.e. 3 injections | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
PLACEBO
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Reporting group description |
- 0.9% sodium chloride - ready-to-use pre-filled syringe prepared at the pharmacy of the investigating center CHU - Dosage: 1 subconjunctival injection of 0.2 ml of 0.9% NaCl to be repeated twice, 1 month apart, i.e. 3 injections | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||||||
Date |
Amendment |
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03 Mar 2016 |
Recruitment has been a major problem since the start of the research despite a much larger number of “selected” patients (72% non-selection in Limoges for example). One of the obstacles stems from the application of the criterion of cardiovascular non-inclusion (Patient with unbalanced arterial hypertension and Patient with a history of stroke, myocardial infarction, angina, thrombophlebitis, Raynaud.).
The relaxation of these 2 criteria would undoubtedly allow a better recruitment since no serious cardiovascular effect was identified in the 21 patients already included, the quantity of product injected locally is low and the current literature does not seem to demonstrate it. serious systemic cardiovascular effects after ocular injection of bevacizumab.
Changes to non-inclusion criteria as follows:
-Patient with unbalanced arterial hypertension
-Patient with a history of an acute cardiovascular event less than 6 months old and / or progressive such as stroke, myocardial infarction, thrombophlebitis
-Patient with a history of angina, Raynaud's syndrome considered unstable
This amendment, apppuived by trhe DSMB, has been submitted and approved by the Ethic committee and the Competent authority. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? Yes | |||||||
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Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||||||
None reported |