Geographic AtrophyPhase 3NCT03525613
A Study to Compare the Efficacy and Safety of Intravitreal APL-2 Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration
A Phase 3 study testing APL-2 in people with Geographic Atrophy, run by Apellis Pharmaceuticals, Inc. at 112 sites in 14 countries.
Trial summary
This is a 24-month, Phase III, multicenter, randomized, double-masked, sham-injection controlled study to assess the efficacy and safety of multiple IVT injections of APL-2 in subjects with GA secondary to AMD. Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Geographic Atrophy
- What is being tested?
- APL-2
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 637 participants
- Where
- 112 sitesin 14 countries
- Study dates
- 31 Aug 2018to 28 Jun 2022
- 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 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- The study eye must meet all inclusion criteria. If both eyes meet the inclusion criteria, the eye with the worst visual acuity at the screening visit will be designated as the study eye. If both eyes have the same visual acuity, the right eye will be selected as the study eye.
- Ocular- specific inclusion criteria apply to the study eye only, unless otherwise specified.
- Age ≥ 60 years.
- Normal Luminance best corrected visual acuity of 24 letters or better using Early Treatment Diabetic Retinopathy Study (ETDRS) charts (approximately 20/320 Snellen equivalent).
- Clinical diagnosis of GA of the macula secondary to AMD as determined by the Investigator and confirmed by the Reading Center.
- The GA lesion must meet the following criteria as determined by the central reading center's assessment of Fundus Autofluorescence (FAF) imaging at screening:
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- Total GA area must be ≥ 2.5 and ≤ 17.5 mm2 (1 and 7 disk areas [DA] respectively)
- If GA is multifocal, at least one focal lesion must be ≥ 1.25 mm2 (0.5 DA), with the overall aggregate area of GA, as specified above in 4a.
- The entire GA lesion must be completely visualized on the macula centered image and must be able to be imaged in its entirety and not contiguous with any areas of peripapillary atrophy.
- Presence of any pattern of hyperautofluorescence in the junctional zone of GA. Absence of hyperautofluorescence (i.e. pattern = none) is exclusionary.
- Adequate clarity of ocular media, adequate pupillary dilation, and fixation to permit the collection of good quality images as determined by the Investigator.
- Meets the following criteria related to microperimetry:
- Able to detect fixation target.
- Total elapsed time to complete the 10-2 68 point exam is ≤ 30 minutes in duration.
- Reliability test ratio must be ≤ 20%.
- Subject is willing and able to undertake microperimetry assessment in the opinion of the investigator.
- Female subjects must be:
- Women of non-child-bearing potential (WONCBP), or
- Women of child-bearing potential (WOCBP) with a negative pregnancy test at screening and must agree to use protocol defined methods of contraception for the duration of the study and refrain from breastfeeding for the duration of the study.
- Males with female partners of child-bearing potential must agree to use protocol defined methods of contraception and agree to refrain from donating sperm for the duration of the study.
- Willing and able to give informed consent and to comply with the study procedures and assessments.
Who cannot join
- Ocular specific exclusion criteria apply to the study eye only, unless otherwise specified.
- GA secondary to a condition other than AMD such as Stargardt disease, cone rod dystrophy or toxic maculopathies like plaquenil maculopathy in either eye.
- Spherical equivalent of the refractive error demonstrating > 6 diopters of myopia or an axial length >26 mm.
- Any history or active choroidal neovascularization (CNV), associated with AMD or any other cause, including any evidence of retinal pigment epithelium rips or evidence of neovascularization anywhere based on SD-OCT imaging and/or fluorescein angiography as assessed by the Reading Center.
- Presence of an active ocular disease that in the opinion of the Investigator compromises or confounds visual function, including but not limited to, uveitis, other macular diseases (e.g. clinically significant epiretinal membrane (ERM), full thickness macular hole or uncontrolled glaucoma/ocular hypertension. Benign conditions in the opinion of the investigator such as peripheral retina dystrophy are not exclusionary).
- Intraocular surgery (including lens replacement surgery) within 3 months prior to randomization.
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- History of laser therapy in the macular region.
- Aphakia or absence of the posterior capsule. Note: YAG laser posterior capsulotomy for posterior capsule opacification done at least 60 days prior to screening is not exclusionary.
