Comparing GNR-067 and Lucentis® for treating wet age-related macular degeneration
International, Multicenter, Randomized, Double-blind, Comparative Clinical Study of the Efficacy, Safety, Pharmacokinetics, and Immunogenicity of GNR-067 and Lucentis® in Patients With Neovascular (Wet) Age-related Macular Degeneration
This study is testing a new treatment called GNR-067 against Lucentis® to see which one works better for people with wet age-related macular degeneration.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 408 (estimated) |
| Ages | 50 Years and up |
| Sex | All |
| Sponsor | Ao Generium Industry-sponsored |
| Drugs / interventions | ranibizumab, bevacizumab |
| Locations | 9 sites (Ivanovo, Ivanovo Region and 8 other locations) |
| Trial ID | NCT04667039 on ClinicalTrials.gov |
What this trial studies
This is a randomized, double-blind, comparative study that evaluates the efficacy, safety, pharmacokinetics, and immunogenicity of GNR-067, a biosimilar to Lucentis®, in patients with neovascular (wet) age-related macular degeneration. The study aims to enroll 408 patients aged 50 years and older who have been diagnosed with this condition. Participants will receive either GNR-067 or Lucentis® through intraocular injection, and their responses will be monitored to determine the effectiveness and safety of the treatments. The ultimate goal is to register GNR-067 for use in the Russian Federation.
Who should consider this trial
Good fit: Ideal candidates are men and women aged 50 years and older with untreated neovascular (wet) age-related macular degeneration.
Not a fit: Patients with other forms of age-related macular degeneration or those who have previously received treatment for neovascular ARMD may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could provide a new effective treatment option for patients suffering from wet age-related macular degeneration.
How similar studies have performed: Other studies have shown success with similar approaches in treating wet age-related macular degeneration, indicating potential for GNR-067.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Men and women aged 50 years and older;
2. The signed informed consent obtained from the patient, or, in cases of severe visual impairment in the patient, with the participation of an impartial witness, prior to any study-related procedures.
Ophthalmic inclusion criteria (must be present in one eye, which will be considered the examined eye)
3. The previously diagnosed neovascular (wet) age-related macular degeneration confirmed at the Screening Visit:
untreated, except for food supplement, vitamins, mineral additives (one examined eye in one patient); 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;
4. The best-corrected visual acuity within a range from 34 to 83 letters (20/200 to 20/25) measured using the ETDRS chart Early Treatment Diabetic Retinopathy Study Research Group protocol (chart at a distance of 4 m) before pupil dilation;
5. The willingness and ability of the patient to perform all planned study visits and procedures (according to the Investigator);
6. IOP ≤21 mmHg (actual);
7. An ECG within normal values or clinically insignificant findings.
Exclusion Criteria:
1. Medical history of CNV treatment with intravitreal injections of VEGF inhibitors (ranibizumab, bevacizumab, aflibercept, or pegaptanib, etc.), or any other investigational poducts into the examined eye;
2. Medical history of subretinal laser photocoagulation or other surgical interventions for ARMD in any eye;
3. Preexisting and current lesions, diseases, or interventions in the eyes.:
In the examined eye:
Keratoplasty or corneal dystrophy Capsulotomy performed 4 weeks prior to screening Aphakia, vitrectomy Presence of a macular hole at any stage Past rhegmatogenous retinal detachment Any other past intraocular surgical interventions in the examined eye (including cataract extraction in the examined eye) within 3 months prior to the Screening Visit
In any eye:
Choroidal neovascularization in any eye due to reasons not related to ARMD (for example, multifocal choroiditis, ocular histoplasmosis syndrome, injury, etc.) Past idiopathic or autoimmune uveitis in any eye Scleromalacia Diagnosed diabetic retinopathy
Current conditions and diseases identified at the screening stage:
High degree myopia (over 8 diopters) in any eye; Presence of progressive glaucoma (intraocular pressure ≥21 mmHg against performed antihypertensive glaucoma therapy) or optic neuropathy that affect or endanger the central field of view in the examined eye at the screening stage; Subretinal hemorrhage and/or hemorrhage in the retinal tissue occupying ≥50% of the total affected area in the examined eye; Presence of a rupture (solution of continuity) of the retinal pigment epithelium (RPE) also extending to the macula in any eye; A scar or subretinal fibrosis in the macular area occupying more than 50% of the total affected area in any eye; Presence of vitreomacular traction or epiretinal membrane significantly affecting central vision; Other than ARMD progressive retinal diseases in the examined or fellow eye that may complicate the assessment of visual acuity; The total size of the lesion is more than 12 disc areas (DA: 30.5 mm2 including areas occupied by blood, neovascularization, or fibrosis), based on a FAG performed at screening; Confirmed or assumed (within 28 days prior to the Screening Visit) intraocular, extraocular, and periocular inflammation or infection in any eye.
