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    Summary
    EudraCT Number:2021-000225-27
    Sponsor's Protocol Code Number:KS301P107
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-07-15
    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 number2021-000225-27
    A.3Full title of the trial
    A Prospective, Randomized, Double-masked, Active Comparator-controlled, Multi-center, Two-arm, Phase 3 Study to Evaluate the Efficacy and Safety of Intravitreal KSI-301 Compared with Intravitreal Aflibercept in Participants with Neovascular (Wet) Age-related Macular Degeneration (wAMD)
    Estudio de fase 3, prospectivo, multicéntrico, aleatorizado, con doble enmascaramiento, controlado con tratamiento activo y con dos brazos de tratamiento para evaluar la eficacia y la seguridad de KSI-301 intravítreo comparado con aflibercept intravítreo en pacientes con degeneración macular neovascular (húmeda) asociada a la edad (DMAEh)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study to Evaluate the Efficacy and Safety of KSI-301 Compared to Aflibercept in Participants with Neovascular (Wet) Age-related Macular Degeneration (wAMD)
    Estudio para evaluar la eficacia y la seguridad de KSI-301 comparado
    con aflibercept en pacientes con degeneración macular neovascular (húmeda) asociada a la edad (DMAEh)
    A.3.2Name or abbreviated title of the trial where available
    Daylight
    Daylight
    A.4.1Sponsor's protocol code numberKS301P107
    A.5.4Other Identifiers
    Name:IND NumberNumber:136167
    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 SponsorKodiak Sciences Inc.
    B.1.3.4CountryUnited States
    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 supportKodiak Sciences Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationKodiak Sciences Inc.
    B.5.2Functional name of contact pointKSI-CL-105 Trial Information
    B.5.3 Address:
    B.5.3.1Street Address2631 Hanover Street
    B.5.3.2Town/ cityPalo Alto
    B.5.3.3Post codeCA 94304
    B.5.3.4CountryUnited States
    B.5.4Telephone number+34900834223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.com
    D. IMP Identification
    D.IMP: 1
    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 nameKSI-301 Drug Product
    D.3.2Product code KSI-301
    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 INNiridescimab vidros
    D.3.9.1CAS number 2411896-53-0
    D.3.9.2Current sponsor codeOG1953
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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 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 Eylea
    D.2.1.1.2Name of the Marketing Authorisation holderBayer AG
    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.3.4Pharmaceutical 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 INNAFLIBERCEPT
    D.3.9.1CAS number 862111-32-8
    D.3.9.3Other descriptive nameAFLIBERCEPT
    D.3.9.4EV Substance CodeSUB26987
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    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
    Neovascular (Wet) Age-related Macular Degeneration (wAMD)
    Degeneración macular neovascular (húmeda) asociada a la edad (DMAEh)
    E.1.1.1Medical condition in easily understood language
    Neovascular (Wet) Age-related Macular Degeneration (wAMD)
    Degeneración macular neovascular (húmeda) asociada a la edad (DMAEh)
    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 SOC
    E.1.2Classification code 10015919
    E.1.2Term Eye disorders
    E.1.2System Organ Class 10015919 - Eye disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10071129
    E.1.2Term Neovascular age-related macular degeneration
    E.1.2System Organ Class 10015919 - Eye disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    E.1.2Classification code 10064930
    E.1.2Term Age-related macular degeneration
    E.1.2System Organ Class 10015919 - Eye disorders
    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 10015919 - Eye disorders
    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 KSI-301 5 mg is non-inferior to aflibercept 2 mg, with respect to the change in best
    corrected visual acuity (BCVA) from Day 1 to Week 40.
    Demostrar que KSI-301 5 mg no es inferior a aflibercept 2 mg en cuanto a la variación de la mejor agudeza visual corregida (MAVC) entre el día 1 y la semana 40.
    E.2.2Secondary objectives of the trial
    To evaluate the efficacy of KSI-301 5 mg compared to aflibercept 2 mg over the study duration by assessing visual parameters.

    To evaluate the efficacy of KSI-301 5 mg compared to aflibercept 2 mg over the study duration by assessing anatomical parameters.

    To evaluate the safety and tolerability of KSI-301 5 mg compared to aflibercept 2 mg.