- Any ocular condition other than GA secondary to AMD that may require surgery or medical intervention during the study period or, in the opinion of the Investigator, could compromise visual function during the study period.
- Any contraindication to IVT injection including current ocular or periocular infection.
- History of prior intravitreal injection.
- Unable to perform microperimetry reliably in the opinion of the investigator
- Prior participation in another interventional clinical study for intravitreal therapies in either eye (including subjects receiving sham).
- Prior participation in another interventional clinical study for geographic atrophy in either eye including investigational oral medication and placebo.
- Participation in any systemic experimental treatment or any other systemic investigational new drug within 6 weeks or 5 half-lives of the active ingredient (whichever is longer) prior to the start of study treatment. Note: clinical trials solely involving observation, over-the-counter vitamins, supplements, or diets are not exclusionary.
- Medical or psychiatric conditions that, in the opinion of the investigator, make consistent follow-up over the 24-month treatment period unlikely, or would make the subject an unsafe study candidate.
- Any screening laboratory value (hematology, serum chemistry or urinalysis) that in the opinion of the Investigator is clinically significant and not suitable for study participation.
- Known hypersensitivity to fluorescein sodium for injection or hypersensitivity to APL-2 or any of the excipients in APL-2 solution.
Trial locations and contacts
112 sites in 14 countries.
112 sites in 14 countries
United States67 sites
Retina Research Institute of Texas
Abilene, Texas, 79606
Vision Research Center Eye Associates of NM
Albuquerque, New Mexico, 87109
Michigan Medicine Kellogg Eye Center
Ann Arbor, Michigan, 48105
Southeast Retina Center, PC
Augusta, Georgia, 30909
California Retina Consultants
Bakersfield, California, 93309
The Retina Care Center
Baltimore, Maryland, 21209
Mid Atlantic Retina
Bethlehem, Pennsylvania, 18017
Retina Vitreous Associates Medical Group
Beverly Hills, California, 90211
Retina Center of NJ, LLC
Bloomfield, New Jersey, 07003
Gailey Eye Clinic Retina Center
Bloomington, Illinois, 61704
Tufts Medical Center
Boston, Massachusetts, 02116
Retinal Diagnostic Center
Campbell, California, 95508
The Retina Group of Washington
Chevy Chase, Maryland, 20815
Northwestern Feinberg School of Medicine
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
Blue Ocean Clinical Research / The Macula Center
Clearwater, Florida, 33761
Texas Retina Associates
Dallas, Texas, 75231
Southwest Retina Research Center, LLC
Durango, Colorado, 81301
Duke University, Duke Eye Center
Durham, North Carolina, 27710
Research - Retina Vitreous Center
Edmond, Oklahoma, 73013
Oregon Retina, LLP
Eugene, Oregon, 97405
Emerson Clinical Research Institute
Falls Church, Virginia, 22046
National Ophthalmic Research Institute (Retina Consultants of Southwest Florida)
Fort Myers, Florida, 33912
Retina Consultants of Orange County
Fullerton, California, 92835
Charles Retina Institute
Germantown, Tennessee, 38138
Colorado Retina Associates
Golden, Colorado, 80401
Associated Retinal Consultants, P.C
Grand Rapids, Michigan, 49564
Cumberland Valley Retina Center
Hagerstown, Maryland, 21740
Mid Atlantic Retina Specialists
Hagerstown, Maryland, 21740
Houston Eye Associates
Houston, Texas, 77025
Retina Consultants of Houston, PA
Houston, Texas, 77030
Atlantis Eyecare
Huntington Beach, California, 92647
Midwest Eye Institute
Indianapolis, Indiana, 46290
University of California, San Diego, Jacobs Retina
La Jolla, California, 92093
Retina and Vitreous Associates of Kentucky, PSC dba Retina Associates of Kentucky
Lexington, Kentucky, 40509
Ophthalmic Consultants of Long Island
Lynbrook, New York, 11563
University of Wisconsin
Madison, Wisconsin, 53705
Retina Associates New Orleans
Metairie, Louisiana, 70006
Bascom Palmer Eye Institute
Miami, Florida, 33136
VitreoRetinal Surgery PA
Minneapolis, Minnesota, 55435
Retina Vitreous Consultants
Monroeville, Pennsylvania, 15146
Bascom Palmer Eye Institute of Naples
Naples, Florida, 34103
Tennessee Retina, PC
Nashville, Tennessee, 37203
New York Eye and Ear Infirmary of Mount Sinai
New York, New York, 10003
Vitreous Retina Macula Consultants of NY
New York, New York, 10022
Byers Eye Institute at Stanford, Stanford School of Medicine
Palo Alto, California, 94303
Doheny Eye Center UCLA
Pasadena, California, 91105
Retina Specialty Institute
Pensacola, Florida, 32503
Mid Atlantic Retina, Wills Eye Hospital
Philadelphia, Pennsylvania, 19107
Arizona Retina & Vitreous Consultants
Phoenix, Arizona, 85021
Retina Consultants San Diego
Poway, California, 92064
Sierra Eye Associates
Reno, Nevada, 89502
Retinal Consultants Med Group, Inc.
