Randomized Phase IIb Study of Brimonidine Drug Delivery System Generation 2 for Geographic Atrophy in Age-Related Macular Degeneration

To evaluate the safety and efficacy of repeat injections of Brimonidine Drug Delivery System (Brimo DDS) Generation 2 (Gen 2) containing 400-μg brimonidine in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). A phase IIb, randomized, multicenter, double-maske...

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Veröffentlicht in:Ophthalmology retina 2023-07, Vol.7 (7), p.573-585
Hauptverfasser: Freeman, William R., Bandello, Francesco, Souied, Eric, Guymer, Robyn H., Garg, Sunir J., Chen, Fred K., Rich, Ryan, Holz, Frank G., Patel, Sunil S., Kim, Kimmie, López, Francisco J., Chen, Fred, Guymer, Robyn, Korobelnik, Jean-Francois, Holz, Frank, Ziemssen, Focke, Campos, Emilio, GrignoloEandi, Chiara, Midena, Edoardo, Peiretti, Enrico, Staurenghi, Giovanni, Viola, Francesco, Bailey, Clare, Esposti, Simona Degli, Jackson, Timothy, Menon, Geeta, Pagliarini, Sergio, Quhill, Fahd, Antoszyk, Andrew, Brooks, Logan, Callanan, David, Csaky, Karl, Edwards, Albert, Eichenbaum, David, Freeman, William, Garg, Sunir, Ghuman, Avtar Thomas, Gonzalez, Victor, Gupta, Sunil, Hamilton, Richard, Khurana, Rahul, Kunimoto, Derek, Kuppermann, Baruch, Lauer, Andreas, Lee, Seong Young, Maturi, Raj, Patel, Sunil, Reddy, Rahul, Rivellese, Mark, Rose, Steven, Segal, Zachary, Wong, Robert
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container_end_page 585
container_issue 7
container_start_page 573
container_title Ophthalmology retina
container_volume 7
creator Freeman, William R.
Bandello, Francesco
Souied, Eric
Guymer, Robyn H.
Garg, Sunir J.
Chen, Fred K.
Rich, Ryan
Holz, Frank G.
Patel, Sunil S.
Kim, Kimmie
López, Francisco J.
Chen, Fred
Guymer, Robyn
Korobelnik, Jean-Francois
Souied, Eric
Holz, Frank
Ziemssen, Focke
Bandello, Francesco
Campos, Emilio
GrignoloEandi, Chiara
Midena, Edoardo
Peiretti, Enrico
Staurenghi, Giovanni
Viola, Francesco
Bailey, Clare
Esposti, Simona Degli
Jackson, Timothy
Menon, Geeta
Pagliarini, Sergio
Quhill, Fahd
Antoszyk, Andrew
Brooks, Logan
Callanan, David
Csaky, Karl
Edwards, Albert
Eichenbaum, David
Freeman, William
Garg, Sunir
Ghuman, Avtar Thomas
Gonzalez, Victor
Gupta, Sunil
Hamilton, Richard
Khurana, Rahul
Kunimoto, Derek
Kuppermann, Baruch
Lauer, Andreas
Lee, Seong Young
Maturi, Raj
Patel, Sunil
Reddy, Rahul
Rich, Ryan
Rivellese, Mark
Rose, Steven
Segal, Zachary
Wong, Robert
description To evaluate the safety and efficacy of repeat injections of Brimonidine Drug Delivery System (Brimo DDS) Generation 2 (Gen 2) containing 400-μg brimonidine in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). A phase IIb, randomized, multicenter, double-masked, sham-controlled, 30-month study (BEACON). Patients diagnosed with GA secondary to AMD and multifocal lesions with total area of > 1.25 mm2 and ≤ 18 mm2 in the study eye. Enrolled patients were randomized to treatment with intravitreal injections of 400-μg Brimo DDS (n = 154) or sham procedure (n = 156) in the study eye every 3 months from day 1 to month 21. The primary efficacy endpoint was GA lesion area change from baseline in the study eye, assessed with fundus autofluorescence imaging, at month 24. The study was terminated early, at the time of the planned interim analysis, because of a slow GA progression rate (∼ 1.6 mm2/year) in the enrolled population. Least squares mean (standard error) GA area change from baseline at month 24 (primary endpoint) was 3.24 (0.13) mm2 with Brimo DDS (n = 84) versus 3.48 (0.13) mm2 with sham (n = 91), a reduction of 0.25 mm2 (7%) with Brimo DDS compared with sham (P = 0.150). At month 30, GA area change from baseline was 4.09 (0.15) mm2 with Brimo DDS (n = 49) versus 4.52 (0.15) mm2 with sham (n = 46), a reduction of 0.43 mm2 (10%) with Brimo DDS compared with sham (P = 0.033). Exploratory analysis showed numerically smaller loss over time in retinal sensitivity assessed with scotopic microperimetry with Brimo DDS than with sham (P = 0.053 at month 24). Treatment-related adverse events were usually related to the injection procedure. No implant accumulation was observed. Multiple intravitreal administrations of Brimo DDS (Gen 2) were well tolerated. The primary efficacy endpoint at 24 months was not met, but there was a numeric trend for reduction in GA progression at 24 months compared with sham treatment. The study was terminated early because of the lower-than-expected GA progression rate in the sham/control group. Proprietary or commercial disclosures may be found after the references.