    To assess the systemic pharmacokinetics (exposure)
    and immunogenicity of KSI-301.
    Evaluar la eficacia de KSI-301 5 mg en comparación con aflibercept 2 mg durante el estudio mediante parámetros visuales.

    Evaluar la eficacia de KSI-301 5 mg en comparación con aflibercept 2 mg durante el estudio mediante parámetros anatómicos.

    Evaluar la seguridad y tolerabilidad de KSI-301 5 mg en comparación con aflibercept 2 mg.

    Evaluar la farmacocinética sistémica (exposición) y la inmunogenicidad de KSI-301.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Active, treatment-naïve choroidal neovascularization (CNV) secondary to AMD, including subfoveal, juxtafoveal, and extrafoveal lesions, or retinal angiomatous proliferations (RAP) lesions with a CNV component that affects the central subfield, as evidenced by FA or OCT in the Study Eye at Screening.
    2. The CNV area in the Study Eye must be at least 50% of total lesion size at Screening.
    3. The lesion area in the Study Eye must be <30 mm2 (12-disc areas) and can include any CNV lesion subtype.
    4. Intra- and/or subretinal fluid and/or subretinal hyperreflective material (SHRM) affecting the central subfield of the Study Eye on OCT at Screening.
    5. BCVA ETDRS score between 83 and 25 letters, inclusive, in the Study Eye at screening and reconfirmed at Day 1.
    6. Decrease in vision in the Study Eye determined by the Investigator to be primarily the result of wAMD.In cases where both eyes are eligible, the eye with the worse BCVA at the Screening Visit will be selected as the Study Eye. If both eyes are eligible and have the same BCVA, the decision of
    which eye to select as the Study Eye will be made by the Investigator. Only one eye per participant can participate in the study.
    7. Capable of giving signed informed consent as described in Appendix 1, which includes compliance with the protocols and restrictions listed in the informed consent form (ICF) and in this protocol.
    8. Male or female ≥50 years of age.
    9. For women of childbearing potential: agreement to remain as abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of <1% per year during the treatment period and for at least 90 days after the last dose of study drug. Women of childbearing potential must have a negative urine pregnancy test result within 28 days prior to Day 1. If the urine pregnancy test is positive, it must be confirmed with a serum pregnancy test.
    a. A woman is considered of childbearing potential if she is postmenarcheal, has not reached a postmenopausal state (≥12 months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus). The definition of childbearing potential may be adapted for alignment with local guidelines or requirements.
    b. Examples of contraceptive methods with a failure rate of <1% per year include bilateral tubal ligation, male sterilization, established, proper use of hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices and copper intrauterine devices.
    c. Contraception methods that do not result in a failure rate of <1% per year such as cap, diaphragm, or sponge with spermicide, or male or female condom with or without spermicide, are not acceptable.
    d. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the participant. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.
    10. For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm, as defined below:
    a. With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of <1% per year during the treatment period and for at least 30 days plus 90 days (a spermatogenesis cycle) after the last dose of study drug. Men must refrain from donating sperm during this same time period.
    11. Ability and willingness to undertake all the scheduled visits and assessments.
    1. Neovascularización coroidea (NVC) activa, no tratada previamente, secundaria a DMAE, incluidas lesiones subfoveales, yuxtafoveales y extrafoveales o lesiones de proliferación angiomatosa retiniana (PAR) con un componente de NVC que afecten al subcampo central, demostradas mediante AF o TCO en el ojo evaluado en el período de selección.
    2. Superficie de NVC en el ojo evaluado correspondiente al 50 %, como mínimo, del tamaño total de lesión en el período de selección.
    3. La superficie de lesión en el ojo evaluado debe ser <30 mm2 (superficie de 12 discos) y puede incluir cualquier subtipo de lesión de NVC.
    4. Líquido intra o subretiniano o material hiperreflectante subretiniano (MHSR) que afecta al subcampo central del ojo evaluado en la TCO en el período de selección.
    5. Puntuación de MAVC según el optotipo ETDRS de entre 83 y 25 letras, ambas inclusive, en el ojo evaluado en el período de selección y reconfirmada el día 1.
