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    Summary
    EudraCT Number:2018-004486-13
    Sponsor's Protocol Code Number:QL1205-002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-06-14
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2018-004486-13
    A.3Full title of the trial
    A Randomized, Phase 3, Double-masked, Parallel-group, Multicenter Study to Compare Efficacy and Safety of QL1205 Versus Lucentis® in Subjects With Neovascular Age-related Macular Degeneration
    Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Multicenter Study to Compare Efficacy and Safety of QL1205 Versus Lucentis® in Patients With Wet-AMD.
    Estudio multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad
    A.4.1Sponsor's protocol code numberQL1205-002
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorQilu Pharmaceutical Co., Ltd.
    B.1.3.4CountryChina
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportQilu Pharmaceutical Co., Ltd.
    B.4.2CountryChina
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationQilu Pharmaceutical Co., Ltd.
    B.5.2Functional name of contact pointVice President,Biological Institute
    B.5.3 Address:
    B.5.3.1Street Address243 Gong Ye Bei Road
    B.5.3.2Town/ cityJinan, Shandong
    B.5.3.3Post code250100
    B.5.3.4CountryChina
    B.5.4Telephone number+865318312 6963
    B.5.5Fax number+865318312 6688
    B.5.6E-mailzhenming.an@qilu-pharma.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Lucentis®
    D.2.1.1.2Name of the Marketing Authorisation holderNovartis Europharm Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLucentis®
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravitreal use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRANIBIZUMAB
    D.3.9.1CAS number 347396-82-1
    D.3.9.4EV Substance CodeSUB22314
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameQL1205-Qilu ranibizumab biosimilar
    D.3.2Product code QL1205
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravitreal use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRanibizumab
    D.3.9.1CAS number 347396-82-1
    D.3.9.4EV Substance CodeSUB22314
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Subjects With Wet (neovascular) Age-related Macular Degeneration (wAMD), aged ≥50 years
    Sujetos con degeneración macular neovascular asociada a la edad (DMAEn)
    E.1.1.1Medical condition in easily understood language
    wet Age-related Macular Degeneration , resulting from damage to the macula, the central portion of the retina caused by the growth of leaky, abnormal blood vessels (choroidal neovascularization)
    DMAEn como resultado de daño de la mácula, la parte central de la retina, causada por el crecimiento anormal de vasos sanguíneos con fugas (neovascularización coroidea)
    E.1.1.2Therapeutic area Diseases [C] - Eye Diseases [C11]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10075568
    E.1.2Term Wet age-related macular degeneration
    E.1.2System Organ Class 100000004853
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To demonstrate that the biosimilar candidate QL1205 is equivalent to Lucentis® (ranibizumab) in subjects with wet (neovascular) age-related macular degeneration (wAMD).
    The primary analysis will be based on change in best corrected visual acuity (BCVA) letters at Week 8 compared to Baseline using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol.
    Demostrar que el candidato biosimilar QL1205 es equivalente a Lucentis® (ranibizumab) en pacientes con degeneración macular húmeda (neovascular) asociada a la edad (DMAEn).
    El análisis principal se basará en el cambio de número de letras en la mejor agudeza visual corregida (MAVC) de la Semana 8 en comparación con la de la visita inicial usando el protocolo del Estudio de Tratamiento Temprano de retinopatía diabética (en inglés, Early Treatment Diabetic Retinopathy Study o ETDRS).
    E.2.2Secondary objectives of the trial
    • To evaluate the efficacy of QL1205 versus Lucentis® in subjects with wAMD based on central foveal thickness (CFT), area of choroidal neovascularization (CNV), and leakage from CNV lesion
    • To evaluate the systemic exposure of QL1205 versus Lucentis® in subjects participating in pharmacokinetic (PK) evaluation
    • To evaluate the safety of QL1205 versus Lucentis®
    • To evaluate immunogenicity of QL1205 versus Lucentis®
    • Evaluar la eficacia de QL1205 frente a Lucentis® en pacientes con DMAEn basándose en el grosor foveal central (GFC), el área de neovascularización coroidea (NVC) y la fuga de la lesión por NVC.