doi_str_mv 10.1016/j.oret.2023.03.001
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A phase IIb, randomized, multicenter, double-masked, sham-controlled, 30-month study (BEACON). Patients diagnosed with GA secondary to AMD and multifocal lesions with total area of &gt; 1.25 mm2 and ≤ 18 mm2 in the study eye. Enrolled patients were randomized to treatment with intravitreal injections of 400-μg Brimo DDS (n = 154) or sham procedure (n = 156) in the study eye every 3 months from day 1 to month 21. The primary efficacy endpoint was GA lesion area change from baseline in the study eye, assessed with fundus autofluorescence imaging, at month 24. The study was terminated early, at the time of the planned interim analysis, because of a slow GA progression rate (∼ 1.6 mm2/year) in the enrolled population. Least squares mean (standard error) GA area change from baseline at month 24 (primary endpoint) was 3.24 (0.13) mm2 with Brimo DDS (n = 84) versus 3.48 (0.13) mm2 with sham (n = 91), a reduction of 0.25 mm2 (7%) with Brimo DDS compared with sham (P = 0.150). At month 30, GA area change from baseline was 4.09 (0.15) mm2 with Brimo DDS (n = 49) versus 4.52 (0.15) mm2 with sham (n = 46), a reduction of 0.43 mm2 (10%) with Brimo DDS compared with sham (P = 0.033). Exploratory analysis showed numerically smaller loss over time in retinal sensitivity assessed with scotopic microperimetry with Brimo DDS than with sham (P = 0.053 at month 24). Treatment-related adverse events were usually related to the injection procedure. No implant accumulation was observed. Multiple intravitreal administrations of Brimo DDS (Gen 2) were well tolerated. The primary efficacy endpoint at 24 months was not met, but there was a numeric trend for reduction in GA progression at 24 months compared with sham treatment. The study was terminated early because of the lower-than-expected GA progression rate in the sham/control group. Proprietary or commercial disclosures may be found after the references.</description><identifier>ISSN: 2468-6530</identifier><identifier>EISSN: 2468-6530</identifier><identifier>DOI: 10.1016/j.oret.2023.03.001</identifier><identifier>PMID: 36906177</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age-related macular degeneration ; Brimonidine ; Drug Delivery Systems - adverse effects ; Geographic atrophy ; Geographic Atrophy - diagnosis ; Geographic Atrophy - drug therapy ; Geographic Atrophy - etiology ; Humans ; Implant ; Intravitreal Injections ; Macular Degeneration - complications ; Macular Degeneration - diagnosis ; Macular Degeneration - drug therapy ; Nonexudative ; Retina</subject><ispartof>Ophthalmology retina, 2023-07, Vol.7 (7), p.573-585</ispartof><rights>2023 American Academy of Ophthalmology</rights><rights>Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-4f848ab2a1f073bff7fd1fd025eeb1ed50eae2796b857b0ca1d0f6e4256d1f493</citedby><cites>FETCH-LOGICAL-c400t-4f848ab2a1f073bff7fd1fd025eeb1ed50eae2796b857b0ca1d0f6e4256d1f493</cites><orcidid>0000-0002-0511-4942 ; 0000-0003-3238-9682 ; 0000-0002-9441-4356 ; 0000-0003-0189-861X ; 0000-0003-2809-9930</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36906177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Freeman, William R.</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Souied, Eric</creatorcontrib><creatorcontrib>Guymer, Robyn H.</creatorcontrib><creatorcontrib>Garg, Sunir J.</creatorcontrib><creatorcontrib>Chen, Fred K.</creatorcontrib><creatorcontrib>Rich, Ryan</creatorcontrib><creatorcontrib>Holz, Frank G.</creatorcontrib><creatorcontrib>Patel, Sunil S.