    6. Disminución de la visión en el ojo evaluado debida principalmente, según el investigador, a DMAE húmeda.
    En los casos en que ambos ojos sean elegibles, se seleccionará como ojo evaluado aquel con peor MAVC en la visita de selección. En caso de que ambos ojos tengan la misma MAVC, el investigador tomará la decisión de cuál de ellos elegir como ojo evaluado. En el estudio solo podrá participar un ojo por participante.
    7. Capaz de otorgar el consentimiento informado firmado como se describe en el apéndice 1, lo que incluye el cumplimiento de los protocolos y restricciones que se recogen en el documento de consentimiento informado (DCI) y en este protocolo.
    8. Varón o mujer de 50 años o más de edad.
    9. Mujeres en edad fértil: compromiso de practicar abstinencia sexual (ausencia de relaciones heterosexuales) o utilizar métodos anticonceptivos con un índice de fallos <1 % anual durante el período de tratamiento y hasta, como mínimo, 90 días después de recibir la última dosis del fármaco del estudio. Las mujeres en edad fértil deberán dar negativo en una prueba de embarazo en orina realizada en los 28 días previos al día 1. Cuando una prueba de embarazo en orina sea positiva, deberá confirmarse mediante una prueba de embarazo en suero.
    a. Se considera que una mujer está en edad fértil si ha tenido la menarquia, no ha alcanzado un estado posmenopáusico (≥12 meses de amenorrea sin causa identificadadistinta de la menopausia) y no se ha sometido a esterilización quirúrgica (extirpaciónde los ovarios o el útero). La definición de edad fértil podrá adaptarse para reflejar lasdirectrices o requisitos locales.
    b. Algunos ejemplos de métodos anticonceptivos con un índice de fallos <1 % anual sonligadura de trompas bilateral, esterilización masculina, uso correcto y sistemático de anticonceptivos hormonales que inhiban la ovulación, dispositivos intrauterinos liberadores de hormonas y dispositivos intrauterinos de cobre.
    c. No serán aceptables los métodos anticonceptivos que no cuenten con un índice de fallos < 1 % anual, como capuchón cervical, diafragma o esponja con espermicida o preservativo masculino o femenino con o sin espermicida.
    d. La fiabilidad de la abstinencia sexual se deberá evaluar en relación con la duración del ensayo clínico y el modo de vida preferido y habitual del paciente. La abstinenciaperiódica (p. ej., métodos del calendario, de la ovulación, sintotérmico y postovulatorio) y el coito interrumpido no son métodos anticonceptivos aceptables.
    10. Varones: compromiso de practicar la abstinencia sexual o utilizar métodos anticonceptivos y compromiso de abstenerse de donar semen, como se define a continuación:
    a. Con parejas en edad fértil, los varones deben comprometerse a practicar la abstinencia sexual o a utilizar preservativo y otro método anticonceptivo que, en conjunto, presenten un índice de fallos <1 % anual durante el periodo de tratamiento y durante, como mínimo, 30 días más 90 días (un ciclo de espermatogénesis) después de recibir la última dosis del fármaco del estudio. También deberán abstenerse de donar semen durante dicho periodo.
    11. Capacidad y disposición a someterse a todas las visitas y evaluaciones programadas.
    E.4Principal exclusion criteria
    1. BCVA of hand motion or worse in the non-Study Eye or non-physical presence of a non- Study Eye (i.e., monocular).
    2. Active or suspected ocular or periocular infection or inflammation in either eye at Screening or on Day 1.
    3. CNV secondary to other causes in the Study Eye, including pathologic myopia, angioid streaks, prior trauma, ocular histoplasmosis, or others.
    4. Any history of macular pathology unrelated to AMD but affecting vision or contributing to subretinal or intraretinal fluid, such as central serous chorioretinopathy.
    5. Fibrosis or atrophy of >50% of the lesion size and/or involving the foveal center of the Study Eye at Screening.
    6. Subretinal blood affecting the foveal center of the Study Eye and/or more than 50% of the lesion size at Screening.
    7. Retinal pigment epithelium tear or rip in the Study Eye at Screening or on Day 1.
    8. Any approved or investigational treatment for neovascular AMD (other than oral vitamin supplements) in the Study Eye at any time.
