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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03683251
Registration number
NCT03683251
Ethics application status
Date submitted
18/09/2018
Date registered
25/09/2018
Date last updated
6/10/2025
Titles & IDs
Public title
Extension Study for the Port Delivery System With Ranibizumab (Portal)
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Scientific title
A Multicenter, Open-Label Extension Study to Evaluate the Long-Term Safety and Tolerability of the Port Delivery System With Ranibizumab in Patients With Neovascular Age-Related Macular Degeneration (Portal)
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Secondary ID [1]
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2020-004427-16
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Secondary ID [2]
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GR40549
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Universal Trial Number (UTN)
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Trial acronym
Portal
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Neovascular Age-Related Macular Degeneration
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - PDS Implant with Ranibizumab 100 mg/mL
Experimental: PDS Implant Cohort 1 (US only) - Participants with PDS implant from Study GX28228 treated with refill-exchanges of 100 mg/mL ranibizumab Q24W. Participants will switch to an every 12 weeks (Q12W) visit schedule from Week 168 to Week 240.
Eligible participants from Study GX28228 will be enrolled upon completion of their final visit.
Experimental: PDS Implant Cohort 2 (US only) - Participants with PDS implant from Study GR40548 treated with refill-exchanges of 100 mg/mL ranibizumab Q24W. Participants will switch to an every 12 weeks (Q12W) visit schedule from Week 144 to Week 240.
Eligible participants from Study GR40548 will be enrolled upon completion of their final visit.
Experimental: PDS Implant Cohort 3 (US only) - Participants in the intravitreal ranibizumab arm of Study GX28228 who will receive the PDS implant upon study entry and refill-exchanges of 100 mg/mL ranibizumab Q24W. Participants will switch to an every 12 weeks (Q12W) visit schedule from Week 168 to Week 240.
Eligible participants from Study GX28228 will be enrolled upon completion of their final visit.
Experimental: PDS Implant Cohort 4 (US only) - Participants in the intravitreal ranibizumab arm of Study GR40548 who will receive the PDS implant upon study entry and refill-exchanges of 100 mg/mL ranibizumab Q24W. Participants will switch to an every 12 weeks (Q12W) visit schedule from Week 144 to Week 240.
Eligible participants from Study GR40548 will be enrolled upon completion of their final visit.
Experimental: PDS Implant Cohort 5 (ex-US only) - Participants from Study WR42221 who completed Week 24 but were not eligible to be randomized within WR42221 and who will be treated with refill-exchanges of ranibizumab 100 mg/mL Q24W. Participants will be in the study for a minimum of 144 weeks and may continue after Week 144 until the PDS has received Health Authority approval (or non-approval) in their respective country and/or until the decision to close the study has been made by the sponsor.
Experimental: PDS Implant Cohort 6 (ex-US only) - Participants from Study WR42221 randomized to the Q24W arm, who will continue to be treated with refill-exchanges of ranibizumab 100 mg/mL Q24W. Participants will be in the study for a minimum of 144 weeks and may continue after Week 144 until the PDS has received Health Authority approval (or non-approval) in their respective country and/or until the decision to close the study has been made by the sponsor.
Experimental: PDS Implant Cohort 7 (ex-US only) - Participants from Study WR42221 randomized to the Q36W arm, who will continue to be treated with refill-exchanges of ranibizumab 100 mg/mL Q36W. Participants will be in the study for a minimum of 144 weeks and may continue after Week 144 until the PDS has received Health Authority approval (or non-approval) in their respective country and/or until the decision to close the study has been made by the sponsor.
Experimental: Sub-study 1: PDS Implant - Participants will receive PDS implant using TPC on Day 1 followed by refill-exchanges of ranibizumab 100 mg/mL via the PDS Q24W.
Experimental: Sub-study 2: Cohort 1 - Participants will undergo re-implantation with the updated PDS implant and receive 2 refill-exchanges of ranibizumab 100 mg/mL Q24W.
Experimental: Sub-study 2: Cohort 2a - Participants who received an updated PDS implant, have \< 24 weeks post-re-implantation follow-up and no refill exchange visit in the main study, will undergo two refill-exchange procedures with ranibizumab 100 mg/mL Q24W post main study re-implantation visit.
Experimental: Sub-study 2: Cohort 2b - Participants who received an updated PDS implant, have \< 48 weeks post-re-implantation follow-up and one refill exchange visit in the main study, will undergo one refill-exchange procedure with ranibizumab 100 mg/mL Q24W post main study re-implantation visit.
