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To Assess the Efficacy and Safety of Intravitreal Ranibizumab in People With Vision Loss Due to Macular Edema

A 12-month, Randomized, Double-masked, Sham-controlled, Multicenter Study to Evaluate the Efficacy and Safety of 0.5mg Ranibizumab Intravtitreal Injections in Patients With Visual Impairment Due to Vascular Endothelial Growth Factor (VEGF)Driven Macular Edema

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01846299
Enrollment
181
Registered
2013-05-03
Start date
2013-10-31
Completion date
2015-09-30
Last updated
2016-05-23

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

Conditions

Macular Edema (ME)

Keywords

Vision Impairment

Brief summary

To evaluate the efficacy and safety of 0.5 mg Ranibizumab intravitreal injections in adult patients with visual impairment due to macular edema (ME).

Interventions

OTHERSham control

The sham vial did not contain active drug (empty sterile vial). The sham injection was an imitation of an intravitreal injection using an injection syringe without a needle touching the eye.

DRUGRanibizumab

Ranibizumab 0.5mg/0.5mL was administered intravitreally to the participant.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Diagnosis of active ME secondary to any causes (for adult patients: except diabetic macular edema (DME), age-related macular degeneration (AMD) and retinal vein occlusion (RVO)); * BCVA must be between ≥ 24 and ≤ 83 letters; * Visual loss should be mainly due to the presence of any eligible types of ME.

Exclusion criteria

* Women of child-bearing potential, * Active malignancies; * History of stroke less than 6 months prior to screening; * Uncontrolled systemic inflammation or infection, related directly to the underlying causal disease of ME; * Active diabetic retinopathy, active ocular/periocular infectious disease or active severe intra-ocular inflammation; * Any type of advanced, severe or unstable ocular disease or its reatment; * ME with a high likelihood of spontaneous resolution. Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Best-corrected Visual Acuity (BCVA) in Study EyeBaseline, Month 2BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.

Secondary

MeasureTime frameDescription
Change From Baseline in Central Subfield Thickness (CSFT) in Study EyeBaseline, Months 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12CSFT wasassessed by optical coherence tomography (OCT). A negative change from baseline indicates improvement.
Change From Baseline in Central Subfield Volume (CSFV) in Study EyeMonths 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12CSFV was assessed OCT. A negative change from baseline indicates improvement.
Number of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 2, Month 6, Month 12The presence of intra-retinal fluid was assessed by OCT.
Number of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 2, Month 6, Month 12The presence of subretinal fluid was assessed by OCT.
Number of Participants With Presence of Active Macular Edema (ME) LeakageMonth 2The presence of active ME leakage was assessed by fluorescein angiography (FA).
Number of Participants Requiring Rescue Treatment at Month 1Month 1Rescue treatment with laser photocoagulation or periocular treatment could be administered at Month 1 only if the participant had a visual acuity loss of \> 5 letters due to disease activity from baseline to Month 1.
Change From Baseline in BCVA in Study Eye up to Month 2Baseline, Month 1, Month 2BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.
Number of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Month 6 , Month 12VA measurements (number of letters correctly identified) were performed with the patient in a sitting position using ETDRS-like visual acuity testing charts at a testing distance of 4 meters.
Number of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Month 6, Month 12VA measurements (number of letters correctly identified) were performed with the patient in a sitting position using ETDRS-like visual acuity testing charts at a testing distance of 4 meters.
Number of Participants With Ranibizumab TreatmentsMonth 12The number of participants administered study treatments, according to treatment frequency, was assessed.
Number of Participants With Re-treatmentsMonth 6, month 12The number of participants, administered re-treatments according to treatment frequency, was assessed. Re-treatment was defined as an administration of study medication following at least one non-missed visit where treatment was not administered in the study eye. Up to Month 12, the maximum number of retreatments was 5.
Number of Primary Reasons for Decision to Treat by Investigator12 monthsThe total number of primary reasons for decisions to treat was assessed. A single participant could have had multiple primary reasons for treatment.
Average Change From Baseline in BCVABaseline (BL), month 1 through month 6, month 1 through month 12BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.

Countries

Australia, Belgium, Canada, Czechia, France, Germany, Hungary, Israel, Italy, Latvia, Netherlands, Russia, Singapore, Slovakia, South Korea, Spain, Switzerland, Turkey (Türkiye), United Kingdom

Participant flow

Recruitment details

A total of 181 participants were enrolled. Of these, 178 adults were randomized in a 2:1 ratio and considered for analysis. The 3 adolescent participants, non-randomized, received open-label treatment and were not included in the analyses. Therefore, the number enrolled = 181 differs from the number randomized = 178 in the participant flow.

