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康柏西普治疗新生血管性年龄相关性黄斑变性的安全性和有效性:一项为期 12 个月的随机 2 期研究结果:AURORA 研究。

Safety and efficacy of conbercept in neovascular age-related macular degeneration: results from a 12-month randomized phase 2 study: AURORA study.

机构信息

Department of Ophthalmology, Peking University People's Hospital, Beijing, China.

Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.

出版信息

Ophthalmology. 2014 Sep;121(9):1740-7. doi: 10.1016/j.ophtha.2014.03.026. Epub 2014 May 1.

Abstract

PURPOSE

To assess the safety and efficacy of multiple injections of 0.5 and 2.0 mg conbercept using variable dosing regimens in patients with neovascular age-related macular degeneration (AMD).

DESIGN

Randomized, double-masked, multicenter, controlled-dose, and interval-ranging phase 2 clinical trial divided into a 3-month loading phase followed by a maintenance phase.

PARTICIPANTS

Patients with choroidal neovascularization secondary to AMD with lesion sizes of 12 disc areas or less and a best-corrected visual acuity (BCVA) letter score of between 73 and 24 were enrolled.

METHODS

Patients were randomized 1:1 to receive either 0.5 or 2.0 mg intravitreal conbercept for 3 consecutive monthly does. After the third dose, each group was reassigned randomly again to monthly (Q1M group) or as-needed (pro re nata [PRN] group) treatment without changing the drug assignment.

MAIN OUTCOME MEASURES

The primary end point was the mean change in BCVA from baseline to month 3, with secondary end points being the mean change in BCVA, mean change in central retinal thickness (CRT), and safety at month 12.

RESULTS

We enrolled 122 patients. At the primary end point at month 3, mean improvements in BCVA from baseline in the 0.5- and 2.0-mg groups were 8.97 and 10.43 letters, respectively. At month 12, mean improvements in BCVA from baseline were 14.31, 9.31, 12.42, and 15.43 letters for the 0.5-mg PRN, 0.5-mg Q1M, 2.0-mg PRN, and 2.0-mg Q1M regimens, respectively. At month 12, mean reductions in CRT in the 4 regimens were 119.8, 129.7, 152.1, and 170.8 μm, respectively. There were no significant differences for the pairwise comparisons between all study groups. The difference in the number of injections between the 2 PRN groups was not statistically significant. Treatment with conbercept generally was safe and well tolerated.

CONCLUSIONS

The significant gains in BCVA at 3 months were the same or better at 12 months in all conbercept dosing groups of neovascular AMD patients. During the 12 months, repeated intravitreal injections of conbercept were well tolerated in these patients. Future clinical trials are required to confirm its long-term efficacy and safety.

摘要

目的

评估在新生血管性年龄相关性黄斑变性(AMD)患者中使用不同剂量方案多次注射 0.5 和 2.0mg 康柏西普的安全性和疗效。

设计

随机、双盲、多中心、对照剂量和间隔范围的 2 期临床试验,分为 3 个月的加载期和维持期。

参与者

纳入患有 AMD 引起的脉络膜新生血管病变、病变大小不超过 12 个视盘面积且最佳矫正视力(BCVA)字母评分在 73 至 24 之间的患者。

方法

患者按 1:1 随机接受 0.5 或 2.0mg 康柏西普连续 3 次每月剂量。第三次剂量后,每组再次随机重新分配至每月(Q1M 组)或按需(pro re nata [PRN] 组)治疗,而不改变药物分配。

主要观察指标

主要终点是从基线到第 3 个月时 BCVA 的平均变化,次要终点是 BCVA 的平均变化、中央视网膜厚度(CRT)的平均变化和第 12 个月时的安全性。

结果

共纳入 122 例患者。在第 3 个月的主要终点时,0.5mg 和 2.0mg 组的 BCVA 从基线的平均改善分别为 8.97 和 10.43 个字母。在第 12 个月时,0.5mg PRN、0.5mg Q1M、2.0mg PRN 和 2.0mg Q1M 方案的 BCVA 从基线的平均改善分别为 14.31、9.31、12.42 和 15.43 个字母。在 4 种方案中,CRT 的平均减少量分别为 119.8、129.7、152.1 和 170.8μm。各组间的两两比较无显著差异。2 个 PRN 组间的注射次数差异无统计学意义。康柏西普治疗通常是安全且耐受良好的。

结论

在新生血管性 AMD 患者的所有康柏西普剂量组中,3 个月时的 BCVA 显著改善在 12 个月时相同或更好。在 12 个月期间,这些患者可耐受重复玻璃体内注射康柏西普。需要进一步的临床试验来证实其长期疗效和安全性。

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