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Intravitreal Faricimab Injections or Fluocinolone Acetonide (0.19 Mg) Intravitreal Implants Vs Observation for Prevention of VA Loss Due to Radiation Retinopathy (AL)

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Jaeb Center for Health Research

Status and phase

Enrolling
Phase 3

Conditions

Radiation Retinopathy
Visual Impairment

Treatments

Drug: Faricimab
Drug: fluocinolone acetonide

Study type

Interventional

Funder types

Other
Industry
NIH

Identifiers

NCT05844982
UG1EY014231 (U.S. NIH Grant/Contract)
Protocol AL

Details and patient eligibility

About

This randomized controlled trial will evaluate the effect of intravitreal faricimab or fluocinolone acetonide (FAc) intravitreal implant compared with observation on long-term visual acuity following treatment of choroidal melanoma with iodine-125 plaque brachytherapy.

Full description

The primary objectives are to compare long-term visual acuity outcomes in eyes that receive repeated treatment with faricimab or fluocinolone acetonide intravitreal implants with those observed initially and treated only if macular edema (ME) develops. The secondary objectives are to determine if repeated treatment with faricimab or fluocinolone acetonide intravitreal implants versus observation can prevent or alter the course of ME from radiation retinopathy and to evaluate the natural history of radiation retinopathy with multimodal imaging including widefield color photographs, widefield fluorescein angiography and OCTA.

Enrollment

600 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria

  • Primary uveal melanoma (excluding iris melanoma) receiving primary treatment with plaque brachytherapy
  • Absence of unrelated cause of visual loss
  • Baseline visual acuity ≥ 34 letters (20/200 Snellen equivalent or better)
  • Posterior tumor margin >0 mm from the center of the macula (i.e., tumor is NOT under the geometric center of the fovea)
  • Posterior tumor margin >0 mm from the closest disc margin (i.e., tumor is not touching the edge of the optic disc)
  • Calculated total dose to center of the macula ≥30 Gy

Key Exclusion Criteria

  • Opaque media
  • Inability to undergo fluorescein angiography
  • Less than 18 years of age
  • Prior vitrectomy
  • Intraocular pressure (IOP) ≥ 25 mmHg or history of steroid- induced IOP elevation that required treatment at baseline
  • IOP ≥ 25 mmHg at randomization or increase in IOP ≥ 8 mmHg from baseline to randomization (following steroid challenge

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

600 participants in 3 patient groups

Intravitreal faricimab
Active Comparator group
Description:
Study eyes assigned to receive faricimab will receive a dose of 6.0 mg of faricimab. Faricimab is supplied in a single use vial.
Treatment:
Drug: Faricimab
Fluocinolone Acetonide Intravitreal Implants
Active Comparator group
Description:
Study eyes assigned to receive fluocinolone acetonide intravitreal implant will receive a dose of 0.19 mg fluocinolone acetonide intravitreal implant (Iluvien). The implant is supplied in a sterile single use applicator with a 25-gauge needle
Treatment:
Drug: fluocinolone acetonide
Observation
No Intervention group

Trial contacts and locations

16

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Central trial contact

Cynthia Stockdale, MPH

Data sourced from clinicaltrials.gov

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