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Phase IIa study to evaluate the efficacy of the ISTH0036 in treatment naive and previously treated patients with Macular Degeneration and Diabetic Macular Edema

TGF-BETa 2 antisense ISTH0036 for the Treatment of diabetic macular Edema (DME) and neovascular age-related maculaR degeneration (nAMD) as Monotherapy or in combination with Aflibercept The “BETTER ? Study

Status
Active, not recruiting
Phases
Phase 2
Study type
Interventional
Source
CTRI
Registry ID
CTRI/2022/04/041823
Enrollment
43
Registered
2022-04-12
Start date
Unknown
Completion date
Unknown
Last updated
2025-11-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Health Condition 1: E133- Other specified diabetes mellituswith ophthalmic complications

Interventions

Intervention1: ISTH0036: The duration of study participation is 9 months preceded by an up to 40 days screening period. Screening and Baseline Visit may be combined. Last treatment is at month 6 and t

Sponsors

Isarna Therapeutics
Lead Sponsor

Eligibility

Inclusion criteria

Inclusion criteria: Patients eligible for inclusion in this study must meet all the following criteria: 1. Patients must provide written informed consent before any study related procedures are performed. 2. Patients must be =18 yrs in the DME cohort and = 50 in the nAMD cohort at Screening. Study eye nAMD: 3. Active CNV lesions secondary to nAMD (including retinal angiomatous proliferation lesions with a CNV component) in the study eye at Screening in treatment naïve nAMD arm. 4. About 50% of the patients in the AMD treatment naïve group should have classic or predominantly classic CNV / Type II CNV or hemorrhage 5. Pretreated CNV lesions secondary to nAMD (including retinal angiomatous proliferation lesions with a CNV component) in the study eye at Screening in pretreated nAMD. About 50% of the patients should be included with SHRM present on OCT despite anti-VEGF therapy or hemorrhage present at initial diagnosis/ therapy start. 6. Intra- and/or subretinal fluid affecting the central subfield of the study eye at Screening with CMT =305 µm in women, and =320µm in men or with a center point thickness of >260 in women and >270 micrometer in men as measured by SD-OCT in treatment naïve nAMD arm. 7. For treatment naïve patients, BCVA between 83 and 23 letters, inclusive, in the study eye at Screening and Baseline using early treatment diabetic retinopathy study (ETDRS) testing. 8. For Treatment naïve and VEGF primed group: Treatment naïve nAMD in study eye 9. For VR-group: Dry or =50 micrometer SRF in vertical extension after receiving 1-6 anti-VEGF injections. Diagnosis no longer than 9 months before Baseline Study eye DME: 10. Active CME secondary to diabetes in the study eye at Screening in treatment naïve DME. 11. Intra- and/or subretinal fluid affecting the central subfield of the study eye at Screening with CMT =305 µm in women, and =320µm in men or with a center point thickness of >260 in women and >270 micrometer in men as measured by SD-OCT in treatment naïve DME arm. 12. For treatment naïve patients, BCVA between 83 and 23 letters, inclusive, in the study eye at Screening and Baseline using early treatment diabetic retinopathy study (ETDRS) testing. 13. Moderate to severe NPDRP assessed via ETDRS severity scale and mild PDRP (with 1 NVE) in study eye (diabetic retinopathy severity scale DRSS 43-61) 14. Absence of prior PRP treatment 15. For Treatment naïve group: Treatment naïve DME in study eye 16. For VR-group: History of CME secondary to diabetes in the study eye with complete resolution of IRF and/or SRF or a =20% reduction in CMT secondary to diabetes after receiving 1-6 monthly anti-VEGF injections over the last 9 months.

Exclusion criteria

Exclusion criteria: Patients meeting any of the following criteria are not eligible for inclusion in this study. Ocular conditions 1. Any active intraocular or periocular infection or active intraocular inflammation (e.g., infectious conjunctivitis, keratitis, scleritis, endophthalmitis, infectious blepharitis) in either eye at Baseline. 2. Presence of amblyopia, amaurosis or ocular disorders in the fellow eye with BCVA Study eye nAMD 3. nAMD diagnosed for more than 9 months 4. Poor quality of SD-OCT images at Screening or Baseline. 5. Central subfield of the study eye affected by geographic atrophy assessed by OCT, color fundus photography (CFP) and fundus autofluorescence (FAF) at Screening. 6. Subretinal blood affecting the central subfield and/or = 50% of the lesion of the study eye at Screening. 7. Concomitant conditions or ocular disorders in the study eye, including retinal diseases other than nAMD, that, in the judgment of the investigator, could require medical or surgical intervention during the study to prevent or treat visual loss that might result from that condition, or that limits the potential to gain visual acuity upon treatment with the investigational product. 8. Structural damage within 0.5-disc diameter of the center of the macula in the study eye, e.g., vitreomacular traction, epiretinal membrane, retinal pigment epithelium (RPE) rip/tear scar, laser burn, at the time of Screening that in the investigator’s opinion could preclude visual function improvement with treatment. 9. Current vitreous hemorrhage or history of vitreous hemorrhage in the study eye within 4 weeks prior to Baseline. 10. Uncontrolled glaucoma in the study eye defined as IOP > 25 mmHg on medication or according to the investigator’s judgment at Screening or Baseline. 11. Aphakia and/or complete absence of the posterior capsule in the study eye at Screening. 12. For Treatment naïve and VEGF primed group: Any prior treatment for nAMD in study eye 13. For VR-group: > 50 micrometer SRF in vertical extension after receiving 1-6 anti-VEGF injections over the last 9 months 14. For VR-group: > 6 anti-VEGF injections Study eye DME 15. Treatment requiring DME diagnosed for more than 9 months 16. Poor quality of SD-OCT images. 17. Focal laser scars within the central 1 mm ETDRS subfield 18. Concomitant conditions or ocular disorders in the study eye, including retinal diseases other than DME, that, in the judgment of the investigator, could require medical or surgical intervention during the study to prevent or treat visual loss that might result from that condition, or that limits the potential to gain visual acuity upon treatment with the investigational product. 19. Structural damage within 0.5-disc diameter of the center of the macula in the study eye, e.g., vitreomacular traction, epiretinal membrane, retinal pigment epithelium (RPE) rip/tear scar, laser burn, at the time of Screening that in the investigator’s opinion could preclude visual function improvement with treatment. 20. Current vitreous hemorrhage or history of vitreous hemorrhage in the study eye within 4 weeks prior to Baseline. 21. Uncontrolled glaucoma in the study eye defined as

Design outcomes

Primary

MeasureTime frame
OCT CMT at 7 months vs. baseline. For treatment naïve patients, improvement versus BL will be analyzed, for anti-VEGF pre-treated patients, maintenance, or improvement of CMT versus BL will be assessed.Timepoint: 9 Months

Secondary

MeasureTime frame
Number and type of adverse events (AE) in all groups Incidence and progression of cataract using LOCS III score in patients treated with ISTH0036 Change in BCVA from baseline up to month 9 Change of central macular volume up to month 9 Timepoint: 9 Months

Countries

India

Contacts

Public ContactDevesh Verma

Cliantha Research Limited

nhdesai@cliantha.com07966219500

Outcome results

None listed

Source: CTRI (via WHO ICTRP) · Data processed: Feb 4, 2026