Sacramento, California, 95819
University of Utah - John A. Moran Center
Salt Lake City, Utah, 84132
San Antonia Eye Center
San Antonio, Texas, 78215
Medical Center Ophthalmology Associates
San Antonio, Texas, 78240
Retina Associates of South Texas
San Antonio, Texas, 78240
Retinal Consultants of San Antonio
San Antonio, Texas, 78240
Brown Retina Institute
San Antonio, Texas, 78251
Orange County Retina Medical Group
Santa Ana, California, 92705
California Retina Consultants
Santa Barbara, California, 93103
New England Retina Consultants
Springfield, Massachusetts, 01107
NJ Retina
Toms River, New Jersey, 08755
Retina Group of New England
Waterford, Connecticut, 06385
AIO Visionary Eye Care
West Mifflin, Pennsylvania, 15122
Strategic Clinical Research Group
Willow Park, Texas, 76087
Center for Retina and Macular Disease
Winter Haven, Florida, 33880
France8 sites
CHU Dijon
Bordeaux, 21 079
CHU de Bordeaux
Bordeaux, 33076
Centre Hospitalier Intercommunal de Créteil
Créteil, 94010
Clinique du Val d'Ouest
Écully, 69130
Hopital Lariboisière
Paris, 75010
CHNO des Quinze-Vingts
Paris, 75012
Centre Ophtalmologique d'Imagerie et Laser
Paris, 75015
CHU de Strasbourg Hopital Civil
Strasbourg, 67091
Germany8 sites
Universitäts-Augenklinik Bonn
Bonn, 53127
University Opthalmology Clinic
Freiburg im Breisgau, 79106
Universitätsmedizin Göttingen Georg-August-Universität
Göttingen, 37075
Universitätsklinikum Schleswig-Holstein
Lübeck, 23538
Augenklinik der LMU München
München, 80336
Augenzentrum am St. Franziskus-Hospital
Münster, 48145
Universitäts-Augenklinik
Münster, 48149
STZ Eyetrial
Tübingen, 72076
Australia6 sites
Adelaide Eye & Retina Clinic
Adelaide, South Australia, 5000
Lions Eye Institute
Nedlands, Western Australia, 6009
Marsden Eye Specialist
Parramatta, New South Wales, 2150
Strathfield Retina Clinic
Strathfield, 2135
Save Sight Institute
Sydney, South Block, 2000
Sydney West Retina
Westmead, 2145
United Kingdom4 sites
The Royal Victoria Hospital
Belfast, BT12 6BA
Liverpool University Hospitals NHS Foundation Trust
Liverpool, L7 8XP
Sunderland Eye Infirmary
Sunderland, SR2 9HP
York Teaching Hospital NHS Foundation Trust
York, YO31 8HE
Israel3 sites
Rambam Medical Centre
Haifa, 3109601
Carmel Medical Center
Haifa, 3436212
Hadassah Medical Center
Jerusalem, 91120
Italy3 sites
Ospedale San Raffaele
Milan, 20132
Luigi Sacco Hospital
Milan, 20157
IRCCS Fondazione G.B. Bietti
Roma, 128
Poland3 sites
Oculomedica Eye Centre
Bydgoszcz, 85-316
Oftalmika Eye Hospital
Bydgoszcz, 85-631
Eye Surgery Center Professor Zagorski
Rzeszów, 35-017
Spain3 sites
Centro Médico Teknon
Barcelona, 08022
Centro de Oftalmologia Barraquer
Barcelona, 314
Hospital Universitario Puerta de Hierro
Majadahonda, Madrir, 2822
Czechia2 sites
AXON Clinical S.R.O
Prague, 150 00
Gemini Eye Clinic
Zlín, 76001
Netherlands2 sites
Academisch Medisch Centrum
Amsterdam, 1105 AZ
Radboud University Medical Center Oogheelkunde
Nijmegen, 6525
About this study
Official title: A Phase 3, Multi-Center, Randomized, Double-Masked, Sham-Controlled Study to Compare the Efficacy and Safety of Intravitreal Pegcetacoplan Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration (AMD)
This is a 24-month, Phase III, multicenter, randomized, double-masked, sham-injection controlled study to assess the efficacy and safety of multiple IVT injections of APL-2 in subjects with GA secondary to AMD.