Treatment: Drugs: PDS Implant with Ranibizumab 100 mg/mL
Will be administered as per the schedule described in individual arm
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Incidence and Severity of Ocular and Systemic (Non-Ocular) Adverse Events (AEs)
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Assessment method [1]
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Timepoint [1]
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Baseline up to Week 240
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Primary outcome [2]
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Incidence, Severity, and Duration of Adverse Event of Special Interest (AESIs)
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Assessment method [2]
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Timepoint [2]
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Baseline up to Week 240
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Primary outcome [3]
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Incidence, Severity, and Duration of PDS-Associated Ocular AESIs During the Postoperative Period (Up to 37 days of Initial Implantation) and Follow-Up Period (>37 days After Implantation Surgery) for Participants who Receive the PDS Implant in the Study
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Assessment method [3]
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Timepoint [3]
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Baseline up to Week 240
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Primary outcome [4]
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Incidence and Severity of Adverse Device Effects
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Assessment method [4]
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Timepoint [4]
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Baseline up to Week 240
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Primary outcome [5]
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Incidence, Causality, Severity, And Duration Of Anticipated Serious Adverse Device Effects
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Assessment method [5]
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Timepoint [5]
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Baseline up to Week 240
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Primary outcome [6]
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Sub-study 1: Rate of Vitreous Hemorrhage Secondary to Choroidal Bleeding That Does not Resolve by the Week 4 Visit After Implant Insertion Surgery.
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Assessment method [6]
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Timepoint [6]
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Baseline to Week 4
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Primary outcome [7]
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Sub-study 2: Number of Participants with Ocular and Systemic (Non-ocular) Adverse Events (AEs) and Severity of These AEs
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Assessment method [7]
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Timepoint [7]
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Baseline to Week 72
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Primary outcome [8]
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Sub-study 2: Number of Participants with Adverse Events of Special Interests (AESIs) and Severity of AESIs
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Assessment method [8]
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Timepoint [8]
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Baseline to Week 72
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Primary outcome [9]
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Sub-study 2: Duration of AESIs
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Assessment method [9]
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Timepoint [9]
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Baseline to Week 72
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Primary outcome [10]
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Sub-study 2: Number of participants with Ocular AESIs and Severity of Ocular AESIs During the Post-operative Period
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Assessment method [10]
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Timepoint [10]
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Up to Day 37 post re-implantation
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Primary outcome [11]
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Sub-study 2: Number of participants with Ocular AESIs and Severity of Ocular AESIs During the Follow-up Period
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Assessment method [11]
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Timepoint [11]
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> 37 days post re-implantation (up to approximately Week 72)
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Primary outcome [12]
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Sub-study 2: Duration of Ocular AESIs During the Post-operative Period
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Assessment method [12]
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Timepoint [12]
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Up to Day 37 post re-implantation
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Primary outcome [13]
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Sub-study 2: Duration of Ocular AESIs During the Follow-up Period
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Assessment method [13]
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Timepoint [13]
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> 37 days post re-implantation (up to approximately Week 72)
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Primary outcome [14]
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Sub-study 2: Number of Participants with Adverse Device Effects (ADEs) and Severity of ADEs
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Assessment method [14]
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Timepoint [14]
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Baseline to Week 72
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Primary outcome [15]
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Sub-study 2: Number of Participants with Anticipated Serious ADEs and Severity of Anticipated Serious ADEs
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Assessment method [15]
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Timepoint [15]
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Baseline to Week 72
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Primary outcome [16]
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Sub-study 2: Duration of Anticipated Serious ADEs
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Assessment method [16]
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Timepoint [16]
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Baseline to Week 72
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Primary outcome [17]
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Sub-study 2: Number of Device Deficiencies
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Assessment method [17]
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Timepoint [17]
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Baseline to Week 72
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Secondary outcome [1]
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Change in Best-Corrected Visual Acuity (BCVA) Score from Baseline Over Time, as Assessed using the ETDRS Visual Acuity Chart at a Starting Distance of 4 Meters
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Assessment method [1]
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ETDRS = Early Treatment Diabetic Retinopathy Study A vision score of 20/20 vision is considered normal. A score of 20/200 is considered being legally blind.
