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    Summary
    EudraCT Number:2021-005173-95
    Sponsor's Protocol Code Number:DX219
    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:2022-07-11
    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 number2021-005173-95
    A.3Full title of the trial
    A Phase 2/3 Double-Masked, Randomized, 2-stage, Multicenter Study of the Efficacy and Safety of OCS-01 Eye Drops in Subjects With Diabetic Macular Edema
    Estudio en fase II/III, doble ciego, aleatorizado, de 2 etapas, multicéntrico de la eficacia y seguridad del colirio OCS-01 en sujetos con edema macular diabético
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2/3 Double-Masked, Randomized, 2-stage, Multicenter Study of the Efficacy and Safety of OCS-01 Eye Drops in Subjects With Diabetic Macular Edema
    Estudio en fase II/III, doble ciego, aleatorizado, de 2 etapas, multicéntrico de la eficacia y seguridad del colirio OCS-01 en sujetos con edema macular diabético
    A.4.1Sponsor's protocol code numberDX219
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05066997
    A.5.4Other Identifiers
    Name:INDNumber:131596
    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 SponsorOculis SA
    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 supportOculis SA
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationOculis SA
    B.5.2Functional name of contact pointBastian Dehmel
    B.5.3 Address:
    B.5.3.1Street AddressEPFL Innovation Park Building D
    B.5.3.2Town/ cityLausanne
    B.5.3.3Post code1015
    B.5.3.4CountrySwitzerland
    B.5.4Telephone number+4121711 3970
    B.5.6E-mailinfo@oculis.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 nameDexamethasone ophthalmic suspension 1.5% (15 mg/mL)
    D.3.2Product code OCS-01
    D.3.4Pharmaceutical form Eye drops, suspension
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOcular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDexamethasone
    D.3.9.2Current sponsor codeOCS-01
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit % (W/V) percent weight/volume
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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 No
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboEye drops, suspension
    D.8.4Route of administration of the placeboOcular use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Diabetic Macular Edema (DME)
    Edema macular diabético (EMD)
    E.1.1.1Medical condition in easily understood language
    Diabetic Macular Edema (DME)
    Edema macular diabético (EMD)
    E.1.1.2Therapeutic area Body processes [G] - Ocular Physiological Phenomena [G14]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10057934
    E.1.2Term Diabetic macular edema
    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
    Stage 1:
    To evaluate the safety and efficacy of OCS-01 versus Vehicle alone in subjects with diabetic macular edema (DME).
    These subjects will not be included in Stage 2 evaluations.

    Stage 2:
    To confirm the efficacy and safety of OCS-01 in subjects with DME.
    Etapa 1:
    Evaluar la seguridad y eficacia de OCS-01 frente a vehículo solo en sujetos con edema macular diabético (EMD).
    Estos sujetos no se incluirán en las evaluaciones de la etapa 2.

