AzTrials
AzTrials

Retinopathy of PrematurityPhase 1ROP1NCT02390531

Phase 1 Trial of Bevacizumab Treatment for Severe Retinopathy of Prematurity

A Phase 1 study testing Bevacizumab in people with Retinopathy of Prematurity, run by Jaeb Center for Health Research at 11 sites in United States.

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 find a dose of intravitreal bevacizumab that is lower than currently used for severe retinopathy of prematurity (ROP), is effective in this study, and can be tested in future larger studies. Read more about this study

Who is it for?
Ages Up to 6 months
Conditions the study is for
Retinopathy of Prematurity
What is being tested?
Bevacizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
11 sitesUnited States
Study dates
28 Apr 2015to 11 May 2021
Phase
Phase 1
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 Up to 6 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Type 1 ROP; defined as:
  • Zone I, any stage ROP with plus disease, or
  • Zone I, stage 3 ROP without plus disease, or
  • Zone II, stage 2 or 3 ROP with plus disease
  • No previous treatment for ROP in the study eye; no previous bevacizumab treatment in the non-study eye

Who cannot join

  • The following exclusions apply to the study eye:
  • Nasolacrimal duct obstruction
  • Major ocular anomalies (e.g., cataract, coloboma)
  • Any opacity that precludes an adequate view of the retina
  • If purulent ocular discharge is present in either eye, then the infant is ineligible.

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • The Emory Eye Center

    Atlanta, Georgia, 30322

  • Wilmer Institute

    Baltimore, Maryland, 21287

  • Boston Children's Hospital

    Boston, Massachusetts, 02115

  • Cincinnati Children's Hospital

    Cincinnati, Ohio, 45229

  • Pediatric Ophthalmology Associates, Inc.

    Columbus, Ohio, 43205

  • Duke University Eye Center

    Durham, North Carolina, 27710

  • Texas Children's Hospital - Dept. Of Ophthalmology

    Houston, Texas, 77030

  • Riley Hospital for Children

    Indianapolis, Indiana, 46202

  • Virginia Pediatric Eye Center

    Norfolk, Virginia, 23502

  • Dean A. McGee Eye Institute, University of Oklahoma

    Oklahoma City, Oklahoma, 73104

  • University of Utah Moran Eye Center

    Salt Lake City, Utah, 84132

Other trials in United States

About this study

The purpose of this study is to find a dose of intravitreal bevacizumab that is lower than currently used for severe retinopathy of prematurity (ROP), is effective in this study, and can be tested in future larger studies.

Read the detailed description

Despite promising initial results using empirical doses of bevacizumab based on half the adult dose for treatment of acute severe ROP, little is known about lower doses of bevacizumab for ROP. An increasing number of ophthalmologists are treating premature infants with severe ROP using bevacizumab. Given the potential systemic and ocular adverse effects of intravitreal bevacizumab injections, determining a lower effective dose of bevacizumab is an important next step. The proposed study will test progressively lower doses to find a dose to take forward to a future larger study.

Being tested
Bevacizumab
Keywords
Retinopathy of Prematurity, Bevacizumab, ROP
Medical subject headings
Retinopathy of Prematurity

What participants receive

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

  • BevacizumabDrug

    Also called Avastin

    Varying dosages in 10µl

Study groups in NCT02390531
Study groupRoleWhat they receive
Bevacizumab 0.250 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.125 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.063 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.031 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.016 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.008 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.004 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab
Bevacizumab 0.002 mgExperimentalDosage of injected Bevacizumab to be studied
Receives: Drug: Bevacizumab

What is being measured

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

  1. Number of Participants With Successful Treatment of ROP

    Success is defined as improvement* by the 4-day exam and no recurrence of type 1 ROP or severe neovascularization requiring additional treatment within 4 weeks of injection.

    • For infants with plus disease, improvement by the 4-day post-injection exam is defined as plus disease no longer being present. For infants with type 1 ROP without plus disease (i.e., zone I, stage 3), improvement by the 4-day post-injection exam is defined as: (1) a significant reduction in severity and/or extent of extraretinal neovascularization, and, (2) if pre-plus was present pre-injection, reduction in the degree of abnormal vascular dilation and/or tortuosity.

