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    Summary
    EudraCT Number:2021-003651-42
    Sponsor's Protocol Code Number:AVT06-GL-C01
    National Competent Authority:Hungary - National Institute of Pharmacy
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2022-02-23
    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 ConcernedHungary - National Institute of Pharmacy
    A.2EudraCT number2021-003651-42
    A.3Full title of the trial
    A Randomized, Double-masked, Parallel-group, Multicenter Clinical Study to Evaluate the Efficacy and Safety of AVT06 Compared with EU-Eylea® in Subjects with Neovascular (wet) Age related Macular Degeneration (ALVOEYE)
    Multicentrikus, randomizált, kettős vak, párhuzamos csoportos klinikai vizsgálat az AVT06 készítmény hatásosságának és biztonságosságának értékelésére az EU-Eylea®-val összehasonlítva neovaszkuláris (nedves), életkorral összefüggő makuladegenerációban szenvedő betegek esetében (ALVOEYE)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical Study to Compare Efficacy and Safety of AVT06 and EU-Eylea (ALVOEYE)

    A.3.2Name or abbreviated title of the trial where available
    ALVOEYE
    A.4.1Sponsor's protocol code numberAVT06-GL-C01
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05155293
    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 SponsorAlvotech Swiss AG
    B.1.3.4CountrySwitzerland
    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 supportAlvotech Swiss AG
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAlvotech Swiss AG
    B.5.2Functional name of contact pointClinical Operations Department
    B.5.3 Address:
    B.5.3.1Street AddressThurgauerstrasse, 54
    B.5.3.2Town/ cityZurich
    B.5.3.3Post codeCH – 8050
    B.5.3.4CountrySwitzerland
    B.5.4Telephone number+41 44 313 95 70
    B.5.6E-mailstephanie.koelbl@alvotech.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 nameAVT06
    D.3.4Pharmaceutical form Solution for injection in vial
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravitreal use
    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.3.1Product nameEylea®
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravitreal use
    D.3.11 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
    Neovaszkuláris (nedves), életkorral összefüggő makuladegeneráció
    E.1.1.1Medical condition in easily understood language
    Age-related macular degeneration (AMD) is the leading cause of irreversible blindness and visual impairment in elderly population
    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 PT
    E.1.2Classification code 10071129
    E.1.2Term Neovascular 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 the equivalent efficacy of AVT06 to Eylea in subjects with neovascular (wet) age-related macular degeneration (AMD)
    E.2.2Secondary objectives of the trial
    • To evaluate the efficacy of AVT06 compared with Eylea in subjects with neovascular (wet) AMD.
    • To evaluate the safety and tolerability of AVT06 compared with Eylea.
    • To assess immunogenicity of AVT06 compared with Eylea.
    • To evaluate the systemic PK of AVT06 and Eylea in a subset of subjects.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Details of the pharmacokinetics (PK) sub-study is included in the study protocol. The primary objective of the sub-study is to evaluate the systemic pharmacokinetics (PK) of AVT06 and Eylea in a subset of subjects.
    E.3Principal inclusion criteria
    Age
    • Subject must be ≥50 years of age, at the time of signing the informed consent.
    Study Eye
    • Subjects must be diagnosed with neovascular (wet) AMD in the study eye.
    • Subjects must have active, treatment naïve, subfoveal CNV lesions secondary to neovascular (wet) AMD, including juxtafoveal lesions with foveal involvement (demonstrated by leakage on FA and/or intraretinal fluid or subretinal fluid on SD-OCT) in the study eye at screening.
    • Subjects with total lesion area ≤9.0 Disc Areas in size (including blood, scars [not involving the center of the fovea], and neovascularization) in the study eye at screening.
    • Subjects with active CNV area must occupy at least 50% of total lesion in the study eye.
    • Subjects with BCVA of 20/40 to 20/200 (between 73 and 34 letters inclusive), in the study eye as assessed by ETDRS letter score at screening and on Day 1 prior to randomization.
