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Diabetic Macular EdemaPhase 3RETAINNCT01171976

Efficacy and Safety of Ranibizumab in Two "Treat and Extend" Treatment Algorithms Versus Ranibizumab As Needed in Patients With Macular Edema and Visual Impairment Secondary to Diabetes Mellitus

A Phase 3 study testing Ranibizumab in people with Diabetic Macular Edema, run by Novartis Pharmaceuticals at 68 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to demonstrate that two investigational treatment regimens have the potential to result in a superior visual acuity improvement as compared to a ranibizumab pro re nata (PRN=as needed) treatment regimen. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetic Macular Edema
What is being tested?
Ranibizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
373 participants
Where
68 sitesin 13 countries
Study dates
Sep 2010to Apr 2013
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient
  • Patients with Type 1 or Type 2 diabetes mellitus (according to American Diabetes Association or World Health Organization [WHO] guidelines) with glycosylated hemoglobin (HbA1c) ≤ 12.0% at screening (Visit 1). Patients should be on diet, exercise, and/or pharmacological treatment for diabetes. Treatment for diabetes must have been stable for at least 3 month.
  • Ocular
  • Patients with visual impairment due to DME in at least one eye who are eligible for laser treatment in the opinion of the investigator. If both eyes are eligible, the one with the worse visual acuity, as assessed at Visit 1, will be selected by the investigator as the study eye.
  • BCVA ≥ 39 and ≤78 letters in the study eye and, inclusively, using Early Treatment Diabetic Retinopathy Study (ETDRS)-like visual acuity testing charts at a testing distance of 4 meters (approximate Snellen equivalent of 20/32 to 20/160) at screening.
  • Concomitant conditions in the study eye are only permitted if, in the opinion of the investigator, they do not prevent improvement of visual acuity on study treatment.

Who cannot join

  • Patient Compliance/ Administrative
  • Pregnant or nursing (lactating) women.
  • Ocular medical history
  • Active intraocular inflammation (grade trace or above) in either eye at enrollment.
  • Any active infection (e.g. conjunctivitis, keratitis, scleritis, uveitis, endophthalmitis) in either eye at the time of enrollment.
  • History of uveitis in either eye at any time.
Show all 18Show fewer
  • Structural damage within 0.5 disc diameter of the center of the macular in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema.
  • Uncontrolled glaucoma in either eye at screening.
  • Prior Ocular treatments
  • Panretinal laser photocoagulation in the study eye within 6 months prior to randomization.
  • Focal/grid laser photocoagulation in the study eye within 3 months prior to randomization.
  • Treatment with anti-angiogenic drugs in either eye.
  • Systemic conditions or treatments
  • History of stroke within 6 months prior to enrollment.
  • Renal failure requiring dialysis.
  • Untreated diabetes mellitus.
  • Blood pressure systolic > 160 mmHg or diastolic > 100 mmHg.
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

68 sites in 13 countries.