</creatorcontrib><creatorcontrib>Kim, Kimmie</creatorcontrib><creatorcontrib>López, Francisco J.</creatorcontrib><creatorcontrib>Chen, Fred</creatorcontrib><creatorcontrib>Guymer, Robyn</creatorcontrib><creatorcontrib>Korobelnik, Jean-Francois</creatorcontrib><creatorcontrib>Souied, Eric</creatorcontrib><creatorcontrib>Holz, Frank</creatorcontrib><creatorcontrib>Ziemssen, Focke</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Campos, Emilio</creatorcontrib><creatorcontrib>GrignoloEandi, Chiara</creatorcontrib><creatorcontrib>Midena, Edoardo</creatorcontrib><creatorcontrib>Peiretti, Enrico</creatorcontrib><creatorcontrib>Staurenghi, Giovanni</creatorcontrib><creatorcontrib>Viola, Francesco</creatorcontrib><creatorcontrib>Bailey, Clare</creatorcontrib><creatorcontrib>Esposti, Simona Degli</creatorcontrib><creatorcontrib>Jackson, Timothy</creatorcontrib><creatorcontrib>Menon, Geeta</creatorcontrib><creatorcontrib>Pagliarini, Sergio</creatorcontrib><creatorcontrib>Quhill, Fahd</creatorcontrib><creatorcontrib>Antoszyk, Andrew</creatorcontrib><creatorcontrib>Brooks, Logan</creatorcontrib><creatorcontrib>Callanan, David</creatorcontrib><creatorcontrib>Csaky, Karl</creatorcontrib><creatorcontrib>Edwards, Albert</creatorcontrib><creatorcontrib>Eichenbaum, David</creatorcontrib><creatorcontrib>Freeman, William</creatorcontrib><creatorcontrib>Garg, Sunir</creatorcontrib><creatorcontrib>Ghuman, Avtar Thomas</creatorcontrib><creatorcontrib>Gonzalez, Victor</creatorcontrib><creatorcontrib>Gupta, Sunil</creatorcontrib><creatorcontrib>Hamilton, Richard</creatorcontrib><creatorcontrib>Khurana, Rahul</creatorcontrib><creatorcontrib>Kunimoto, Derek</creatorcontrib><creatorcontrib>Kuppermann, Baruch</creatorcontrib><creatorcontrib>Lauer, Andreas</creatorcontrib><creatorcontrib>Lee, Seong Young</creatorcontrib><creatorcontrib>Maturi, Raj</creatorcontrib><creatorcontrib>Patel, Sunil</creatorcontrib><creatorcontrib>Reddy, Rahul</creatorcontrib><creatorcontrib>Rich, Ryan</creatorcontrib><creatorcontrib>Rivellese, Mark</creatorcontrib><creatorcontrib>Rose, Steven</creatorcontrib><creatorcontrib>Segal, Zachary</creatorcontrib><creatorcontrib>Wong, Robert</creatorcontrib><creatorcontrib>BEACON Study Group</creatorcontrib><title>Randomized Phase IIb Study of Brimonidine Drug Delivery System Generation 2 for Geographic Atrophy in Age-Related Macular Degeneration</title><title>Ophthalmology retina</title><addtitle>Ophthalmol Retina</addtitle><description>To evaluate the safety and efficacy of repeat injections of Brimonidine Drug Delivery System (Brimo DDS) Generation 2 (Gen 2) containing 400-μg brimonidine in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). A phase IIb, randomized, multicenter, double-masked, sham-controlled, 30-month study (BEACON). Patients diagnosed with GA secondary to AMD and multifocal lesions with total area of &gt; 1.25 mm2 and ≤ 18 mm2 in the study eye. Enrolled patients were randomized to treatment with intravitreal injections of 400-μg Brimo DDS (n = 154) or sham procedure (n = 156) in the study eye every 3 months from day 1 to month 21. The primary efficacy endpoint was GA lesion area change from baseline in the study eye, assessed with fundus autofluorescence imaging, at month 24. The study was terminated early, at the time of the planned interim analysis, because of a slow GA progression rate (∼ 1.6 mm2/year) in the enrolled population. Least squares mean (standard error) GA area change from baseline at month 24 (primary endpoint) was 3.24 (0.13) mm2 with Brimo DDS (n = 84) versus 3.48 (0.13) mm2 with sham (n = 91), a reduction of 0.25 mm2 (7%) with Brimo DDS compared