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Assessment of Patients Treated With JETREA® for Vitreomacular Traction

Assessment of Anatomical and Functional Outcomes in Patients Treated With Ocriplasmin for Vitreomacular Traction/Symptomatic Vitreomacular Adhesion (VMT/sVMA)

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02035748
Enrollment
628
Registered
2014-01-14
Start date
2014-04-30
Completion date
2015-09-30
Last updated
2016-10-12

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

Conditions

Vitreomacular Adhesion, Vitreomacular Traction

Keywords

Vitreomacular traction, Symptomatic vitreomacular adhesion, Ocriplasmin, JETREA

Brief summary

The purpose of this study is to observe the anatomical and functional outcomes of ocriplasmin (JETREA®) over a 6-month follow-up period.

Detailed description

After receiving a single intravitreal injection as per country's product label (Day 0), subjects were followed for a 6-month period (Day 180).

Interventions

0.5 mg/0.2 mL solution for injection

Sponsors

Alcon Research
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Diagnosis of vitreomacular traction/symptomatic vitreomacular adhesion (VMT/sVMA), with evidence of focal VMA visible on Spectral Domain Optical Coherence Tomography (SD-OCT). * Read, sign, and date an Institutional Review Board/Ethics Committee-approved informed consent form. * Other protocol-defined inclusion criteria may apply.

Exclusion criteria

* Women of childbearing potential if pregnant, breastfeeding, or not in agreement to use adequate birth control methods to prevent pregnancy throughout the study. * Hypersensitivity to ocriplasmin or any of the JETREA® excipients. * Active or suspected intraocular or periocular infection. * Presence of Epiretinal Membrane (ERM) over the macula at baseline. * Broad VMT/VMA \>1500 microns at baseline. * History of vitrectomy in the study eye. * History of laser photocoagulation to the macula in the study eye. * Any relevant concomitant ocular condition that, in the opinion of the investigator, could be expected to worsen or require surgical intervention during the study period. * Macular hole of \>400µm diameter in the study eye. * High myopia in the study eye. * Pseudo-exfoliation, Marfan's syndrome, phacodonesis or any other finding in the Investigator's opinion suggesting lens/zonular instability. * Aphakia. * History of retinal detachment. * Diabetic retinopathy, ischaemic retinopathies, retinal vein occlusions. * Recent ocular surgery or ocular injection. * Vitreous hemorrhage. * Exudative age-related macular degeneration (AMD). * Therapy with another investigational agent within 30 days prior to Visit 1. * Active, simultaneous enrollment in another ophthalmology clinical study. * Other protocol-defined

Design outcomes

Primary

MeasureTime frameDescription
Proportion of Subjects With Nonsurgical Resolution of Focal Vitreomacular Traction (VMT/VMA) at Day 28, as Determined by Central Reading Center (CRC) Spectral Domain Optical Coherence Tomography (SD-OCT) EvaluationBaseline, Day 28Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 28. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 28. One eye (study eye) contributed to the analysis.

Secondary

MeasureTime frameDescription
Nonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at DistanceBaseline (Day 0), Day 28, Day 90, Day 180BCVA (with spectacles or other visual corrective devices) was assessed using Early Treatment Diabetic Retinopathy Study (ETDRS) testing at 4 meters. The charts contain 14 rows of letters. BCVA was calculated as the number of letters read correctly and improvement defined as an increase (gain) in letters read from the baseline assessment. One eye (study eye) contributed to the analysis.
Proportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at BaselineDay 28, Day 90, Day 180The closure of macular hole (a full thickness defect of the retinal tissue involving the anatomical fovea) is defined as a flattened and reattached hole rim along the whole circumference of macular hole. Closure was determined by SD-OCT evaluation and the percentage of subjects tabulated. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who had macular hole at baseline and OCT value at each specific visit. One eye (study eye) contributed to the analysis.
Proportion of Subjects With Nonsurgical Resolution of VMT/sVMABaseline, Day 90, Day 180Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 90 and Day 180. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 90/Day 180. One eye (study eye) contributed to the analysis.
Proportion of Subjects Experiencing Pars Plana Vitrectomy (PPV) at Day 180Day 180Pars plana vitrectomy (the surgical removal of vitreous gel from the eye) was captured in Concomitant Ocular Procedures. Proportion of subjects is reported as a percentage. One eye (study eye) contributed to the analysis.
Mean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)Baseline (Day 0), Day 28, Day 180Nonsurgical change in central foveal thickness (CFT values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy) was determined by subtracting the measurements in subretinal fluid and retinal pigment epithelium (RPE) elevations and/or SHRM (subretinal hyper-reflective material, such as choroidal neovascularization (CNV)) from the value in total retinal measurement. A lower CFT indicates improvement. One eye (study eye) contributed to the analysis.

Participant flow

Recruitment details

Subjects were recruited from 87 study centers located in Europe and Canada (10 Italy, 5 Netherlands, 4 Poland, 4 Portugal, 12 Spain, 15 United Kingdom, 3 Belgium, 12 France, 9 Germany, 5 Hungary, and 8 Canada).

Pre-assignment details

Of the 628 enrolled, 160 subjects were exited prior to initiation of treatment. This reporting group includes all treated subjects (468).