- Conditions
- Geographic Atrophy
- Being tested
- APL-2, Sham Procedure
- Medical subject headings
- Geographic Atrophy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
APL-2Drug
Also called Pegcetacoplan
Complement (C3) Inhibitor
APL-2Drug
Also called Pegcetacoplan
Complement (C3) Inhibitor
Sham ProcedureOther
Subjects will receive a Sham procedure every month
Sham ProcedureOther
Subjects will receive a Sham procedure every other month
| Study group | Role | What they receive |
|---|---|---|
| APL-2 15mg 0.1 mL Monthly for 24 months | Experimental | A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every month Receives: Drug: APL-2 |
| APL-2 15mg 0.1 mL EOM for 24 months | Experimental | A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every other month Receives: Drug: APL-2 |
| Sham Procedure Monthly for 24 months | Experimental | Sham Procedure monthly for 24 months Receives: Other: Sham Procedure |
| Sham Procedure Every Other Month for 24 months | Experimental | Sham Procedure every other month for 24 months Receives: Other: Sham Procedure |
What is being measured
The primary outcome is the main question the study is designed to answer.
Least Squares (LS) Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 12
The GA lesion area was measured by a quantified central reading center based on FAF images. LS mean was calculated using a mixed effect model for repeated measure (MMRM) model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 12
Secondary outcomes (6)
LS Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 24
The GA lesion area was measured by a quantified central reading center based on FAF images. LS mean was calculated using a mixed effect model for repeated measure model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 24
Mean Change in Total Area of GA Lesions in the Study Eye Through Month 24
The mean change in GA lesion area through Month 24 was measured by assuming a piecewise linear trend in time with knots by FAF images at Months 6, 12, 18, and 24 and was calculated using a MMRM model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: From Baseline (screening) through Month 24
LS Mean Change From Baseline in Mean Threshold Sensitivity of All Points of the Study Eye at Month 24
Mean threshold sensitivity of all points was determined from the mesopic microperimetry as an assessment of the macular functional response. Microperimetry offers the option to test retinal light sensitivity while directly observing the fundus and allows for monitoring of macular function loss associated with GA progression. The microperimetry reading center overlaid the baseline FAF images with GA lesions traced by the imaging reading center and the corresponding macular integrity assessment microperimetry baseline scanning laser ophthalmoscope image and identified perilesional (within 500 microns outside the atrophy border), paralesional (beyond 500 microns outside the atrophy border), and extralesional (outside the atrophy border) loci on the microperimetry grid to determine the mean threshold sensitivity for these 3 areas. LS mean was calculated using a MMRM model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 24
LS Mean Change From Baseline in Monocular Maximum Reading Speed of the Study Eye at Month 24
The maximum reading speed of the study eye was calculated per Minnesota Low-Vision Reading Test (MNREAD) or Radner Reading Charts user manuals, with no adjustment for reading inaccuracy. An additional step to cap resulting reading speed values at a maximum of 300 words per minute (wpm) was implemented. Maximum reading speed was calculated as the mean of the 3 highest non-zero reading speeds (or 2, or 1 value, as available), except when all wpm were calculated as 0 then the maximum reading speed was calculated as 0. LS mean was calculated using a MMRM model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 24
LS Mean Change From Baseline in Mean Functional Reading Independence (FRI) Index Score at Month 24
