The primary objectives of this study were to evaluate the safety and efficacy of LKA651 in patients with macular edema from diabetic macular edema (DME),
This study was a 3-arm, parallel group, randomized, patient- and investigator-masked trial planned in 90 patients with Diabetic macular edema (DME). The study consisted of a screening period of 60 days, main study (12 weeks), and an extension period (12 weeks). The study was stratified such that sentinel safety cohorts were first enrolled to test the safety of the combination of LKA651 and Lucentis before proceeding with further patient randomization. After determination of safety from Day 15 data from each sentinel cohort, patients were enrolled into 1 of 3 arms: LKA651 monotherapy, LKA651 plus Lucentis, and Lucentis monotherapy. Every patient was dosed 3 times in 4 week intervals in the treatment phase and was then followed up for an extension phase of an additional 12 weeks during which Lucentis was allowed to be administered as rescue at the discretion of the Investigator. No predefined rescue criteria were outlined as guidance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
91
Novartis Investigative Site
Beverly Hills, California, United States
Novartis Investigative Site
Number of Participants With Adverse Events
An AE is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a patient or clinical investigation patient. The severity of the AEs (mild, moderate, severe) was based on the Common Terminology Criteria for Adverse Events (CTCAE). Number of participants in each category is reported in the table. A participant who falls multiple times in one category is counted only once.
Time frame: Adverse events are reported from first dose of study treatment until end of study treatment plus 12 weeks post treatment, up to a maximum timeframe of approximately 24 weeks (approximately 168 days).
Number of Participants With Ocular Adverse Events by Preferred Term in Study Eye
An AE is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a patient or clinical investigation patient.
Time frame: Adverse events are reported from first dose of study treatment until end of study treatment plus 12 weeks post treatment, up to a maximum timeframe of approximately 24 weeks (approximately 168 days).
Number of Participants With Non-ocular Adverse Events (>=2%)
An AE is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a patient or clinical investigation patient.
Time frame: Adverse events are reported from first dose of study treatment until end of study treatment plus 12 weeks post treatment, up to a maximum timeframe of approximately 24 weeks (approximately 168 days).
Intraocular Pressure (IOP) in Study Eye
Intraocular pressure was measured per the study site's regular practice.
Time frame: Screening, and Day 85
Best Corrected Visual Acuity (BCVA) by Early Treatment Diabetic Retinopathy Study (ETDRS) Visual Acuity Charts in Study Eye
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Rancho Cordova, California, United States
Novartis Investigative Site
Miami, Florida, United States
Novartis Investigative Site
‘Aiea, Hawaii, United States
Novartis Investigative Site
Boston, Massachusetts, United States
Novartis Investigative Site
Austin, Texas, United States
Novartis Investigative Site
San Antonio, Texas, United States
Novartis Investigative Site
Berlin, Germany
Novartis Investigative Site
Göttingen, Germany
Novartis Investigative Site
Hanover, Germany
...and 12 more locations
BCVA was assessed using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts. Visual function of the study eye was assessed using the ETDRS protocol. BCVA in study eye was analyzed with a mixed model for repeated measures. The model included treatment, visit, and the treatment by visit interaction as independent variables. An unstructured residual covariance structure was used. Baseline BCVA value and treatment naïve and treatment experienced variable were used as covariates. Min and max possible scores are 0-100 respectively. A higher score represents better visual functioning.
Time frame: Days 2, 8, 15, 29, 43, 57, and 85
Inner Macular Thickness (Inferior)
Macular thickness was measured by spectral domain optical coherence tomography (SD-OCT).
Time frame: Week 12 (Day 85)
Inner Macular Thickness (Temporal)
Macular thickness was measured by spectral domain optical coherence tomography (SD-OCT).
Time frame: Week 12 (Day 85)
Outer Macular Thickness (Inferior)
Macular thickness was measured by spectral domain optical coherence tomography (SD-OCT).
Time frame: Week 12 (Day 85)
Outer Macular Thickness (Temporal)
Macular thickness was measured by spectral domain optical coherence tomography (SD-OCT).
Time frame: Week 12 (Day 85)
Number of Participants Without Changes in Foveal Avascular Zone as Measured by Fluorescein Angiography (FA) in Study Eye
Foveal avascular zone was assessed by fluorescein angiography (FA).
Time frame: Days 29, 57, 85, End of Study (Up to Day 140)
Mixed Model Repeated Measures Analysis of Ratio to Baseline in Central Subfield Retinal Thickness (CSFT) in the Study Eye
Central subfield thickness was measured by spectral domain optical coherence tomography (SD-OCT). Central subfield retinal thickness was analyzed with a mixed model for repeated measures. The model included treatment, visit, and the treatment by visit interaction as independent variables. An unstructured residual covariance structure was used. Log-transformed baseline central subfield retinal thickness and treatment naïve and treatment experienced variable were used as covariates. Results were back-transformed to show results as a ratio to baseline.
Time frame: Days 8, 15, 29, 43, 57, 85
Number of Participants Who Needed Retreatment With Anti-VEGF in Study Eye After Week 12
Time frame: Week 12 (Day 85) up to Day 140
Time to Retreatment in Study Eye With Anti-VEGF After Week 12
Time to retreatment with anti VEGF (as determined by the investigator) after Week 12 during the additional 12 week extension phase (that was up to 16 weeks after the last dose) was examined with a Kaplan Meier plot.
Time frame: Week 12 (Day 85) up to Day 140
Summary Statistics of Pharmacokinetics - Serum Concentrations of LKA651
PK parameters were determined using non-compartmental methods using the most recent version of WinNonlin Phoenix (Version 8.2). Concentrations below the lower limit of quantification (LLOQ) were treated as 1/2 LLOQ in summary statistics.
Time frame: Day 1 (0, 0.5 and 4 hrs post dose), Day 2, Day 8, Day 15, Day 29 (0, 0.5 and 4 hrs post dose), Day 43, Day 57 (0, 0.5 and 4 hrs post dose), Day 85
Summary Statistics of Pharmacokinetics - AUC0-28d of LKA651 (Serum)
Area under the curve over the dosing interval 0 to 28 days.
Time frame: Day 1 - 4 hrs post dose, Day 2, Day 8, Day 15, Day 29 - 4 hrs post dose, Day 43, Day 57 - 4 hrs post dose, Day 85
Summary Statistics of Pharmacokinetics - Serum Concentrations of Lucentis
Time frame: Day 1 - 4 hrs post dose, Day 2, Day 8, Day 15, Day 29 - 4 hrs post dose, Day 43, Day 57 - 4 hrs post dose, Day 85
Summary Statistics of Pharmacokinetics - AUC0-28d of Lucentis (Serum)
Area under the curve over the dosing interval 0 to 28 days.
Time frame: Day 1 - 4 hrs post dose, Day 2, Day 8, Day 15, Day 29 - 4 hrs post dose, Day 43, Day 57 - 4 hrs post dose, Day 85