    Etapa 2:
    Confirmar la eficacia y la seguridad de OCS-01 en sujetos con EMD.
    E.2.2Secondary objectives of the trial
    Not Applicable
    No aplicable
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Inclusion Criteria for Stage 1
    1)Have a signed informed consent form before any study-specific procedures are performed
    2)Be a male or female adult subject age 18 to 85 years. Race and ethnicity information will be collected based on National Institutes of Health criteria
    3)Have DME with presence of intraretinal and/or subretinal fluid in the study eye, with central subfield thickness (CST) of ≥310μm (may be adjusted based on gender specific requirements) by Spectral domain optical coherence tomography (SD-OCT) at screening (V1) (as assessed by an independent reading center); CST is not part of the eligibility reconfirmation on Day 1
    4)Participants require Best Corrected Visual Acuity (BCVA) ETDRS letter score >34 letters (>20/200 Snellen equivalent) in the non–study eye at screening (as per definition of monocular blindness)
    5)Have an BCVA ETDRS letter score ≤ 65 (Snellen 20/50) and ≥ 24 (Snellen 20/320) in the study eye at screening and baseline (V1 and V2)
    6)Have a documented diagnosis of type 1 or type 2 diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of ≤ 12.0% (≤108 mmol/mol) at V1 (Screening)
    Clarification: For inclusion criteria 7 and 8, each subject must meet one criterion or the other
    7)Participants who have been treated with any antivascular endothelial growth factor (VEGF) agents intravitreally (IVT) and/or corticosteroids periocular or IVT in the study eye in the past and for whom the following washout periods before Day 1 would apply:
    a. Anti-VEGF agents IVT: 3 months
    b. Periocular or IVT corticosteroids: i. Triamcinolone: 4 months; ii. Biodegradable slow-release steroid IVT implant (eg, Ozurdex): 6 Months; iii. Nonbiodegradable slow-release steroid implant (eg, Iluvien, Retisert, Yutiq): 3 years
    8)Participants who are anti-VEGF and corticosteroid IVT treatment-naïve (have not received previous treatment with any anti-VEGF and corticosteroid IVT) in the study eye
    9)Have a negative urine pregnancy test at Visit 1, if women of childbearing potentia those who have experienced menarche and who are not surgically sterilized [bilateral tubal ligation, hysterectomy or bilateral oophorectomy] or postmenopausal [12 months after last menses]) and must use adequate birth control throughout the study period (see Ap. 5 of the protocol)
    Inclusion Criteria for Stage 2
    1)Have a signed informed consent form before any study-specific procedures are performed
    2)Be a male or female adult subject age 18 to 85 years. Race and ethnicity information will be collected based on National Institutes of Health criteria
    3)Have DME with presence of intraretinal and/or subretinal fluid in the study eye, with CST of ≥310μm (may be adjusted based on gender specific requirements) by SD-OCT at screening (Visit 1) (as assessed by an independent reading center); CST is not part of the eligibility reconfirmation on Day 1
    4)Participants require BCVA ETDRS letters score >34 letters (>20/200 Snellen equivalent) in the non–study eye at screening (as per definition of monocular blindness).
    5)Have a BCVA ETDRS letters score ≤ 65 (Snellen 20/50) and ≥ 24 (Snellen 20/320) in the study eye at screening and baseline (Visit 1 and Visit 2)
    6)Have a documented diagnosis of type 1 or type 2 diabetes mellitus and a HbA1c of ≤ 12.0% (≤108 mmol/mol) at Visit 1 (Screening)
    Clarification: For inclusion criteria 7 and 8, each subject must meet one criterion or the other
    7)Participants who have been treated with any anti- VEGF agents IVT and/or corticosteroids periocular or IVT in the study eye in the past and for whom the following washout periods before Day 1 would apply:
    a. Anti-VEGF agents IVT: 3 months
    b. Periocular or IVT corticosteroids: i. Triamcinolone: 4 months; ii. Biodegradable slow-release steroid IVT implant (eg, Ozurdex): 6 Months; iii. Nonbiodegradable slow-release steroid implant (eg, Iluvien, Retisert, Yutiq): 3 years.
    8)Participants who are anti-VEGF and corticosteroid IVT treatment-naïve (ie, have not received previous treatment with any anti-VEGF and corticosteroid IVT) in the study eye
    9)Have a negative urine pregnancy test at Visit 1, if WOCBP those who have experienced menarche and who are not surgically sterilized [bilateral tubal ligation, hysterectomy or bilateral oophorectomy] or postmenopausal [12 months after last menses]) and must use adequate birth control throughout the study period (see Ap. 5 of the protocol)
    Criterios de inclusión para etapa 1
    1)Haber firmado un formulario de consentimiento informado antes de realizar cualquier procedimiento específico del estudio