with sham (P = 0.150). At month 30, GA area change from baseline was 4.09 (0.15) mm2 with Brimo DDS (n = 49) versus 4.52 (0.15) mm2 with sham (n = 46), a reduction of 0.43 mm2 (10%) with Brimo DDS compared with sham (P = 0.033). Exploratory analysis showed numerically smaller loss over time in retinal sensitivity assessed with scotopic microperimetry with Brimo DDS than with sham (P = 0.053 at month 24). Treatment-related adverse events were usually related to the injection procedure. No implant accumulation was observed. Multiple intravitreal administrations of Brimo DDS (Gen 2) were well tolerated. The primary efficacy endpoint at 24 months was not met, but there was a numeric trend for reduction in GA progression at 24 months compared with sham treatment. The study was terminated early because of the lower-than-expected GA progression rate in the sham/control group. Proprietary or commercial disclosures may be found after the references.</description><subject>Age-related macular degeneration</subject><subject>Brimonidine</subject><subject>Drug Delivery Systems - adverse effects</subject><subject>Geographic atrophy</subject><subject>Geographic Atrophy - diagnosis</subject><subject>Geographic Atrophy - drug therapy</subject><subject>Geographic Atrophy - etiology</subject><subject>Humans</subject><subject>Implant</subject><subject>Intravitreal Injections</subject><subject>Macular Degeneration - complications</subject><subject>Macular Degeneration - diagnosis</subject><subject>Macular Degeneration - drug 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Focke ; Bandello, Francesco ; Campos, Emilio ; GrignoloEandi, Chiara ; Midena, Edoardo ; Peiretti, Enrico ; Staurenghi, Giovanni ; Viola, Francesco ; Bailey, Clare ; Esposti, Simona Degli ; Jackson, Timothy ; Menon, Geeta ; Pagliarini, Sergio ; Quhill, Fahd ; Antoszyk, Andrew ; Brooks, Logan ; Callanan, David ; Csaky, Karl ; Edwards, Albert ; Eichenbaum, David ; Freeman, William ; Garg, Sunir ; Ghuman, Avtar Thomas ; Gonzalez, Victor ; Gupta, Sunil ; Hamilton, Richard ; Khurana, Rahul ; Kunimoto, Derek ; Kuppermann, Baruch ; Lauer, Andreas ; Lee, Seong Young ; Maturi, Raj ; Patel, Sunil ; Reddy, Rahul ; Rich, Ryan ; Rivellese, Mark ; Rose, Steven ; Segal, Zachary ; Wong, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-4f848ab2a1f073bff7fd1fd025eeb1ed50eae2796b857b0ca1d0f6e4256d1f493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age-related macular degeneration</topic><topic>Brimonidine</topic><topic>Drug Delivery Systems - adverse effects</topic><topic>Geographic atrophy</topic><topic>Geographic Atrophy - diagnosis</topic><topic>Geographic Atrophy - drug therapy</topic><topic>Geographic Atrophy - etiology</topic><topic>Humans</topic><topic>Implant</topic><topic>Intravitreal Injections</topic><topic>Macular Degeneration - complications</topic><topic>Macular Degeneration - diagnosis</topic><topic>Macular Degeneration - drug therapy</topic><topic>Nonexudative</topic><topic>Retina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Freeman, William R.</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Souied, Eric</creatorcontrib><creatorcontrib>Guymer, Robyn H.</creatorcontrib><creatorcontrib>Garg, Sunir J.</creatorcontrib><creatorcontrib>Chen, Fred K.</creatorcontrib><creatorcontrib>Rich, Ryan</creatorcontrib><creatorcontrib>Holz, Frank G.</creatorcontrib><creatorcontrib>Patel, Sunil S.</creatorcontrib><creatorcontrib>Kim, Kimmie</creatorcontrib><creatorcontrib>López, Francisco J.