This comparative effectiveness research proposal (Studies of Comparative Treatments for Retinal Vein Occlusion 2 [SC0RE2] Study) aims to support alternative treatment protocols for decreased vision due to macular edema secondary to central retinal vein occlusion (CRVO) based on results of recent randomized trials. This proposed study called the SCORE2 Comparative Trial (SCT) will determine if bevacizumab is non-inferior to aflibercept for the treatment of macular edema due to RVO. The non-inferiority margin will be set at an Early Treatment Diabetic Retinopathy Study visual acuity letter score of 5. The SCT will also provide insight into treatment regimens after the initial 6 months to determine if the frequency of intravitreal injections can be reduced in eyes that have responded well to treatment (which would represent a more cost-effective treatment regimen, with fewer risks to patients of injection-related adverse events and a lesser logistical treatment burden for patients and providers), and the impact of alternative treatment strategies (intravitreal dexamethasone) in eyes that have not responded well to initial treatment with anti-VEGF therapy. So, in addition to the primary aim of test for non-inferiority of bevacizumab to aflibercept in visual acuity outcome at Month 6 for eyes, secondary aims will investigate different dosing strategies after Month 6. In addition, secondary analyses will examine retinal thickening and other retinal outcomes based on SD-OCT and wide field fluorescein angiograms (within a subset of sites). The SCT will also add to our knowledge of the safety profile of these anti-vascular endothelial growth factor (anti-VEGF) medications. We propose to enroll 360 CRVO patients over a 24-month period, and follow for 13-months. This application is for The EMMES Corporation to serve as the Data Coordinating Center (DCC) for the SCT, with our primary focus to provide data management, statistical, and operational support over 5 years of support.

Public Health Relevance

Macular edema from central retinal vein occlusion is a frequent cause of vision loss and remains a major public health problem despite recent findings from Industry-sponsored Anti-VEGF trials. Therefore, additional avenues of research as proposed in the SCT are necessary to identify cost-effective treatment regimens, with fewer risks to patients and a lesser logistical treatment burden for patients and providers.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10EY023529-05
Application #
9461533
Study Section
Special Emphasis Panel (ZEY1)
Program Officer
Bhargava, Sangeeta
Project Start
2013-09-30
Project End
2019-03-31
Budget Start
2018-04-01
Budget End
2019-03-31
Support Year
5
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Emmes Corporation
Department
Type
DUNS #
096360284
City
Rockville
State
MD
Country
United States
Zip Code
20850
Peterson, Jan S; Rockwell Jr, Kenneth; Scott, Ingrid U et al. (2018) LONG-TERM PHYSICAL STABILITY, STERILITY, AND ANTI-VEGF BIOACTIVITY OF REPACKAGED BEVACIZUMAB IN 2-ML GLASS VIALS. Retina :
Scott, Ingrid U; VanVeldhuisen, Paul C; Ip, Michael S et al. (2017) SCORE2 Report 2: Study Design and Baseline Characteristics. Ophthalmology 124:245-256
Scott, Ingrid U; VanVeldhuisen, Paul C; Ip, Michael S et al. (2017) Baseline Factors Associated With 6-Month Visual Acuity and Retinal Thickness Outcomes in Patients With Macular Edema Secondary to Central Retinal Vein Occlusion or Hemiretinal Vein Occlusion: SCORE2 Study Report 4. JAMA Ophthalmol 135:639-649
Scott, Ingrid U; VanVeldhuisen, Paul C; Ip, Michael S et al. (2017) Effect of Bevacizumab vs Aflibercept on Visual Acuity Among Patients With Macular Edema Due to Central Retinal Vein Occlusion: The SCORE2 Randomized Clinical Trial. JAMA 317:2072-2087
Scott, Ingrid U; Figueroa, Maria J; Oden, Neal L et al. (2017) SCORE2 Report 5: Vision-Related Function in Patients With Macular Edema Secondary to Central Retinal or Hemiretinal Vein Occlusion. Am J Ophthalmol 184:147-156
Scott, Ingrid U; VanVeldhuisen, Paul C; Ip, Michael S et al. (2016) SCORE2 Report 1: Techniques to Optimize Recruitment in Phase III Clinical Trials of Patients With Central Retinal Vein Occlusion. Am J Ophthalmol 170:25-31