The FRI was an interviewer-administered questionnaire with 7 items on functional reading activities most relevant to GA AMD subjects. It had 1 total index score. For each FRI Index reading activity performed in the past 7 days, subjects were asked about the extent to which they required assistance beyond eyeglasses/contact lenses, including the use of low-vision aids, adjustments in the activity, or help from another subject. Mean FRI Index scores ranged from 1 (unable to do independently) to 4 (totally independent), with higher scores indicating higher functional reading independence. A negative change from baseline indicated a decrease in the FRI; disease worsening. LS mean was calculated using a MMRM model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 24
LS Mean Change From Baseline in Normal-Luminance Best-Corrected Visual Acuity (NL-BCVA) Score of the Study Eye at Month 24
The NL-BCVA was assessed by early treatment diabetic retinopathy study (ETDRS) chart prior to dilating the eyes at a starting distance of 4 meters and ranged from 0 (least score) to 100 (best score). If the 4-meter score was >19 letters read correctly, the visual acuity score was the sum of total letters correctly read at 4 meters plus the addition of 30. If the 4-meter score was ≤19 letters read correctly, the visual acuity score was the sum of total letters read correctly at 4 meters and total letters read correctly at the 1-meter distance. If no letters were read correctly at either the 4-meter distance or the 1-meter distance, the visual acuity score was 0. A positive change in the value indicated improvement in visual acuity. LS mean was calculated using a MMRM model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
Measured: Baseline (screening) and Month 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 May 2018
- Study start31 Aug 2018
- Primary completion28 Jun 2021
- Study completion28 Jun 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Geographic AtrophyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 637 participants (actual)
Sponsor and investigators
- Lead sponsor
- Apellis Pharmaceuticals, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03525613
- Sponsor's protocol ID
- APL2-304
- Status last verified
- Jun 2023
- First submitted
- 20 Apr 2018
- Last updated
- 6 Jul 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Birner K, Mai J, Boryshchuk D, Frommlet F, Enzendorfer ML, Schurer-Waldheim S, Gumpinger M, Vogl WD, Leingang O, Sacu S, Schmidt-Erfurth U. Exploring Trial Endpoints in Geographic Atrophy Based on Localized Functional Changes in Microperimetry and AI-Quantified OCT Biomarkers. Invest Ophthalmol Vis Sci. 2026 Jan 5;67(1):22. doi: 10.1167/iovs.67.1.22.
PubMed 41533918Sadda S, Hatcher KA, Shah BK, Kondapalli SS, Li C, Baumal CR. Outer Retinal Tubulation and Geographic Atrophy: A Natural History Analysis of Sham Observed Eyes from the OAKS and DERBY Trials. Ophthalmol Ther. 2025 Jul;14(7):1611-1619. doi: 10.1007/s40123-025-01156-5. Epub 2025 May 19.
PubMed 40388106Wykoff CC, Lad EM, Heier JS. Syfovre Approval for Geographic Atrophy. JAMA Ophthalmol. 2024 Jul 1;142(7):685-686. doi: 10.1001/jamaophthalmol.2024.1754. No abstract available.
PubMed 38814626Fu DJ, Bagga P, Naik G, Glinton S, Faes L, Liefers B, Lima R, Wignall G, Keane PA, Ioannidou E, Ribeiro Reis AP, McKeown A, Scheibler L, Patel PJ, Moghul I, Pontikos N, Balaskas K. Pegcetacoplan Treatment and Consensus Features of Geographic Atrophy Over 24 Months. JAMA Ophthalmol. 2024 Jun 1;142(6):548-558. doi: 10.1001/jamaophthalmol.2024.1269.
PubMed 38722644Heier JS, Lad EM, Holz FG, Rosenfeld PJ, Guymer RH, Boyer D, Grossi F, Baumal CR, Korobelnik JF, Slakter JS, Waheed NK, Metlapally R, Pearce I, Steinle N, Francone AA, Hu A, Lally DR, Deschatelets P, Francois C, Bliss C, Staurenghi G, Mones J, Singh RP, Ribeiro R, Wykoff CC; OAKS and DERBY study investigators. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023 Oct 21;402(10411):1434-1448. doi: 10.1016/S0140-6736(23)01520-9.