    9. Prior macular laser (e.g., thermal laser or photodynamic therapy laser) in the Study Eye.
    10. Any history or evidence of a concurrent ocular condition present in the Study Eye, that in the opinion of the Investigator could require either medical or surgical intervention or affect macular edema or alter visual acuity during the study (e.g., vitreomacular traction, epiretinal membrane).
    11. History of cataract surgery and/or minimally invasive glaucoma surgery (MIGS) in the Study Eye within 2 months of screening.
    12. History of Yttrium-Aluminum Garnet (YAG) laser capsulotomy in the Study Eye within 2 months of screening.
    13. Uncontrolled glaucoma (defined as intraocular pressure ≥ 25 mmHg despite treatment with antiglaucoma medication) in the Study Eye.
    14. History of glaucoma-filtering surgery (trabeculectomy or tube shunt) in the Study Eye.
    15. History of retinal detachment or treatment or surgery for retinal detachment in the Study Eye.
    16. History of uveitis in either eye.
    17. Significant media opacities, including cataract, in the Study Eye that might interfere with visual acuity, assessment of safety, OCT or fundus photography.
    18. Cataract in the Study Eye that in the judgment of the Investigator is expected to require surgical extraction within 12 months of screening.
    19. Aphakia in the Study Eye.
    20. Prior vitrectomy in the Study Eye.
    21. Prior intraocular or periocular steroids in the Study Eye.
    22. Current vitreous hemorrhage or history of vitreous hemorrhage in the Study Eye within 3 months of Screening.
    23. History of corneal transplant in the Study Eye.
    24. Women who are pregnant or lactating or intending to become pregnant during the study
    25. Recent history (within the 6 months prior to screening) of myocardial infarction, stroke, transient ischemic attack, acute congestive heart failure or any acute coronary event.
    26. History of a medical condition that, in the judgment of the Investigator, would preclude scheduled study visits, completion of the study, or a safe administration of investigational product.
    27. History of hypersensitivity to any component of KSI-301, aflibercept, ophthalmic dye (fluorescein), dilating drops, or any of the anesthetic or antimicrobial preparations used during the study, as assessed by the Investigator.
    28. Participation in an investigational study within 30 days prior to the screening visit that involved treatment with any investigational drug (excluding vitamins and minerals) or device, except for non-therapeutic ophthalmic imaging devices.
    29. Active cancer within the 12 months prior to Screening except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin cancer, and prostate cancer with a Gleason score of <6 and stable prostate-specific antigen for >12 months.
    30. Treatment with systemic anti-VEGF therapeutics within 90 days prior to Screening.
    31. Uncontrolled blood pressure defined as a systolic value ≥180 mmHg or diastolic value ≥100 mmHg while at rest at Screening or on Day 1.
    • If a participant’s initial blood pressure measurement exceeds these values, up to two additional readings may be taken later the same day or on a different day during the screening period. If a participant’s blood pressure is controlled by antihypertensive medications, the participant must be on a stable medication regimen continuously for 21 days prior to Day 1.
    1. MAVC de movimiento de la mano o peor en el ojo no evaluado o ausencia física de un ojo no evaluado (es decir, sujeto monocular).
    2. Infección o inflamación ocular o periocular activa en cualquier ojo en la selección o el día 1.
    3. NVC secundaria a otras causas en el ojo evaluado, como miopía patológica, estrías angioides, traumatismo previo, histoplasmosis ocular u otras.
    4. Antecedentes de procesos maculares no relacionados con la DMAE, pero que afecten a la visión o contribuyan al líquido sub o intrarretiniano, como coriorretinopatía serosa central.
    5. Fibrosis o atrofia correspondiente a más del 50 % del tamaño de lesión o que afecta al centro de la fóvea del ojo evaluado en el período de selección
    6. Sangre subretiniana que afecta al centro de la fóvea del ojo evaluado o a más del 50 % del tamaño de lesión en el período de selección.
    7. Desgarro o rotura del epitelio pigmentario de la retina en el ojo evaluado en el período de selección o el día 1.
    8. Cualquier tratamiento aprobado o experimental contra la DMAE neovascular (aparte de suplementos vitamínicos orales) en el ojo evaluado en cualquier momento.
