Bevacizumab Treatment For Type 1 ROP
Purpose
Type 1 retinopathy of prematurity in zone I represents the most severe type of ROP and has the worst prognosis. It is unknown whether low-dose bevacizumab will be successful in these severe cases. Also unknown is the timing and extent of peripheral retinal vascularization after low-dose bevacizumab compared with the standard dose. The current study will evaluate whether doses of 0.063 mg and 0.25mg are effective as treatment for type 1 ROP, with ROP and retinal vessels all in zone I.
Condition
- Retinopathy of Prematurity
Eligibility
- Eligible Ages
- Under 6 Months
- Eligible Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
The study participant must have at least one eye meeting all of the inclusion criteria in order to be eligible to participate: 1. Birth weight < 1251 grams 2. Newly diagnosed (within 2 days) type 1 ROP in zone I in one or both eyes
Exclusion Criteria
Participants meeting any of the following exclusion criteria will be excluded from study participation. 1. Previous treatment for ROP 2. Stage 4 or 5 ROP in either eye 3. Treatment could not be done within 2 days of diagnosis of type 1 ROP 4. Investigator unwilling to randomize or parent unwilling to accept randomized assignment to either treatment 5. Transfer to another hospital anticipated within the next 4 weeks where exams by study-certified examiners are not available. If hospital discharge is anticipated within the next 4 weeks, parents unable or unwilling to return to the PEDIG site for outpatient follow-up visits. 6. Active ocular infection or purulent nasolacrimal duct obstruction in either eye One eye will be excluded, and other eye may be eligible, if either of the following are present: - Visually significant ocular anomaly (e.g., cataract, coloboma) - Opacity that precludes an adequate view of the retina
Study Design
- Phase
- Phase 2
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Investigator, Outcomes Assessor)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Bevacizumab- 0.063 mg |
Participants will receive a single intravitreal injection of 0.063 mg of bevacizumab in one or both eyes following enrollment into the study. The injection/s should be given as soon as possible but no later than 2 days after the diagnosis of type 1 ROP meeting all of the inclusion criteria and none of the exclusion criteria. |
|
|
Experimental Bevacizumab- 0.25 mg |
Participants will receive a single intravitreal injection of 0.25 mg of bevacizumab in one or both eyes following enrollment into the study. The injection/s should be given as soon as possible but no later than 2 days after the diagnosis of type 1 ROP meeting all of the inclusion criteria and none of the exclusion criteria. |
|
Recruiting Locations
Lexington 4297983, Kentucky 6254925 40508
Little Rock 4119403, Arkansas 4099753 72202
Irvine 5359777, California 5332921 92697
Los Angeles 5368361, California 5332921 90095
Sacramento 5389489, California 5332921 95817
San Francisco 5391959, California 5332921 94143
Atlanta 4180439, Georgia 4197000 30322
Chicago 4887398, Illinois 4896861 60611
Chicago 4887398, Illinois 4896861 60612
Hyde Park 4896728, Illinois 4896861 60637
Indianapolis 4259418, Indiana 4921868 46202
Indianapolis 4259418, Indiana 4921868 46202
Baltimore 4347778, Maryland 4361885 21204-5809
Boston 4930956, Massachusetts 6254926 02215
New York 5128581, New York 5128638 10065
Durham 4464368, North Carolina 4482348 27710
Cincinnati 4508722, Ohio 5165418 45229
Columbus 4509177, Ohio 5165418 43205
Philadelphia 4560349, Pennsylvania 6254927 19104
Pittsburgh 5206379, Pennsylvania 6254927 15224
Mt. Pleasant 4588165, South Carolina 4597040 29464
Houston 4699066, Texas 4736286 77030
Salt Lake City 5780993, Utah 5549030 84132
Norfolk 4776222, Virginia 6254928 23502
More Details
- NCT ID
- NCT04634578
- Status
- Recruiting
- Sponsor
- Jaeb Center for Health Research
Detailed Description
Infants with type 1 ROP and no prior treatment for ROP will be randomly assigned (1:1) to treatment with either intravitreous bevacizumab 0.063 mg or either intravitreous bevacizumab 0.25 mg. Study exams will be at 1 day, 4 days (if no improvement on day 1), 1, 2, 3, and 4 weeks, and at 2 and 4-months post-treatment (and re-treatment when indicated). Additional study exams will occur at adjusted age 6 and 12 months. Non-study examinations will be at clinician discretion and are likely to occur more often. The primary outcome will be treatment success within each dose group, defined as improvement by the day 4 exam and no recurrence of type 1 ROP or severe neovascularization requiring additional treatment within 4 weeks of injection. Important secondary outcomes include safety and efficacy. refractive outcomes, and the extent of retinal vascularization at 2 and 4 months post-injection between the two dose groups.