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Safety and Efficacy of Faricimab in Patients With NPDR (MAGIC)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05681884
Recruitment Status : Recruiting
First Posted : January 12, 2023
Last Update Posted : October 23, 2023
Sponsor:
Collaborator:
Genentech, Inc.
Information provided by (Responsible Party):
Greater Houston Retina Research

Brief Summary:
The purpose of this Phase 2 study is comprised of two groups to evaluate the safety, tolerability, and efficacy of faricimab in patients with Non-Proliferative Diabetic Retinopathy.

Condition or disease Intervention/treatment Phase
Non-Proliferative Diabetic Retinopathy Drug: Faricimab Phase 2

Detailed Description:

Group 1: Subjects will be administered intravitreal faricimab every 4 through week 48 and then will be receive faricimab every 16 weeks with an end of study visit at week 96. At any visit after Week 48, if rescue criteria are met, faricimab 6mg will be given every 4 weeks and the subject will continue dosing through the end of the trial.

Group 2: Subjects are seen and observed every 16 weeks. Starting at Week 48, subjects will be administered intravitreal faricimab every 4 weeks from week 48 to week 92 with an end of study visit at week 96. At any visit before Week 48, if rescue criteria are met, faricimab will be given every 4 weeks and the subject will continue dosing through the end of the trial.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 150 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Randomized during the enrollment phase of the study in a 1:1 ratio to one of two treatment arms.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Faricimab for Retinal Non-Perfusion Associated With Non-Proliferative Diabetic Retinopathy: The MAGIC Phase 2, Multi-Center, Open-Label, Randomized Controlled Trial
Actual Study Start Date : May 16, 2023
Estimated Primary Completion Date : March 20, 2026
Estimated Study Completion Date : April 13, 2026

Resource links provided by the National Library of Medicine

Drug Information available for: Faricimab

Arm Intervention/treatment
Experimental: Group 1

Subjects will be administered intravitreal faricimab 6 mg every 4 weeks (defined as every 28 days + 7 days and at least 21 days between injections) through week 48. Starting at Week 48, subjects will be treated every 16 weeks (weeks 48, 64 & 80) with an end of study visit at week 96.

Rescue: At any visit after Week 48, if rescue criteria are met, faricimab 6mg will be given every 4 weeks and the subject will continue dosing through the end of the trial.

Drug: Faricimab
Faricimab is a humanized bispecific antibody binding to human Ang-2 and VEGF. For Phase III studies, the Ro 686-7461 drug product is provided in single-dose 2-mL glass vials (6 mg/0.05 mL) with L-histidine/acetate buffered solution (approximately pH 5.5) containing sodium chloride, sucrose, L-methionine, polysorbate 20, and water for injection.

Experimental: Group 2

Subjects are seen and observed every 16 weeks. Starting at Week 48, subjects will be administered intravitreal faricimab 6 mg every 4 weeks from week 48 to week 92, (defined as every 28 days ± 7 days and at least 21 days between injections) with an end of study visit at week 96.

Rescue: At any visit before Week 48, if rescue criteria are met, faricimab 6mg will be given every 4 weeks and the subject will continue dosing through the end of the trial.

Drug: Faricimab
Faricimab is a humanized bispecific antibody binding to human Ang-2 and VEGF. For Phase III studies, the Ro 686-7461 drug product is provided in single-dose 2-mL glass vials (6 mg/0.05 mL) with L-histidine/acetate buffered solution (approximately pH 5.5) containing sodium chloride, sucrose, L-methionine, polysorbate 20, and water for injection.




Primary Outcome Measures :
  1. Primary Objective [ Time Frame: 48 weeks ]
    Analyze the change in the area of retinal non-perfusion (RNP) within the macula over 48 weeks using ultrawide-field fluorescein angiography (UWFA) and optical coherence tomography-angiography (OCT -A) within eyes that have NPDR.

  2. Primary Objective [ Time Frame: 48 weeks ]
    Analyze the change in the area of retinal non-perfusion (RNP) outside the macula over 48 weeks using ultrawide-field fluorescein angiography (UWFA) and optical coherence tomography-angiography (OCT -A) within eyes that have NPDR.


