E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Geographic Atrophy Secondary to Age-Related Macular Degeneration |
|
E.1.1.1 | Medical condition in easily understood language |
Geographic Atrophy Secondary to Age-Related Macular Degeneration |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Eye Diseases [C11] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063947 |
E.1.2 | Term | Geographic atrophy |
E.1.2 | System Organ Class | 100000004853 |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the long-term safety of IVT injected pegcetacoplan. |
|
E.2.2 | Secondary objectives of the trial |
1. To assess changes in the total area of geographic atrophy (GA) lesion in the study eye measured by fundus autofluorescence (FAF).
2. To assess changes in visual function as measured by:
a. Normal-luminance best-corrected visual acuity score (NL-BCVA) in the study eye
b. Low-luminance best-corrected visual acuity score (LL-BCVA) in the study eye
c. Low-luminance deficit (LLD) in the study eye
d. Reading speed in the study eye
3. To assess the macular functional response as assessed by mesopic microperimetry in the
study eye (selected subjects [those who had the assessment performed in the antecedent
study] only).
4. To evaluate changes in subject-reported outcomes as measured by:
a. National Eye Institute Visual Functioning Questionnaire 25 Item Version (NEI VFQ-25)
b. Functional Reading Independence (FRI) Index. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Ocular-specific inclusion criteria apply to the study eye only.
1. Participated in APL2-103 (NCT03777332) or completed the treatment at Month 24 of
either APL2-303 (Derby, NCT03525613) or APL2-304 (Oaks, NCT03525600). Specifically, for the APL2-303 and APL2-304 studies, the following criterion also applies:
a. Subjects who did not permanently discontinue treatment but missed the Month 24 visit are also eligible to participate in this extension study; however, to be eligible,
these subjects must be screened within 60 days from the last day of the expected
Month 24 visit window for the antecedent study.
2. Clarity of ocular media, adequate pupillary dilation, and fixation to permit the collection
of good quality images as determined by the investigator.
3. Female subjects must be:
a. Women of nonchildbearing potential, or
b. Women of childbearing potential (WOCBP) with a negative serum pregnancy test at
screening and must agree to use protocol defined methods of contraception for the
duration of the study and 90 days after their last dose of pegcetacoplan, and refrain
from breastfeeding for the duration of the study.
4. Males with female partners of childbearing potential must agree to use protocol defined
methods of contraception and agree to refrain from donating sperm for the duration of the
study and for 90 days after their last dose of pegcetacoplan.
5. Willing and able to give informed consent and to comply with the study procedures and assessments. |
|
E.4 | Principal exclusion criteria |
Ocular-specific exclusion criteria apply to the study eye only.
1. Subjects who permanently discontinued the study drug prior to Month 24 in the APL2-304 or APL2-304 studies and only for safety assessments. Temporary pause of the study drug is not exclusionary.
2. Presence of an active ocular disease that, in the opinion of the investigator, compromises
or confounds visual function, including, but not limited to, macular hole or other macular
diseases (eg, clinically significant epiretinal membrane). Benign conditions in the opinion
of the investigator such as peripheral retinal dystrophy are not exclusionary.
3. Any contraindication to IVT injection including current ocular or periocular infection.
4. Medical or psychiatric condition that, in the opinion of the investigator, is clinically
significant and not suitable for study participation or make consistent follow-up over the 36-month treatment period unlikely.
5. Known hypersensitivity to fluorescein sodium for injection or hypersensitivity to
pegcetacoplan or any of the excipients in pegcetacoplan solution.
6. Pregnancy, breastfeeding, or positive pregnancy test. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Incidence and severity of ocular and systemic AEs |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Incidence and severity of ocular and systemic AEs (time frame: up to 36 months) |
|
E.5.2 | Secondary end point(s) |
• The total area of GA lesion(s) in the study eye (in mm2) as assessed by fundus autofluorescence (FAF)
• NL-BCVA score (study eye) as assessed by Early Treatment Diabetic Retinopathy Study (ETDRS) chart
• LL-BCVA score (study eye) as assessed by ETDRS chart
• LLD (study eye)
• Monocular maximum reading speed (study eye) and monocular critical print size, as assessed by Minnesota Reading (MNRead) charts or Radner
• Binocular maximum reading speed and binocular critical print size, as assessed by MNRead charts or Radner.
• The number of absolute scotomatous points (study eye) assessed by mesopic microperimetry (selected subjects [those who had the assessment performed in the antecedent study] only)
• Macular sensitivity (study eye) as assessed by mesopic microperimetry (selected subjects [those who had the assessment performed in the antecedent study] only)
• Mean FRI Index score
• NEI VFQ-25 composite score, near activity subscale score, and distance activity subscale score |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
•The total area of GA lesion(s) in the study eye (in mm2) as assessed by FAF at Month 12, 24 and 36.
• NL-BCVA score (study eye) and LL-BCVA score (study eye) as assessed by ETDRS chart at Month 12, 24 and 36.
• LLD (study eye) at Month 12, 24 and 36.
• Monocular maximum reading speed (study eye) and monocular critical print size at Month 12, 24 and 36.
• Binocular maximum reading speed and binocular critical print size at Month 12, 24 and 36.
The number of absolute scotomatous points (study eye) at Month 12, 24, and 36.
• Macular sensitivity (study eye) at Month 12, 24, and 36.
• Mean FRI Index score at Month 12, 24, and 36
• NEI VFQ-25 composite score, near activity subscale score, and distance activity subscale score at Month 12, 24, and 36. |
|
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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 | No |
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 | 14 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 52 |
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 |
Brazil |
Canada |
Israel |
New Zealand |
United States |
France |
Germany |
Italy |
Netherlands |
Poland |
Spain |
United Kingdom |
Czechia |
Argentina |
|
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
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 | 3 |
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 |