4. Any intravitreal injections of corticosteroids (e.g., triamcinolone acetonide) for ≥30 days in a row in the examined eye 90 days prior to the Screening Visit and/or injection of an intravitreal corticosteroid implant with a gradual release of the medicinal product into the examined eye within 180 days prior to the Screening Visit;
5. Known allergic reactions and/or hypersensitivity to Lucentis® (ranibizumab) or any ingredients of GNR-067;
6. Known allergic reactions and/or hypersensitivity to fluorescein sodium (for injections);
7. Uncontrolled arterial hypertension (BP ≥180/90 mmHg);
8. Diseases of the immune and endocrine system, not controlled by drug therapy (including decompensated diabetes mellitus and thyroid diseases);
9. Medical history or current (active cancer)of oncological diseases with the exception of cured basal cell carcinoma;
10. Vaccination (any vaccine) within 30 days prior to the Screening Visit and/or the need for vaccination during the study period;
11. Systemic treatment with corticosteroids (more than 10 mg of prednisolone equivalent) within 6 months prior to the Screening Visit;
12. Use of systemic medicinal products known to be toxic for the eye lens, retina, or optic nerve during the study.
13. Medical history of a clinically significant pathology identified during the screening period including, but not limited to:
Unstable angina pectoris, myocardial infarction, arrhythmia requiring drug therapy, Class III or IV congestive heart failure according to the New York Heart Association classification within one year before the Screening Visit; Brain injury, stroke, or transient ischemic attack within one year prior to the Screening Visit; Severe renal failure (estimated glomerular filtration rate according to the CKD-EPI formula \<40 mL/min/1.73 m2); Severe hepatic impairment (serum alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) activity of 2.5 or more times higher than the laboratory upper limit of normal (ULN), and/or the level of total bilirubin of 1.5 or more times higher than the laboratory ULN);
Variation of peripheral blood parameters:
Leukocytes: \<3.8 × 109/L Platelets: \<100 × 109 cells/L Hemoglobin: ≥10.0 g/dL
14. Pregnancy and breastfeeding;
15. Patients who received blood or blood component transfusions within 10 days prior to the Screening Visit;
16. History (within three years prior to the Screening Visit) of tuberculosis, alcoholism, narcotic, drug dependence and/or substance abuse, or presence of the above at the Screening stage;
17. Acute hepatitis or liver cirrhosis of any etiology; antibodies to hepatitis C or HBsAg at the Screening Visit; acquired immune deficiency syndrome or infection with human immunodeficiency virus (HIV) confirmed by test results;
18. Participation of the patient in any clinical studies and/or use of experimental medicinal products within 3 months prior to the Screening Visit.
Where this trial is running
Ivanovo, Ivanovo Region and 8 other locations
- Regional budgetary healthcare institution "Ivanovo Regional Clinical Hospital" — Ivanovo, Ivanovo Region, Russian Federation (Not_yet_recruiting)
- 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, Leningrad Region, Russian Federation (Recruiting)
- Federal 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 Region, Russian Federation (Not_yet_recruiting)
- Federal 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 Region, Russian Federation (Not_yet_recruiting)
- State Budgetary Healthcare Institution of the Novosibirsk Region "State Novosibirsk Regional Clinical Hospital" — Novosibirsk, Novosibirsk Region, Russian Federation (Recruiting)
- State Budgetary Healthcare Institution of the Omsk region "Clinical ophthalmological hospital named after V.P. Vykhodtseva" — Omsk, Omsk Region, Russian Federation (Recruiting)
- State Autonomous Healthcare Institution "Republican Clinical Ophthalmological Hospital of the Ministry of Health of the Republic of Tatarstan" Kazan — Kazan, Republic Of Tatarstan, Russian Federation (Not_yet_recruiting)
- Limited Liability Company "Kuzlyar" — Kazan, Republic Of Tatarstan, Russian Federation (Not_yet_recruiting)
- Federal State Budgetary Educational Institution of Higher Education "Samara State Medical University" of the Ministry of Health of the Russian Federation — Kazan, Republic Of Tatarstan, Russian Federation (Not_yet_recruiting)
Study contacts
- Study coordinator: Olga Zozulya, SD
- Email: ovzozulya@generium.ru
- Phone: +7-925-400-01-26
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.