    • Evaluar la exposición sistémica de QL1205 frente a Lucentis® en pacientes que participen en la evaluación farmacocinética (FC)
    • Evaluar la seguridad de QL1205 frente a Lucentis®
    • Evaluar la inmunogenicidad de QL1205 frente a Lucentis®
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Pharmacokinetics (PK) sub-study. To evaluate the systemic exposure of QL1205 versus Lucentis®. A subgroup of 60 subjects at a select number of participating centers will be sequentially asked to participate in an evaluation of pharmacokinetics (PK). These subjects will be asked to provide blood samples for measurement of serum ranibizumab immediately before the first dose of study treatment and 22 hours after the first dose (administered on Day1) and the sixth dose (administered at Week 20) at expected time to maximum serum concentration (0.9 days). The primary analysis set will be the PK Analysis population (please refer to the protocol QL1205-002).
    Subestudio de farmacocinética (PK). Evaluar la exposición sistémica de QL1205 frente a Lucentis®. A un subgrupo de 60 sujetos en una selección de centros participantes se les pedirá que participen en una evaluación de farmacocinética (PK). Se les pedirá a estos sujetos que proporcionen muestras de sangre para medir el ranibizumab en suero inmediatamente antes de la primera dosis del tratamiento del estudio y 22 horas después de la primera dosis (administrada el Día 1) y la sexta dosis (administrada en la semana 20) en el tiempo esperado hasta la máxima concentración en suero (0.,9 días). El análisis principal será la población de Análisis PK (consulte el protocolo QL1205-002).
    E.3Principal inclusion criteria
    1. Willingness and ability to undertake all scheduled visits and assessments as judged by the investigator
    2. Age ≥ 50 years at Screening
    3. Males, or females of nonchildbearing potential (eg, permanently sterilized or postmenopausal [defined as 12 months with no menses without an alternative medical cause before Screening])
    4. Newly diagnosed, treatment-naive, active subfoveal CNV lesion secondary to AMD in the study eye. Active CNV means presence of leakage as evidenced by fluorescein angiography (FA) and intra- or sub-retinal fluid as evidenced by optical coherence tomography (OCT) that is confirmed by the central reading center during Screening
    5. Total lesion area ≤ 9.0 disc areas in size (including blood, scars, and neovascularization) as assessed by FA in the study eye and confirmed by the central reading center before randomization
    6. The area of CNV must be ≥ 50% of the total lesion area in the study eye confirmed by the central reading center before randomization
    7. Best corrected visual acuity of 20/40 to 20/200 in the study eye using ETDRS chart (≤ 73 and ≥ 34 ETDRS letters) at Screening and at Day 1 before randomization
    8. Fellow eye should not be expected to need any anti-vascular endothelial growth factor (VEGF) treatment for the duration of study participation
    9. Written informed consent form (ICF) obtained before any study-related procedures are performed
    10. Male subjects of reproductive potential must be willing to completely abstain from sexual intercourse or agree to use an appropriate method of contraception from the time of signing the ICF and for the duration of study participation through 3 months after the last dose of study drug. See Appendix 17.1 for examples of acceptable contraception. (The investigator and each subject will determine the appropriate method of contraception for the subject during the participation in the study.)
    a. A man of reproductive potential is any man who has not been surgically sterilized (eg, has not undergone bilateral orchiectomy or vasectomy)
    1. Disposición y capacidad para realizar todas las visitas y las evaluaciones programadas en opinión del investigador
    2. Edad ≥ 50 años en la selección
    3. Hombres, o mujeres sin capacidad de gestación (por ejemplo, esterilizadas de forma permanente o en estado postmenopáusico [entendido como la ausencia de menstruación durante 12 meses sin una causa médica alternativa antes de la selección])
    4. Diagnóstico reciente, ausencia de tratamiento previo, lesión por NVC subfoveal activa secundaria a la DMAE en el ojo de estudio. La NVC activa conlleva la presencia de fugas de líquido demostradas mediante angiografías con fluoresceína (AF) y de líquido intrarretiniano o subretiniano demostradas mediante tomografía de coherencia óptica (TCO) confirmadas por el centro de lectura central durante la selección
    5. Área total de la lesión ≤9,0 áreas de disco en tamaño (lo que incluye sangre, cicatrices y neovascularización) según lo evaluado mediante la AF en el ojo de estudio y confirmado por el Centro de Lectura Central antes de la aleatorización
    6. Área de NVC ≥50 % del total del área de la lesión en el ojo de estudio, confirmada por el centro de lectura central antes de la aleatorización
    7. Mejor agudeza visual corregida de 20/40 a 20/200 en el ojo de estudio usando un gráfico ETDRS (≤73 y ≥34 letras de ETDRS) en la Selección y en el Día 1 antes de la aleatorización.
