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Diabetic Macular EdemaPhase 2INFINITYNCT04418427

ADVM-022 Intravitreal Gene Therapy for DME

A Phase 2 study testing 6E11 vg/eye of ADVM-022, 2E11 vg/eye of ADVM-022 and Aflibercept in people with Diabetic Macular Edema and Diabetic Retinopathy, run by Adverum Biotechnologies, Inc. at 14 sites in 2 countries.

Completed

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

Official record
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Trial summary

A Phase 2, Multi-Center, Randomized, Double-Masked*, Active Controlled Study of ADVM-022 (AAV.7m8-aflibercept) in Subjects with Diabetic Macular Edema [INFINITY] Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetic Macular Edema, Diabetic Retinopathy
What is being tested?
6E11 vg/eye of ADVM-022, 2E11 vg/eye of ADVM-022 and Aflibercept
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
14 sitesin 2 countries
Study dates
28 May 2020to 14 Jun 2023
Phase
Phase 2
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

  • Age ≥ 18
  • Type 1 or Type 2 diabetes mellitus
  • Willing and able to provide informed consent
  • Vision impairment due to center involving diabetic macular edema

Who cannot join

  • Uncontrolled diabetes defined as HbA1C >10%, or history of diabetic ketoacidosis within 3 months prior to randomization; or subjects who, within the last 3 months, initiated intensive insulin treatment (a pump or multiple daily injection) or plan to do so in the next 3 months.
  • Acute coronary syndrome, myocardial infarction or coronary artery revascularization, CVA, TIA in the last 6 months
  • Uncontrolled hypertension defined as average SBP ≥160 mmHg or an average DBP ≥100 mmHg
  • Known severe renal impairment
  • High risk Proliferative Diabetic Retinopathy
  • History of retinal disease in the study eye other than diabetic retinopathy
Show all 10Show fewer
  • History of retinal detachment (with or without repair) in the study eye
  • History of vitrectomy, trabeculectomy, or other filtration surgery in the study eye
  • Any prior focal or grid laser photocoagulation or any prior PRP in the study eye
  • Current or planned pregnancy or breastfeeding

Trial locations and contacts

14 sites in 2 countries.

14 sites in 2 countries

United States13 sites
  • Adverum Clinical Site

    Abilene, Texas, 79606

  • Adverum Clinical Site

    Austin, Texas, 78705

  • Adverum Clinical Site

    Bakersfield, California, 93309

  • Adverum Clinical Site

    Beverly Hills, California, 90211

  • Adverum Clinical Site

    Deerfield Beach, Florida, 33064

  • Adverum Clinical Site

    Golden, Colorado, 80401

  • Adverum Clinical Site

    Houston, Texas, 77030

  • Adverum Clinical Site

    Nashville, Tennessee, 37203

  • Adverum Clinical Site

    Philadelphia, Pennsylvania, 19107

  • Adverum Clinical Site

    Phoenix, Arizona, 85014

  • Adverum Clinical Site

    Reno, Nevada, 89502

  • Adverum Clinical Site

    The Woodlands, Texas, 77384

  • Adverum Clinical Site

    West Columbia, South Carolina, 29169

Other trials in United States

Puerto Rico1 site
  • Adverum Clinical Site

    Arecibo, 00612

Other trials in Puerto Rico

About this study

Official title: A Phase 2, Multi-Center, Randomized, Double-Masked, Active Controlled Study of ADVM-022 (AAV.7m8-aflibercept) in Subjects With Diabetic Macular Edema [INFINITY]

A Phase 2, Multi-Center, Randomized, Double-Masked*, Active Controlled Study of ADVM-022 (AAV.7m8-aflibercept) in Subjects with Diabetic Macular Edema [INFINITY]

Read the detailed description

ADVM-022 (also known as Ixo-vec and AAV.7m8-aflibercept) is an investigational gene therapy product developed for the treatment of serious retinal vascular diseases including Diabetic Macular Edema (DME), a vision-threatening complication of diabetic retinopathy. DME can affect up to 10% of individuals with both type 1 and type 2 diabetes mellitus. Current therapies for treating DME include anti-vascular endothelial growth factor (anti-VEGF) agents that require frequent and long-term intravitreal (IVT) injections to achieve and maintain efficacy. ADVM-022 is intended provide sustained intraocular expression of aflibercept from a single IVT injection to potentially reduce the current treatment burden and prevent disease progression and vision loss due to undertreatment.