    9. Laserterapia macular previa (p. ej., láser térmico o laserterapia fotodinámica) en el ojo evaluado.
    10. Antecedentes o signos de una enfermedad ocular concomitante en el ojo evaluado que, en opinión del investigador, podría precisar una intervención médica o quirúrgica o afectar al edema macular o alterar la agudeza visual durante el estudio (p. ej., tracción vitreomacular, membrana epirretiniana).
    11. Antecedentes de cirugía de cataratas o cirugía de glaucoma mínimamente invasiva (CGMI) en el ojo evaluado en los 2 meses previos a la selección.
    12. Antecedentes de capsulotomía con láser de granate de itrio y aluminio (YAG) en el ojo evaluado en los 2 meses previos a la selección.
    13. Glaucoma no controlado (definido como una presión intraocular ≥ 25 mm Hg a pesar del tratamiento con medicación antiglaucomatosa) en el ojo evaluado.
    14. Antecedentes de cirugía de filtración del glaucoma (trabeculectomía o derivación con tubo) en el ojo evaluado.
    15. Antecedentes de desprendimiento de retina, tratamiento o intervención quirúrgica por desprendimiento de retina en el ojo evaluado.
    16. Antecedentes de uveítis en cualquiera de los ojos.
    17. Opacidades significativas de los medios, incluidas cataratas, en el ojo evaluado que pudieran interferir en la agudeza visual, la evaluación de la seguridad, la TCO o la fotografía del fondo del ojo.
    18. Catarata en el ojo evaluado que, en opinión del investigador, previsiblemente va a necesitar una extracción quirúrgica en los 12 meses posteriores a la selección.
    19. Afaquia en el ojo evaluado.
    20. Vitrectomía previa en el ojo en estudio.
    21. Administración previa de esteroides intra o perioculares en el ojo evaluado.
    22. Hemorragia vítrea presente o antecedentes de hemorragia vítrea en el ojo evaluado en los 3 meses previos a la selección.
    23. Antecedentes de trasplante de córnea en el ojo evaluado.
    24. Mujeres embarazadas o en periodo de lactancia o con intención de quedarse embarazadas durante el estudio.
    25. Antecedentes recientes (en los 6 meses previos a la selección) de infarto de miocardio, ictus, accidente isquémico transitorio, insuficiencia cardíaca congestiva aguda o cualquier episodio coronario agudo.
    26. Antecedentes de una enfermedad que, en opinión del investigador, impediría las visitas programadas del estudio, la finalización del estudio o una administración segura del producto en investigación.
    27. Antecedentes de hipersensibilidad a cualquiera de los componentes de KSI-301, aflibercept, colorante oftálmico (fluoresceína), colirio dilatador o a cualquiera de los preparados anestésicos o antimicrobianos utilizados durante el estudio, según el criterio del investigador.
    28. Participación en un estudio de investigación en los 30 días previos a la visita de selección que suponga el tratamiento con cualquier fármaco (excepto vitaminas y minerales) o dispositivo en investigación, excepto los dispositivos de imagen oftalmológica no terapéuticos.
    29. Cáncer activo en los 12 meses previos a la selección, excepto carcinoma in situ de cuello uterino debidamente tratado, cáncer de piel distinto del melanoma y cáncer de próstata con una puntuación de Gleason <6 y un antígeno prostático específico estable durante más de 12 meses.
    30. Tratamiento con un fármaco anti-VEGF sistémico en los 90 días previos a la selección.
    31. Presión arterial no controlada definida como un valor sistólico ≥180 mm Hg o un valor diastólico ≥100 mm Hg en reposo en el periodo de selección o el día 1.
    E.5 End points
    E.5.1Primary end point(s)
    Mean change in BCVA from baseline (Day 1) to Week 40, in Early Treatment Diabetic Retinopathy Study (ETDRS) Letters.
    Variación media de la MAVC entre el momento basal (día 1) y la semana 40, en las letras del estudio sobre el tratamiento precoz de la retinopatía diabética (ETDRS)
    E.5.1.1Timepoint(s) of evaluation of this end point
    The primary endpoint will be assessed using ETDRS data collected up to Week 40.