    • Presence of intra and/or subretinal fluid as identified in the center subfield by SD-OCT attributable to active CNV in the study eye at screening.
    • Subjects with central retinal thickness of ≥300 µm in the study eye as determined by SD OCT at screening.
    Sex
    Male or female
    a) Male subjects:
    • A male subject must agree to use contraception as detailed in Appendix 6 of this protocol during the treatment period and for at least 3 months after the last intravitreal injection of study treatment and refrain from donating sperm during this period.
    b) Female subjects:
    • A female subject is eligible to participate if she is not pregnant (see Appendix 6), not breastfeeding, not intending to become pregnant during the treatment period and for at least 3 months after the last intravitreal injection of study treatment, and at least 1 of the following conditions applies:
    i) Not a woman of childbearing potential (WOCBP) as defined in Appendix 6.
    OR
    ii) A WOCBP who agrees to follow the contraceptive guidance in Appendix 6 during the treatment period and for at least 3 months after the last intravitreal injection of study treatment.
    Informed Consent
    Capable of giving signed informed consent as described in Appendix 2, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
    E.4Principal exclusion criteria
    Study Eye
    • Scar, fibrosis, or atrophy involving the center of the fovea in the study eye.
    History of retinal detachment in the study eye.
    Presence of RPE tears involving the macula in the study eye.
    History of any vitreous hemorrhage within 4 weeks before randomization in the study eye.
    Prior vitrectomy or laser surgery of the macula (including photodynamic therapy or focal laser photocoagulation) in the study eye.
    Uncontrolled ocular hypertension (defined as IOP ≥25 mmHg despite treatment with anti glaucoma medication) at screening and randomization visits in the study eye.
    Any history of macular hole in the study eye.
    Any concurrent macular abnormality other than wet AMD which could affect central vision or the efficacy of the study treatment in the study eye.
    Aphakia or absence of the posterior capsule (unless it occurred as a result of a posterior capsulotomy with neodymium doped yttrium aluminium garnet [YAG] laser following cataract surgery with intraocular lens implantation) in the study eye.
    Significant media opacities, including cataract or inadequate pupil dilatation, which might interfere with visual acuity or assessment of safety in the study eye.
    History of corneal transplant, corneal dystrophy, or corneal ectasia (such as either keratoconus or keratoglobus) in the study eye.
    Subjects with previous ocular (intraocular and peribulbar) corticosteroids injection/implant within 1 year in the study eye prior to randomization.
    Topical ocular corticosteroids for 30 or more consecutive days within 90 days prior to randomization in the study eye.
    Previous therapeutic radiation in the region of the study eye.
    Any prior ocular treatment, including surgery or another investigational product for neovascular AMD (including anti-VEGF therapy), in the study eye, except dietary supplements or vitamins.
    Concurrent ocular condition which, in the opinion of the Investigator, could require medical or surgical intervention during the study period and/or confound the interpretation of the study results.
    Either Eye
    History or clinical evidence of uveitis, diabetic retinopathy, diabetic macular edema, or any other vascular disease affecting the retina, other than neovascular AMD.
    Active or suspected ocular or periocular infection, within 2 weeks before randomization.
    Active scleritis or episcleritis or presence of scleromalacia.
    Fellow Eye
    Any ocular treatment, including surgery or another investigational product for neovascular AMD (including anti-VEGF treatment), in the fellow eye, within 6 months before randomization, except dietary supplements or vitamins.
    Subjects with BCVA of 20/200 or less (34 letters or less) in the fellow eye as assessed by ETDRS letter score at screening and on Day 1 prior to randomization.
    Subjects with any diagnosis and/or signs of neovascular AMD requiring intravitreal anti VEGF in the fellow eye, or in the opinion of the Investigator, are expected to require such treatments before the evaluation of the primary efficacy endpoint (ie, Week 8) and completion of PK sampling (ie, Week 12) for the subjects in the PK sub-study.