This Phase 2, randomized, controlled study (INFINITY) enrolled 36 eligible participants with DME. The participants were randomized to receive one of the two dose levels of ADVM-022 or assigned to the control arm to receive a sham ocular injection with a preceding aflibercept injection. Participants randomized to the ADVM-022 arms were assigned to receive a preceding aflibercept or sham ocular injection. All participants were monitored regularly for disease activity and may have received supplemental aflibercept based on predefined retreatment criteria. All participants were to be followed over a 96- week follow-up period.

To enhance safety monitoring for participants in this study, the sponsor unmasked treatment assignment (in April 2021) due to the occurrence of a suspected unexpected serious adverse reaction (SUSAR) which occurred early in the study in the high dose (ADVM-022 6E11 vg/eye) arm. Interpretation of the results of this study should consider the potential confounding nature of this unmasking in the context of the observed dose-limiting events and the associated additional use of topical/intravitreal/systemic steroids, particularly in the high dose ADVM-022 arm.

In this study ADVM-022 (Ixo-vec) demonstrated improved efficacy across endpoints, reducing the need for supplemental aflibercept in DME management and demonstrating a clinically meaningful delay in DME worsening and improved outcomes across multiple endpoints compared to the control arm (sham + Aflibercept). However, the benefit of the ADVM-022 6E11 vg/eye dose was affected by dose-limiting toxicities in some participants. In terms of safety outcomes, the most common ADVM-022-related adverse events were mild-to-moderate intraocular inflammation, a known and expected side effect of ocular gene therapy, which was generally responsive to corticosteroid eye drops. No Ixo-vec-related events were reported in the fellow eye or systemically, indicating no off-target effects.

Being tested
6E11 vg/eye of ADVM-022, 2E11 vg/eye of ADVM-022, Aflibercept
Keywords
ADVM-022, ADVM-022-04, AAV.7m8, Anti-VEGF therapy, Blindness, INFINITY, Gene therapy, Aflibercept (Eylea), Retinal Diseases, Eye Diseases, AAV Vector, Adverum, DME, Diabetic macular edema, Diabetic eye disease, Diabetic retinopathy, DR, AAV.7m8-aflibercept, Ixoberogene soroparvovec, Ixo-vec
Medical subject headings
Diabetic Retinopathy, Blindness, Retinal Diseases, Eye Diseases

What participants receive

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

  • 6E11 vg/eye of ADVM-022Biological

    Also called AAV.7m8-aflibercept

    ADVM-022 (AAV.7m8-aflibercept) is a recombinant, replication-incompetent adeno-associated virus (AAV.7m8) gene therapy vector carrying a coding sequence for aflibercept

  • 2E11 vg/eye of ADVM-022Biological

    Also called AAV.7m8-aflibercept

    ADVM-022 (AAV.7m8-aflibercept) is a recombinant, replication-incompetent adeno-associated virus (AAV.7m8) gene therapy vector carrying a coding sequence for aflibercept

  • AfliberceptBiological

    Also called Eylea

    Commercially available Active Comparator

Study groups in NCT04418427
Study groupRoleWhat they receive
1Experimental6E11 vg/eye ADVM-022 +/- aflibercept 2mg IVT
Receives: Biological: 6E11 vg/eye of ADVM-022; Biological: Aflibercept
2Experimental2E11 vg/eye ADVM-022 +/- aflibercept 2mg IVT
Receives: Biological: 2E11 vg/eye of ADVM-022; Biological: Aflibercept
3Active comparatorAflibercept 2mg IVT
Receives: Biological: Aflibercept

What is being measured

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

  1. Time to Worsening of DME Disease Activity in the Study Eye.

    Time to worsening of DME disease activity in the study eye through 96 weeks.