    A dose will be considered effective if it successfully treats at least 80% of subjects.

    Measured: 4 weeks post-injection

Secondary outcomes (13)
  1. Distribution of VEGF Levels

    The parents of each infant enrolled in the study will be given the option to participate in a study to measure levels of vascular endothelial growth factor (VEGF) and Avastin in the plasma. Participants in this optional study will have blood collected for analysis The distribution of VEGF and Avastin levels (median, range, and quartiles) will be described before injection, and at 2 weeks and 4 weeks post-injection. For each dosage level, at 2, and 4-weeks post-injection, the change from pre-injection will be calculated.

    Measured: 2 weeks post-injection

  2. Distribution of VEGF Levels

    The parents of each infant enrolled in the study will be given the option to participate in a study to measure levels of VEGF and Avastin in the plasma. Participants in this optional study will have blood collected for analysis The distribution of VEGF and Avastin levels (median, range, and quartiles) will be described before injection, and at 2 weeks and 4 weeks post-injection. For each dosage level, at 2, and 4-weeks post-injection, the change from pre-injection will be calculated.

    Measured: 4 weeks post-injection

  3. Distribution of Avastin Levels

    The parents of each infant enrolled in the study will be given the option to participate in a study to measure levels of VEGF and Avastin in the plasma. Participants in this optional study will have blood collected for analysis The distribution of VEGF and Avastin levels (median, range, and quartiles) will be described before injection, and at 2 weeks and 4 weeks post-injection. For each dosage level, at 2, and 4-weeks post-injection, the change from pre-injection will be calculated, and a 95% confidence interval calculated for the change.

    Measured: 2 weeks post-injection

  4. Distribution of Avastin Levels

    The parents of each infant enrolled in the study will be given the option to participate in a study to measure levels of VEGF and Avastin in the plasma. Participants in this optional study will have blood collected for analysis The distribution of VEGF and Avastin levels (median, range, and quartiles) will be described before injection, and at 2 weeks and 4 weeks post-injection. For each dosage level, at 2, and 4-weeks post-injection, the change from pre-injection will be calculated, and a 95% confidence interval calculated for the change.

    Measured: 4 weeks post-injection

  5. Number of Study Eyes Requiring Additional Treatment/s for ROP

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: 12-month corrected age

  6. Any Adverse Events or Complications Since the 4-week Exam

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: 12-month corrected age

  7. Visual Fixation Status at 12 Months

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: 12-month corrected age

  8. Proportion of Infants for Whom at Least One Event Was Reported

    Adverse events reported at any time during the study will be tabulated for all enrolled infants and coded using the MedRA system. For each dosage level, an estimate and 95% confidence interval of the proportions will be obtained using the exact binomial method

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: Enrollment to 12-month corrected age

  9. Proportion of Infants With an Adverse Event Thought by Investigator to be Related to Study Drug

    Adverse events reported at any time during the study will be tabulated for all enrolled infants and coded using the MedRA system. For each dosage level, an estimate and 95% confidence interval of the proportions will be obtained using the exact binomial method

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: Enrollment to 12-month corrected age

  10. Count of Infants for Whom at Least One Serious Adverse Event Was Reported

    Adverse events reported at any time during the study will be tabulated for all enrolled infants and coded using the MedRA system. For each dosage level, an estimate and 95% confidence interval of the proportions will be obtained using the exact binomial method.

    Measured: Enrollment to 12-month corrected age

  11. Number of Infant Deaths

    Adverse events reported at any time during the study will be tabulated for all enrolled infants and coded using the MedRA system.

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: Enrollment to 12-month corrected age

  12. Number of Infants With 24-Month Extended Follow Up Exam

    A subset of infants enrolled in ROP1 will have extended follow up consisting of one additional office exam with developmental testing.

    This testing will provide a cross-sectional evaluation of visual acuity, refractive error, and development at the adjusted age 24-month visit.

    24-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 24 months.