    8. Para el otro ojo no debería preverse la necesidad de tratamiento contra el factor de crecimiento endotelial vascular (FCEV) durante la participación en el estudio.
    9.Obtención del Formulario de Consentimiento Informado (FCI) por escrito antes de realizar cualquier procedimiento relacionado con el estudio.
    10. Los pacientes varones con potencial reproductivo deben estar dispuestos a abstenerse de mantener relaciones sexuales o comprometerse a utilizar un método anticonceptivo adecuado desde el momento en que firman el FCI y durante la participación en el estudio hasta 3 meses después de la administración de la última dosis del estudio. Véase el Apéndice 17.1 para obtener ejemplos de anticonceptivos aceptables. (El investigador y cada paciente determinarán el método anticonceptivo adecuado para dicho paciente durante su participación en el estudio).
    a. Se entiende como hombre con potencial reproductivo cualquier hombre que no se haya sometido a esterilización quirúrgica (es decir, que no se haya sometido a orquiectomía bilateral o vasectomía).
    E.4Principal exclusion criteria
    1. Previous ocular treatment/surgery for wAMD in either eye
    2. Previous intravitreal treatment/vitreal surgery in either eye
    3. Any previous intravitreal anti-VEGF treatment (eg, bevacizumab, aflibercept, ranibizumab) in either eye
    4. Any previous systemic anti-VEGF treatment
    5. Sub- or intraretinal hemorrhage involving the fovea in the study eye of 50% or more of the total lesion area assessed by FA and confirmed by the central reading center
    6. Subfoveal fibrosis or atrophy in the study eye assessed by FA and confirmed by the central reading center
    7. Scarring exceeding 50% of total lesion size
    8. Choroidal neovascularization in either eye due to nonAMD causes assessed by FA and confirmed by the central reading center
    9. Retinal pigment epithelial tear involving the macula in the study eye as assessed by FA and confirmed by the central reading center
    10. Any concurrent intraocular condition in the study eye (eg, cataract or diabetic retinopathy) that, in the opinion of the investigator, could require treatment during the study period to prevent or treat loss of visual acuity
    11. Other intraocular surgery (including cataract surgery) or periocular surgery in the study eye within 3 months before randomization, except for eyelid surgery within 30 days before randomization
    12. Corneal transplant in the study eye
    13. Active or recent (within 28 days before randomization) intraocular, extraocular, and periocular inflammation or infection in either eye, including conjunctivitis, keratitis, scleritis, or endophthalmitis
    14. Current vitreous hemorrhage in the study eye
    15. History of retinal detachment in the study eye
    16. History of macular hole in the study eye
    17. History of idiopathic or autoimmune-associated uveitis in either eye
    18. Aphakia or absence of the posterior capsule in the study eye, unless it occurred as a result of a Yttrium Aluminium Garnet posterior capsulotomy in association with prior posterior chamber intraocular lens implantation
    19. Presence of advanced glaucoma or optic neuropathy that involves or threatens the central visual field in the study eye
    20. History of glaucoma filtering surgery in the study eye
    21. Uncontrolled ocular hypertension in the study eye, defined as intraocular pressure ≥ 25 mm Hg despite treatment with anti-glaucoma medication
    22. Spherical equivalent of the refractive error in the study eye demonstrating more than 8 diopters of myopia
    23. Contraindication for Lucentis® (hypersensitivity to ranibizumab or to any of the excipients, active or suspected ocular or periocular infection, or active severe intraocular inflammation), or known allergic reactions to any ingredients of QL1205
