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NCT02699450: BOULEVARD

A Study of Faricimab (RO6867461) in Participants With Center-Involving Diabetic Macular Edema

Completed Phase 2 Results posted Last updated 25 September 2020
What this trial tests

Phase 2 trial testing Faricimab in Diabetic Macular Edema in 229 participants. Completed in 14 December 2017.

Timeline
27 April 2016
Primary endpoint
15 September 2017
14 December 2017

Quick facts

Lead sponsorHoffmann-La Roche
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment229
Start date27 April 2016
Primary completion15 September 2017
Estimated completion14 December 2017
Sites60 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Hoffmann-La Roche — full company profile →

Who can join

18 and older, any sex, with Diabetic Macular Edema. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Mean Change From Baseline in BCVA Letter Score at Week 24, in Treatment-Naive Participants Primary · Baseline, Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab10.38.8 – 11.9
Arm B: 1.5 mg Faricimab11.710.1 – 13.3
Arm C: 6 mg Faricimab13.912.2 – 15.6
Mean Change From Baseline in BCVA Letter Score at Week 24, in Previously Treated Participants Secondary · Baseline, Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab8.95.7 – 10.8
Arm C: 6 mg Faricimab9.67.0 – 12.3
Mean Change From Baseline in BCVA Letter Score at Week 24, in All Participants Secondary · Baseline, Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab9.48.1 – 10.7
Arm B: 1.5 mg Faricimab11.710.0 – 13.4
Arm C: 6 mg Faricimab12.310.9 – 13.7
Mean Percentage of Participants Who Gained ≥15 ETDRS Letters From Baseline BCVA Score at Week 24, in Treatment-Naive Participants Secondary · Baseline, Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab35.327.3 – 44.1
Arm B: 1.5 mg Faricimab36.027.9 – 45.0
Arm C: 6 mg Faricimab42.533.5 – 52.1
Mean Percentage of Participants Who Gained ≥15 ETDRS Letters From Baseline BCVA Score at Week 24, in Previously Treated Participants Secondary · Baseline up to Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab16.89.6 – 27.8
Arm C: 6 mg Faricimab23.214.1 – 35.7
Mean Percentage of Participants Who Gained ≥15 ETDRS Letters From Baseline BCVA Score at Week 24, in All Participants Secondary · Baseline up to Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab28.722.7 – 35.5
Arm B: 1.5 mg Faricimab35.327.4 – 44.2
Arm C: 6 mg Faricimab35.928.9 – 43.6
Mean Percentage of Participants With BCVA ≥69 Letters (20/40 or Better) at Week 24, in Treatment-Naive Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab69.060.2 – 76.7
Arm B: 1.5 mg Faricimab78.570.3 – 84.9
Arm C: 6 mg Faricimab75.866.8 – 83.0
Mean Percentage of Participants With BCVA ≥69 Letters (20/40 or Better) at Week 24, in Previously Treated Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab69.057.3 – 78.7
Arm C: 6 mg Faricimab68.455.4 – 79.0
Mean Percentage of Participants With BCVA ≥69 Letters (20/40 or Better) at Week 24, in All Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab69.062.1 – 75.2
Arm B: 1.5 mg Faricimab78.970.8 – 85.2
Arm C: 6 mg Faricimab73.265.9 – 79.4
Mean Percentage of Participants With BCVA ≥84 Letters (20/20 or Better) at Week 24, in Treatment-Naive Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab11.56.9 – 18.7
Arm B: 1.5 mg Faricimab8.74.8 – 15.3
Arm C: 6 mg Faricimab9.85.5 – 16.8
Mean Percentage of Participants With BCVA ≥84 Letters (20/20 or Better) at Week 24, in Previously Treated Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab10.55.0 – 20.6
Arm C: 6 mg Faricimab8.23.3 – 19.1
Mean Percentage of Participants With BCVA ≥84 Letters (20/20 or Better) at Week 24, in All Participants Secondary · Week 24

Best corrected visual acuity (BCVA) at a starting test distance of 4 meters was measured using a set of three Precision VisionTM or Lighthouse distance acuity charts (modified ETDRS Charts 1, 2, and R) prior to dilating eyes by a trained and certified visual acuity examiner masked to study drug arm assignment. The BCVA examiner was masked to study eye and treatment assignment and only performed the refraction and BCVA assessment, but was not allowed to perform any other tasks involving direct care. The BCVA examiner was also masked to the BCVA letter scores of a participant's previous visits a

GroupValue95% CI
Arm A: 0.3 mg Ranibizumab11.17.3 – 16.6
Arm B: 1.5 mg Faricimab10.66.2 – 17.5
Arm C: 6 mg Faricimab9.15.6 – 14.6

Adverse events — posted to ClinicalTrials.gov

Time frame: From Baseline until the final study visit (up to 36 weeks). Reporting threshold: 3%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Arm A: 0.3 mg Ranibizumab
Serious: 9/89 (10%)
Deaths: 2/89
Arm B: 1.5 mg Faricimab
Serious: 7/55 (13%)
Deaths: 1/55
Arm C: 6 mg Faricimab
Serious: 8/80 (10%)
Deaths: 2/80

Serious adverse events (45 terms)