Secondary Outcome Measures :
  1. Change in area of RNP [ Time Frame: Baseline through week 96 ]
    Change in area of RNP, as assessed by a central reading center; linear regression of change in area of RNP (dependent variable) between the monthly faricimab and observation groups, adjusted for age, sex, and disease severity as defined by Baseline ETDRS

  2. Change in area of RNP within the macula [ Time Frame: Baseline through week 48 and from baseline through week 96 ]
    Change in area of RNP within the macula, as assessed by ultrawide-field fluorescein; linear regression of change in area of RNP (dependent variable) between the monthly faricimab and observation groups, adjusted for age, sex, and disease severity as defined by Baseline ETDRS

  3. Change in area of RNP outside of the macula [ Time Frame: Baseline through week 48 and from baseline through week 96 ]
    Change in area of RNP outside of the macula, as assessed by ultrawide-field fluorescein from baseline to week 96; linear regression of change in area of RNP (dependent variable) between the monthly faricimab and observation groups, adjusted for age, sex, and disease severity as defined by Baseline ETDRS

  4. Percentage of subjects with disease [ Time Frame: Baseline through week 96 ]
    Percentage of subjects with neovascularization and/or vitreous hemorrhage and/or DME

  5. Mean change in ETDRS [ Time Frame: Baseline through week 48 and from baseline through week 96 ]
    Mean change in ETDRS BCVA

  6. Mean change in CST [ Time Frame: Baseline through week 48 and from baseline through week 96 ]
    Mean change in CST



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • - Provide signed IRB-approved informed consent form (ICF) prior to any study-specific procedures
  • Willing and able to comply with clinic visits and study-related procedures and likely to return for all study visits, in the investigator's judgement
  • Men or women > 18 years of age at the time of signing the Informed Consent Form
  • Diagnosis of diabetes mellitus (type 1 or type 2)
  • For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 3 months after the final dose of study treatment. A woman is considered to be of childbearing potential if she is post-menarcheal, has not reached a post-menopausal state (>12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus). The definition of childbearing potential may be adapted for alignment with local guidelines or requirements. Examples of acceptable contraceptive methods include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.

Contraception methods that do not result in a failure rate of < 1% per year such as male or female condom with or without spermicide; and cap, diaphragm, or sponge with spermicide are not acceptable.

The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the subject. If a subject is usually not sexually active but becomes active, they, with their partner, must comply with the contraceptive requirements of the study.

Ocular inclusion criteria for study eye:

Subjects must meet the following ocular inclusion criteria for the study eye for entry into the study:

  • ETDRS BCVA > 20/400 in the study eye
  • Non-proliferative diabetic retinopathy, as confirmed by the site investigator
  • Substantial non-perfusion (defined as greater than 5 disc areas on Wide-Field Fluorescein Angiograph (WFFA)), as assessed by site investigator

Exclusion Criteria:

  • Any known hypersensitivity to any of the components in the faricimab injection
  • Any known hypersensitivity to any contrast media (e.g., fluorescein), dilating eye drops, disinfectants (e.g., iodine), or any of the anesthetics and antimicrobial preparations used by the site during the study
  • Active cancer within the past 12 months prior to Screen/Baseline except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, and prostate cancer with a Gleason score of ≤6 and a stable prostate-specific antigen for >12 months
  • Stroke (cerebral vascular accident) or myocardial infarction within 6 months prior to Screen/Baseline
  • Pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of faricimab

    o Women of childbearing potential must have a negative urine pregnancy test at the Screen/Baseline visit for both Group 1 and Group 2. Women of childbearing potential must also have a negative urine pregnancy test on any visit where they will receive treatment with IP or rescue medication. Urine pregnancy tests must be completed prior to the administration of IP/rescue medication and prior to FA being performed.

  • Participation in an investigational trial that involves treatment with any drug or device (with the exception of vitamins or minerals) within 3 months (or 5 half-lives, whichever is longer) prior to Screen/Baseline, or during the course of this study
  • Any prior or concomitant systemic anti-VEGF treatment within 4 months prior to Screen/Baseline
  • Any use of any prohibited therapies during times of prohibition.

Ocular exclusion criteria for study eye:

Subjects who meet any of the following exclusion criteria for the study eye will be excluded from study entry:

  • Any history of treatment with anti-VEGF or any periocular or IVT corticosteroids in the study eye within 4 months prior to Screen/Baseline
  • SD-OCT central subfield thickness (CST) measurement > 325 µm, in the study eye due to DME.
  • Evidence of infectious ocular infection, in the study eye at Screen/Baseline
  • Any pan-retinal photocoagulation (PRP) treatment received in the study eye prior to Screen/Baseline
  • Retinal vein occlusion in the study eye
  • Cystoid macular edema not attributed to diabetes (instead caused by epiretinal membrane, macular telangiectasia, Coats disease, and inherited retinal diseases) in the study eye
  • Current vitreous hemorrhage obscuring imaging in the study and/or dilated indirect examination
  • Any intraocular surgery (e.g., cataract surgery) within 4 weeks prior to Screen/Baseline in the study eye
  • Active intraocular inflammation including scleritis at screening/baseline

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05681884


Contacts
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Contact: Cassie Cone (281) 773-1442 cassandra.cone@retinaconsultantstexas.com
Contact: Patrice Brock 888-352-0555 pbrock@ctrgresearch.com