PubMed 37865470Tzoumas N, Riding G, Williams MA, Steel DH. Complement inhibitors for age-related macular degeneration. Cochrane Database Syst Rev. 2023 Jun 14;6(6):CD009300. doi: 10.1002/14651858.CD009300.pub3.
PubMed 37314061
Study at a glance
From the registry record, last updated by the sponsor on 6 Jul 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Multi-Center, Randomized, Double-Masked, Sham-Controlled Study to Compare the Efficacy and Safety of Intravitreal Pegcetacoplan Therapy With Sham Injections in Patients With Geographic Atrophy (GA) Secondary to Age-Related Macular Degeneration (AMD)
- ClinicalTrials.gov ID
- NCT03525613
- Acronym / sponsor ID
- APL2-304
- Conditions
- Geographic Atrophy
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 637 participants (actual)
- Lead sponsor
- Apellis Pharmaceuticals, Inc.Industry (pharma, biotech, devices)
- Study start
- 31 Aug 2018 (actual)
- Primary completion
- 28 Jun 2021 (actual)
- Study completion
- 28 Jun 2022 (actual)
- First posted
- 15 May 2018 (actual)
- Results
- Posted 6 Jul 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a 24-month, Phase III, multicenter, randomized, double-masked, sham-injection controlled study to assess the efficacy and safety of multiple IVT injections of APL-2 in subjects with GA secondary to AMD.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| APL-2 15mg 0.1 mL Monthly for 24 months | Experimental | Drug: APL-2A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every month |
| APL-2 15mg 0.1 mL EOM for 24 months | Experimental | Drug: APL-2A single dose of 15 mg APL-2/0.1 mL will be administered via intravitreal injection in this study. Subjects will receive an injection every other month |
| Sham Procedure Monthly for 24 months | Experimental | Other: Sham ProcedureSham Procedure monthly for 24 months |
| Sham Procedure Every Other Month for 24 months | Experimental | Other: Sham ProcedureSham Procedure every other month for 24 months |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (21 listed)
- The study eye must meet all inclusion criteria. If both eyes meet the inclusion criteria, the eye with the worst visual acuity at the screening visit will be designated as the study eye. If both eyes have the same visual acuity, the right eye will be selected as the study eye.
- Ocular- specific inclusion criteria apply to the study eye only, unless otherwise specified.
- Age ≥ 60 years.
- Normal Luminance best corrected visual acuity of 24 letters or better using Early Treatment Diabetic Retinopathy Study (ETDRS) charts (approximately 20/320 Snellen equivalent).
- Clinical diagnosis of GA of the macula secondary to AMD as determined by the Investigator and confirmed by the Reading Center.
Key exclusion criteria (18 listed)
- Ocular specific exclusion criteria apply to the study eye only, unless otherwise specified.
- GA secondary to a condition other than AMD such as Stargardt disease, cone rod dystrophy or toxic maculopathies like plaquenil maculopathy in either eye.
- Spherical equivalent of the refractive error demonstrating > 6 diopters of myopia or an axial length >26 mm.
- Any history or active choroidal neovascularization (CNV), associated with AMD or any other cause, including any evidence of retinal pigment epithelium rips or evidence of neovascularization anywhere based on SD-OCT imaging and/or fluorescein angiography as assessed by the Reading Center.
- Presence of an active ocular disease that in the opinion of the Investigator compromises or confounds visual function, including but not limited to, uveitis, other macular diseases (e.g. clinically significant epiretinal membrane (ERM), full thickness macular hole or uncontrolled glaucoma/ocular hypertension. Benign conditions in the opinion of the investigator such as peripheral retina dystrophy are not exclusionary).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| APL-2Also: PegcetacoplanComplement (C3) Inhibitor | Drug | APL-2 15mg 0.1 mL Monthly for 24 months |
| APL-2Also: PegcetacoplanComplement (C3) Inhibitor | Drug | APL-2 15mg 0.1 mL EOM for 24 months |
| Sham ProcedureSubjects will receive a Sham procedure every month | Other | Sham Procedure Monthly for 24 months |
| Sham ProcedureSubjects will receive a Sham procedure every other month | Other | Sham Procedure Every Other Month for 24 months |
Primary outcome
Least Squares (LS) Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 12
Time frame: Baseline (screening) and Month 12
The GA lesion area was measured by a quantified central reading center based on FAF images. LS mean was calculated using a mixed effect model for repeated measure (MMRM) model. Baseline was defined as the last available, non-missing observation prior to first study drug administration.