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Timepoint [1]
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Baseline up to Week 240
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Secondary outcome [2]
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Percentage of Participants who Lose <15, <10, or <5 Letters in BCVA Score from Baseline Over Time
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Assessment method [2]
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Timepoint [2]
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Baseline up to Week 240
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Secondary outcome [3]
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Percentage of Participants with BCVA Score of 38 Letters (of 20/200 Approximate Snellen Equivalent) or Worse over Time
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Assessment method [3]
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Timepoint [3]
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Baseline up to Week 240
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Secondary outcome [4]
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Percentage of Participants with BCVA Score of 69 Letters (20/40 Approximate Snellen Equivalent) or Better over Time
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Assessment method [4]
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Timepoint [4]
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Baseline up to Week 240
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Secondary outcome [5]
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Change from Baseline in Center Point Thickness (CPT) Over Time
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Assessment method [5]
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CPT is defined as the retinal thickness in the center point of the fovea measured between the internal limiting membrane and the inner third of the retinal pigment epithelium layer. CPT is measured using optical coherence tomography (OCT).
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Timepoint [5]
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Baseline up to Week 240
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Secondary outcome [6]
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Percentage of Participants who Undergo Supplemental Treatment with Intravitreal Ranibizumab 0.5 mg During Each Refill-exchange Interval
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Assessment method [6]
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Timepoint [6]
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Baseline up to Week 240
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Secondary outcome [7]
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Sub-study 1: Incidence of Ocular Adverse Events (AEs) and Adverse Events of Special Interest (AESIs) in the Study eye
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Assessment method [7]
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Timepoint [7]
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Baseline up to Week 104
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Secondary outcome [8]
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Sub-study 1: Incidence of AEs Commonly Seen After Transscleral Cyclophotocoagulation (TS-CPC) for Treatment of Glaucoma in the Study eye
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Assessment method [8]
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Timepoint [8]
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Baseline up to Week 104
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Secondary outcome [9]
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Sub-study 1: Time From Surgery to Vitreous Hemorrhage Resolution in the Study eye
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Assessment method [9]
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Timepoint [9]
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Baseline up to Week 104
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Secondary outcome [10]
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Sub-study 1: Incidence of Vitreous Hemorrhage Grade 3 and Higher in the Study eye over time
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Assessment method [10]
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Timepoint [10]
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Baseline up to Week 104
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Secondary outcome [11]
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Sub-study 1: Distribution of Vitreous Hemorrhage Grade in the Study eye Over Time
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Assessment method [11]
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Timepoint [11]
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Baseline up to Week 104
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Secondary outcome [12]
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Sub-study 1: Rate of Vitrectomy in the Study eye
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Assessment method [12]
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Timepoint [12]
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Baseline up to Week 104
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Secondary outcome [13]
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Sub-study 1: Percentage of Participants who Lose <15, <10, or <5 Letters in BCVA Score From Baseline Over Time
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Assessment method [13]
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Timepoint [13]
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Baseline up to Week 104
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Secondary outcome [14]
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Sub-study 1: Change in BCVA Score From Baseline Over Time
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Assessment method [14]
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Timepoint [14]
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Baseline up to Week 104
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Secondary outcome [15]
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Sub-study 1: Change from Baseline in CPT Over Time
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Assessment method [15]
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Timepoint [15]
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Baseline up to Week 104
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Secondary outcome [16]
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Sub-study 1: Change From Baseline in Center Subfield Thickness (CST) Over Time
