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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05610319
Registration number
NCT05610319
Ethics application status
Date submitted
2/11/2022
Date registered
9/11/2022
Date last updated
15/08/2024
Titles & IDs
Public title
Treat & Extend Versus Fixed Dosing With Faricimab for Management of Diabetic Macular Edema: A Pragmatic, Multi-center, Open-label, Randomized, Controlled Trial
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Scientific title
Treat & Extend Versus Fixed Dosing With Faricimab for Management of Diabetic Macular Edema: A Pragmatic, Multi-center, Open-label, Randomized, Controlled Trial
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Secondary ID [1]
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MR44143
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Secondary ID [2]
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2022-01
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Universal Trial Number (UTN)
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Trial acronym
INSITE-DME
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetic Macular Edema
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Condition category
Condition code
Eye
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Diseases / disorders of the eye
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Cardiovascular
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Faricimab
Experimental: Treat and Extend - 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.
Other: Control/Usual Care Arm - 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.
Treatment: Drugs: Faricimab
Faricimab will be administered via intravitreal injection.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Change in Best Corrected Visual Acuity
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Assessment method [1]
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Change in best corrected visual acuity (3.9 letter non-inferiority margin)
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Timepoint [1]
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Baseline to Week 100
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Secondary outcome [1]
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Decrease in Diabetic Retinopathy Severity Score
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Assessment method [1]
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A 2-step improvement in diabetic retinopathy severity score
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Timepoint [1]
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Baseline to Week 100
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Secondary outcome [2]
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Decrease in Diabetic Retinopathy Severity Score
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Assessment method [2]
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A 3-step improvement in diabetic retinopathy severity score
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Timepoint [2]
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Baseline to Week 100
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Secondary outcome [3]
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Change in Central Subfield Thickness
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Assessment method [3]
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Change in central subfield thickness on OCT
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Timepoint [3]
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Baseline to Week 100
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Secondary outcome [4]
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Change in Vision Related Quality of Life
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Assessment method [4]
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Change in vision-related quality of life (VFQ-25)
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Timepoint [4]
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Baseline to Week 100
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Secondary outcome [5]
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Change in Letters of Vision
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Assessment method [5]
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Gaining or losing =5, =10, or =15 letters of vision
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Timepoint [5]
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Baseline to Week 100
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Secondary outcome [6]
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Absence of Diabetic Macular Edema
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Assessment method [6]
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Absence of diabetic macular edema in the study eye
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Timepoint [6]
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Week 100
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Secondary outcome [7]
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Absence of Intraretinal Fluid (IRF)
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Assessment method [7]
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Absence of intraretinal fluid (IRF) in the study eye
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Timepoint [7]
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Week 100
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Secondary outcome [8]
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Dosing Interval
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Assessment method [8]
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Dosing interval at week 100
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Timepoint [8]
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Week 100
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Secondary outcome [9]
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Presence of Safety Outcomes
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Assessment method [9]
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Safety outcomes (ocular and systemic AEs and SAEs)
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Timepoint [9]
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Baseline to Week 100
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Eligibility
Key inclusion criteria
1. Age = 18 years
2. Diagnosis of diabetes mellitus (type 1 or type 2).
3. 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.***
4. Visual impairment due to DME, with best corrected visual acuity of 80 to 20 letters (Snellen VA 20/25 - 20/400).
5. Media clarity, pupillary dilation, and individual cooperation sufficient for adequate OCT and fundus photographs.
6. Hemoglobin A1c must be <10% within 2 months prior to 1st study treatment.
7. Provide signed informed consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Active or history of ocular inflammation or suspected/active ocular infection in either eye.
2. High-risk proliferative diabetic retinopathy in the study eye.**
3. Tractional retinal detachment, preretinal fibrosis or visually significant epiretinal membrane involving the macula.
4. Uncontrolled glaucoma (intraocular pressure >30 with or without medications).
5. Any intravitreal, periocular or implant corticosteroids within 26 weeks (6 months) before day 1 or any use of Iluvien implants.
6. Treatment with Panretinal photocoagulation (PRP) within 12 weeks before day 1.
7. Treatment with macular laser.
8. Any cataract surgery or any other intraocular surgery within 12 weeks before day 1.
9. Macular edema in study eye due to a cause other than DME.
10. 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).