6 secondary outcomes
LS Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 24
Time frame: Baseline (screening) and Month 24
Mean Change in Total Area of GA Lesions in the Study Eye Through Month 24
Time frame: From Baseline (screening) through Month 24
LS Mean Change From Baseline in Mean Threshold Sensitivity of All Points of the Study Eye at Month 24
Time frame: Baseline (screening) and Month 24
LS Mean Change From Baseline in Monocular Maximum Reading Speed of the Study Eye at Month 24
Time frame: Baseline (screening) and Month 24
LS Mean Change From Baseline in Mean Functional Reading Independence (FRI) Index Score at Month 24
Time frame: Baseline (screening) and Month 24
LS Mean Change From Baseline in Normal-Luminance Best-Corrected Visual Acuity (NL-BCVA) Score of the Study Eye at Month 24
Time frame: Baseline (screening) and Month 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Jul 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41533918Birner K, Mai J, Boryshchuk D, Frommlet F, Enzendorfer ML, Schurer-Waldheim S, Gumpinger M, Vogl WD, Leingang O, Sacu S, Schmidt-Erfurth U. Exploring Trial Endpoints in Geographic Atrophy Based on Localized Functional Changes in Microperimetry and AI-Quantified OCT Biomarkers. Invest Ophthalmol Vis Sci. 2026 Jan 5;67(1):22. doi: 10.1167/iovs.67.1.22.
- Derived from this study: PubMed 40388106Sadda S, Hatcher KA, Shah BK, Kondapalli SS, Li C, Baumal CR. Outer Retinal Tubulation and Geographic Atrophy: A Natural History Analysis of Sham Observed Eyes from the OAKS and DERBY Trials. Ophthalmol Ther. 2025 Jul;14(7):1611-1619. doi: 10.1007/s40123-025-01156-5. Epub 2025 May 19.
- Derived from this study: PubMed 38814626Wykoff CC, Lad EM, Heier JS. Syfovre Approval for Geographic Atrophy. JAMA Ophthalmol. 2024 Jul 1;142(7):685-686. doi: 10.1001/jamaophthalmol.2024.1754. No abstract available.
- Derived from this study: PubMed 38722644Fu DJ, Bagga P, Naik G, Glinton S, Faes L, Liefers B, Lima R, Wignall G, Keane PA, Ioannidou E, Ribeiro Reis AP, McKeown A, Scheibler L, Patel PJ, Moghul I, Pontikos N, Balaskas K. Pegcetacoplan Treatment and Consensus Features of Geographic Atrophy Over 24 Months. JAMA Ophthalmol. 2024 Jun 1;142(6):548-558. doi: 10.1001/jamaophthalmol.2024.1269.
- Derived from this study: PubMed 37865470Heier JS, Lad EM, Holz FG, Rosenfeld PJ, Guymer RH, Boyer D, Grossi F, Baumal CR, Korobelnik JF, Slakter JS, Waheed NK, Metlapally R, Pearce I, Steinle N, Francone AA, Hu A, Lally DR, Deschatelets P, Francois C, Bliss C, Staurenghi G, Mones J, Singh RP, Ribeiro R, Wykoff CC; OAKS and DERBY study investigators. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023 Oct 21;402(10411):1434-1448. doi: 10.1016/S0140-6736(23)01520-9.
- Derived from this study: PubMed 37314061Tzoumas N, Riding G, Williams MA, Steel DH. Complement inhibitors for age-related macular degeneration. Cochrane Database Syst Rev. 2023 Jun 14;6(6):CD009300. doi: 10.1002/14651858.CD009300.pub3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
112 sites in 14 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing APL-2 in people with Geographic Atrophy, run by Apellis Pharmaceuticals, Inc. at 112 sites in 14 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 21 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 6 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 112 sites in United States, France, Germany, Australia, United Kingdom and 9 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 6 Jul 2023). 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?
Least Squares (LS) Mean Change From Baseline in Total Area of GA Lesions in the Study Eye at Month 12 (time frame: Baseline (screening) and 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 NCT03525613, which also lists 6 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 6 Jul 2023.