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Assessment method [16]
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Timepoint [16]
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Baseline up to Week 104
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Secondary outcome [17]
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Sub-study 2: Number of Participants with Ocular AESIs and Severity of AESIs Following Refill-exchange
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Assessment method [17]
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Timepoint [17]
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Up to approximately Week 72
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Secondary outcome [18]
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Sub-study 2: Duration of AESIs Following Refill-exchange
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Assessment method [18]
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Timepoint [18]
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Up to approximately Week 72
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Secondary outcome [19]
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Sub-study 2: Number of Participants With ADEs and Severity of ADEs Following Refill-exchange
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Assessment method [19]
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Timepoint [19]
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Up to approximately Week 72
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Secondary outcome [20]
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Sub-study 2: Number of Participants with Anticipated Serious ADEs and Severity of Anticipated Serious ADEs Following Refill-exchange
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Assessment method [20]
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Timepoint [20]
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Up to approximately Week 72
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Secondary outcome [21]
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Sub-study 2: Number of Device Deficiencies Following Refill-exchange
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Assessment method [21]
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Timepoint [21]
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Up to approximately Week 72
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Eligibility
Key inclusion criteria
* Previous enrollment in and completion of Study GX28228 (Ladder) or Study GR40548 (Archway), without early treatment or study discontinuation in either study OR Previous enrollment in Study WR42221 (Velodrome) and either not eligible to be randomized in Study WR42221 at Week 24 or completed the study (from the Q24W or Q36W arm)
* Ability and willingness to undertake all scheduled visits and assessments
* For women of childbearing potential: agreement to remain abstinent or use contraceptive measures
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Pregnant or breastfeeding, or intending to become pregnant during the treatment period and for at least 28 days after the last intravitreal injection of ranibizumab or 1 year after the last Implant refill-exchange of ranibizumab
* History of other ocular diseases that give reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab, that might affect interpretation of the results of the study or that renders the participant at high risk for treatment complications
* History of other diseases, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the Implant and that might affect interpretation of the results of the study or that renders the participant at high risk of treatment complications
* Requirement for continuous use of any medications or treatments indicated in the "Prohibited Therapy"
Sub-study 1
Inclusion Criteria
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures
Participants must meet the following ocular criteria for the study eye for substudy entry:
* Diagnosis of exudative nAMD within 2 years prior to the enrollment visit
* Previous treatment with at least two anti-VEGF ITV injections (e.g., ranibizumab, bevacizumab, or aflibercept) for nAMD per standard of care within 6 months prior to the enrollment visit
* Demonstrated response to prior anti-VEGF ITV treatment since diagnosis, as evidenced at enrollment by the following:
Overall decrease in nAMD disease activity detected on SD-OCT AND Stable or improved best-corrected visual acuity (BCVA)
* All subtypes of nAMD lesions are permissible (i.e., type I, type II, type III, or mixed forms per optical coherence tomography (OCT) classification) nAMD lesions at the time of diagnosis must involve the macula (6 mm diameter centered at the fovea).
* Sufficiently clear ocular media and adequate pupillary dilation to allow for analysis and grading by the central reading center of FP and SD-OCT images.
Exclusion Criteria Prior Ocular Treatments Study Eye
* History of vitrectomy surgery, submacular surgery, or other surgical intervention for AMD
* Prior treatment with Visudyne, external-beam radiation therapy, or transpupillary thermotherapy
* Previous treatment with corticosteroid ITV injection
* Previous intraocular device implantation
* Previous laser (any type) used for AMD treatment
Either Eye
* Treatment with anti-VEGF agents other than ranibizumab within 1 month prior to the enrollment visit
* Prior participation in a clinical trial involving anti-VEGF drugs within 6 months prior to the enrollment visit, other than ranibizumab
CNV Lesion Charateristics Study Eye
* Subretinal hemorrhage that involves the center of the fovea, if the hemorrhage is greater than 0.5 disc area (1.27 mm2 ) in size at screening
* Subfoveal fibrosis or subfoveal atrophy
Either Eye
- CNV due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
Concurrent Ocular Conditions Study Eye
* Retinal pigment epithelial tear
* Any concurrent intraocular condition (e.g., cataract, glaucoma, diabetic retinopathy, or epiretinal membrane) that would either require surgical intervention during the study to prevent or treat visual loss that might result from that condition or affect interpretation of study results
* Active intraocular inflammation (grade trace or above)
* History of vitreous hemorrhage
* History of rhegmatogenous retinal detachment
* History of rhegmatogenous retinal tears or peripheral retinal breaks within 3 months prior to the enrollment visit
* Aphakia or absence of the posterior capsule
* Previous violation of the posterior capsule is also an exclusion criterion unless it occurred as a result of yttrium-aluminum garnet (YAG) laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation.