    24. Current treatment for active systemic infection
    25. Subjects with seropositivity for hepatitis B, hepatitis C antibody, HIV antibody, syphilis tests, or any immunodeficiency and/or immunosuppressive disease or active systemic infection. Seropositivity for hepatitis B is defined as (1) positive for hepatitis B surface antigen and (2) positive for hepatitis B virus DNA
    26. Reasonable suspicion of a disease or condition that might render the subject at high risk of treatment complications or affect interpretation of the study results (as judged by the investigator), such as uncontrolled hypertension (systolic blood pressure > 160 mm Hg or diastolic blood pressure > 100 mm Hg), stroke, or myocardial infarction within 6 months before randomization
    27. Participation in another clinical trial within the previous 3 months or any previous participation in a clinical trial of anti-angiogenic drugs with receipt of previous study drug within 3 months of signing the ICF for this study
    28. Topical ocular corticosteroids administrated for ≥ 30 consecutive days in the study eye within 90 days before randomization
    29. Any systemic treatment or therapy (including prescribed herbal medication) to treat neovascular AMD within 30 days before randomization, and such treatment or therapy will not be allowed during the study period. However, dietary supplements, vitamins, or minerals will be allowed
    30. PK subgroup only: contraindication for additional blood sampling (as judged by the investigator)
    1. Tratamiento/cirugía ocular previos para la DMAEn en cualquier ojo
    2. Tratamiento intravítreo/cirugía vítrea previos en cualquier ojo
    3. Cualquier tratamiento intravítreo para el FCEV previo (por ejemplo, bevacizumab, aflibercept, ranibizumab) en cualquier ojo
    4. Cualquier tratamiento sistémico para el FCEV previo
    5. Hemorragia subretiniana o intrarretiniana que afecte a la fóvea en el ojo de estudio en el 50 % o más del área total de la lesión evaluada por AF y confirmada por el Centro de Lectura Central
    6. Fibrosis o atrofia subfoveal en el ojo de estudio evaluada por AF y confirmada por el Centro de Lectura Central
    7. Cicatriz que sobrepase el 50 % del tamaño total de la lesión
    8. Neovascularización coroidea en cualquier ojo debida a causas distintas de la DMAE evaluada por AF y confirmada por el Centro de Lectura Central
    9. Desgarro del epitelio pigmentario retiniano que afecte a la mácula en el ojo de estudio evaluado por AF y confirmado por el Centro de Lectura Central
    10. Cualquier otra patología concomitante en el ojo de estudio (por ejemplo, cataratas o retinopatía diabética) que, a juicio del investigador, pueda precisar de tratamiento durante el período del estudio para evitar o tratar la pérdida de agudeza visual
    11. Otra intervención quirúrgica intraocular (incluida la cirugía de cataratas) o periocular en el ojo de estudio en los 3 meses anteriores a la aleatorización, excepto cirugía del párpado en los 30 días anteriores a la aleatorización
    12. Trasplante de córnea en el ojo de estudio
    13. Inflamación o infección intraocular, extraocular y periocular activa o reciente (en los 28 días anteriores a la aleatorización) en cualquier ojo, lo que incluye conjuntivitis, queratitis, escleritis o endoftalmitis
    14. Hemorragia vítrea presente en el ojo de estudio
    15. Antecedentes de desprendimiento de retina en el ojo de studio
    16. Antecedentes de agujero macular en el ojo de estudio
    17. Antecedentes de uveítis idiopática o asociada a una patología autoinmune en cualquiera de los ojos
    18. Afaquia o ausencia de la cápsula posterior en el ojo del estudio, salvo que haya ocurrido a consecuencia de la capsulotomía posterior con láser YAG (itrio-aluminio-granate) junto con el implante previo de una lente intraocular de cámara posterior.
