Diabetic Macular EdemaPhase 4INSITE-DMENCT05610319
Treat & Extend Versus Fixed Dosing With Faricimab for Management of Diabetic Macular Edema: A Pragmatic, Multi-center, Open-label, Randomized, Controlled Trial
A Phase 4 study testing Faricimab in people with Diabetic Macular Edema, run by McMaster University at 46 sites in 4 countries.
Trial summary
This study will assess a pragmatic, treat and extend regimen of faricimab against the standard of a fixed dosing regimen. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetic Macular Edema
- What is being tested?
- Faricimab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 446 participants
- Where
- 46 sitesin 4 countries
- Study dates
- 1 May 2023to Dec 2026
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
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 years
- Diagnosis of diabetes mellitus (type 1 or type 2).
- Macular thickening secondary to DME (CI-DME) involving the center of the fovea on Optical Coherence Tomography - Central subfield thickness (CST) ≥ 325 μm on Spectralis at screening.***
- Visual impairment due to DME, with best corrected visual acuity of 80 to 20 letters (Snellen VA 20/25 - 20/400).
- Media clarity, pupillary dilation, and individual cooperation sufficient for adequate OCT and fundus photographs.
- Hemoglobin A1c must be <10% within 2 months prior to 1st study treatment.
- Provide signed informed consent.
Who cannot join
- Active or history of ocular inflammation or suspected/active ocular infection in either eye.
- High-risk proliferative diabetic retinopathy in the study eye.**
- Tractional retinal detachment, preretinal fibrosis or visually significant epiretinal membrane involving the macula.
- Uncontrolled glaucoma (intraocular pressure >30 with or without medications).
- Any intravitreal, periocular or implant corticosteroids within 26 weeks (6 months) before day 1 or any use of Iluvien implants.
- Treatment with Panretinal photocoagulation (PRP) within 12 weeks before day 1.
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- Treatment with macular laser.
- Any cataract surgery or any other intraocular surgery within 12 weeks before day 1.
- Macular edema in study eye due to a cause other than DME.
- If clinical exam and/or OCT and/or wide-field fluorescein angiography (WF-FA) suggest that (a) macular edema is considered to be related to ocular surgery such as cataract extraction or (b) if primary cause for macular edema is vitreoretinal interface abnormalities (e.g. a taut posterior hyaloid or epiretinal membrane).
- Any ocular condition is present such that visual acuity loss would not improve from resolution of macular edema in opinion of the investigator (e.g. foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, nonretinal condition)
- Any history of ocular conditions that might affect macular edema (e.g. vein occlusion, idiopathic or infectious or non-infectious uveitis, ocular inflammatory disease, neovascular glaucoma etc.)
- Women of child-bearing potential who are lactating, pregnant, or intending to become pregnant within the next 100 weeks.
- Current or anticipated incarceration.
- Terminal illness with expected survival less than 100 weeks.
- Known hypersensitivity to faricimab or any of the excipients in the faricimab injection.
- Currently enrolled in a study that does not permit co-enrollment.
- Unable to obtain informed consent due to language or other operational barriers.
- Anticipated problems, in the judgment of the site investigator, maintaining compliance with the protocol, including attending study visits, completing assessments or procedures.
- Prior enrollment in this trial.
- Other reason to exclude the patient, as approved by the sponsor and site investigator.
- Previous treatment with anti-VEGF and:
- <12 weeks prior to day 1 (washout period).*or,
- Diagnosis of DME is > 2 years of enrollment or,
- Do not have a demonstrated response to anti-VEGF treatment based on clinical discretion.
Trial locations and contacts
46 sites in 4 countries.
46 sites in 4 countries
Australia16 sites
Adelaide Eye & Retina Centre
Adelaide, South Australia, 5000
Eye Clinic Albury Wodonga
Albury, New South Wales, 2640
Nexus Eyecare Blacktown
Blacktown, New South Wales
Eastern Suburbs Eye Specialists
Bondi Junction, New South Wales, 2022
Centre for Eye Research Australia
East Melbourne, Victoria, 3002
Hobart Eye Surgeons
Hobart, Tasmania, 7008
Retina and Eye Consultants
Hurstville, New South Wales, 2220
Lane Cove Eye
Lane Cove, New South Wales, 2066
South West Retina
Liverpool, New South Wales, 2170
Lions Eye Institute Limited
Nedlands, Western Australia, 6009
Marsden Eye Specialists
Parramatta, New South Wales, 2150
Retina Specialists Victoria
Rowville, Victoria, 3178
Strathfield Retina Clinic
Strathfield, New South Wales, 2135
South Eastern Sydney Health
Sydney, New South Wales, 2000
Sydney Retina
Sydney, New South Wales, 2000
Queensland Eye Institute
Woolloongabba, Queensland, 4012
United States11 sites
Austin Retina Associates
Austin, Texas, 78705
Retina Consultants of Texas
Beaumont, Texas, 77707
Retina & Vitreous of Texas
Bellaire, Texas, 77401
Retina Consultants of Houston, dba Retina Consultants of Texas
Bellaire, Texas, 77401
Mississippi Retina Associates
Jackson, Mississippi, 39202
Valley Retina Institute
McAllen, Texas, 78503
Retinal Consultants Medical Group Inc.