    El criterio de valoración principal se medirá usando los datos ETDRS recogidos hasta la semana 40.
    E.5.2Secondary end point(s)
    • Mean change in BCVA (ETDRS Letters) from baseline (Day 1) by visit over time.
    • Proportion of participants who gain ≥5, ≥10 and ≥15 ETDRS letters from baseline (Day 1) by visit over time.
    • Proportion of participants who lose ≥5, ≥10 and ≥15 ETDRS letters from baseline (Day 1) by visit over time.
    • Proportion of participants with BCVA Snellen equivalent of 20/40 or better from baseline (Day 1) over time.
    • Proportion of participants with BCVA Snellen equivalent of 20/200 or worse from baseline (Day 1) over time.
    • Mean change in OCT CST from baseline (Day 1) to Week 40 and over time.
    • Incidence of ocular and systemic AEs up to Week 44.
    • Systemic anti-drug antibody status over time (in the ADA-evaluable population).
    • Systemic pharmacokinetic profile (i.e., systemic exposure) over time (in the PK-evaluable population).
    - Variación media de la MAVC (optotipo ETDRS) entre el momento basal (día 1) y cada visita sucesiva.
    - Proporción de participantes que ganan ≥5, ≥10 y ≥15 letras ETDRS con respecto al momento basal (día 1) en cada visita sucesiva.
    - Proporción de participantes que pierden ≥5, ≥10 y ≥15 letras ETDRS con respecto al momento basal (día 1) en cada visita sucesiva.
    - Proporción de participantes con una MAVC de Snellen equivalente a 20/40 o mejor con respecto al momento basal (día 1) a lo largo del tiempo.
    - Proporción de participantes con una MAVC de 20/200 o peor con respecto al momento basal (día 1) a lo largo del tiempo.
    - Variación media del espesor del subcampo central (ESC) de la tomografía de coherencia óptica (TCO) y otros parámetros morfológicos entre el
    momento basal (día 1) y la semana 40 y a lo largo del tiempo.
    - Incidencia de acontecimientos adversos oculares y sistémicos hasta la semana 44.
    - Presencia de anticuerpos sistémicos contra el fármaco a lo largo del tiempo (en la población evaluable por ACF).
    - Perfil farmacocinético sistémico a lo largo del tiempo (en la población evaluable por FC).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Key secondary endpoints will be assessed at Week 40 (for efficacy) or Week 44 (for safety)
    Los criterios de valoración secundarios clave se evaluarán en la semana 40 (para la eficacia) o la semana 44 (para la seguridad)
    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 No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    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 No
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA26
    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
    United States
    Hungary
    Latvia
    Poland
    Slovakia
    Spain
    Czechia
    E.8.7Trial 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
    The end of the study is defined as the last follow-up visit of the last participant enrolled (i.e., the last enrolled participant’s final visit) or a Sponsor decision to terminate the study, whichever comes first.

    A participant is considered to have completed the study if he/she has completed all phases of the study, including the Week 44 safety follow-up assessment.
    Se define el final del estudio como la última visita de seguimiento del último paciente reclutado (es decir; la visita final del último paciente reclutado) o la decisión del promotor de terminar el estudio, lo que ocurra antes.
    Se considera que un paciente ha completado el estudio si ha completado todas las fases del estudio, incluyendo las evaluaciones de la semana 44 de seguimiento de seguridad.
    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 months0
    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 months0
    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: 250
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 250
    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 Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    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 state40
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 160
    F.4.2.2In the whole clinical trial 500
    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)
    All participants will return to standard of care treatment, at the discretion of their Treating Physician, after completion of their final follow-up visit or once they discontinue from the study prematurely. The Sponsor will not provide continued access to study treatment following the end of the study or the end of each participant’s study treatment period.
    Una vez que los pacientes hayan completado la visita final de seguimiento o se hayan retirado prematuramente del estudio volverán a recibir tratamiento estandar a criterio de su médico. El promotor no proporcionará a los pacientes acceso continuado al tratamiento del estudio una vez que éste haya finalizado o que los pacientes hayan finalizado el tratamiento del estudio.
    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 Decision2021-10-26
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-10-19
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-04-06
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