    19. Presencia de glaucoma avanzado o neuropatía óptica que afecte o amenace al campo central de visión en el ojo de estudio
    20. Antecedentes de cirugía filtrante para glaucoma en el ojo de estudio
    21. Hipertensión ocular no controlada en el ojo de estudio, definida como presión intraocular ≥25 mmHg, a pesar de recibir tratamiento con medicación para el glaucoma
    22. Equivalente esférico del error refractivo en el ojo de estudio que demuestre más de 8 dioptrías de myopia
    23. Contraindicación para Lucentis® (hipersensibilidad a ranibizumab o a alguno de los excipientes, infección ocular o periocular activa o sospecha de tal infección, o inflamación intraocular activa grave), o reacciones alérgicas conocidas a algún ingrediente de QL1205
    24. Tratamiento en curso para infección sistémica activa
    25. Pacientes seropositivos para hepatitis B, anticuerpo de la hepatitis C, anticuerpo del VIH, pruebas de sífilis, o cualquier enfermedad inmunodeficiente y/o inmunodepresiva o infección sistémica activa. La seropositividad para hepatitis B se define como (1) resultado positivo para el antígeno superficial de hepatitis B y (2) resultado positivo para el ADN del virus de la hepatitis B
    26. Sospecha razonable de una patología que pueda suponer para el paciente un alto riesgo de presentar complicaciones debido al tratamiento o que pueda confundir la interpretación de los resultados del estudio (según el criterio del investigador), como hipertensión no controlada (presión arterial sistólica >160 mmHg o presión arterial diastólica >100 mmHg), apoplejía o infarto de miocardio en los 6 meses anteriores a la aleatorización
    27. Participación en otro ensayo clínico en los 3 meses previos o cualquier participación previa en un ensayo clínico de medicamentos antiangiogénicos con recepción del medicamento en estudio previo dentro de los 3 meses anteriores a la firma del FCI para este estudio
    28. Administración de corticosteroides oculares tópicos durante ≥30 días consecutivos en el ojo de estudio en un período de 90 días anteriores a la aleatorización
    29. Cualquier tratamiento o terapia sistémicos (incluyendo medicación de herbolario recetada) para tratar la DMAE neovascular en los 30 días anteriores a la aleatorización, y tales tratamientos o terapias no estarán permitidos durante el período de estudio. En cambio, se permitirán suplementos dietéticos, vitaminas o minerales
    30. Solo para el subgrupo FC: contraindicación para la extracción de muestras de sangre adicionales (según el criterio del investigador)
    E.5 End points
    E.5.1Primary end point(s)
    Primary Efficacy Endpoint:
    • Change in BCVA letters at Week 8 compared to Baseline in the study eye using the ETDRS protocol
    Variación en el número de letras de AVMC que se observe en la Semana 8 en comparación con el de la visita inicial mediante el protocolo ETDRS
    E.5.1.1Timepoint(s) of evaluation of this end point
    Primary Efficacy Endpoint:
    • at Week 8 compared to Baseline
    Criterio principal de valoración de la eficacia:
    - En la Semana 8 en comparación con el de la visita inicial
    E.5.2Secondary end point(s)
    Secondary Endpoint:
    • Change in CFT at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 52 compared to Baseline in the study eye, as measured by OCT
    • Change in BCVA letters over the course of the study compared to Baseline in the study eye using the ETDRS protocol
    • Change in total size of CNV leakage area at Week 24 and Week 52 compared to Baseline in the study eye, as measured by FA
    • Change in total size of CNV at Week 24 and Week 52 compared to Baseline in the study eye, as measured by FA
    • Percentage of subjects with loss of ≤ 15 letters using ETDRS, evaluated as change at Week 8, Week 24 and Week 52 compared to Baseline in the study eye
    • Percentage of subjects with gain of > 15 letters using ETDRS, evaluated as change at Week 8, Week 24, and Week 52 compared to Baseline in the study eye
    • Change in intra/subretinal fluid status measured by OCT in the study eye
    • Number of subjects without intra- or sub-retinal fluid at Week 24 and Week 52 in the study eye
    • Number of subjects with retinal pigment epithelium detachments in the study eye

    Pharmacokinetic Endpoint:
    • Cmax: maximum observed concentration at certain time points

    Immunogenicity Endpoint:
    • Immunogenicity (anti-ranibizumab antibodies, ADA, and NAb) measurement before treatment at Day 1, Week 4, Week 8, Week 12, Week 24, and Week 52. Additional samples for monitoring of immunogenicity are to be collected from subjects with any signs of intraocular inflammation, as these may indicate an immune reaction.