    2)Ser adulto, masculino o femenino, con edad entre 18 y los 85. La información sobre raza y origen étnico se recogerá según los criterios de los INS
    3)Tener EMD con presencia de líquido intrarretiniano y/o subretiniano en el ojo del estudio, con un espesor del subcampo central (ESC) de ≥310μm (puede ajustarse en función de los requisitos específicos de sexo) mediante TCO-DE en la selección (V1) (evaluada por un centro de lectura independiente); el ESC no forma parte de la reconfirmación de la elegibilidad el día 1
    4)Los participantes requieren 1 puntuación de letras de ETDRS en la AVMC >34 letras (>20/200 equivalente de Snellen) en el ojo que no se estudia en la selección (según la definición de ceguera monocular)
    5)Tener una puntuación de letras de ETDRS en la AVMC ≤65 (Snellen 20/50) y ≥24 (Snellen 20/320) en el ojo del estudio en la selección y en el inicio (V1 y V2).
    6)Tener un diagnóstico documentado de diabetes mellitus de tipo 1 o tipo 2 y una hemoglobina A1c glucosilada (HbA1c) ≤12,0 % (≤108 mmol/mol) en la V1 (selección)
    Aclaración: Para los criterios de inclusión 7 y 8, cada sujeto debe cumplir un criterio o el otro
    7)Participantes que hayan sido tratados con cualquier fármaco de factor de crecimiento endotelial antivascular (anti-VEGF) por vía intravítrea (IVT) y/o corticoesteroides perioculares o IVT en el ojo del estudio en el pasado y para los que se aplicarían los siguientes periodos de lavado farmacológico antes del día 1:
    a. Fármacos anti-VEGF IVT: 3 meses
    b. Corticoesteroides perioculares o IVT: i. Triamcinolona: 4 meses; ii. Implante IVT biodegradable de corticoesteroides de liberación prolongada (p. ej., Ozurdex): 6 meses; iii. Implante no biodegradable de corticoesteroides de liberación prolongada (p. ej., Iluvien, Retisert, Yutiq): 3 años
    8)Participantes no tratados anteriormente con anti-VEGF y corticoesteroides IVT (no han recibido tratamiento previo con ningún anti-VEGF y corticoesteroide IVT) en el ojo del estudio
    9)Tener resultado negativo en la prueba de embarazo en orina en la V1, si las mujeres en edad fértil han experimentado la menarquia y no han sido esterilizadas quirúrgicamente [ligadura de trompas bilateral, histerectomía u ovariectomía bilateral] o son posmenopáusicas [12 meses después de la última menstruación]) y deben utilizar un método anticonceptivo adecuado durante todo el periodo del estudio (ver protocol Ap.5)
    Criterios de inclusión para la etapa 2
    1)Haber firmado un formulario de consentimiento informado antes de realizar cualquier procedimiento específico del estudio
    2)Ser adulto, masculino o femenino, con edad entre 18 y los 85. La información sobre raza y origen étnico se recogerá según los criterios de los INS
    3)Tener DME con presencia de líquido intrarretiniano y/o subretiniano en el ojo del estudio, con un ESC de ≥310μm (puede ajustarse en función de los requisitos específicos de sexo) mediante TCO-DE en la selección (V1) (evaluada por un centro de lectura independiente); el ESC no forma parte de la reconfirmación de la elegibilidad el día 1
    4)Los participantes requieren 1 puntuación de letras de ETDRS en la AVMC >34 letras (>20/200 equivalente de Snellen) en el ojo que no se estudia en la selección (según la definición de ceguera monocular)
    5)Tener 1 puntuación de letras de ETDRS en la AVMC ≤65 (Snellen 20/50) y ≥24 (Snellen 20/320) en el ojo del estudio en la selección y en el inicio (V1 y V2)
    6)Tener un diagnóstico documentado de diabetes mellitus de tipo 1 o tipo 2 y una HbA1c ≤12,0 % (≤108 mmol/mol) en la V1 (selección)
    Aclaración: Para los criterios de inclusión 7 y 8, cada sujeto debe cumplir un criterio o el otro
    7)Participantes que hayan sido tratados con cualquier fármaco anti-VEGF IVT y/o corticoesteroides perioculares o IVT en el ojo del estudio en el pasado y para los que se aplicarían los siguientes periodos de lavado farmacológico antes del día 1:
    a.Fármacos anti-VEGF IVT: 3 meses
    b.Corticoesteroides perioculares o IVT: i. Triamcinolona: 4 meses; ii. Implante IVT biodegradable de corticoesteroides de liberación prolongada (p. ej., Ozurdex): 6 meses; iii. Implante no biodegradable de corticoesteroides de liberación prolongada (p. ej., Iluvien, Retisert, Yutiq): 3 años
    8)Participantes no tratados anteriormente con anti-VEGF ni corticoesteroides IVT (es decir, no han recibido tratamiento previo con ningún anti-VEGF ni corticoesteroide IVT) en el ojo del estudio
    9)Tener resultado negativo en la prueba de embarazo en orina en la visita 1, si las MEF han experimentado la menarquia y no han sido esterilizadas quirúrgicamente [ligadura de trompas bilateral, histerectomía u ovariectomía bilateral] o son posmenopáusicas [12 meses después de la última menstruación]) y deben utilizar un método anticonceptivo adecuado durante todo el periodo del estudio (ver protocol Ap.5)
    E.4Principal exclusion criteria
    Exclusion Criteria Stage 1

