This is a randomized, double-blind, comparative, parallel group study of the efficacy, safety pharmacokinetics, and immunogenicity of GNR-067 and Lucentis® in patients with neovascular (wet) age-related macular degeneration.
Age-related macular degeneration (ARMD) is a chronic progressive disease that is the main cause of visual disability in elderly patients (aged over 60 years) in industrialized countries. Due to increased human longevity, it is expected for the number of patients with this disease to grow worldwide up to 288 million people by 2040. The highest risk of vision loss is posed by neovascular (exudative or wet ARMD) macular degeneration observed in 10-20% of cases. The pathological changes of ARMD are based on the increased production of the vascular endothelial growth factor (VEGF) which affects proprioceptors located on the surface of endothelial cells and causes an anomalous permeability of vessels and stimulates neovascularization GNR-067 (JSC "GENERIUM", the Russian Federation) is a humanized recombinant monoclonal antibody selectively binding to the human vascular endothelial growth factor \[VEGF-A\] and is a biosimilar of of the original product Lucentis® ("Novartis Pharma AG", Switzerland). This III phase study is aimed to compare the effectiveness, safety, pharmacokinetics and immunogenicity of GNR-067 (JSC "GENERIUM", the Russian Federation) and Lucentis® ("Novartis Pharma AG", Switzerland) in order to register of the drug GNR-067 (JSC "GENERIUM", the Russian Federation), a solution for intraocular injection administration, in the Russian Federation. The study included patients (n = 408) aged 50 years and older with neovascular (wet) age-related macular degeneration, types 1 and 2 (occult and classical) choroidal neovascularization (CNV) with the following activity signs: accumulation of intraretinal and/or subretinal (under the neurosensory retina or pigment epithelium) fluid, extravasal dye exit from the newly formed vessels, and the presence of a subfoveal and/or juxtafoveal membrane and the presence of CNV foci of more than 50% of the total lesion area. With block randomization, the patients were divided into two groups in a 2:1 ratio (investigational/reference product): 272 patients to the group of the investigational product GNR-067 and 136 patients to the group of the reference product Lucentis®. The duration of the study for each patient will be approximately 52 ± 4 weeks, including a screening period (3 weeks), treatment period and a follow-up period (4 weeks). In this study GNR-067 and Lucentis® will be used intravitreally once every 4 weeks (thirteen injections in total) in 0.5 mg doses (the injection volume is 0.05 mL).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
408
Regional budgetary healthcare institution "Ivanovo Regional Clinical Hospital"
Ivanovo, Ivanovo Oblast, Russia
NOT_YET_RECRUITINGThe proportion of patients (%) with an increase in the best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart) of 15 or more letters at Week 8 versus baseline in the compared groups.
Global evaluation of treatment effectiveness (the best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart)) of 15 or more letters are a validated tool and has been used to evaluate the clinical response to ranibizumab in patients with with neovascular (wet) age-related macular degeneration.
Time frame: At 8 Week after comparative treatment beginning (GNR-067 vs. Lucentis®).
The proportion of patients (%) with an increase in the best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart) of 15 or more letters at Week 24, Week 52 versus baseline in the compared groups.
The best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart)) of 15 or more letters are a validated tool and has been used to evaluate the clinical response to ranibizumab in patients with with neovascular (wet) age-related macular degeneration.
Time frame: At Week 24, Week 52 after comparative treatment start (GNR-067 vs. Lucentis®) and compared to baseline.
The proportion of patients (%) with a decrease in the best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart) of 15 or fewer letters at Week 8, Week 24, and Week 52 versus baseline in the compared groups.
The best-corrected visual acuity (BCVA) score on the ETDRS chart (measured using logMAR/Snellen chart) of 15 or fewer letters are a validated tool and has been used to evaluate the clinical response to ranibizumab in patients with with neovascular (wet) age-related macular degeneration.
Time frame: At Week 8, Week 24, Week 52 weeks after comparative treatment start (GNR-067 vs. Lucentis®) and compared to baseline.
The decrease of the central retinal thickness (CRT) measured with optical coherence tomography in the spectral range at Week 8, Week 24, Week 52 versus baseline in the compared groups.
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State Budgetary Healthcare Facility of the St. Petersburg Region "First St. Petersburg State Medical University named after academician I.P. Pavlova "of the Ministry of Health of the Russian Federation
Saint Petersburg, Leningradskaya Oblast', Russia
RECRUITINGFederal State Budgetary Educational Institution of Higher Education "Moscow State University of Medicine and Dentistry named after A.I. Evdokimov "of the Ministry of Health of the Russian Federation
Moscow, Moscow Oblast, Russia
NOT_YET_RECRUITINGFederal State Autonomous Institution "Interbranch Scientific and Technical Complex" Eye Microsurgery "named after academician S.N. Fedorov "of the Ministry of Health of the Russian Federation
Moscow, Moscow Oblast, Russia
NOT_YET_RECRUITINGState Budgetary Healthcare Institution of the Novosibirsk Region "State Novosibirsk Regional Clinical Hospital"
Novosibirsk, Novosibirsk Oblast, Russia
RECRUITINGState Budgetary Healthcare Institution of the Omsk region "Clinical ophthalmological hospital named after V.P. Vykhodtseva"
Omsk, Omsk Oblast, Russia
RECRUITINGState Autonomous Healthcare Institution "Republican Clinical Ophthalmological Hospital of the Ministry of Health of the Republic of Tatarstan" Kazan
Kazan', Tatarstan Republic, Russia
NOT_YET_RECRUITINGLimited Liability Company "Kuzlyar"
Kazan', Tatarstan Republic, Russia
NOT_YET_RECRUITINGFederal State Budgetary Educational Institution of Higher Education "Samara State Medical University" of the Ministry of Health of the Russian Federation
Kazan', Tatarstan Republic, Russia
NOT_YET_RECRUITINGThe decrease of the central retinal thickness (CRT) in patient with neovascular (wet) age-related macular are standard of the optical coherence tomography (OCT).
Time frame: At Week 8, Week 24, Week 52 versus baseline in the compared groups.
The proportion of patients (%) with the presence (incomplete recovery) of intraretinal fluid and subretinal fluid at Week 8, Week 24, Week 52 versus baseline in the compared groups.
The presence (incomplete recovery) of intraretinal fluid and subretinal fluid in patient with neovascular (wet) age-related macular are standard for fluorescent angiography.
Time frame: At Week 8, Week 24, Week 52 versus baseline in the compared groups
The assessment of changes in visual acuity and quality of life of patients by the questionnaire method using the NEI VFQ-25 medical ophthalmological questionnaire at Week 24 Week 52 versus baseline in the compared groups.
NEI VFQ-25 medical ophthalmological questionnaire is standard of the assessment changes in visual acuity and quality of life of patients with neovascular (wet) age-related macular.
Time frame: At Week 24 Week 52 versus baseline in the compared groups.
Immunogenicity
The frequency of antidrug antibodies formation.
Time frame: The frequency of formation of ADAs to ranibizumab at Day 1, Day 8, Week 8, Week 24, Week 36, and Week 52 of treatment with the investigational or reference product with the characterization of antibodies.