    Criterios secundarios de valoración de la eficacia:
    • Variación del GFC que se observe en la Semana 2, la Semana 4, la Semana 8, la Semana 16, la Semana 24 y la Semana 52 en comparación con la visita inicial, determinada por TCO
    • Variación en las letras de AVMC a lo largo del estudio en comparación con las observadas en la visita inicial en el ojo de estudio mediante el protocolo ETDRS
    • Variación del tamaño total del área de fuga por NVC en la Semana 24 y en la Semana 52 en comparación con la visita inicial en el ojo de estudio, determinada por AF
    • Variación del tamaño total de la NVC en la Semana 24 y en la Semana 52 en comparación con la visita inicial en el ojo de estudio, determinada por AF
    • Porcentaje de pacientes con pérdida de ≤15 letras según el estudio ETDRS, evaluado conforme a las variaciones observadas en la Semana 8, la Semana 24 y la Semana 52 en comparación con el porcentaje observado en la visita inicial en el ojo de estudio
    • Porcentaje de pacientes con ganancia de >15 letras según el estudio ETDRS, evaluado conforme a las variaciones observadas en la Semana 8, la Semana 24 y la Semana 52 en comparación con el porcentaje observado en la visita inicial en el ojo de estudio
    • Variación del estado del fluido intrarretiniano o subretiniano determinado por TCO en el ojo de studio
    • Número de pacientes sin fluido intrarretiniano o subretiniano en la Semana 24 y en la Semana 52 en el ojo de estudio
    • Número de pacientes con desprendimientos del epitelio pigmentario retiniano en el ojo de studio.
    Pharmacocinética
    • Cmáx: concentración máxima observada en determinados momentos

    Inmunogenicidad
    • Evaluación de inmunogenicidad (anticuerpos contra ranibizumab, anticuerpos antifármaco [AAF], AAF neutralizantes [AAN]) antes del tratamiento el día 1, la Semana 4, la Semana 8, la Semana 12, la Semana 24 y la Semana 52. Se recogerán muestras adicionales de los pacientes con cualquier signo de inflamación intraocular para la monitorización de la inmunogenicidad, ya que tales signos pueden indicar una reacción inmune.
    E.5.2.1Timepoint(s) of evaluation of this end point
    • Change in CFT at Week 2,Week 4,Week 8,Week 16,Week 24,Week 52
    • Change in BCVA letters over the course of the study
    • Change in total size of CNV leakage area at Week 24,Week 52
    • Change in total size of CNV at Week 24,Week 52
    • Percentage of subjects with loss of ≤ 15 letters using ETDRS, evaluated as change at Week 8, Week 24,Week 52
    • Percentage of subjects with gain of > 15 letters using ETDRS, evaluated as change at Week 8, Week 24, Week 52
    • Change in intra/subretinal fluid status measured by OCT
    • Number of subjects without intra/sub-retinal fluid at Week 24,Week 52
    • Number of subjects with retinal pigment epithelium detachments

    PK Endpoint: Cmax at certain time points
    Immunogenicity Endpoint: before treatment at Day 1,Week 4,Week 8,Week 12,Week 24,Week 52
    • Variación del GFC Semanas 2, 4, 8, 16, 24 y 52.
    • Variación en letras de AVMC a lo largo del estudio.
    • Variación del tamaño del área de fuga por NVC en Semanas 24 y 52.
    • Variación del tamaño total de NVC en Semanas 24 y 52.
    • % de pacientes con pérdida de ≤15 letras según el ETDRS, según variaciones en Semanas 8, 24 y 52.
    • % de pacientes con ganancia de >15 letras según el ETDRS, según variaciones en Semanas 8, 24 y 52.
    • Variación del estado del fluido intrarretiniano o subretiniano por TCO.
    • Nº de pacientes sin fluido intrarretiniano o subretiniano en las Semanas 24 y 52.
    • Nº de pacientes con desprendimientos del epitelio pigmentario retiniano.
    Farmacocinética: Cmáx en determinados momentos
    Inmunogenicidad: antes del tto.día 1, las Semanas 4, 8, 12, 24 y 52.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence Yes
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity
    Inmunogenicidad
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Lucentis
    Lucentis
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned28
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA40
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Bulgaria
    China
    Czech Republic
    Hungary
    India
    Latvia
    Poland
    Russian Federation
    Slovakia
    Spain
    Ukraine
    E.8.7Trial has a data monitoring committee No
    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
    Last Subject Last Visit (LSLV)
    Último Paciente Última visita
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 328
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 328
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state28
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 206
    F.4.2.2In the whole clinical trial 656
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-06-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-06-07
    P. End of Trial
    P.End of Trial StatusOngoing
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