Participants by arm

ArmCount
Ocriplasmin
Ocriplasmin 0.125 mg in a 0.1 mL volume administered as a single dose by intravitreal injection
468
Total468

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event5
Overall StudyDeath3
Overall StudyLost to Follow-up2
Overall StudyPhysician Decision3
Overall StudyProgressive Disease1
Overall StudyWithdrawal by Subject6

Baseline characteristics

CharacteristicOcriplasmin
Age, Continuous71.7 years
STANDARD_DEVIATION 8.3
Sex: Female, Male
Female
345 Participants
Sex: Female, Male
Male
123 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
1 / 628247 / 468
serious
Total, serious adverse events
1 / 62846 / 468

Outcome results

Primary

Proportion of Subjects With Nonsurgical Resolution of Focal Vitreomacular Traction (VMT/VMA) at Day 28, as Determined by Central Reading Center (CRC) Spectral Domain Optical Coherence Tomography (SD-OCT) Evaluation

Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 28. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 28. One eye (study eye) contributed to the analysis.

Time frame: Baseline, Day 28

Population: This analysis population includes all subjects who received treatment with IP and had at least one post-treatment measurement of SD-OCT (FAS). Missing data imputed using the last observation carried forward (LOCF) method. Subjects who had vitrectomy after VMT/sVMA resolution were considered as 'no resolution' after timepoint of vitrectomy.

ArmMeasureValue (NUMBER)
OcriplasminProportion of Subjects With Nonsurgical Resolution of Focal Vitreomacular Traction (VMT/VMA) at Day 28, as Determined by Central Reading Center (CRC) Spectral Domain Optical Coherence Tomography (SD-OCT) Evaluation47.4 percentage of subjects
Secondary

Mean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)

Nonsurgical change in central foveal thickness (CFT values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy) was determined by subtracting the measurements in subretinal fluid and retinal pigment epithelium (RPE) elevations and/or SHRM (subretinal hyper-reflective material, such as choroidal neovascularization (CNV)) from the value in total retinal measurement. A lower CFT indicates improvement. One eye (study eye) contributed to the analysis.

Time frame: Baseline (Day 0), Day 28, Day 180

Population: Full Analysis Set. Missing data is imputed using LOCF. CFT values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy.

ArmMeasureGroupValue (MEAN)Dispersion
OcriplasminMean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)Baseline (Day 0), n=466276.1 micrometersStandard Deviation 166.4
OcriplasminMean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)Change from baseline at Day 28, n=465-43.2 micrometersStandard Deviation 113.47
OcriplasminMean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)Change from baseline at Day 180, n=466-45.4 micrometersStandard Deviation 131.84
Secondary

Nonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at Distance

BCVA (with spectacles or other visual corrective devices) was assessed using Early Treatment Diabetic Retinopathy Study (ETDRS) testing at 4 meters. The charts contain 14 rows of letters. BCVA was calculated as the number of letters read correctly and improvement defined as an increase (gain) in letters read from the baseline assessment. One eye (study eye) contributed to the analysis.

Time frame: Baseline (Day 0), Day 28, Day 90, Day 180

Population: Full Analysis Set. Missing data imputed using LOCF. BCVA values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy.

ArmMeasureGroupValue (MEAN)Dispersion
OcriplasminNonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at DistanceChange from baseline at Day 281.7 lettersStandard Deviation 6.7
OcriplasminNonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at DistanceChange from baseline at Day 903.0 lettersStandard Deviation 7.07
OcriplasminNonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at DistanceChange from baseline at Day 1803.5 lettersStandard Deviation 7.77
Secondary

Proportion of Subjects Experiencing Pars Plana Vitrectomy (PPV) at Day 180

Pars plana vitrectomy (the surgical removal of vitreous gel from the eye) was captured in Concomitant Ocular Procedures. Proportion of subjects is reported as a percentage. One eye (study eye) contributed to the analysis.

Time frame: Day 180

Population: Full Analysis Set

ArmMeasureValue (NUMBER)
OcriplasminProportion of Subjects Experiencing Pars Plana Vitrectomy (PPV) at Day 18012.0 percentage of subjects
Secondary

Proportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at Baseline

The closure of macular hole (a full thickness defect of the retinal tissue involving the anatomical fovea) is defined as a flattened and reattached hole rim along the whole circumference of macular hole. Closure was determined by SD-OCT evaluation and the percentage of subjects tabulated. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who had macular hole at baseline and OCT value at each specific visit. One eye (study eye) contributed to the analysis.

Time frame: Day 28, Day 90, Day 180

Population: Full Analysis Set. Missing data imputed using LOCF. Subjects who had vitrectomy after MH closure were considered as 'no MH closure' after the timepoint of vitrectomy.

ArmMeasureGroupValue (NUMBER)
OcriplasminProportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at BaselineDay 2839.5 percentage of subjects
OcriplasminProportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at BaselineDay 9040.7 percentage of subjects
OcriplasminProportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at BaselineDay 18041.9 percentage of subjects
Secondary

Proportion of Subjects With Nonsurgical Resolution of VMT/sVMA

Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 90 and Day 180. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 90/Day 180. One eye (study eye) contributed to the analysis.

Time frame: Baseline, Day 90, Day 180

Population: Full Analysis Set. Missing data imputed using LOCF. Subjects who had vitrectomy after VMT/sVMA resolution were considered as 'no resolution' after the timepoint of vitrectomy.

ArmMeasureGroupValue (NUMBER)
OcriplasminProportion of Subjects With Nonsurgical Resolution of VMT/sVMADay 9047.9 percentage of subjects
OcriplasminProportion of Subjects With Nonsurgical Resolution of VMT/sVMADay 18049.4 percentage of subjects

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