Participants by arm

ArmCount
Ranibizumab
A 0.5 mg ranibizumab intravitreal injection was given to the study eye at baseline, and then as needed based on evidence of disease activity.
118
Sham
Sham injection was given to the study eye at baseline, and then treatment was given based on evidence of disease activity. At Month 1, if treatment was needed, sham was administered. At Month 2, participants could switch to open-label ranibizumab on an as needed basis.
60
Total178

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event20
Overall StudyDeath12
Overall StudyLost to Follow-up30
Overall StudyPhysician Decision42
Overall StudyProtocol deviation10
Overall StudyWithdrawal by Subject16

Baseline characteristics

CharacteristicRanibizumabShamTotal
Age, Continuous63.5 Years
STANDARD_DEVIATION 13.97
61.8 Years
STANDARD_DEVIATION 15.55
62.9 Years
STANDARD_DEVIATION 14.5
Sex: Female, Male
Female
45 Participants23 Participants68 Participants
Sex: Female, Male
Male
73 Participants37 Participants110 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
58 / 11921 / 560 / 2
serious
Total, serious adverse events
15 / 1196 / 561 / 2

Outcome results

Primary

Change From Baseline in Best-corrected Visual Acuity (BCVA) in Study Eye

BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.

Time frame: Baseline, Month 2

Population: Full analysis set: The full analysis set included all randomized participants who received at least one dose of study treatment.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
RanibizumabChange From Baseline in Best-corrected Visual Acuity (BCVA) in Study Eye5.7 lettersStandard Error 0.81
Sham With RanibizumabChange From Baseline in Best-corrected Visual Acuity (BCVA) in Study Eye2.9 lettersStandard Error 0.89
p-value: 0.011195% CI: [0.4, 5.16]Mixed Models Analysis
Secondary

Average Change From Baseline in BCVA

BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.

Time frame: Baseline (BL), month 1 through month 6, month 1 through month 12

Population: The FAS was used for this analysis. The FAS included randomized participants who received at least one dose of study medication.

ArmMeasureGroupValue (MEAN)Dispersion
RanibizumabAverage Change From Baseline in BCVAAverage change from BL, month 1 through month 66.39 lettersStandard Deviation 8.405
RanibizumabAverage Change From Baseline in BCVAAverage change from BL, month 1 through month 127.40 lettersStandard Deviation 9.052
Sham With RanibizumabAverage Change From Baseline in BCVAAverage change from BL, month 1 through month 64.50 lettersStandard Deviation 8.095
Sham With RanibizumabAverage Change From Baseline in BCVAAverage change from BL, month 1 through month 125.82 lettersStandard Deviation 8.927
Secondary

Change From Baseline in BCVA in Study Eye up to Month 2

BCVA was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity (VA) testing charts at an initial testing distance of 4 meters. A positive change from baseline indicated improvement.

Time frame: Baseline, Month 1, Month 2

Population: The full analysis set (FAS) was considered for the analysis. The FAS. The FAS included all randomized participants who received at least one dose of study treatment. Only participants of the FAS, who had data at baseline and the specific post-baseline time point, were included in the analysis for that time point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
RanibizumabChange From Baseline in BCVA in Study Eye up to Month 2Month 1 (n=116,59)4.7 lettersStandard Error 0.7
RanibizumabChange From Baseline in BCVA in Study Eye up to Month 2Month 2 (n=114,59)5.8 lettersStandard Error 0.76
Sham With RanibizumabChange From Baseline in BCVA in Study Eye up to Month 2Month 1 (n=116,59)1.4 lettersStandard Error 0.98
Sham With RanibizumabChange From Baseline in BCVA in Study Eye up to Month 2Month 2 (n=114,59)2.8 lettersStandard Error 1.05
Secondary

Change From Baseline in Central Subfield Thickness (CSFT) in Study Eye

CSFT wasassessed by optical coherence tomography (OCT). A negative change from baseline indicates improvement.

Time frame: Baseline, Months 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

Population: The full analysis set (FAS) was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants of the FAS, who had data at baseline and the specific post-baseline time point, were included in the analysis for that time point.