    OCULAR
    1) Have macular edema considered to be because of a cause other than Diabetic macular edema (DME).
    Note: an eye should not be considered eligible if: (1) the macular edema is considered to be related to ocular surgery such as cataract extraction;(2) clinical exam and/or OCT suggest that vitreoretinal interface abnormalities disease (eg, a taut posterior hyaloid or epiretinal membrane) is the primary cause of the macular edema, or (3) the macular edema is considered to be related to another condition such as age-related macular degeneration, uveitis, retinal vein occlusion, or drug toxicity. If the DME consists of circumscribed, focal leakage that the evaluating Investigator believes should be treated with laser and no other treatments, the eye is not eligible to be a study eye.
    2) Have a decrease in Best Corrected Visual Acuity (BCVA) because of causes other than DME (eg, foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, previous vitreoretinal surgery, central serous retinopathy, nonretinal condition, substantial cataract, macular ischemia) that, in the Investigator’s opinion, is likely to be decreasing BCVA by 3 lines or more (ie, cataract would be reducing acuity to 20/40 or worse if eye was otherwise normal).
    3) Have a known history of significant macular ischemia which would prevent gain in visual acuity in the study eye.
    4) Have any other ocular disease that may cause substantial reduction in BCVA, including, retinal detachment, epiretinal membrane, vitreous hemorrhage or fibrosis involving the macula in the study eye, ocular inflammation (uveitis), other retinal inflammatory or infectious diseases.
    5) Have active or suspected periocular or ocular infection in the study eye (eg, keratitis, scleritis, or conjunctivitis). Mild noninfectious blepharitis is accepted.
    6) Have a history of noninfectious uveitis in the study eye.
    7) History of herpetic ocular disease in the study eye.
    8) Hazy ocular media in the study eye, as assessed by the Investigator, that may affect fundus examination and OCT measurements.
    9) Intraocular pressure (IOP) more than 21 mm Hg at Screening in the study eye (glaucoma suspects).
    10) History of glaucoma and/or steroid induced elevated IOP in either eye.
    11) Cup to disc ratio more than 0.5 in either eye.
    12) Subjects who plan to continue using contact lenses as a main source of vision correction during the study in the study eye.
    13) Subjects who plan to use cosmetic contact lenses in the study eye during the study.
    14) History of major intraocular ocular surgery within 3 months including cataract surgery in the study eye.
    15) Panretinal photocoagulation. Grid laser within 1000 microns of the foveal center.