    Measured: 24-month corrected age

  13. Number of Fellow Eyes Requiring Additional Treatment/s for ROP

    12-month corrected age calculated as the estimated date of confinement (EDC), or due date, plus 12 months

    Measured: 12-month corrected age

Timeline

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

  1. First posted17 Mar 2015 (estimated)
  2. Study start28 Apr 2015
  3. Primary completion4 Jun 2019
  4. Study completion11 May 2021

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Model description
8 bevacizumab doses were evaluated in this dose de-escalation study in the following dosage amounts: 0.250mg, 0.125mg, 0.063mg, 0.031mg, 0.016mg, 0.008mg, 0.004mg, 0.002mg. Each dose was planned to be used in up to 14 infants to ensure at least 10 infants with 4-week outcomes
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02390531
Sponsor's protocol ID
ROP1
Other IDs
2U10EY011751
Acronym
ROP1
Status last verified
Nov 2022
First submitted
17 Feb 2015
Last updated
3 Nov 2022
Data monitoring committee
Yes
Individual data sharing
Yes: In accordance with the NIH data sharing policy, a de-identified database is placed in the public domain on the PEDIG public website after the completion of each protocol and publication of the primary manuscript.

Publications

  • Wallace DK, Kraker RT, Freedman SF, Crouch ER, Hutchinson AK, Bhatt AR, Rogers DL, Yang MB, Haider KM, VanderVeen DK, Siatkowski RM, Dean TW, Beck RW, Repka MX, Smith LE, Good WV, Hartnett ME, Kong L, Holmes JM; Pediatric Eye Disease Investigator Group (PEDIG). Assessment of Lower Doses of Intravitreous Bevacizumab for Retinopathy of Prematurity: A Phase 1 Dosing Study. JAMA Ophthalmol. 2017 Jun 1;135(6):654-656. doi: 10.1001/jamaophthalmol.2017.1055.

    PubMed 28448664
  • Kraker RT, Wallace DK, Beck RW, Saunders CT, Lorenzi E, Melia BM, Li Z; Pediatric Eye Disease Investigator Group. Choice of Dose Level for a Randomized Clinical Trial of Low-Dose Bevacizumab vs Laser for Type 1 Retinopathy of Prematurity. JAMA Ophthalmol. 2021 Oct 1;139(10):1143-1144. doi: 10.1001/jamaophthalmol.2021.3192.

    PubMed 34410311
  • Wallace DK, Dean TW, Hartnett ME, Kong L, Smith LE, Hubbard GB, McGregor ML, Jordan CO, Mantagos IS, Bell EF, Kraker RT; Pediatric Eye Disease Investigator Group. A Dosing Study of Bevacizumab for Retinopathy of Prematurity: Late Recurrences and Additional Treatments. Ophthalmology. 2018 Dec;125(12):1961-1966. doi: 10.1016/j.ophtha.2018.05.001. Epub 2018 Jun 7.

    PubMed 29887334
  • Crouch ER, Kraker RT, Wallace DK, Holmes JM, Repka MX, Collinge JE, Bremer DL, Gray ME, Smith HA, Steinkuller PG; Writing Committee for Pediatric Eye Disease Investigator Group. Secondary 12-Month Ocular Outcomes of a Phase 1 Dosing Study of Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmol. 2020 Jan 1;138(1):14-20. doi: 10.1001/jamaophthalmol.2019.4488.

    PubMed 31697304
  • Wallace DK, Kraker RT, Freedman SF, Crouch ER, Bhatt AR, Hartnett ME, Yang MB, Rogers DL, Hutchinson AK, VanderVeen DK, Haider KM, Siatkowski RM, Dean TW, Beck RW, Repka MX, Smith LE, Good WV, Kong L, Cotter SA, Holmes JM; Pediatric Eye Disease Investigator Group (PEDIG). Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmol. 2020 Jun 1;138(6):698-701. doi: 10.1001/jamaophthalmol.2020.0334.

    PubMed 32324197

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Bevacizumab in people with Retinopathy of Prematurity, run by Jaeb Center for Health Research at 11 sites in United States.

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 5 inclusion and 5 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 3 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 3 Nov 2022). 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?

Number of Participants With Successful Treatment of ROP (time frame: 4 weeks post-injection). 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 NCT02390531, which also lists 5 linked publications.

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 3 Nov 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in