ArmMeasureGroupValue (MEAN)Dispersion
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 1 (n=112,59)-83.6 micrometers (um)Standard Deviation 127.45
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 6 (n=109,54)-110.6 micrometers (um)Standard Deviation 133.1
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 3 (n=113,59)-86.5 micrometers (um)Standard Deviation 136.43
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 7 (n=105,52)-113.3 micrometers (um)Standard Deviation 130.84
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 9 (n=105,52)-111.6 micrometers (um)Standard Deviation 127.99
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 4 (n=109,57)-94.5 micrometers (um)Standard Deviation 141.55
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 10 (n=103,50)-114.1 micrometers (um)Standard Deviation 131.12
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 2 (n=112,59)-82.5 micrometers (um)Standard Deviation 140.06
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 11 (n=101,49)-112.1 micrometers (um)Standard Deviation 124
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 5 (n=105,57)-98.6 micrometers (um)Standard Deviation 136.28
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 12 (n=103,50)-121.0 micrometers (um)Standard Deviation 124.67
RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 8 (n=105,51)-113.1 micrometers (um)Standard Deviation 127.11
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 12 (n=103,50)-116.8 micrometers (um)Standard Deviation 137.99
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 8 (n=105,51)-107.7 micrometers (um)Standard Deviation 157.4
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 1 (n=112,59)-14.3 micrometers (um)Standard Deviation 97.36
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 2 (n=112,59)-30.6 micrometers (um)Standard Deviation 102.77
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 3 (n=113,59)-92.2 micrometers (um)Standard Deviation 129.85
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 4 (n=109,57)-95.5 micrometers (um)Standard Deviation 140.68
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 5 (n=105,57)-107.6 micrometers (um)Standard Deviation 142.22
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 6 (n=109,54)-84.1 micrometers (um)Standard Deviation 137.86
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 7 (n=105,52)-112.9 micrometers (um)Standard Deviation 148.13
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 9 (n=105,52)-116.3 micrometers (um)Standard Deviation 146.43
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 10 (n=103,50)-116.6 micrometers (um)Standard Deviation 147.26
Sham With RanibizumabChange From Baseline in Central Subfield Thickness (CSFT) in Study EyeMonth 11 (n=101,49)-123.5 micrometers (um)Standard Deviation 140.65
Secondary

Change From Baseline in Central Subfield Volume (CSFV) in Study Eye

CSFV was assessed OCT. A negative change from baseline indicates improvement.

Time frame: Months 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

Population: The full analysis set (FAS) was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants of the FAS, who had data at baseline and the specific post-baseline time point, were included in the analysis for that time point.

ArmMeasureGroupValue (MEAN)Dispersion
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 1 (n=112,59)-0.296 microliters (ul)Standard Deviation 0.457
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 12 (n=103,50)-0.447 microliters (ul)Standard Deviation 0.4837
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 2 (n=112,59)-0.276 microliters (ul)Standard Deviation 0.5362
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 3 (n=113,59)-0.322 microliters (ul)Standard Deviation 0.5812
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 4 (n=109,57)-0.333 microliters (ul)Standard Deviation 0.5568
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 5 (n=105,57)-0.383 microliters (ul)Standard Deviation 0.5592
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 6 (n=109,54)-0.388 microliters (ul)Standard Deviation 0.5167
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 7 (n=105,52)-0.438 microliters (ul)Standard Deviation 0.5267
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 8 (n=105,51)-0.405 microliters (ul)Standard Deviation 0.5074
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 9 (n=105,52)-0.446 microliters (ul)Standard Deviation 0.6066
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 10 (n=103,50)-0.439 microliters (ul)Standard Deviation 0.6241
RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 11 (n=101,49)-0.406 microliters (ul)Standard Deviation 0.4871
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 10 (n=103,50)-0.433 microliters (ul)Standard Deviation 0.6407
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 6 (n=109,54)-0.344 microliters (ul)Standard Deviation 0.553
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 12 (n=103,50)-0.455 microliters (ul)Standard Deviation 0.591
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 1 (n=112,59)-0.032 microliters (ul)Standard Deviation 0.3969
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 9 (n=105,52)-0.444 microliters (ul)Standard Deviation 0.621
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 2 (n=112,59)-0.104 microliters (ul)Standard Deviation 0.3958
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 7 (n=105,52)-0.438 microliters (ul)Standard Deviation 0.6098
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 3 (n=113,59)-0.348 microliters (ul)Standard Deviation 0.5075
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 11 (n=101,49)-0.459 microliters (ul)Standard Deviation 0.6157
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 4 (n=109,57)-0.378 microliters (ul)Standard Deviation 0.5436
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 8 (n=105,51)-0.421 microliters (ul)Standard Deviation 0.6484
Sham With RanibizumabChange From Baseline in Central Subfield Volume (CSFV) in Study EyeMonth 5 (n=105,57)-0.401 microliters (ul)Standard Deviation 0.5893
Secondary

Number of Participants Requiring Rescue Treatment at Month 1

Rescue treatment with laser photocoagulation or periocular treatment could be administered at Month 1 only if the participant had a visual acuity loss of \> 5 letters due to disease activity from baseline to Month 1.