68 sites in 13 countries

United Kingdom10 sites
  • Novartis Investigative Site

    Aberdeen, AB25 2ZN

  • Novartis Investigative Site

    Bristol, BS1 2LX

  • Novartis Investigative Site

    Frimley, Surrey, GU16 7UJ

  • Novartis Investigative Site

    Leeds, LS9 7TF

  • Novartis Investigative Site

    Manchester, M13 9WL

  • Novartis Investigative Site

    Newcastle upon Tyne, NE1 4LP

  • Novartis Investigative Site

    Sheffield, S10 2JF

  • Novartis Investigative Site

    Southampton, SO16 6YD

  • Novartis Investigative Site

    Sunderland, SR2 9HP

  • Novartis Investigative Site

    Wolverhampton, WV10 0QP

Other trials in United Kingdom

France9 sites
  • Novartis Investigative Site

    Bordeaux, 33 000

  • Novartis Investigative Site

    Dijon, 21034

  • Novartis Investigative Site

    Lille, 59 037

  • Novartis Investigative Site

    Limoges, 87042

  • Novartis Investigative Site

    Lyon, 69003

  • Novartis Investigative Site

    Nantes, 44093

  • Novartis Investigative Site

    Nice, 6 000

  • Novartis Investigative Site

    Paris, 75015

  • Novartis Investigative Site

    Paris, 75475

Other trials in France

Spain8 sites
  • Novartis Investigative Site

    Alicante, Valencia, 03016

  • Novartis Investigative Site

    L'Hospitalet de Llobregat, Catalonia, 08907

  • Novartis Investigative Site

    Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35016

  • Novartis Investigative Site

    Madrid, Madrid, 28040

  • Novartis Investigative Site

    Málaga, Andalusia, 29010

  • Novartis Investigative Site

    Santiago de Compostela, Galicia, 15705

  • Novartis Investigative Site

    Valencia, Valencia, 46015

  • Novartis Investigative Site

    Valladolid, Castille and León, 47011

Other trials in Spain

Italy6 sites
  • Novartis Investigative Site

    Florence, FI, 50134

  • Novartis Investigative Site

    Milan, MI, 20122

  • Novartis Investigative Site

    Milan, MI, 20132

  • Novartis Investigative Site

    Milan, MI, 20157

  • Novartis Investigative Site

    Roma, RM, 00133

  • Novartis Investigative Site

    Roma, RM, 00198

Other trials in Italy

Czechia5 sites
  • Novartis Investigative Site

    Hradec Králové, 505 05

  • Novartis Investigative Site

    Olomouc, 775 20

  • Novartis Investigative Site

    Pilsen, 301 00

  • Novartis Investigative Site

    Prague, Czech Republic, 169 02

  • Novartis Investigative Site

    Prague, 128 08

Other trials in Czechia

Netherlands5 sites
  • Novartis Investigative Site

    Amsterdam, 1081 HV

  • Novartis Investigative Site

    Amsterdam, 1105 AZ

  • Novartis Investigative Site

    Leiden 2333 ZA, Netherlands, 2333

  • Novartis Investigative Site

    Nijmegen, 6525 EX

  • Novartis Investigative Site

    Rotterdam, 3011 BH

Other trials in Netherlands

Hungary4 sites
  • Novartis Investigative Site

    Budapest, 1083

  • Novartis Investigative Site

    Budapest, 1133

  • Novartis Investigative Site

    Debrecen, 4012

  • Novartis Investigative Site

    Győr, 9024

Other trials in Hungary

Ireland4 sites
  • Novartis Investigative Site

    Dublin, Ireland

  • Novartis Investigative Site

    Dublin

  • Novartis Investigative Site

    Kilkenny

  • Novartis Investigative Site

    Limerick

Other trials in Ireland

Poland4 sites
  • Novartis Investigative Site

    Bielsko-Biala, 43-300

  • Novartis Investigative Site

    Lublin, 20-954

  • Novartis Investigative Site

    Warsaw, 00-416

  • Novartis Investigative Site

    Wroclaw, 50-367

Other trials in Poland

Switzerland4 sites
  • Novartis Investigative Site

    Bern, 3010

  • Novartis Investigative Site

    Bern, 3012

  • Novartis Investigative Site

    Binningen, 4102

  • Novartis Investigative Site

    Zurich, Switzerland, 8063

Other trials in Switzerland

Belgium3 sites
  • Novartis Investigative Site

    Ghent, 9000

  • Novartis Investigative Site

    Kortrijk, 8500

  • Novartis Investigative Site

    Leuven, 3000

Other trials in Belgium

Greece3 sites
  • Novartis Investigative Site

    Athens, 152 31

  • Novartis Investigative Site

    Heraklion Crete, Crete, GR-71110

  • Novartis Investigative Site

    Thessaloniki, 546 36

Other trials in Greece

Portugal3 sites
  • Novartis Investigative Site

    Coimbra, 3000-354

  • Novartis Investigative Site

    Lisbon, 1150-199

  • Novartis Investigative Site

    Porto, Portugal, 4099-001

Other trials in Portugal

About this study

Official title: A 2 Year Randomized, Single-masked, Multicenter, Controlled Phase IIIb Trial Assessing the Efficacy and Safety of 0.5 mg Ranibizumab in Two "Treat and Extend" Treatment Algorithms vs. 0.5 mg Ranibizumab As Needed in Patients With Macular Edema and Visual Impairment Secondary to Diabetes Mellitus

The purpose of this study is to demonstrate that two investigational treatment regimens have the potential to result in a superior visual acuity improvement as compared to a ranibizumab pro re nata (PRN=as needed) treatment regimen.

Being tested
Ranibizumab
Keywords
DME, Diabetic macula edema, RETAIN, ranibizumab

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RanibizumabDrug

    Ranibizumab (Lucentis®) was supplied in vials containing a dose of 0.5 mg/0.05 mL in an aqueous solution (pH 5.5) with histidine, trehalose, and polysorbate 20.