</creatorcontrib><creatorcontrib>Chen, Fred</creatorcontrib><creatorcontrib>Guymer, Robyn</creatorcontrib><creatorcontrib>Korobelnik, Jean-Francois</creatorcontrib><creatorcontrib>Souied, Eric</creatorcontrib><creatorcontrib>Holz, Frank</creatorcontrib><creatorcontrib>Ziemssen, Focke</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Campos, Emilio</creatorcontrib><creatorcontrib>GrignoloEandi, Chiara</creatorcontrib><creatorcontrib>Midena, Edoardo</creatorcontrib><creatorcontrib>Peiretti, Enrico</creatorcontrib><creatorcontrib>Staurenghi, Giovanni</creatorcontrib><creatorcontrib>Viola, Francesco</creatorcontrib><creatorcontrib>Bailey, Clare</creatorcontrib><creatorcontrib>Esposti, Simona Degli</creatorcontrib><creatorcontrib>Jackson, Timothy</creatorcontrib><creatorcontrib>Menon, Geeta</creatorcontrib><creatorcontrib>Pagliarini, Sergio</creatorcontrib><creatorcontrib>Quhill, Fahd</creatorcontrib><creatorcontrib>Antoszyk, Andrew</creatorcontrib><creatorcontrib>Brooks, Logan</creatorcontrib><creatorcontrib>Callanan, David</creatorcontrib><creatorcontrib>Csaky, Karl</creatorcontrib><creatorcontrib>Edwards, Albert</creatorcontrib><creatorcontrib>Eichenbaum, David</creatorcontrib><creatorcontrib>Freeman, William</creatorcontrib><creatorcontrib>Garg, Sunir</creatorcontrib><creatorcontrib>Ghuman, Avtar Thomas</creatorcontrib><creatorcontrib>Gonzalez, Victor</creatorcontrib><creatorcontrib>Gupta, Sunil</creatorcontrib><creatorcontrib>Hamilton, Richard</creatorcontrib><creatorcontrib>Khurana, Rahul</creatorcontrib><creatorcontrib>Kunimoto, Derek</creatorcontrib><creatorcontrib>Kuppermann, Baruch</creatorcontrib><creatorcontrib>Lauer, Andreas</creatorcontrib><creatorcontrib>Lee, Seong Young</creatorcontrib><creatorcontrib>Maturi, Raj</creatorcontrib><creatorcontrib>Patel, Sunil</creatorcontrib><creatorcontrib>Reddy, Rahul</creatorcontrib><creatorcontrib>Rich, Ryan</creatorcontrib><creatorcontrib>Rivellese, Mark</creatorcontrib><creatorcontrib>Rose, Steven</creatorcontrib><creatorcontrib>Segal, Zachary</creatorcontrib><creatorcontrib>Wong, Robert</creatorcontrib><creatorcontrib>BEACON Study Group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology retina</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Freeman, William R.</au><au>Bandello, Francesco</au><au>Souied, Eric</au><au>Guymer, Robyn H.</au><au>Garg, Sunir J.</au><au>Chen, Fred K.</au><au>Rich, Ryan</au><au>Holz, Frank G.</au><au>Patel, Sunil S.</au><au>Kim, Kimmie</au><au>López, Francisco J.</au><au>Chen, Fred</au><au>Guymer, Robyn</au><au>Korobelnik, Jean-Francois</au><au>Souied, Eric</au><au>Holz, Frank</au><au>Ziemssen, Focke</au><au>Bandello, Francesco</au><au>Campos, Emilio</au><au>GrignoloEandi, Chiara</au><au>Midena, Edoardo</au><au>Peiretti, Enrico</au><au>Staurenghi, Giovanni</au><au>Viola, Francesco</au><au>Bailey, Clare</au><au>Esposti, Simona Degli</au><au>Jackson, Timothy</au><au>Menon, Geeta</au><au>Pagliarini, Sergio</au><au>Quhill, Fahd</au><au>Antoszyk, Andrew</au><au>Brooks, Logan</au><au>Callanan, David</au><au>Csaky, Karl</au><au>Edwards, Albert</au><au>Eichenbaum, David</au><au>Freeman, William</au><au>Garg, Sunir</au><au>Ghuman, Avtar Thomas</au><au>Gonzalez, Victor</au><au>Gupta, Sunil</au><au>Hamilton, Richard</au><au>Khurana, Rahul</au><au>Kunimoto, Derek</au><au>Kuppermann, Baruch</au><au>Lauer, Andreas</au><au>Lee, Seong Young</au><au>Maturi, Raj</au><au>Patel, Sunil</au><au>Reddy, Rahul</au><au>Rich, Ryan</au><au>Rivellese, Mark</au><au>Rose, Steven</au><au>Segal, Zachary</au><au>Wong, Robert</au><aucorp>BEACON Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized Phase IIb Study of Brimonidine Drug Delivery System Generation 2 for Geographic Atrophy in Age-Related Macular