    SYSTEMIC
    16) Participants who are currently enrolled in or have participated in any other clinical study involving an investigational product (IP) or device, or in any other type of medical research, within 30 days before screening and up to completion of the current study.
    17) Systemic corticosteroids (prednisone or methylprednisolone) either oral or injectable are not allowed in the study.
    The use of acute inhaled corticosteroids is permissible during the study for up to 14 days.
    18) Any prior or concomitant systemic anti-VEGF treatment within 6 months before Day 1.
    19) Significant medical conditions that in the opinion of the Investigator may affect the subject compliance with study visits.
    20) Female participants must not be pregnant or breastfeeding.
    21) WOCBP who are not able to comply with adequate birth control throughout the study period.
    22) History of chronic renal failure that requires dialysis or kidney transplant.

    Exclusion Criteria Stage 2
    For Stage 2 Exclusion criteria, please refer to Clinical Study Protocol.
    Criterios de exclusión etapa 1

    OCULAR
    1) Tener edema macular que se considera debido a una causa distinta del EMD.
    Nota: Un ojo no debe considerarse apto si: (1) el edema macular se considera relacionado con la cirugía ocular, como la eliminación de cataratas; (2) el examen clínico y/o la TCO sugieren que la enfermedad por anomalías en la interfaz vitreorretiniana (p. ej., una hipertrofia posterior o membrana epirretiniana) es la causa principal del edema macular, o (3) el edema macular se considera relacionado con otra afección, como la degeneración macular asociada a la edad, uveitis, oclusión de la vena de la retina o toxicidad farmacológica. Si el EMD consta de fuga focal circunscrita que el investigador evaluador considera que debe tratarse con láser y ningún otro tratamiento, el ojo no es apto para ser un ojo del estudio.
    2) Tener una disminución de la AVMC debido a causas distintas al EMD (p. ej., atrofia foveal, anomalías pigmentarias, exudados duros subfoveales densos, cirugía vitreorretiniana previa, retinopatía serosa central, afección no retiniana, cataratas significativas, isquemia macular) que, en opinión del investigador, probablemente disminuya la AVMC en 3 líneas o más (es decir, cataratas que reducirían la agudeza a 20/40 o peor si, por lo demás, el ojo fuera normal).
    3) Tener antecedentes conocidos de isquemia macular significativa que impediría la ganancia de agudeza visual en el ojo del estudio.
    4) Tener cualquier otra enfermedad ocular que pueda causar una reducción sustancial de la AVMC, incluido desprendimiento de retina, membrana epirretiniana, hemorragia vítrea o fibrosis que afecte a la mácula del ojo del estudio, inflamación ocular (uveítis), otras enfermedades inflamatorias o infecciosas de la retina.
    5) Tener una infección ocular o periocular activa o sospechada en el ojo del estudio (p. ej., queratitis, escleritis o conjuntivitis). Se acepta blefaritis no infecciosa leve.
    6) Tener antecedentes de uveítis no infecciosa en el ojo del estudio.
    7) Antecedentes de enfermedad ocular herpética en el ojo del estudio.
    8) Medios oculares nebulosos en el ojo del estudio, según la evaluación del investigador, que pueden afectar al examen del fondo de ojo y a las mediciones de la TCO.
    9) Presión intraocular (PIO) superior a 21 mmHg en la selección en el ojo del estudio (sospecha de glaucoma).
    10) Los antecedentes de glaucoma y/o corticoesteroides indujeron una PIO elevada en alguno de los ojos.
    11) Relación copa-disco superior a 0,5 en alguno de los ojos.
    12) Sujetos que piensen continuar usando lentes de contacto como fuente principal de corrección de la visión durante el estudio en el ojo del estudio.
    13) Sujetos que piensen usar lentes de contacto cosméticas en el ojo del estudio durante el estudio.
    14) Antecedentes de cirugía ocular intraocular mayor en los 3 meses anteriores, incluida la cirugía de cataratas en el ojo del estudio.
    15) Fotocoagulación panretiniana. Láser en rejilla a 1000 micras del centro de la fóvea.

    SISTEMICO
    16) Participantes que estén incluidos actualmente o hayan participado en algún otro estudio clínico con un dispositivo o producto en investigación (PEI), o en algún otro tipo de investigación médica, en los 30 días anteriores a la selección y hasta la finalización del estudio actual.
    17) Los corticoesteroides sistémicos (prednisona o metilprednisolona) orales o inyectables no están permitidos en el estudio.
    Se permite el uso de corticoesteroides inhalados agudos durante el estudio durante un máximo de 14 días.
    18) Algún tratamiento anti-VEGF sistémico previo o concomitante en los 6 meses anteriores al día 1.
    19) Afecciones médicas significativas que, en opinión del investigador, puedan afectar al cumplimiento del sujeto con las visitas del estudio.
    20) Las participantes no deben estar embarazadas ni en periodo de lactancia.
    21) MEF que no pueden cumplir con un método anticonceptivo adecuado durante todo el periodo del estudio.
    22) Antecedentes de insuficiencia renal crónica que requiera diálisis o trasplante de riñón.

    Criterios de exclusión etapa 2
    Referir al protocol del estudio clínico para criterios de exclusión etapa 2
    E.5 End points
    E.5.1Primary end point(s)
    Stage 1
    The primary efficacy endpoint for Stage 1 of this study is the mean change from baseline BCVA ETDRS letters score to Week 12 (Visit 7). The primary efficacy analysis for Stage 1 will be conducted in the ITT with intercurrent events handled as detailed for Stage 2 below.