Study groups in NCT01171976
Study groupRoleWhat they receive
TE Ranibizumab 0.5 mg and LaserExperimentalOn Day 1, all patients received an intravitreal injection with 0.5 mg ranibizumab and subsequently entered Phase A which comprised of monthly injections. Laser therapy was applied at Day 1. It could then be re-administered according to ETDRS criteria at any visit with 0.5 mg ranibizumab treatment if deemed necessary by the Treating Investigator with a minimal treatment interval between laser treatments of 3 months. Laser therapy was administered ≥ 30 minutes prior to the ranibizumab injection.
Receives: Drug: Ranibizumab
TE Ranibizumab 0.5 mg aloneExperimentalPatients received ranibizumab intravitreal injection therapy only.
Receives: Drug: Ranibizumab
PRN Ranibizumab 0.5 mgActive comparatorPatients received ranibizumab intravitreal injection therapy as needed according to signs and symptoms of disease.
Receives: Drug: Ranibizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Visual Acuity of the Study Eye: Average Change From Baseline to Month 1 Through Month 12

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline to Month 12

Secondary outcomes (9)
  1. Visual Acuity of the Study Eye: Average Change From Baseline to Month 1 Through Month 24

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline to Month 24

  2. Visual Acuity of the Study Eye: Change From Baseline at Month 12

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline and Month 12

  3. Visual Acuity of the Study Eye: Change From Baseline at Month 24

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline and Month 24

  4. Visual Acuity of the Study Eye: Categorized Change From Baseline at Month 12

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline, Month 12

  5. Visual Acuity of the Study Eye: Categorized Change From Baseline at Month 24

    Visual acuity was assessed at every study visit for the study eye using best correction determined from protocol refraction. The BCVA measurements were taken in a sitting position using ETDRS-like VA testing charts at a starting distance of 4 meters.

    Measured: Baseline, 24 month

  6. Central Subfield Thickness of the Study Eye: Percent Change From Baseline at Month 12

    High Resolution OCT was performed at every study visit by Spectral Domain OCT (if not available Time Domain OCT was acceptable) and the images were transferred to a digital video disc. These assessments were performed by trained and adequately qualified experts at the sites and prior to any study drug administration. CSFT is the average retinal thickness of the circular area with 1 mm diameter around the foveal center.

    Measured: Baseline, Month 12

  7. Central Subfield Thickness of the Study Eye: Percent Change From Baseline at Month 24

    High Resolution OCT was performed at every study visit by Spectral Domain OCT (if not available Time Domain OCT was acceptable) and the images were transferred to a digital video disc. These assessments were performed by trained and adequately qualified experts at the sites and prior to any study drug administration. CSFT is the average retinal thickness of the circular area with 1 mm diameter around the foveal center.

    Measured: Baseline and 24 month

  8. Visual Functioning Questionnaire (VFQ-25) Change From Baseline in Total Score at Month 12 and Month 24

    The National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) was used to measure the influence of visual disability and symptoms on general health. The 12 subscales in the VFQ-25 are general health, general vision, ocular pain, near activities, distance activities, social function, mental health, role difficulties, dependency, driving, color vision, and peripheral vision. For each, the patient was asked to rate their condition on a scale of 1-5 or 1-6, where a low number reflects a better outcome. Each response was recoded per the scoring rules outlined in the National Eye Institute (NEI) VFQ-25 Scoring Algorithm. Under this scoring algorithm , the recoded values range between 0 and 100 and a high score means a better functioning

    Measured: Baseline, Month 12 and Month 24

  9. EuroQoL (EQ-5D) Thermometer Score: Change From Baseline at Month 12 and Month 24

    The Euro Quality of Life Questionnaire (EQ-5D) is an indirect utility questionnaire. It is a standardized instrument was utilized to measure health outcomes related to 5 dimensions, namely: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The possible range for each dimension was 1 to 3, where 1= "no problems", 2="some problems" and 3="extreme problems" . A composite health index was then defined by combining the levels for each dimension. Overall, 243 health states are possible. For each health state, the EuroQol group has assigned a utility value typically between 0 and 1 with lower scores representing a higher level of dysfunction

    Measured: Baseline, Month 12 and Month 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jul 2010 (estimated)
  2. Study startSep 2010
  3. Primary completionApr 2013
  4. Study completionApr 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
373 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01171976
Sponsor's protocol ID
CRFB002D2304
Other IDs
2010-019795-74
Acronym
RETAIN
Status last verified
Sep 2014
First submitted
27 Jul 2010
Last updated
15 Sep 2014

Publications

  • Prunte C, Fajnkuchen F, Mahmood S, Ricci F, Hatz K, Studnicka J, Bezlyak V, Parikh S, Stubbings WJ, Wenzel A, Figueira J; RETAIN Study Group. Ranibizumab 0.5 mg treat-and-extend regimen for diabetic macular oedema: the RETAIN study. Br J Ophthalmol. 2016 Jun;100(6):787-95. doi: 10.1136/bjophthalmol-2015-307249. Epub 2015 Oct 9.

    PubMed 26453639

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ranibizumab in people with Diabetic Macular Edema, run by Novartis Pharmaceuticals at 68 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Sep 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 68 sites in United Kingdom, France, Spain, Italy, Czechia and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Sep 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Visual Acuity of the Study Eye: Average Change From Baseline to Month 1 Through Month 12 (time frame: Baseline to Month 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01171976, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2014.

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