ReactionSystemArm A: 0.3 mg RanibizumabArm B: 1.5 mg FaricimabArm C: 6 mg Faricimab
Cardiac failure congestiveCardiac disorders
CellulitisInfections and infestations
PneumoniaInfections and infestations
AnaemiaBlood and lymphatic system disorders
Acute left ventricular failureCardiac disorders
Angina pectorisCardiac disorders
Cardiac arrestCardiac disorders
Coronary artery diseaseCardiac disorders
AscitesGastrointestinal disorders
Gastrointestinal haemorrhageGastrointestinal disorders
VomitingGastrointestinal disorders
Diabetic retinopathyEye disorders
Retinal vein occlusionEye disorders
Visual acuity reducedEye disorders
Vitreous haemorrhageEye disorders
AstheniaGeneral disorders
DeathGeneral disorders
Hepatic cirrhosisHepatobiliary disorders
BronchitisInfections and infestations
GangreneInfections and infestations
OsteomyelitisInfections and infestations
Fracture displacementInjury, poisoning and procedural complications
Multiple injuriesInjury, poisoning and procedural complications
Procedural complicationInjury, poisoning and procedural complications
Road traffic accidentInjury, poisoning and procedural complications
Other adverse events (38 terms — click to expand)

ReactionSystemArm A: 0.3 mg RanibizumabArm B: 1.5 mg FaricimabArm C: 6 mg Faricimab
AnaemiaBlood and lymphatic system disorders
Conjunctival haemorrhageEye disorders
HypertensionVascular disorders
Upper respiratory tract infectionInfections and infestations
Urinary tract infectionInfections and infestations
Diabetic retinal oedemaEye disorders
NasopharyngitisInfections and infestations
Dry eyeEye disorders
Retinal exudatesEye disorders
DiarrhoeaGastrointestinal disorders
Oedema peripheralGeneral disorders
Eye painEye disorders
Vision blurredEye disorders
Vitreous detachmentEye disorders
BronchitisInfections and infestations
Gastroenteritis viralInfections and infestations
FallInjury, poisoning and procedural complications
ArthralgiaMusculoskeletal and connective tissue disorders
CataractEye disorders
Eye pruritusEye disorders
Lacrimation increasedEye disorders
Vitreous haemorrhageEye disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
Blood creatine phosphokinase increasedInvestigations
Blood pressure increasedInvestigations
Blood triglycerides increasedInvestigations
Red blood cell sedimentation rate increasedInvestigations
HyperlipidaemiaMetabolism and nutrition disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Eyelid oedemaEye disorders
Cataract subcapsularEye disorders
Vitreous floatersEye disorders
DyspepsiaGastrointestinal disorders
HypercholesterolaemiaMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: Cardiac failure congestive, Cellulitis, Pneumonia, Anaemia, Acute left ventricular failure, Angina pectoris, Cardiac arrest, Coronary artery disease.

Data from ClinicalTrials.gov NCT02699450 adverse events section.

Sponsor's own description

This is a multiple-center, multiple-dose, randomized, active comparator-controlled, double-masked, three parallel group, 36-week study in participants with center-involving diabetic macular edema (DME). Only one eye will be selected as the study eye. Where both eyes meet all eligibility criteria, the eye with the worse best corrected visual acuity (BCVA) will be defined as the study eye. The study will consist of a treatment period (20 weeks) and an observational period (up to 16 weeks). Treatment naive participants will be randomized in a 1:1:1 ratio to one of the Arms A, B and C, respectively. Participants previously treated with intravitreal (IVT) anti-vascular endothelial growth factor (VEGF) will be randomized in a 1:1 ratio to Arms A and C.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Diabetic Retinopathy: Pathophysiology and Treatments.
    Wang W, Lo ACY. · · 2018 · cited 810× · PMID 29925789 · DOI 10.3390/ijms19061816
  2. Targeting key angiogenic pathways with a bispecific CrossMAb optimized for neovascular eye diseases.
    Regula JT, Lundh von Leithner P, Foxton R, Barathi VA, et al · · 2016 · cited 262× · PMID 27742718 · DOI 10.15252/emmm.201505889
  3. Simultaneous Inhibition of Angiopoietin-2 and Vascular Endothelial Growth Factor-A with Faricimab in Diabetic Macular Edema: BOULEVARD Phase 2 Randomized Trial.
    Sahni J, Patel SS, Dugel PU, Khanani AM, et al · · 2019 · cited 203× · PMID 30905643 · DOI 10.1016/j.ophtha.2019.03.023
  4. Pathophysiology of Diabetic Retinopathy: The Old and the New.
    Kusuhara S, Fukushima Y, Ogura S, Inoue N, et al · · 2018 · cited 155× · PMID 30362302 · DOI 10.4093/dmj.2018.0182
  5. Efficacy of Every Four Monthly and Quarterly Dosing of Faricimab vs Ranibizumab in Neovascular Age-Related Macular Degeneration: The STAIRWAY Phase 2 Randomized Clinical Trial.
    Khanani AM, Patel SS, Ferrone PJ, Osborne A, et al · · 2020 · cited 140× · PMID 32729897 · DOI 10.1001/jamaophthalmol.2020.2699
  6. The use of CrossMAb technology for the generation of bi- and multispecific antibodies.
    Klein C, Schaefer W, Regula JT. · · 2016 · cited 126× · PMID 27285945 · DOI 10.1080/19420862.2016.1197457
  7. Retinal and choroidal angiogenesis: a review of new targets.
    Cabral T, Mello LGM, Lima LH, Polido J, et al · · 2017 · cited 114× · PMID 28835854 · DOI 10.1186/s40942-017-0084-9
  8. Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.
    Virgili G, Parravano M, Evans JR, Gordon I, et al · · 2018 · cited 103× · PMID 30325017 · DOI 10.1002/14651858.cd007419.pub6

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