    Time to worsening of DME disease activity defined by either: An increase in CST > 50 µm as assessed by SD-OCT compared to the lower of the two CST measurements recorded at Day 1 or Week 4; A loss of > 5 letters in BCVA due to worsening DME disease activity compared to the higher of the two BCVA measurements recorded at Day 1 or Week 4. Number of weeks was relative to Day 1.

    Measured: Day 1 through 96 weeks

Secondary outcomes (11)
  1. Incidence of Ocular Adverse Events (AEs)

    Incidence of ocular adverse events (AEs) through 96 weeks

    Measured: 96 weeks

  2. Incidence of Non-ocular Adverse Events (AEs)

    Incidence of non-ocular adverse events (AEs) through 96 weeks.

    Measured: Day 1 through 96 weeks

  3. Change From Baseline Central Subfield Thickness (CST) in Study Eye

    Central subfield thickness is a measurement of the thickness of the retina in a circular area around the fovea. Least squares mean change from Baseline in central subfield thickness at Week 96 is presented for the study eye.

    Measured: Baseline through 96 weeks

  4. Change From Baseline in Best Corrected Visual Acuity (BCVA) Score Over Time in the Study Eye

    Least squares mean change from Baseline in BCVA score over time was measured over time through week 96 in the study eye by ETDRS letters.

    Measured: 96 weeks

  5. Frequency of Supplemental Aflibercept Injections (2 mg IVT) in the Study Eye Over Time During the Study

    Frequency of supplemental aflibercept (2 mg IVT) injections was assessed in the study eye over time during the study.

    Participants were analyzed according to the study treatments they actually received on Days 1 and 8.

    The rate of supplemental aflibercept per year = Total number of supplemental aflibercept injections / Total years at-risk (at-risk duration starting at Day 8).

    Measured: Day 1 through 96 weeks

  6. Incidence of 2-step Improvement in Diabetic Retinopathy Severity Score (DRSS) in the Study Eye Over Time

    Diabetic Retinopathy Severity Score was determined by the Central Reading Center using ultra-wide field color retinopathy fundus photography. The score represents a comprehensive evaluation of retinal health, including the presence of microaneurysms, hemorrhages, and other abnormalities in the retina of the study eye. The score ranges from 10 to 85 and is divided into 13-steps used to classify increasing diabetic retinopathy severity (with higher scored indicating more advanced stages of Diabetic Retinopathy). In this endpoint a 2-step improvement indicates an improvement in a participant across 2 steps of the 13-step scale.

    Measured: From Day 1 through 96 weeks

  7. Incidence of 3-step Improvement in DRSS (Diabetic Retinopathy Severity Score) in the Study Eye Over Time

    Diabetic Retinopathy Severity Score was determined by the Central Reading Center using ultra-wide field color retinopathy fundus photography. The score represents a comprehensive evaluation of retinal health, including the presence of microaneurysms, hemorrhages, and other abnormalities in the retina of the study eye. The score ranges from 10 to 85 and is divided into 13-steps used to classify increasing diabetic retinopathy severity (with higher scored indicating more advanced stages of Diabetic Retinopathy). In this endpoint a 3-step improvement indicates an improvement in a participant across 3 steps of the 13-step scale.

    Measured: From Day 1 through 96 weeks

  8. Incidence of 2-step Worsening in DRSS (Diabetic Retinopathy Severity Score) in the Study Eye Over Time

    Diabetic Retinopathy Severity Score was determined by the Central Reading Center using ultra-wide field color retinopathy fundus photography. The score represents a comprehensive evaluation of retinal health, including the presence of microaneurysms, hemorrhages, and other abnormalities in the retina of the study eye. The score ranges from 10 to 85 and is divided into 13-steps used to classify increasing diabetic retinopathy severity (with higher scored indicating more advanced stages of Diabetic Retinopathy). In this endpoint a 2-step worsening indicates a worsening across 2 steps of the 13-step scale.