Modesto, California, 95356
University Retina and Macula Associates
Oak Forest, Illinois, 60452
Vitreo-Retina Medical Group
Sacramento, California, 95825
Retina Consultants of Houston, dba Retina Consultants of Texas
San Antonio, Texas, 78240
Eye Associates of Northeast Louisiana Dba Haik Humble Eye Center
West Monroe, Louisiana, 71291
Canada11 sites
Calgary Retina Consultants
Calgary, Alberta, T2H 0C8
Alberta Retina Consultants
Calgary, Alberta, T5H 0X5
The Research Institute of St. Joe's Hamilton
Hamilton, Ontario, L8G 5E4
St. Joseph's Healthcare London
London, Ontario, N6A 4V2
Maisonneuve-Rosemont Hospital
Montreal, Quebec, H1T 2M4
Retina Surgical Associates
New Westminster, British Columbia, V3L 5H1
Retina Institute of Ottawa
Ottawa, Ontario, K2B 7E9
Toronto Retina Institute
Toronto, Ontario, M3C 0G9
Vitreous Retina Macula Specialists of Toronto
Toronto, Ontario, M8X 2X3
West Coast Retina
Vancouver, British Columbia, V5Z 1K1
UBC Eye Centre, Vancouver General Hospital
Vancouver, British Columbia, V5Z 1M9
United Kingdom8 sites
Bradford Royal Infirmary
Bradford, England
University Hospitals Bristol-Weston
Bristol, England
Frimley Health
Frimley, England
Liverpool University Hospitals
Liverpool, England
King's College Hospital
London, England
London North West University
London, England
Moorfields Eye Hospital
London, England
The Royal Wolverhampton
Wolverhampton, England
About this study
This study will assess a pragmatic, treat and extend regimen of faricimab against the standard of a fixed dosing regimen.
- Conditions
- Diabetic Macular Edema
- Being tested
- Faricimab
- Keywords
- Treat and Extend, Faricimab, Anti-VEGF
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FaricimabDrug
Faricimab will be administered via intravitreal injection.
| Study group | Role | What they receive |
|---|---|---|
| Treat and Extend | Experimental | Participants randomized to the T\&E Arm will initially receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), with treatment intervals increased/extended, reduced, or maintained based on CST assessments, until week 100. Receives: Drug: Faricimab |
| Control/Usual Care Arm | Other | Participants in the control arm will receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), for 6 treatments. Afterwards, participants will continue to receive 6mg faricimab IVT every 8 weeks until week 100. Receives: Drug: Faricimab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Best Corrected Visual Acuity
Change in best corrected visual acuity (3.9 letter non-inferiority margin)
Measured: Baseline to Week 100
Secondary outcomes (9)
Decrease in Diabetic Retinopathy Severity Score
A 2-step improvement in diabetic retinopathy severity score
Measured: Baseline to Week 100
Decrease in Diabetic Retinopathy Severity Score
A 3-step improvement in diabetic retinopathy severity score
Measured: Baseline to Week 100
Change in Central Subfield Thickness
Change in central subfield thickness on OCT
Measured: Baseline to Week 100
Change in Vision Related Quality of Life
Change in vision-related quality of life (VFQ-25)
Measured: Baseline to Week 100
Change in Letters of Vision
Gaining or losing ≥5, ≥10, or ≥15 letters of vision
Measured: Baseline to Week 100
Absence of Diabetic Macular Edema
Absence of diabetic macular edema in the study eye
Measured: Week 100
Absence of Intraretinal Fluid (IRF)
Absence of intraretinal fluid (IRF) in the study eye
Measured: Week 100
Dosing Interval
Dosing interval at week 100
Measured: Week 100
Presence of Safety Outcomes
Safety outcomes (ocular and systemic AEs and SAEs)
Measured: Baseline to Week 100
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Nov 2022
- Study start1 May 2023
- Primary completionDec 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Diabetic Macular EdemaStudies of the same condition, open and under way.
- More trials run by McMaster UniversityThe sponsor's other registered studies.
