The study was designed in 2 stages. Part A consisted of a dose-escalation RG-7204 design in which 6 cohorts received a single MP0112 dose of 0.04 mg, 0.15 mg, 0.4 mg, 1.0 mg, 2.0 mg, or 3.6 mg. Patients were enrolled into the study sequentially.
The first patient in each dose cohort received a single intravitreal injection of MP0112 in 1 eye. If no severe or serious ocular adverse event (AE) that was considered to be drug related occurred within 2 weeks of administration, the remaining 5 patients in the dose cohort were recruited and dosed. Dose escalation proceeded only (1) after all patients in a dose cohort had received the specified dose; (2) if moderate ocular toxicity, as defined by the protocol, affected no more than 2 of 6 patients within the inhibitors dosing cohort after a minimum follow-up of 1 week; and (3) if the Medical Review Committee had approved the dose escalation. MP0112 was administered as a single intravitreal injection (0.05 mL) using a 30-gauge needle and standard techniques, including the use of a lid speculum, topical anesthesia and 5% povidone-iodine. XL184 ic50 All patients remained under observation in the clinic for up to 5 hours after dosing. Patients were examined before and after injection and received a safety follow-up call the
day after dosing, with referral to an ophthalmologist if required. Follow-up visits were made 3 days, and 1, 2, 4, 8, 12, and 16 weeks after treatment. At day 3, patients underwent a complete eye exam (including slit-lamp biomicroscopy
and indirect ophthalmoscopy) and pharmacokinetic assessment. At each study visit, patients were assessed for AEs, concomitant medications, pharmacokinetics (until week 12), complete eye exams, BCVA and OCT. FA was assessed at baseline and week 4 (Figure 1). At the investigators’ discretion, patients could be given rescue therapy with standard-of-care treatments from 2 weeks after administration of MP0112. The criteria for initiation of rescue therapy differed slightly by region: in the Czech Republic and France, patients were eligible for rescue therapy if they experienced at least 1 of the following: visual most acuity (VA) deterioration of ≥6 letters from baseline; an increase in lesion size or leakage; the formation of new lesions; or an increase in subretinal fluid. In Switzerland, rescue therapy applied to patients who experienced VA deterioration of ≥6 letters from baseline or a decrease in CRT of <50 μm from baseline. All patients, including those who received rescue therapy, were followed for 16 weeks. OCT was performed at each study site using Stratus OCT 3 (Carl Zeiss Meditec, Jena, Germany) and Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany), if available. The same OCT unit was used for all visits for a given patient so as to allow for comparison among visits.