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Proliferative Diabetic RetinopathyPhase 4CONCEPTNCT03506750

Day Regimes of CONbercept on CytokinEs of PDR Patients Undergoing Vitrectomy - Trial (CONCEPT)

A Phase 4 study testing IVC, Blood and aqueous humor at the time of IVC and Collect blood, aqueous humor, and initial vitreous at the time of surgery. in people with Proliferative Diabetic Retinopathy and VEGF Overexpression, run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Patients with proliferative diabetic retinopathy requiring surgical intervention will receive a pre-operative injection of Conbercept. Patients will be recruited into different groups according to variable time intervals (1 to 7 days) between intravitreous injection and surgery. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
IVC, Blood and aqueous humor at the time of IVC and Collect blood, aqueous humor, and initial vitreous at the time of surgery.
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
200 participants
Where
1 siteChina
Study dates
3 Jun 2017to 31 Dec 2018
Phase
Phase 4
Are there results?
None posted in the registry

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

  • 18 years or older
  • Type 1 or 2 diabetes
  • PDR patients requiring surgical intervention for complications of vitreous hemorrhage or traction retinal detachment and pre-operative IVC treatment.
  • women postmenopausal for 12 months before the study, surgically sterile, or not pregnant and on effective contraception.

Who cannot join

  • previous retinal vein occlusion.
  • any intraocular surgery within the previous 12 months.
  • myopia of > or = to 8 diopters.
  • active ocular or periocular infection
  • treatment with an investigational agent for any condition 60 days prior to enrollment.
  • evidence of severe cardiac disease.
Show all 9Show fewer
  • clinically significant peripheral vascular disease (previous surgery, amputation, or symptoms of claudication)
  • uncontrolled hypertension (treated systolic blood pressure > 155 mmHg or diastolic blood pressure > 95 mmHg)
  • stroke within the preceding 12 months.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • First Affiliated Hospital of Nanjing Medical University

    Nanjing, Jiangsu, 210029

    Zizhong Hu, Dr, 15195960100, huzizhong@njmu.edu.cn

    Recruiting

Other trials in China

About this study

Official title: Different Day Regimes of Preoperative CONbercept Administration on CytokinEs of Proliferative Diabetic Retinopathy Patients Undergoing Vitrectomy: a Prospective Randomized Controlled Clinical Trial (CONCEPT)

Patients with proliferative diabetic retinopathy requiring surgical intervention will receive a pre-operative injection of Conbercept. Patients will be recruited into different groups according to variable time intervals (1 to 7 days) between intravitreous injection and surgery. At initial, pre-injection aqueous humor and blood sample will be collected in order to provide baseline VEGF-A, -B, placental growth factor (PIGF), and other cytokine levels. At the onset of the vitrectomy, a second aqueous humor, blood, and vitreous sample will be taken to obtain intra-operative levels of , VEGF-A, -B, PIGF, and other cytokine levels.

Read the detailed description

Proliferative diabetic retinopathy (PDR), characterized by neovascularization and fibrous proliferation, is a severe and common complication of diabetes mellitus (DM). Persistent vitreous hemorrhage (VH) caused by neovascularization and tractional retinal detachment (TRD) caused by fibrous proliferation can lead to permanent vision loss or even blindness, which are the most common indications for surgical intervention.

As neovascularization is the basal pathophysiological change of PDR and vascular endothelial growth factor (VEGF) has been acknowledged as primary angiogenesis factor, the preoperative adjunctive use of VEGF blockade is rationally proposed. The anti-VEGF drugs have been reported to be effective in bringing about regression of retinal neovascularization, shortening surgical duration, avoiding risk of iatrogenic retinal hole and secondary operation for the recurrent VH.

Conbercept (KH902) is a newly developed anti-VEGF drug and has been applied in clinic. Because of its additional binding domain of VEGFR-2, conbercept can bind to all isoforms of VEGF-A, VEGF-B, and placental growth factor (PLGF). A number of studies have presented its high affinity in the treatment of fundus diseases such as wet age-related macular degeneration (wet-AMD), macular edema secondary to retinal vein occlusion[8] and diabetic retinopathy. Also, recent randomized controlled trials have shown its protective effect of conbercept for the surgical treatment of PDR.

Although the overwhelming clinical evidence supports the anti-VEGF drugs as the preoperative adjuncts for PDR, the optimal duration between anti-VEGF injection and surgical intervention has not yet reached a consensus. Longer duration is related to higher incidence of the development or progression of TRD. It might provide clues by investigation of the pattern of cytokine changes in humor aqueous, vitreous, and blood. No studies have been done to date in patients with PDR to quantify the reduction of intravitreal VEGF-A, -B, PLGF or other cytokines levels in these patients following intravitreal Conbercept injection or to evaluate the effects of VEGF or PIGF blockade on the neovascular regression and surgical outcome in patients with extensive diabetic proliferative neovascularization.

The goal of this study is to quantify the reduction of changes of VEGF-A, -B, PLGF levels in patients receiving r pre-operative intravitreal Conbercept after variable time intervals (1, 2, 3, 4, 5, 6, 7 days).

