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Diabetic Macular EdemaPhase 3REFINENCT02259088

A 12-month, Randomized, Efficacy and Safety Study of 0.5 mg Ranibizumab vs Laser in Chinese Diabetic Macular Edema (DME) Patients

A Phase 3 study testing Ranibizumab (RFB002) and Laser in people with Diabetic Macular Edema and Visual Impairment, run by Novartis Pharmaceuticals at 28 sites in China.

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

Study of efficacy and safety of 0.5 mg ranibizumab in Chinese patients with diabetic macular edema (DME) Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetic Macular Edema, Visual Impairment
What is being tested?
Ranibizumab (RFB002) and Laser
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
384 participants
Where
28 sitesChina
Study dates
5 Nov 2014to 17 Jan 2017
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

  • Male or female Chinese patients ≥ 18 years of age with diabetes mellitus and with HbA1c ≤10.0%
  • Stable medication for diabetes within 3 months prior to Visit 1
  • Visual impairment due to DME with BCVA score between 78 and 39 letters as measured by ETDRS-like charts at 4 meters

Who cannot join

  • Stroke or myocardial infarction less than 3 months prior to screening visit
  • Uncontrolled hypertension
  • Active ocular infection or intraocular inflammation in any eye
  • Treatment with any anti-angiogenic drugs within 3 months prior to baseline visit in any eye
  • Active proliferative diabetic retinopathy in study eye
  • Use of other investigational drugs within 30 days and systemic anti-VEGF drugs within 6 months prior to baseline visit
  • Prior laser photocoagulation or intraocular procedure within 3 months prior to baseline in study eye
  • History of intravitreal corticosteroid treatment in phakic study eye, and in aphakic or pseudophakic within 3 months prior to screening

Trial locations and contacts

28 sites in 1 country.

28 sites in 1 country

China28 sites
  • Novartis Investigative Site

    Beijing, Beijing Municipality, 100044

  • Novartis Investigative Site

    Beijing, Beijing Municipality, 100191

  • Novartis Investigative Site

    Beijing, Beijing Municipality, 100730

  • Novartis Investigative Site

    Beijing, 100034

  • Novartis Investigative Site

    Beijing, 100050

  • Novartis Investigative Site

    Beijing, 100053

  • Novartis Investigative Site

    Beijing, 100176

  • Novartis Investigative Site

    Beijing, 100730

  • Novartis Investigative Site

    Changsha, Hunan, 410011

  • Novartis Investigative Site

    Chengdu, Sichuan, 610041

  • Novartis Investigative Site

    Chongqing, 400042

  • Novartis Investigative Site

    Guangzhou, Guangdong, 510060

  • Novartis Investigative Site

    Guangzhou, Guangdong, 510632

  • Novartis Investigative Site

    Hangzhou, Zhejiang, 310003

  • Novartis Investigative Site

    Hangzhou, Zhejiang, 310014

  • Novartis Investigative Site

    Harbin, Heilongjiang, 150001

  • Novartis Investigative Site

    Nanchang, Jiangxi, 330019

  • Novartis Investigative Site

    Qingdao, Shandong, 2666000

  • Novartis Investigative Site

    Shanghai, 200080

  • Novartis Investigative Site

    Shanghai, 200092

  • Novartis Investigative Site

    Shantou, Guangdong, 515041

  • Novartis Investigative Site

    Tianjin, Tianjin Municipality, 300020

  • Novartis Investigative Site

    Tianjin, Tianjin Municipality, 300070

  • Novartis Investigative Site

    Wenzhou, Zhejiang, 325027

  • Novartis Investigative Site

    Wuhan, Hubei, 430022

  • Novartis Investigative Site

    Wuhan, Hubei, 430070

  • Novartis Investigative Site

    Wuxi, Jiangsu

  • Novartis Investigative Site

    Xi’an, Shanxi, 710032

Other trials in China

About this study

Official title: A 12-month, Randomized, Double-masked, Multicenter, Laser-controlled Phase III Study Assessing the Efficacy and Safety of 0.5 mg Ranibizumab Dosed PRN in Subjects With Visual Impairment Due to Diabetic Macular Edema in Chinese Patients

Study of efficacy and safety of 0.5 mg ranibizumab in Chinese patients with diabetic macular edema (DME)

Read the detailed description

The purpose of this study was to provide efficacy and safety data on 0.5 mg ranibizumab intravitreal injections compared to laser photocoagulation in Chinese patients with visual impairment due to DME. Treatment was driven by achieving vision stabilization.

Being tested
Ranibizumab (RFB002), Laser, Sham injection, Sham laser
Keywords
DME, macular edema, vision impairment, Chinese, diabetes
Medical subject headings
Vision Disorders, Macular Edema, Diabetes Mellitus

What participants receive

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

  • Ranibizumab (RFB002)Drug

    Also called Lucentis

    Ranibizumab 0.5 mg/0.05 mL for intravitreal injection

  • LaserProcedure or surgery

    Laser photocoagulation according to Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines

  • Sham injectionDrug

    Imitation of an intravitreal injection consisting of an empty vial and an injection syringe without a needle

  • Sham laserProcedure or surgery

    Imitation of an active laser

Study groups in NCT02259088
Study groupRoleWhat they receive
Ranibizumab (RFB002)Experimental3 initial intravitreal injections to the study eye at Day 1, Month 1 and Month 2, followed by as-needed intravitreal injections of ranibizumab 0.5 mg guided by VA stabilization, plus sham laser
Receives: Drug: Ranibizumab (RFB002); Procedure: Sham laser
LaserActive comparatorLaser photocoagulation applied to the study eye at Day 1, followed by active laser photocoagulation at intervals no shorter than 3 months apart, plus sham injections
Receives: Procedure: Laser; Drug: Sham injection