Degeneration</atitle><jtitle>Ophthalmology retina</jtitle><addtitle>Ophthalmol Retina</addtitle><date>2023-07</date><risdate>2023</risdate><volume>7</volume><issue>7</issue><spage>573</spage><epage>585</epage><pages>573-585</pages><issn>2468-6530</issn><eissn>2468-6530</eissn><abstract>To evaluate the safety and efficacy of repeat injections of Brimonidine Drug Delivery System (Brimo DDS) Generation 2 (Gen 2) containing 400-μg brimonidine in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). A phase IIb, randomized, multicenter, double-masked, sham-controlled, 30-month study (BEACON). Patients diagnosed with GA secondary to AMD and multifocal lesions with total area of &gt; 1.25 mm2 and ≤ 18 mm2 in the study eye. Enrolled patients were randomized to treatment with intravitreal injections of 400-μg Brimo DDS (n = 154) or sham procedure (n = 156) in the study eye every 3 months from day 1 to month 21. The primary efficacy endpoint was GA lesion area change from baseline in the study eye, assessed with fundus autofluorescence imaging, at month 24. The study was terminated early, at the time of the planned interim analysis, because of a slow GA progression rate (∼ 1.6 mm2/year) in the enrolled population. Least squares mean (standard error) GA area change from baseline at month 24 (primary endpoint) was 3.24 (0.13) mm2 with Brimo DDS (n = 84) versus 3.48 (0.13) mm2 with sham (n = 91), a reduction of 0.25 mm2 (7%) with Brimo DDS compared with sham (P = 0.150). At month 30, GA area change from baseline was 4.09 (0.15) mm2 with Brimo DDS (n = 49) versus 4.52 (0.15) mm2 with sham (n = 46), a reduction of 0.43 mm2 (10%) with Brimo DDS compared with sham (P = 0.033). Exploratory analysis showed numerically smaller loss over time in retinal sensitivity assessed with scotopic microperimetry with Brimo DDS than with sham (P = 0.053 at month 24). Treatment-related adverse events were usually related to the injection procedure. No implant accumulation was observed. Multiple intravitreal administrations of Brimo DDS (Gen 2) were well tolerated. The primary efficacy endpoint at 24 months was not met, but there was a numeric trend for reduction in GA progression at 24 months compared with sham treatment. The study was terminated early because of the lower-than-expected GA progression rate in the sham/control group. Proprietary or commercial disclosures may be found after the references.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36906177</pmid><doi>10.1016/j.oret.2023.03.001</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-0511-4942</orcidid><orcidid>https://orcid.org/0000-0003-3238-9682</orcidid><orcidid>https://orcid.org/0000-0002-9441-4356</orcidid><orcidid>https://orcid.org/0000-0003-0189-861X</orcidid><orcidid>https://orcid.org/0000-0003-2809-9930</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 2468-6530
ispartof Ophthalmology retina, 2023-07, Vol.7 (7), p.573-585
issn 2468-6530
2468-6530
language eng
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source MEDLINE; Alma/SFX Local Collection
subjects Age-related macular degeneration
Brimonidine
Drug Delivery Systems - adverse effects
Geographic atrophy
Geographic Atrophy - diagnosis
Geographic Atrophy - drug therapy
Geographic Atrophy - etiology
Humans
Implant
Intravitreal Injections
Macular Degeneration - complications
Macular Degeneration - diagnosis
Macular Degeneration - drug therapy
Nonexudative
Retina
title Randomized Phase IIb Study of Brimonidine Drug Delivery System Generation 2 for Geographic Atrophy in Age-Related Macular Degeneration
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