    Other
    Any prior systemic treatment with anti-VEGF therapy.
    History of hypersensitivity or anaphylaxis to study treatments (including any excipient), and/or history of hypersensitivity to fluorescein sodium for injection in angiography or to any other compound used for the study procedures.
    Prior treatment with any investigational drugs within 30 days or 5 half-lives (whichever is longer) of the previous investigational treatment before initiation of the study treatment or concomitant enrollment in any other clinical study involving an investigational study treatment.
    Acute coronary event or stroke within 6 months before randomization.
    Uncontrolled diabetes mellitus with glycosylated hemoglobin (HbA1c) >8%.
    Cardiovascular disease including uncontrolled hypertension, uncontrolled heart failure, history of coronary event or stoke, or clinically significant electrocardiogram (ECG) abnormality, including subjects with QT interval corrected using Fridericia’s formula [QTcF] >480 ms at screening, confirmed by repeat assessment. Uncontrolled hypertension is defined in Appendix 10.
    Any condition that, in the Investigator´s opinion, can interfere with full participation in the study, including administration of the study treatment and attending required visits; can pose a significant risk to the participant, or interfere with interpretation of study data.
    Malignancy diagnosed within 5 years except treated and considered cured cutaneous squamous or basal cell carcinoma, in situ cervical cancer, or in situ breast ductal carcinoma.
    Subjects not suitable for participation, whatever the reason, as judged by the Investigator, including medical or psychiatric conditions, or participants potentially at risk of noncompliance to study procedures.
    E.5 End points
    E.5.1Primary end point(s)
    • Change from baseline to Week 8 in BCVA as measured by ETDRS letter score.
    E.5.1.1Timepoint(s) of evaluation of this end point
    From baseline to Week 8 in BCVA as measured by ETDRS letter score.
    E.5.2Secondary end point(s)
    • Change from baseline in BCVA as assessed by ETDRS letter score at Week 4, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Gain of ≥5, 10, 15 letter score in BCVA from baseline to Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Loss of ≥5, 10, 15 letter score in BCVA from baseline to Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Change from baseline in CST as assessed by SD OCT at Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Change from baseline in CNV area as assessed by FA and color FP at Week 8, Week 24, and Week 52.
    • Incidence of ocular and non-ocular TEAEs, AESIs, and SAEs.
    • Evaluation of ophthalmic parameters (IOP, biomicroscopy, and indirect ophthalmoscopy).
    • Evaluation of routine safety parameters, including safety laboratory, 12-lead ECG results, vital signs, and physical examination.
    • Proportion of subjects testing positive for ADAs, including NAb from baseline to Week 8, Week 16, Week 24, and Week 52.
    • Evaluate systemic PK profile of free and bound aflibercept from baseline (Day 1 predose) to Day 1 (1 to 4 hours postdose), Day 2, Day 3, Week 4, Week 8, and Week 12.
    E.5.2.1Timepoint(s) of evaluation of this end point
    • Change from baseline in BCVA as assessed by ETDRS letter score at Week 4, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Gain of ≥5, 10, 15 letter score in BCVA from baseline to Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Loss of ≥5, 10, 15 letter score in BCVA from baseline to Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Change from baseline in CST as assessed by SD OCT at Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, and Week 52.
    • Change from baseline in CNV area as assessed by FA and color FP at Week 8, Week 24, and Week 52.
    • Proportion of subjects testing positive for ADAs, including NAb from baseline to Week 8, Week 16, Week 24, and Week 52.

    For full list please see the Protocol.
    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 No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Information not present in EudraCT
    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 concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA42
    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
    Argentina
    Brazil
    India
    Japan
    Georgia
    Russian Federation
    Ukraine
    Bulgaria
    Czechia
    Hungary
    Latvia
    Poland
    Slovakia
    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
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months9
    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: 200
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 490
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 245
    F.4.2.2In the whole clinical trial 690
    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. Standard of care applies
    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 Decision2023-03-13
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-02-16
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2024-09-23
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