11. 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)
12. 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.)
13. Women of child-bearing potential who are lactating, pregnant, or intending to become pregnant within the next 100 weeks.
14. Current or anticipated incarceration.
15. Terminal illness with expected survival less than 100 weeks.
16. Known hypersensitivity to faricimab or any of the excipients in the faricimab injection.
17. Currently enrolled in a study that does not permit co-enrollment.
18. Unable to obtain informed consent due to language or other operational barriers.
19. Anticipated problems, in the judgment of the site investigator, maintaining compliance with the protocol, including attending study visits, completing assessments or procedures.
20. Prior enrollment in this trial.
21. Other reason to exclude the patient, as approved by the sponsor and site investigator.
22. 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.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/05/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/08/2026
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Actual
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Sample size
Target
446
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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Eye Clinic Albury Wodonga - Albury
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Recruitment hospital [2]
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Nexus Eyecare Blacktown - Blacktown
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Recruitment hospital [3]
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Eastern Suburbs Eye Specialists - Bondi Junction
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Recruitment hospital [4]
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Retina and Eye Consultants - Hurstville
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Recruitment hospital [5]
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Lane Cove Eye - Lane Cove
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Recruitment hospital [6]
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South West Retina - Liverpool
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Recruitment hospital [7]
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Marsden Eye Specialists - Parramatta
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Recruitment hospital [8]
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Strathfield Retina Clinic - Strathfield
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Recruitment hospital [9]
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South Eastern Sydney Health - Sydney
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Recruitment hospital [10]
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Sydney Retina - Sydney
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Recruitment hospital [11]
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Queensland Eye Institute - Woolloongabba
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Recruitment hospital [12]
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Adelaide Eye & Retina Centre - Adelaide
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Recruitment hospital [13]
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Hobart Eye Surgeons - Hobart
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Recruitment hospital [14]
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Centre for Eye Research Australia - East Melbourne
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Recruitment hospital [15]
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Retina Specialists Victoria - Rowville
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Recruitment hospital [16]
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Lions Eye Institute Limited - Nedlands
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Recruitment postcode(s) [1]
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2640 - Albury
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Recruitment postcode(s) [2]
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- Blacktown
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Recruitment postcode(s) [3]
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2022 - Bondi Junction
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Recruitment postcode(s) [4]
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2220 - Hurstville
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Recruitment postcode(s) [5]
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2066 - Lane Cove
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Recruitment postcode(s) [6]
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2170 - Liverpool
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Recruitment postcode(s) [7]
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2150 - Parramatta
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Recruitment postcode(s) [8]
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2135 - Strathfield
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Recruitment postcode(s) [9]
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2000 - Sydney
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Recruitment postcode(s) [10]
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4012 - Woolloongabba
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Recruitment postcode(s) [11]
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5000 - Adelaide
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Recruitment postcode(s) [12]
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7008 - Hobart
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Recruitment postcode(s) [13]
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3002 - East Melbourne
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Recruitment postcode(s) [14]
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3178 - Rowville
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Recruitment postcode(s) [15]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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United States of America
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State/province [2]
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Illinois
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United States of America
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Louisiana
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Country [4]
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United States of America
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Mississippi
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Country [5]
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United States of America
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State/province [5]
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Texas
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Country [6]
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Canada
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State/province [6]
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Alberta
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Country [7]
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Canada
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State/province [7]
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British Columbia
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Country [8]
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Canada
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Ontario
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Country [9]
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Canada
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State/province [9]
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Quebec
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Country [10]
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United Kingdom
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State/province [10]
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England
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Funding & Sponsors
Primary sponsor type
Other
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Name
McMaster University
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Hoffmann-La Roche
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
This study will assess a pragmatic, treat and extend regimen of faricimab against the standard of a fixed dosing regimen.
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Trial website
https://clinicaltrials.gov/study/NCT05610319
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr. Varun Chaudhary, MD, FRCS(C)
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Address
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McMaster University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Gina Del Fabbro, BPH
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Address
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Country
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Phone
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905-525-9140
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05610319
Download to PDF