Phase 3
N=621
Study to Compare the Efficacy and Safety of Intravitreal APL-2 Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration
Geographic Atrophy
Bottom Line
View on ClinicalTrials.gov: NCT03525600 ↗Enrolled (actual)
621
Serious AEs
9.2%
Results posted
Jun 2023
Primary outcome: Primary: Least Squares (LS) Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 12 — 1.7344; 1.7563; 1.9640 mm^2 — p=0.0615
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- APL-2 (Drug); Sham Procedure (Other)
- Age
- Adult, Older Adult · 60+ yrs
- Sex
- All
- Sponsor
- Apellis Pharmaceuticals, Inc.
- Primary completion
- Jun 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Least Squares (LS) Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 12 |
1.7344; 1.7563; 1.9640 | 0.0615 |
| SECONDARY LS Mean Change From Baseline in the Total Area of GA Lesions in the Study Eye at Month 24 |
3.2275; 3.3395; 3.9726 | 0.0004 sig |
| SECONDARY Mean Change in Total Area of GA Lesions in the Study Eye Through Month 24 |
0.9075; 0.8829; 0.9622; 0.8409; 0.8473; 1.0132 | 0.4282 |
| SECONDARY LS Mean Change From Baseline in Monocular Maximum Reading Speed of the Study Eye at Month 24 |
-22.897; -25.532; -22.355 | — |
| SECONDARY LS Mean Change From Baseline in Mean Functional Reading Independence (FRI) Index Score at Month 24 |
-0.408; -0.371; -0.360 | — |
| SECONDARY LS Mean Change From Baseline in Normal-Luminance Best-Corrected Visual Acuity (NL-BCVA) Score of the Study Eye at Month 24 |
-8.126; -8.947; -6.217 | — |
Summary
This is a 24-month, Phase III, multicenter, randomized, double-masked, sham-injection controlled study to assess the efficacy and safety of multiple IVT injections of APL-2 in subjects with GA secondary to AMD.
Eligibility Criteria
Inclusion Criteria
The study eye must meet all inclusion criteria. If both eyes meet the inclusion criteria, the eye with the worst visual acuity at the screening visit will be designated as the study eye. If both eyes have the same visual acuity, the right eye will be selected as the study eye.
Ocular- specific inclusion criteria apply to the study eye only, unless otherwise specified.
- Age ≥ 60 years.
- Normal Luminance best corrected visual acuity of 24 letters or better using Early Treatment Diabetic Retinopathy Study (ETDRS) charts (approximately 20/320 Snellen equivalent).
- Clinical diagnosis of GA of the macula secondary to AMD as determined by the Investigator and confirmed by the Reading Center.
- The GA lesion must meet the following criteria as determined by the central reading center's assessment of Fundus Autofluorescence (FAF) imaging at screening:
- Total GA area must be ≥ 2.5 and ≤ 17.5 mm2 (1 and 7 disk areas [DA] respectively)
- If GA is multifocal, at least one focal lesion must be ≥ 1.25 mm2 (0.5 DA), with the overall aggregate area of GA as specified above in 4a.
- The entire GA lesion must be completely visualized on the macula centered image and must be able to be imaged in its entirety and not contiguous with any areas of peripapillary atrophy.
- Presence of any pattern of hyperautofluorescence in the junctional zone of GA. Absence of hyperautofluorescence (i.e. pattern = none) is exclusionary.
- Adequate clarity of ocular media, adequate pupillary dilation, and fixation to permit the collection of good quality images as determined by the Investigator.
- Female subjects must be:
- Women of non-child-bearing potential (WONCBP), or
- Women of child-bearing potential (WOCBP) with a negative serum pregnancy test at screening and must agree to use protocol defined methods of contraception for the duration of the study and refrain from breastfeeding for the duration of the study.
- Males with female partners of child-bearing potential must agree to use protocol defined methods of contraception and agree to refrain from donating sperm for the duration of the study.
- Willing and able to give informed consent and to comply with the study procedures and assessments.
Exclusion Criteria
Ocular specific exclusion criteria apply to the study eye only, unless otherwise specified.
- GA secondary to a condition other than AMD such as Stargardt disease, cone rod dystrophy or toxic maculopathies like plaquenil maculopathy in either eye.
- Spherical equivalent of the refractive error demonstrating > 6 diopters of myopia or an axial length >26 mm.
- Any history or active choroidal neovascularization (CNV), associated with AMD or any other cause, including any evidence of retinal pigment epithelium rips or evidence of neovascularization anywhere based on SD-OCT imaging and/or fluorescein angiography as assessed by the Reading Center.
- Presence of an active ocular disease that in the opinion of the Investigator compromises or confounds visual function, including but not limited to, uveitis, other macular diseases (e.g. clinically significant epiretinal membrane (ERM), full thickness macular hole or uncontrolled glaucoma/ocular hypertension. Benign conditions in the opinion of the investigator such as peripheral retina dystrophy are not exclusionary).
- Intraocular surgery (including lens replacement surgery) within 3 months prior to randomization.
- History of laser therapy in the macular region.
- Aphakia or absence of the posterior capsule. Note: YAG laser posterior capsulotomy for posterior capsule opacification done at least 60 days prior to screening is not exclusionary.
- Any ocular condition other than GA secondary to AMD that may require surgery or medical intervention during the study period or, in the opinion of the Investigator, could compromise visual function during the study period.
- Any contraindication to IVT injection including current ocular or periocular infection.
- History of prior intravit
Data sourced from ClinicalTrials.gov (NCT03525600). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.