Time frame: Month 1

Population: The FAS was used for this analysis. The FAS included all randomized participants who received at least one dose of study treatment.

ArmMeasureValue (NUMBER)
RanibizumabNumber of Participants Requiring Rescue Treatment at Month 10 Participants
Sham With RanibizumabNumber of Participants Requiring Rescue Treatment at Month 10 Participants
Secondary

Number of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 Letters

VA measurements (number of letters correctly identified) were performed with the patient in a sitting position using ETDRS-like visual acuity testing charts at a testing distance of 4 meters.

Time frame: Month 2, Month 6 , Month 12

Population: The full analysis set (FAS) was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants of the FAS, who had data at baseline and the specific post-baseline time point, were included in the analysis for that time point.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 10 letters (n=106,50)55 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 15 letters (n=114,59)26 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 10 letters (n=114,59)35 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 5 letters (n=114,59)55 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 1 letter (n=114,59)80 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 15 letters (n=111,55)30 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 10 letters (n=111,55)41 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 5 letters (n=111,55)67 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 1 letters (n=111,55)87 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 15 letters (n=106,50)44 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 5 letters (n=106,50)72 Participants
RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 1 letters (n=106,50)86 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 5 letters (n=106,50)37 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 10 letters (n=106,50)27 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 10 letters (n=111,55)21 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 15 letters (n=114,59)7 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 15 letters (n=106,50)22 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 10 letters (n=114,59)11 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 5 letters (n=111,55)34 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 5 letters (n=114,59)19 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 12, Gain of >= 1 letters (n=106,50)42 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 2, Gain of >= 1 letter (n=114,59)38 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 1 letters (n=111,55)40 Participants
Sham With RanibizumabNumber of Participants With ≥ 1, ≥ 5, ≥ 10 and ≥ 15 Letters Gain or Reaching 84 LettersMonth 6, Gain of >= 15 letters (n=111,55)15 Participants
Secondary

Number of Participants With > 1, > 5, > 10 and > 15 Letters Loss

VA measurements (number of letters correctly identified) were performed with the patient in a sitting position using ETDRS-like visual acuity testing charts at a testing distance of 4 meters.

Time frame: Month 2, Month 6, Month 12

Population: The full analysis set (FAS) was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants of the FAS, who had data at baseline and the specific post-baseline time point, were included in the analysis for that time point.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 1 letter (n=106,50)10 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >1 letter (n=114,59)17 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >5 letters (n=114,59)8 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >10 letters (n=114,59)2 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >15 letters (n=114,59)0 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >1 letter (n=111,55)14 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >5 letters (n=111,55)5 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >10 letters (n=111,55)3 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >15 letters (n=111,55)1 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 5 letters (n=106,50)6 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 10 letters (n=106,50)2 Participants
RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 15 letters (n=106,50)1 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 10 letters (n=106,50)3 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 1 letter (n=106,50)5 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >5 letters (n=111,55)7 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >1 letter (n=114,59)9 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 5 letters (n=106,50)3 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >5 letters (n=114,59)4 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >10 letters (n=111,55)4 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >10 letters (n=114,59)3 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 12, Loss of >= 15 letters (n=106,50)2 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 2, Loss of >15 letters (n=114,59)0 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >15 letters (n=111,55)1 Participants
Sham With RanibizumabNumber of Participants With > 1, > 5, > 10 and > 15 Letters LossMonth 6, Loss of >1 letter (n=111,55)12 Participants
Secondary

Number of Participants With Presence of Active Macular Edema (ME) Leakage

The presence of active ME leakage was assessed by fluorescein angiography (FA).

Time frame: Month 2

Population: The FAS was used this analysis. The FAS included randomized participants who received at least one dose of study treatment.

ArmMeasureValue (NUMBER)
RanibizumabNumber of Participants With Presence of Active Macular Edema (ME) Leakage96 Participants
Sham With RanibizumabNumber of Participants With Presence of Active Macular Edema (ME) Leakage53 Participants
Secondary

Number of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to Baseline

The presence of intra-retinal fluid was assessed by OCT.