* Spherical equivalent of the refractive error demonstrating more than 8 diopters of myopia
* Preoperative refractive error that exceeds 8 diopters of myopia, for participants who have undergone prior refractive or cataract surgery in the study eye
* Intraocular surgery (including cataract surgery) within 3 months preceding the enrollment visit
* Uncontrolled ocular hypertension or glaucoma and any such condition the investigator determines may require a glaucoma-filtering surgery during a patient's participation in the study
* History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery
* History of corneal transplant
* History of prior vitrectomy surgery and absence of posterior capsule
Either Eye
* History of idiopathic or autoimmune-associated uveitis
* Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis
Concurrent Systemic Conditions
* Inability to comply with study schedule or procedures as described in the study protocol
* Uncontrolled blood pressure
* History of stroke within the last 3 months prior to informed consent
* Uncontrolled atrial fibrillation within 3 months of informed consent
* History of myocardial infarction within the last 3 months prior to informed consent
* History of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the implant and that might affect interpretation of the results of the study or renders the patient at high risk of treatment complications in the opinion of the investigator
* Current systemic treatment for a confirmed active systemic infection
* Use of any systemic anti-VEGF agents
* Chronic use of oral corticosteroids
* Active cancer within 12 months of enrollment
* Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month preceding the informed consent (excluding vitamins and minerals)
* Use of antimitotic or antimetabolite therapy within 30 days or 5 elimination half-lives of the enrollment visit
* History of albinism
* Pregnant or breastfeeding, or intending to become pregnant during the treatment period and for at least 28 days after the last ITV injection of ranibizumab or 1 year after the last implant refill-exchange of ranibizumab
Sub-study 2
Inclusion Criteria:
* Having experienced septum dislodgement in the original implant while in the main study or after exiting the main study Ocular Inclusion Criteria for Study Eye
* Sufficiently clear ocular media and adequate pupillary dilation to allow for analysis and grading by central reading center
Exclusion Criteria (Cohort 1 only):
Concurrent Ocular Conditions-Study Eye
* Any ocular condition that may render the patient at high risk for surgical or treatment complications
* Intraocular surgery (including cataract surgery) within 1 month preceding the enrollment visit
* Any use of medicated intraocular implants (other than the PDS implant), at any time prior to enrollment
* History of rhegmatogenous retinal tears or peripheral retinal breaks within 3 months prior to the enrollment visit
* Any concurrent ocular condition that would require surgical intervention during the study to prevent or treat visual loss
* Concurrent conjunctival, Tenon's capsule, and/or scleral condition in the supero-temporal quadrant of the eye (e.g., scarring, thinning, mass) that may affect the refill-exchange procedure of the PDS implant
* Ongoing ocular complications that might affect participant safety
Concurrent Ocular Conditions-Either Eye
* Suspected or active ocular or periocular infection
* Any history of uveitis
* Active blepharitis
Concurrent Systemic Conditions
* Recent history (in the last 3 months prior to enrollment) of other disease, other non-diabetic metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a condition that contraindicates the use of ranibizumab or surgical placement of the PDS implant; that might affect interpretation of the results of the study; or that renders the participant at high risk for treatment complications
* Active cancer within the last 12 months, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or prostate cancer
* Current systemic treatment for a confirmed active systemic infection - Participation in an investigational trial that involves treatment with any drug or device (with the exception of vitamins and minerals or enrollment in the main study GR40549) within 6 months prior to enrollment.
* Use of antimitotic or antimetabolite therapy within 30 days or 5 elimination half-lives.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
20/09/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/09/2029
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Actual
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Sample size
Target
1000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Eyeclinic Albury Wodonga - Albury
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Recruitment hospital [2]
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Eye and Retina Consultants - Hurstville
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Recruitment postcode(s) [1]
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2640 - Albury
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Recruitment postcode(s) [2]
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2220 - Hurstville
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Arizona
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United States of America
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California
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United States of America
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Colorado
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United States of America
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Connecticut
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United States of America
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Florida
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United States of America
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Georgia
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United States of America
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Illinois
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United States of America
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Iowa
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United States of America
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Kansas
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United States of America
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Kentucky
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0
United States of America
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Maine
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0
United States of America
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Maryland
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United States of America
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Massachusetts
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0
United States of America
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State/province [14]
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Michigan
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0
United States of America
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State/province [15]
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Minnesota
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United States of America
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State/province [16]
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Missouri
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Wolverhampton
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Funding & Sponsors
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Commercial sector/industry
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Name
Hoffmann-La Roche
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Summary
Brief summary
This study will evaluate the long-term safety and tolerability of the Port Delivery System with ranibizumab (PDS) (100 mg/mL) in participants with neovascular age-related macular degeneration (nAMD) who have either completed Phase II Study GX28228 (Ladder), Phase III Study GR40548 (Archway), Phase IIIb Study WR42221 (Velodrome), or completed Week 24 visit in Study WR42221 but were not eligible to be randomized in WR42221.
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Trial website
https://clinicaltrials.gov/study/NCT03683251
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Trial related presentations / publications
Eichenbaum DA, Freeman WR, Chang MA, Brooks L, Chaudhry N, Dadgostar H, McCannel CA, Michels M, Mittra RA, Wolfe JD, Beindl VC, Jaycock P, Bobbala A, Gune S, Spicer G, Callaway N. Endophthalmitis in Eyes Treated with the Port Delivery System with Ranibizumab: Summary of Cases during Clinical Trial Development. Ophthalmol Retina. 2025 Feb;9(2):127-143. doi: 10.1016/j.oret.2024.08.005. Epub 2024 Aug 16.
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Public notes
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Contacts
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Clinical Trials
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Hoffmann-La Roche
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Contact person for public queries
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Reference Study ID Number: GR40549 https://forpatients.roche.com/
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Address
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888-662-6728 (U.S. and Canada)
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data\_sharing
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03683251
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