Locations
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United States, California
California Retina Consultants Recruiting
Bakersfield, California, United States, 93309
Contact: Luis Lopez    661-325-4393    luis.lopez@californiaretina.com   
Principal Investigator: Dante Pieramici, MD         
Retinal Consultants Medical Group Recruiting
Modesto, California, United States, 95356
Contact: Diana Heredia    916-339-2693    herediad@retinalmd.com   
Principal Investigator: Margaret Chang, MD         
United States, Florida
Florida Retina Institute Withdrawn
Jacksonville, Florida, United States, 32216
Florida Retina Institute Recruiting
Orlando, Florida, United States, 32806
Contact: Martha Haddox    407-849-9621    marthah@floridaretinainstitute.com   
Principal Investigator: Matthew Cunningham, MD         
Retina Group of Florida Recruiting
Sarasota, Florida, United States, 34233
Contact: Courtney Smith    941-924-0303    CSmith@retinasarasota.com   
Principal Investigator: Jesse McCann, MD         
United States, Minnesota
Retina Consultants of Minnesota St. Louis Park Recruiting
Saint Louis Park, Minnesota, United States, 55416
Contact: Mallorie Schieck    952-259-6264    mschieck@retinamn.com   
Principal Investigator: Abdhish Bhavsar, MD         
United States, Mississippi
Mississippi Retina Associates Recruiting
Jackson, Mississippi, United States, 39202
Contact: Anne Britt    601-948-0761    abritt@msretina.com   
Principal Investigator: Michael Borne, MD         
United States, New York
Long Island Vitreoretinal Consultants Recruiting
Westbury, New York, United States, 11590
Contact: Kristen D'Amore    516-466-0390    kdamore@vrcny.com   
Principal Investigator: Philip Ferrone, MD         
United States, North Carolina
North Carolina Retina Associates Recruiting
Wake Forest, North Carolina, United States, 27587
Contact: Amanda Smith    919-435-9382    asmith@ncretina.com   
Principal Investigator: John Thordsen, MD         
United States, South Carolina
Charleston Neuroscience Institute Recruiting
Ladson, South Carolina, United States, 29456
Contact: Carlos Ortiz    843-763-4466    c.ortiz@retinacharleston.com   
Principal Investigator: Virgil Alfaro, MD         
Palmetto Retina Center Recruiting
West Columbia, South Carolina, United States, 29169
Contact: Shan Woody    803-931-0077    swoody@palmettoretina.com   
Principal Investigator: Stephen Hypes, MD         
United States, Tennessee
Tennessee Retina, PC Withdrawn
Nashville, Tennessee, United States, 37203
United States, Texas
Austin Retina Associates Recruiting
Austin, Texas, United States, 78705
Contact: Jenae Goode    512-451-0103    jgoode@austinretina.com   
Principal Investigator: Robert Wong, MD         
Retina Consultants of Texas Recruiting
Beaumont, Texas, United States, 77707
Contact: Jessica Hamiton    800-833-5921    jessica.hamilton@retinaconsultantstexas.com   
Principal Investigator: Will Pearce, MD         
Retina Consultants of Texas Recruiting
Bellaire, Texas, United States, 77401
Contact: Allison Stroh    800-833-5921    allison.stroh@retinaconsultantstexas.com   
Principal Investigator: David Brown, MD         
Retina Consultants of Texas Recruiting
Katy, Texas, United States, 77494
Contact: Kourtney Storey    800-833-5921    Kourtney.Storey@retinaconsultantstexas.com   
Principal Investigator: Effie Rahman, MD         
Retina Consultants of Texas Recruiting
San Antonio, Texas, United States, 78240
Contact: Lydia Adams    800-833-5921    lydia.adams@retinaconsultantstexas.com   
Principal Investigator: Sarah Holy, MD         
Retina Consultants of Texas Recruiting
The Woodlands, Texas, United States, 77384
Contact: Cassie Cone    800-833-5921    ccone@retinaconsultantsofamerica.com   
Principal Investigator: Charles Wykoff, MD         
United States, Utah
Retina Associates of Utah Withdrawn
Salt Lake City, Utah, United States, 84107
United States, Washington
Retina Center NW, PLLC Withdrawn
Silverdale, Washington, United States, 98383
Sponsors and Collaborators
Greater Houston Retina Research
Genentech, Inc.
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Responsible Party: Greater Houston Retina Research
ClinicalTrials.gov Identifier: NCT05681884    
Other Study ID Numbers: ML43601
164104 ( Other Identifier: FDA (IND) )
First Posted: January 12, 2023    Key Record Dates
Last Update Posted: October 23, 2023
Last Verified: October 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Retinal Diseases
Diabetic Retinopathy
Eye Diseases
Diabetic Angiopathies
Vascular Diseases
Cardiovascular Diseases
Diabetes Complications
Diabetes Mellitus
Endocrine System Diseases
Faricimab
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Antineoplastic Agents