What is being measured

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

  1. Mean Average Change From Baseline in Best-Corrected Visual Acuity (BCVA) (Letters) to Month 1 Through 12

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. Twelve monthly BCVA values were averaged [(Month1+Month2+...+Month12)/12], and the baseline BCVA value was subtracted from the average. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Baseline, Monthly from Month 1 through Month 12

Secondary outcomes (20)
  1. Mean Change From Baseline in BCVA (Letters) at Each Visit

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Baseline, Monthly from Month 1 through Month 12

  2. Mean Change From Baseline in Central Sub-Field Thickness (CSFT) at Each Visit

    CSFT (the average retinal thickness of the circular area within 1 millimeter diameter around the foveal center) was assessed using Optical Coherence Tomography (OCT). A negative change value indicates an improvement in macular edema, while a positive change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Baseline, Monthly from Month 1 through Month 12

  3. Percentage of Patients With BCVA Gain of ≥ 10 and ≥ 15 Letters From Baseline at Month 12

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Baseline, Month 12

  4. Percentage of Patients With BCVA Loss of < 10 and < 15 Letters From Baseline to Month 12

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Baseline, Month 12

  5. Percentage of Patients With BCVA ≥ 73 Letters at Month 12

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. BCVA ≥ 73 letters is approximately equivalent to 20/40 on a Snellen chart. One eye (study eye) contributed to the analysis.

    Measured: Month 12

  6. Mean Average Change in BCVA From Month 4 to Month 12 Compared to Month 3

    Visual acuity with eyeglasses was assessed in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS)-like charts at an initial testing distance of 4 meters. A letter score was calculated based on the number of letters correctly identified at the specified distance. Nine monthly BCVA values were averaged [(Month4+Month5+...+Month12)/9],and the Month 3 BCVA value was subtracted from the average. A positive change value indicates an improvement in visual acuity, while a negative change value indicates a worsening. One eye (study eye) contributed to the analysis.

    Measured: Monthly from Month 3 through Month 12

  7. Mean Change From Baseline in Patient-Reported Visual Functioning at Month 6 and Month 12, Composite Score

    Visual functioning was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in visual functioning, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  8. Mean Change From Baseline in Patient-Reported General Health at Month 6 and Month 12

    General health was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in general health, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  9. Mean Change From Baseline in Patient-Reported General Vision at Month 6 and Month 12

    General vision was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in general vision, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  10. Mean Change From Baseline in Patient-Reported Color Vision at Month 6 and Month 12

    Color vision was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in color vision, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  11. Mean Change From Baseline in Patient-Reported Peripheral Vision at Month 6 and Month 12

    Peripheral vision was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in peripheral vision, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  12. Mean Change From Baseline in Patient-Reported Ocular Pain at Month 6 and Month 12

    Ocular pain was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in ocular pain, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  13. Mean Change From Baseline in Patient-Reported Near Activities at Month 6 and Month 12

    Near activities were assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in near activities, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  14. Mean Change From Baseline in Patient-Reported Distance Activities at Month 6 and Month 12

    Distance activities were assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in distance activities, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  15. Mean Change From Baseline in Patient-Reported Social Functioning at Month 6 and Month 12

    Social functioning was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in social functioning, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  16. Mean Change From Baseline in Patient-Reported Mental Health at Month 6 and Month 12

    Mental health was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in mental health, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  17. Mean Change From Baseline in Patient-Reported Roles Difficulties at Month 6 and Month 12

    Roles difficulties were assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in roles difficulties, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  18. Mean Change From Baseline in Patient-Reported Dependency at Month 6 and Month 12

    Dependency was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in dependency, while a negative change value indicates a worsening.

    Measured: Baseline, Month 6, Month 12

  19. Mean Change From Baseline in Patient-Reported Driving at Month 6 and Month 12

    Driving was assessed by the patient using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) on a scale from 0 to 100, where 0 = worst possible score and 100 = best. A positive change value indicates a perceived improvement in driving, while a negative change value indicates a worsening. Note: Many patients did not answer the driving related question as they did not drive at all.

    Measured: Baseline, Month 6, Month 12

  20. Mean Number of Ranibizumab Re-treatments Received in the Study Eye From Month 3 Onward

    A ranibizumab re-treatment was defined as an administration of ranibizumab injection at a scheduled visit following at least one non-missed visit where ranibizumab was not administered in the study eye due to visual acuity stabilization. This outcome measure was pre-specified for the Ranibizumab 0.5 mg arm only.

    Measured: Monthly from Month 3 through Month 12

Timeline

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

  1. First posted8 Oct 2014 (estimated)
  2. Study start5 Nov 2014
  3. Primary completion17 Jan 2017
  4. Study completion17 Jan 2017

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
384 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02259088
Sponsor's protocol ID
CRFB002D2305
Acronym
REFINE
Status last verified
Jan 2019
First submitted
3 Oct 2014
Last updated
1 Feb 2019
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ranibizumab (RFB002) and Laser in people with Diabetic Macular Edema and Visual Impairment, run by Novartis Pharmaceuticals at 28 sites in China.

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 3 inclusion and 8 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 1 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in China. 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 1 Feb 2019). 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?

Mean Average Change From Baseline in Best-Corrected Visual Acuity (BCVA) (Letters) to Month 1 Through 12 (time frame: Baseline, Monthly from Month 1 through Month 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 1 Feb 2019.

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