Time frame: Month 2, Month 6, Month 12

Population: The FAS was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants (n), with values 'Absent' or 'Definite' for both the baseline and corresponding post-baseline time point, were included in the analysis.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 2, Absent (n=112,59)98 Participants
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 2, Definite (n=112,59)14 Participants
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 6, Absent (n=109,55)97 Participants
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 6, Definite (n=109,55)12 Participants
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 12, Absent (n=103,50)78 Participants
RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 12, Definite (n=103,50)25 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 12, Absent (n=103,50)39 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 2, Absent (n=112,59)46 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 6, Definite (n=109,55)12 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 2, Definite (n=112,59)13 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 12, Definite (n=103,50)11 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Intra-retinal Fluid in Study Eye Compared to BaselineMonth 6, Absent (n=109,55)43 Participants
Secondary

Number of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to Baseline

The presence of subretinal fluid was assessed by OCT.

Time frame: Month 2, Month 6, Month 12

Population: The FAS was considered for the analysis. The FAS included all randomized participants who received at least one dose of study treatment. Only participants (n), with values 'Absent' or 'Definite' for both the baseline and corresponding post-baseline time point, were included in the analysis.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 12, Absent (n=104,50)77 Participants
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 2, Absent (n=113,59)77 Participants
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 6, Absent (n=109,55)75 Participants
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 2, Definite (n=110,55)36 Participants
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 6, Definite (n=109,55)35 Participants
RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 12, Definite (n=103,50)27 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 6, Definite (n=109,55)20 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 6, Absent (n=109,55)35 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 12, Absent (n=104,50)37 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 12, Definite (n=103,50)13 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 2, Absent (n=113,59)33 Participants
Sham With RanibizumabNumber of Participants With Presence or Absence of Subretinal Fluid in Study Eye Compared to BaselineMonth 2, Definite (n=110,55)26 Participants
Secondary

Number of Participants With Ranibizumab Treatments

The number of participants administered study treatments, according to treatment frequency, was assessed.

Time frame: Month 12

Population: The safety set was used for this analysis. The safety set included randomized participants who received at least one dose of study treatment. Two participants from the sham group were included in the ranibizumab group based on the actual treatment received.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 1220 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 1012 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 314 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 517 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 00 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 113 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 25 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 813 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 67 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 116 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 76 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 93 Participants
RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 43 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 16 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 23 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 57 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 80 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 120 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 00 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 37 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 45 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 611 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 70 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 96 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 1011 Participants
Sham With RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 110 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 110 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 60 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 80 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 100 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 70 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 50 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 02 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 120 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 10 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 30 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 90 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 20 Participants
Sham Without RanibizumabNumber of Participants With Ranibizumab TreatmentsFrequency of injections = 40 Participants
Secondary

Number of Participants With Re-treatments

The number of participants, administered re-treatments according to treatment frequency, was assessed. Re-treatment was defined as an administration of study medication following at least one non-missed visit where treatment was not administered in the study eye. Up to Month 12, the maximum number of retreatments was 5.

Time frame: Month 6, month 12

Population: The safety set was used for this analysis. The safety set included randomized participants who received at least one dose of study treatment. Two participants from the sham group were included in the ranibizumab group based on the actual treatment received.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 121 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 313 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 224 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 134 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 53 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 45 Participants
RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 215 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 23 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 115 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 112 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 27 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 35 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 45 Participants
Sham With RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 50 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 30 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 10 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 50 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 40 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 20 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 12, Frequency of re-treatment = 10 Participants
Sham Without RanibizumabNumber of Participants With Re-treatmentsMonth 6, Frequency of re-treatment = 20 Participants
Secondary

Number of Primary Reasons for Decision to Treat by Investigator

The total number of primary reasons for decisions to treat was assessed. A single participant could have had multiple primary reasons for treatment.

Time frame: 12 months

Population: The safety set was used for this analysis. The safety set included randomized participants who received at least one dose of study treatment. Two participants from the sham group were included in the ranibizumab group based on the actual treatment received.

ArmMeasureGroupValue (NUMBER)
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorVision impairment38 Number of primary reasons
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorOCT abnormality637 Number of primary reasons
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorFA abnormality11 Number of primary reasons
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorColor fundus photography abnormality0 Number of primary reasons
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorClinical abnormality3 Number of primary reasons
RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorWithout documentation (missing reason)0 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorWithout documentation (missing reason)0 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorVision impairment22 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorColor fundus photography abnormality0 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorClinical abnormality0 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorOCT abnormality345 Number of primary reasons
Sham With RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorFA abnormality5 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorOCT abnormality1 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorFA abnormality0 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorWithout documentation (missing reason)0 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorColor fundus photography abnormality0 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorVision impairment0 Number of primary reasons
Sham Without RanibizumabNumber of Primary Reasons for Decision to Treat by InvestigatorClinical abnormality0 Number of primary reasons

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026