Being tested
IVC, Blood and aqueous humor at the time of IVC, Collect blood, aqueous humor, and initial vitreous at the time of surgery., IVC-sham
Keywords
Conbercept, PLGF

What participants receive

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

  • IVCDrug

    Patients with PDR will receive intravitreal injection of conbercept (0.5 mg/0.05 mL; Chengdu Kanghong Biotech, Inc., Chengdu, Sichuan, China) in the inferior-temporal sector 4 mm from the sclerocorneal limbus before pars plana vitrectomy (PPV) surgery.

  • Blood and aqueous humor at the time of IVCProcedure or surgery

    Initial blood and aqueous humor will be harvested at the time of IVC.

  • Collect blood, aqueous humor, and initial vitreous at the time of surgery.Procedure or surgery

    Blood, aqueous humor, and vitreous will be collected at the time of surgery.

  • IVC-shamProcedure or surgery

    Patients with PDR will receive sham intravitreal injection of conbercept in the inferior-temporal sector 4 mm from the sclerocorneal limbus 4 days before PPV surgery.

Study groups in NCT03506750
Study groupRoleWhat they receive
IVC-1dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 1 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-2dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 2 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-3dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 3 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-4dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 4 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-5dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 5 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-6dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 6 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-7dayExperimentalpatients with proliferative diabetic retinopathy receiving IVC 7 days before surgery
Receives: Drug: IVC; Procedure: Blood and aqueous humor at the time of IVC; Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.
IVC-shamSham comparatorpatients with proliferative diabetic retinopathy receiving sham IVC
Receives: Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.; Procedure: IVC-sham
non-DRPlacebo comparatorpatients with other retinopathy (idiopathic macular hole or epiretinal membrane)
Receives: Procedure: Collect blood, aqueous humor, and initial vitreous at the time of surgery.

What is being measured

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

  1. Changes of intraocular VEGF and PLGF of patients with proliferative diabetic retinopathy post-IVC (intravitreous injection of Conbercept).

    Measured: 1-7 days

Secondary outcomes (9)
  1. Changes of serum angiogenesis-related pro-cytokines in patients with proliferative diabetic retinopathy

    Measured: 1-7 days

  2. Changes of intraocular and serum profibrotic cytokines in patients with proliferative diabetic retinopathy post-IVC.

    Measured: 1-7 days

  3. Changes of intraocular and serum inflammatory cytokines in patients with proliferative diabetic retinopathy post-IVC.

    Measured: 1-7 days

  4. Vitreous concentration of Conbercept

    Detection of Vitreous concentration of the drug of Conbercept (Conbercept is a kind of fusion protein)

    Measured: 1-7 days

  5. Effect of IVC on surgery time of surgery

    surgery time of vitrectomy

    Measured: Surgery day

  6. Effect of IVC on intraoperative complication of surgery

    Record the intraoperative complication: bleeding and iatrogenic retinal hole when surgically removing the proliferative membranes.

    Measured: Surgery day

  7. Effect of IVC on regression of neovascularization on vitreous fibrovascular membrane with optic coherence tomography angiography (OCTA)

    OCTA monitor the changes of neovascularization on vitreous fibrovascular membrane after IVC and before surgery

    Measured: 1 to 7 days

  8. Effect of IVC on postoperative visual acuity

    Best-corrected visual acuity postoperatively

    Measured: 1 to12 months

  9. Effect of IVC on postoperative complications

    Record number of patient with vitreous re-bleeding and iris neovascularization postoperatively.

    Measured: 1 to12 months

Timeline

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

  1. First posted24 Apr 2018
  2. Study start3 Jun 2017
  3. Primary completion1 Sep 2018 (estimated)
  4. Study completion31 Dec 2018 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03506750
Sponsor's protocol ID
CONCEPT
Acronym
CONCEPT
Status last verified
Apr 2018
First submitted
9 Mar 2018
Last updated
24 Apr 2018
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Chen DY, Sun NH, Chen X, Gong JJ, Yuan ST, Hu ZZ, Lu NN, Korbelin J, Fukunaga K, Liu QH, Lu YM, Han F. Endothelium-derived semaphorin 3G attenuates ischemic retinopathy by coordinating beta-catenin-dependent vascular remodeling. J Clin Invest. 2021 Feb 15;131(4):e135296. doi: 10.1172/JCI135296.

    PubMed 33586674

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing IVC, Blood and aqueous humor at the time of IVC and Collect blood, aqueous humor, and initial vitreous at the time of surgery. in people with Proliferative Diabetic Retinopathy and VEGF Overexpression, run by The First Affiliated Hospital with Nanjing Medical University at 1 site 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 4 inclusion and 9 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: status not confirmed, as of the sponsor's last update on 24 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. Some participants in this study may receive a placebo. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Zizhong Hu, Dr (15195960100, huzizhong@njmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes of intraocular VEGF and PLGF of patients with proliferative diabetic retinopathy post-IVC (intravitreous injection of Conbercept). (time frame: 1-7 days). 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 NCT03506750, 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 24 Apr 2018.

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