    Stage 2
    The primary efficacy endpoint for Stage 2 in this study is the mean change from baseline BCVA ETDRS letters score to Week 52. The primary efficacy analyses will be conducted in the ITT with intercurrent events handled in the following manners:
    1) Discontinuation of study drug and nonoptimal compliance will be ignored (that is, measured values will be used regardless of compliance or discontinuation of study drug) [treatment policy strategy].
    2) Withdrawal because of AEs or lack of efficacy [assumed to be missing not at random (MNAR)]: missing data after withdrawal will be imputed employing multiple imputations using Vehicle treatment group-based regression methodology, regardless of randomized treatment group is used to impute missing data [hypothetical strategy].
    3) Missing data without withdrawal or withdrawal because of reasons other than lack of efficacy or AEs [assumed to be missing at random (MAR)]: missing data will be imputed employing multiple imputations using randomized treatment-based Markov Chain Monte Carlo methodology to impute nonmonotone missing and using regression methodology to impute monotone missing [hypothetical strategy].
    Etapa 1
    El criterio de valoración principal de la eficacia para la etapa 1 de este estudio es el cambio medio desde la puntuación inicial de letras de ETDRS en la AVMC hasta la semana 12 (visita 7). El análisis principal de la eficacia para la etapa 1 se realizará en la población IDT con acontecimientos intercurrentes tratados como se detalla a continuación para la etapa 2.

    Etapa 2
    El criterio de valoración principal de la eficacia para la etapa 2 de este estudio es el cambio medio desde la puntuación inicial de letras de ETDRS en la AVMC hasta la semana 52. Los análisis principales de la eficacia se realizarán en la población IDT con acontecimientos intercurrentes tratados de las siguientes formas:
    1) La interrupción del fármaco del estudio y el cumplimiento no óptimo se ignorarán (es decir, los valores medidos se utilizarán independientemente del cumplimiento o la interrupción del fármaco del estudio) (estrategia de la política de tratamiento).
    2) Retirada debido a AA o falta de eficacia (supuestamente ausentes no al azar [missing not at random, MNAR]): los datos ausentes después de la retirada se imputarán empleando la metodología de regresión basada en el grupo de tratamiento con el vehículo, independientemente del grupo de tratamiento aleatorizado, para imputar los datos ausentes (estrategia hipotética)].
    3) Faltan datos sin retirada o retirada por motivos distintos a la falta de eficacia o AA (supuestamente ausentes al azar [missing at random, MAR]): los datos ausentes se imputarán empleando imputaciones múltiples utilizando la metodología de Monte Carlo basada en cadenas de Markov a partir del tratamiento aleatorizado para imputar la ausencia no monótona y utilizando la metodología de regresión para imputar la ausencia monótona [estrategia hipotética].
    E.5.1.1Timepoint(s) of evaluation of this end point
    Stage 1: Visit 7
    Stage 2: Week 52
    Etapa 1: visita 7
    Etapa 2: semana 52
    E.5.2Secondary end point(s)
    Stage 2:
    The proportion of subjects with a 3-line or greater gain in BCVA assessed with the ETDRS scale at Visit 9 (Week 52) compared with baseline.

    Please refer to Clinical Study Protocol for Other Secondary Efficacy Endpoints (section 7.1.5) for both Stages.
    Etapa 2:
    Proporción de sujetos con una ganancia de 3 líneas o superior en la AVMC evaluada con la escala ETDRS en la visita 9 (semana 52) en comparación con el inicio.

    Referir al Protocolo del Estudio Clínico para ver otros criterios de evaluación para ambas etapas (sección 7.1.5)
    E.5.2.1Timepoint(s) of evaluation of this end point
    At week 52
    En la semana 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 No
    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 Yes
    E.6.13.1Other scope of the trial description
    Tolerability
    Tolerabilidad
    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) Yes
    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 No
    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) No
    E.8.2.2Placebo Yes
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    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
    Spain
    Hungary
    Slovakia
    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
    LVLS
    UVUP
    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 months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days13
    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: 241
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 241
    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 state24
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 184
    F.4.2.2In the whole clinical trial 482
    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
    Ninguno
    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 Decision2022-09-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-09-06
    P. End of Trial
    P.End of Trial StatusOngoing
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