    Note: 2-step worsening in DRSS was observed in 2 participants in both the control arm and the ADVM-022 6E11 vg/eye arm. These participants experienced ocular adverse events which may have contributed, at least in part, to the worsening in DRSS. This included one participant in the ADVM-022 6E11 vg/eye arm who had a SUSAR of Hypotony of eye (secondary to intraocular inflammation).

    Measured: From Day 1 through 96 weeks

  9. Incidence of 3-step Worsening in DRSS (Diabetic Retinopathy Severity Score) in the Study Eye Over Time

    Diabetic Retinopathy Severity Score was determined by the Central Reading Center using ultra-wide field color retinopathy fundus photography. The score represents a comprehensive evaluation of retinal health, including the presence of microaneurysms, hemorrhages, and other abnormalities in the retina of the study eye. The score ranges from 10 to 85 with higher scored indicating more advanced stages of Diabetic Retinopathy. The incidence of 3-step worsening in DRSS score over time at Week 96 is presented. Visits with a 3-step or greater worsening in DRSS were considered separate events.

    Note: 3-step worsening in DRSS was observed in one participant each in the control arm and the ADVM-022 6E11 vg/eye arm. Both participants experienced ocular adverse events which may have contributed, at least in part, to the worsening in DRSS. This included one participant in the ADVM-022 6E11 vg/eye arm who had a SUSAR of Hypotony of eye (secondary to intraocular inflammation).

    Measured: From Day 1 through 96 weeks

  10. Occurrence of Any Vision Threatening Complications in the Study Eye (Anterior Segment Neovascularization, Vitreous Hemorrhage, or Any Other High-risk Proliferative DR, or Tractional Retinal Detachment) Over Time Through Week 96

    Occurrence of any vision threatening complication over time though 96 weeks. Results present the incidence of participants who experienced "Any Vision Threatening Complications" (defined as any Vitreous Haemorrhage adverse event (AE), Anterior Segment Neovascularization AE, High-risk proliferative DR (defined as DSSR >= 71), or Tractional Retinal Detachment AE) in the study eye from Day 1 through 96 weeks.

    Note: AEs of Vitreous Haemorrhage and High-risk proliferative DR were reported in 1 participant in the control arm and in 2 separate participants in the 6E11 vg/eye arm. No AE of Tractional Retinal Detachment or Anterior Segment Neovascularization occurred.

    Measured: From Day 1 through 96 weeks

  11. Incidence of CST <300 μm Over Time Through Week 96 in the Study Eye

    Central subfield thickness is a measurement of the thickness of the retina in a circular area around the fovea. Incidence of participants with Central subfield thickness of less than 300 μm over time in the study eye through Week 96 is presented.

    Measured: Day 1 through 96 weeks

Timeline

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

  1. First posted5 Jun 2020
  2. Study start28 May 2020
  3. Primary completion22 Nov 2022
  4. Study completion14 Jun 2023

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04418427
Sponsor's protocol ID
ADVM-022-04
Acronym
INFINITY
Status last verified
Jun 2025
First submitted
28 May 2020
Last updated
10 Jul 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing 6E11 vg/eye of ADVM-022, 2E11 vg/eye of ADVM-022 and Aflibercept in people with Diabetic Macular Edema and Diabetic Retinopathy, run by Adverum Biotechnologies, Inc. at 14 sites in 2 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 4 inclusion and 10 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 10 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States, Puerto Rico. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 10 Jul 2025). 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?

Time to Worsening of DME Disease Activity in the Study Eye. (time frame: Day 1 through 96 weeks). 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 10 Jul 2025; AzTrials last refreshed its copy on 31 Oct 2026.

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