- 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Two-armed, parallel, non-inferiority randomized controlled trial
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 446 participants (estimated)
Sponsor and investigators
- Lead sponsor
- McMaster University
- Sponsor type
- University, hospital or other
- Collaborators
- Hoffmann-La Roche
- Responsible party
- Sponsor
- Investigators
- Dr. Varun Chaudhary, MD, FRCS(C), Principal investigator, McMaster University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05610319
- Sponsor's protocol ID
- 2022-01
- Other IDs
- MR44143
- Acronym
- INSITE-DME
- Status last verified
- Apr 2026
- First submitted
- 2 Nov 2022
- Last updated
- 17 Apr 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 17 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Treat & Extend Versus Fixed Dosing With Faricimab for Management of Diabetic Macular Edema: A Pragmatic, Multi-center, Open-label, Randomized, Controlled Trial
- ClinicalTrials.gov ID
- NCT05610319
- Acronym / sponsor ID
- INSITE-DME / 2022-01
- Conditions
- Diabetic Macular Edema
- Keywords
- Treat and Extend, Faricimab, Anti-VEGF
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 446 participants (estimated)
- Lead sponsor
- McMaster UniversityUniversity, hospital or other
- Collaborators
- Hoffmann-La Roche
- Study start
- 1 May 2023 (actual)
- Primary completion
- Dec 2026 (estimated)
- Study completion
- Dec 2026 (estimated)
- First posted
- 9 Nov 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will assess a pragmatic, treat and extend regimen of faricimab against the standard of a fixed dosing regimen.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Two-armed, parallel, non-inferiority randomized controlled trial
| Arm | Type | Receives |
|---|---|---|
| Treat and Extend | Experimental | Drug: FaricimabParticipants randomized to the T\&E Arm will initially receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), with treatment intervals increased/extended, reduced, or maintained based on CST assessments, until week 100. |
| Control/Usual Care Arm | Other | Drug: FaricimabParticipants in the control arm will receive 6 milligrams (mg) faricimab intravitreal (IVT) injections monthly (28d +/-7 days), for 6 treatments. Afterwards, participants will continue to receive 6mg faricimab IVT every 8 weeks until week 100. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Age ≥ 18 years
- Diagnosis of diabetes mellitus (type 1 or type 2).
- Macular thickening secondary to DME (CI-DME) involving the center of the fovea on Optical Coherence Tomography - Central subfield thickness (CST) ≥ 325 μm on Spectralis at screening.***
- Visual impairment due to DME, with best corrected visual acuity of 80 to 20 letters (Snellen VA 20/25 - 20/400).
- Media clarity, pupillary dilation, and individual cooperation sufficient for adequate OCT and fundus photographs.
Key exclusion criteria (25 listed)
- Active or history of ocular inflammation or suspected/active ocular infection in either eye.
- High-risk proliferative diabetic retinopathy in the study eye.**
- Tractional retinal detachment, preretinal fibrosis or visually significant epiretinal membrane involving the macula.
- Uncontrolled glaucoma (intraocular pressure >30 with or without medications).
- Any intravitreal, periocular or implant corticosteroids within 26 weeks (6 months) before day 1 or any use of Iluvien implants.
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 |
|---|---|---|
| FaricimabFaricimab will be administered via intravitreal injection. | Drug | Control/Usual Care Arm, Treat and Extend |
Primary outcome
Change in Best Corrected Visual Acuity
Time frame: Baseline to Week 100
Change in best corrected visual acuity (3.9 letter non-inferiority margin)
9 secondary outcomes
Decrease in Diabetic Retinopathy Severity Score
Time frame: Baseline to Week 100
Decrease in Diabetic Retinopathy Severity Score
Time frame: Baseline to Week 100
Change in Central Subfield Thickness
Time frame: Baseline to Week 100
Change in Vision Related Quality of Life
Time frame: Baseline to Week 100
Change in Letters of Vision
Time frame: Baseline to Week 100
Absence of Diabetic Macular Edema
Time frame: Week 100
Absence of Intraretinal Fluid (IRF)
Time frame: Week 100
Dosing Interval
Time frame: Week 100
Presence of Safety Outcomes
Time frame: Baseline to Week 100
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Apr 2026.
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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.
Dr. Varun Chaudhary, MD, FRCS(C) principal investigator
McMaster University
46 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Faricimab in people with Diabetic Macular Edema, run by McMaster University at 46 sites in 4 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 7 inclusion and 25 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: under way, not looking for participants, as of the sponsor's last update on 17 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 46 sites in Australia, United States, Canada, United Kingdom. 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 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?
This study is still under way. Results are not available in the source record yet.
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?
Change in Best Corrected Visual Acuity (time frame: Baseline to Week 100). 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 17 Apr 2026.