Combination Therapy for Neovascular Age Related Macular Degeneration

Condition(s) targeted: Macular Degeneration

Intervention: intravitreal bevacizumab and triamcinolone acetonide (Drug)

Phase: N/A

Status: Recruiting

Sponsored by: Yonsei University

Official(s) and/or principal investigator(s):
Hyoung Jun Koh, Principal Investigator, Affiliation: YUMC

Overall contact:
Hyoung Jun Koh, Phone: 82-2-2228-3570, Email: hjkoh@yumc.yonsei.ac.kr

Exudative age related macular degeneration (ARMD) is most common cause of blindness in old population. It is clear that no single therapy addresses the multifactorial pathogenesis of the disease. Recently, studies of intravitreal anti-VEGF therapies such as pegaptanib and bevacizumab have shown the beneficial effect in visual acuity in the treatment of neovascular ARMD. However, the problem with these intravitreal injections is that therapy must be frequently administered for a prolonged but unknown period of time to maintain the benefit. Prolonged, frequent injections may be associated with additional safety risk,lack of convenience and high treatment cost.

Intravitreal steroid injection with anti-inflammatory properties limits any further VEGF upregulation initiated by the inflammation which has been known as one of the pathogenesis and causes of recurrence after the treatment of the neovascular ARMD.

The researchers hypothesize that the combined treatment of intravitreal bevacizumab and triamcinolone acetonide may decrease the recurrence rate after the treatment and obviate the frequent intravitreal injections in the treatment of neovascular ARMD.

In this study, the researchers will compare the recurrence rate of combined treatment of intravitreal bevacizumab and triamcinolone acetonide versus intravitreal bevacizumab alone in the treatment of neovascular ARMD.

Official title: Intravitreal Bevacizumab Combined With Intravitreal Triamcinolone Acetonide Injection Versus Intravitreal Bevacizumab for Age Related Macular Degeneration

Study design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study

Primary outcome:

recurrence rate

best corrected visual acuity

Secondary outcome: complication rate

Minimum age: 50 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Neovascular ARMD confirmed with 90+ noncontact lens biomicroscopy, fluorescein

angiography, ocular coherence tomography

Exclusion Criteria:

- Intractable systemic hypertension

- Recent myocardial infarct within 6 months at enrollment

- Recent cerebrovascular attack within 6 months

Hyoung Jun Koh, Phone: 82-2-2228-3570, Email: hjkoh@yumc.yonsei.ac.kr

Department of Ophthalmology, Yonsei University College of Medicine, Seoul 120-752, Korea, Republic of; Recruiting
Hyoung Jun Koh, Principal Investigator

Related publications:

Costa RA, Jorge R, Calucci D, Melo LA Jr, Cardillo JA, Scott IU. Intravitreal bevacizumab (Avastin) in combination with verteporfin photodynamic therapy for choroidal neovascularization associated with age-related macular degeneration (IBeVe Study). Graefes Arch Clin Exp Ophthalmol. 2007 Feb 28; [Epub ahead of print]

Augustin AJ, Puls S, Offermann I. Triple therapy for choroidal neovascularization due to age-related macular degeneration: verteporfin PDT, bevacizumab, and dexamethasone. Retina. 2007 Feb;27(2):133-40.

Dhalla MS, Shah GK, Blinder KJ, Ryan EH Jr, Mittra RA, Tewari A. Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration. Retina. 2006 Nov-Dec;26(9):988-93.

Aisenbrey S, Ziemssen F, Volker M, Gelisken F, Szurman P, Jaissle G, Grisanti S, Bartz-Schmidt KU. Intravitreal bevacizumab (Avastin) for occult choroidal neovascularization in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2006 Dec 21; [Epub ahead of print]

Gomi F, Nishida K, Oshima Y, Sakaguchi H, Sawa M, Tsujikawa M, Tano Y. Intravitreal bevacizumab for idiopathic choroidal neovascularization after previous injection with posterior subtenon triamcinolone. Am J Ophthalmol. 2007 Mar;143(3):507-509. Epub 2006 Dec 8.

Jonas JB, Libondi T, Ihloff AK, Harder B, Kreissig I, Schlichtenbrede F, Sauder G, Spandau UH. Visual acuity change after intravitreal bevacizumab for exudative age-related macular degeneration in relation to subfoveal membrane type. Acta Ophthalmol Scand. 2007 Feb 26; [Epub ahead of print]

Starting date: March 2007
Ending date: November 2007
Last updated: January 28, 2008