E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Macular Telangiectasia type 2 |
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E.1.1.1 | Medical condition in easily understood language |
Macular Telangiectasia (MacTel) is a disease affecting the macula, causing loss of central vision. MacTel develops when there are problems with the tiny blood vessels around the fovea. |
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E.1.1.2 | Therapeutic area | Body processes [G] - Ocular Physiological Phenomena [G14] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The overall objective of this study is to evaluate the efficacy and safety of NT-501 for the treatment of MacTel.
Primary objective: • To determine the rate of change in the ellipsoid zone (EZ; inner segment/outer segment [IS/OS]) area loss over 24 months, as measured by study eye spectral-domain optical coherence tomography (SD-OCT) in participants with MacTel
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E.2.2 | Secondary objectives of the trial |
The secondary objective of this study is to evaluate the safety of NT-501 in patients with MacTel Type 2. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To participate in this study, the potential participant and at least 1 of their eyes must meet all of the following criteria:
1. Participant must have at least 1 study eye with a positive diagnosis of MacTel with evidence of fluorescein leakage typical of MacTel and at least one of the other features that include hyperpigmentation that is outside of a 500 micron radius from the center of the fovea, retinal opacification, crystalline deposits, right-angle vessels, or inner/outer lamellar cavities 2. Participant must have an IS/OS PR break and EZ (area of IS/OS loss) as measured by SD OCT between 0.16 and 2.00 mm2 3. Participant’s best-corrected visual acuity (BCVA) is 54-letter score or better (20/80 or better) as measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at screening 4. Participant must have steady fixation in the foveal or parafoveal area and sufficiently clear media for good quality photographs 5. Participant must be greater than 21 years of age or less than 80 years of age at screening 6. Participant must be able to provide written informed consent to participate in the study, in accordance with the International Conference on Harmonisation Good Clinical Practices guidelines, and local regulations, before initiating any study related procedures 7. Women of childbearing potential must agree to use highly effective contraception (Germany and France only)
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E.4 | Principal exclusion criteria |
To participate in this study, the potential participant must not meet any of the following criteria. The ocular exclusion criteria are related to the study eye (unless indicated for either eye):
1. Participant is medically unable to comply with study procedures or follow-up visits 2. Participant received intravitreal steroid therapy for non neovascular MacTel within the last 3 months 3. Participant has ever received intravitreal anti-vascular endothelial growth factor (VEGF) therapy in the study eye OR has, within the past 3 months, received intravitreal anti VEGF therapy in the fellow eye at randomization 4. Participant has evidence of ocular disease other than MacTel that, in the judgment of the examining physician, may confound the diagnosis, procedures, or outcome of the study (eg, glaucoma, severe nonproliferative or proliferative diabetic retinopathy, uveitis) 5. Participant has a chronic requirement (eg, ≥ 4 weeks at a time) for ocular medications and/or has a diagnosed disease that, in the judgment of the examining physician, may be vision threatening or may affect the primary outcome (artificial tears are permitted) 6. Participant has evidence of intraretinal neovascularization or subretinal neovascularization (SRNV), as evidenced by hemorrhage, hard exudate, subretinal fluid or intraretinal fluid in either eye 7. Participant has evidence of central serous chorio-retinopathy in either eye 8. Participant has evidence of pathologic myopia in either eye 9. Participant has significant corneal or media opacities in either eye 10. Participant has had a vitrectomy, penetrating keratoplasty, trabeculectomy, or trabeculoplasty 11. Participant has any of the following lens opacities: cortical opacity > standard 3, posterior subcapsular opacity > standard 2, or a nuclear opacity > standard 3 as measured on the Age Related Eye Disease Study (AREDS) clinical lens grading system 12. Participant has undergone lens removal in the previous 3 months or YAG laser within 4 weeks 13. Participant was a participant in any other clinical trial of an intervention (drug or device) within the last 6 months 14. Participant is on chemotherapy 15. Participant is pregnant or breastfeeding 16. Participant has a history of malignancy that would compromise the 24-month study survival 17. Participant with a history of ocular herpes virus in either eye 18. Participant has, in the opinion of the investigator, any physical or mental condition that would increase the risk of participation in the study or may interfere with the study procedures, evaluations, and outcome assessments 19. Participant has evidence of intraretinal hyperreflectivity by OCT
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint will be the rate of change in the EZ (IS/OS) area loss over 24 months, as measured by study eye SD-OCT in participants with MacTel |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline, day 1, week 1 and 1, 3, 6, 12, 16, 20, and 24 months |
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E.5.2 | Secondary end point(s) |
Secondary efficacy end point:
- Mean change in aggregate sensitivity of microperimetry within the EZ line break area through 24 months - Mean change in reading speed from baseline through 24 months - Mean change in the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) near activities subscale score from baseline through 24 months
Secondary Safety Endpoint: - Number and proportion of participants with a loss in BCVA of 15 or more letters from baseline in the study eye using the Early Treatment Diabetic Retinopathy Study (ETDRS) distance chart Number and proportion of participants with at least 1 treatment emergent serious adverse event |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Baseline, day 1, week 1 and 1, 3, 6, 12, 16, 20, and 24 months |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
United States |
France |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |