A Phase 3 interventional study of KSI-301 and Aflibercept in Diabetic Macular Edema, sponsored by Kodiak Sciences Inc. Terminated at 72 sites in 8 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-08-22.
Sponsored by Kodiak Sciences Inc · Phase 3, Interventional, and Treatment
This Phase 3 study will evaluate the efficacy, durability, and safety of KSI-301 compared to aflibercept in participants with treatment-naïve DME.
This is a Phase 3, prospective, randomized, double-masked, two-arm, multi-center non-inferiority study evaluating the efficacy and safety of repeated intravitreal dosing of KSI-301 5 mg in participants with treatment-naïve DME.
The primary endpoint will be assessed at Year 1; additional secondary endpoints for efficacy will be assessed at Years 1 and 2.
842 studies on the registry are indexed under Macular Edema; 57 are open to participants now.
This study's enrollment of 459 is above the median of 50 across 619 interventional studies indexed under Macular Edema.
Browse Macular Edema studies →Kodiak Sciences Inc is the lead sponsor of 12 studies on the registry; 3 are open to participants now.
Of its 8 completed or terminated interventional studies of FDA-regulated products, 6 (75%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Intravitreal injection of KSI-301 (5 mg) once every 4 weeks for 3 monthly doses followed by an individualized dosing regimen (every 8 to 24 weeks) via intravitreal injection from Week 16 to Week 100.
Drug: KSI-301 · Other: Sham Procedure
Intravitreal injection of aflibercept (2 mg) once every 4 weeks for 5 monthly doses followed by aflibercept (2 mg) once every 8 weeks via intravitreal injection from Week 24 to 100.
Drug: Aflibercept · Other: Sham Procedure
Intravitreal Injection
Intravitreal Injection
Also known as: Eylea
The sham is a procedure that mimics an intravitreal injection. It involves pressing the blunt end of an empty syringe (without a needle) against the anesthetized eye. It will be administered to participants in both treatments arms at applicable visits to maintain masking.
Mean Change in BCVA
Mean change in best-corrected visual acuity (BCVA) from baseline to the average of Weeks 60 and 64 (using Early Treatment Diabetic Retinopathy Study (ETDRS) Letters). Best Corrected Visual Acuity (BCVA) was measured on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters. The BCVA letter score ranges from 0 to 100 (best score), and a gain in BCVA letter score from baseline indicates an improvement in visual acuity.
Time frame: Day 1 to Week 64
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Studies KS301P104 and KS301P105 Combined
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Studies KS301P104 and KS301P105 combined. The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).
Time frame: Day 1 to Week 52
Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Study KS301P105
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Study KS301P105. The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).
Time frame: Day 1 to Week 52
Percentage of Patients in the KSI-301 Arm on a Q8W, Q12W, Q16W, Q20W, or Q24W Treatment Interval
Percentage of patients in the KSI-301 arm on a Q8W, Q12W, Q16W, Q20W, or Q24W treatment interval at the primary endpoint. Analyses include KSI-301 patients who completed a treatment interval from Week 56 onwards.
Time frame: Week 56
Mean Number of Intravitreal Injections
Mean number of intravitreal injections from Day 1 to Week 60
Time frame: Day 1 to Week 60
Mean Change in OCT CST
Mean change in Optical Coherence Tomography (OCT) central subfield retinal thickness (CST) baseline to the average of Weeks 60 and 64
Time frame: Day 1 to Week 64
Participants were recruited based on physician referral at 75 medical centers between September 2020 and January 2022. The first participant was enrolled on 30 September 2020 and the last on 31 January 2022.
| Milestone | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Started | 229 | 228 |
| Completed | 208 | 204 |
| Not completed | 21 | 24 |
| Withdrew: Adverse event | 9 | 10 |
| Withdrew: Withdrawal by subject | 7 | 6 |
| Withdrew: Lost to follow-up | 5 | 6 |
| Withdrew: Physician decision | 0 | 1 |
| Withdrew: Subject did not meet inclusion criteria 1 so was withdrawn from the study | 0 | 1 |
Mean change in best-corrected visual acuity (BCVA) from baseline to the average of Weeks 60 and 64 (using Early Treatment Diabetic Retinopathy Study (ETDRS) Letters). Best Corrected Visual Acuity (BCVA) was measured on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters. The BCVA letter score ranges from 0 to 100 (best score), and a gain in BCVA letter score from baseline indicates an improvement in visual acuity.
| ETDRS Letters | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Mean Change in BCVA | 6.7 ± 0.80 | 11.5 ± 0.81 |
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Studies KS301P104 and KS301P105 combined. The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).
| Participants | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Studies KS301P104 and KS301P105 Combined | 6 | 3 |
Percentage of patients with a ≥ 2-step worsening on the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS) from baseline at Week 52 using last observation carried forward (LOCF) in Study KS301P105. The Diabetic Retinopathy Disease Severity Scale (DRSS) may be used to describe overall retinopathy severity as well as the change in severity over time. Severity range from level 10 (DR absent) to level 85 (advanced proliferative DR: posterior fundus obscured, or center of macula detached).
| Participants | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Percentage of Patients With a ≥ 2-step Worsening on the ETDRS DRSS in Study KS301P105 | 6 | 3 |
Percentage of patients in the KSI-301 arm on a Q8W, Q12W, Q16W, Q20W, or Q24W treatment interval at the primary endpoint. Analyses include KSI-301 patients who completed a treatment interval from Week 56 onwards.
| Participants | KSI-301 (Arm A) |
|---|---|
| Number of participants on the KSI-301 Q8W | 54 |
| Number of participants on the KSI-301 Q12W | 23 |
| Number of participants on the KSI-301 Q16W | 14 |
| Number of participants on the KSI-301 Q20W | 10 |
| Number of participants on the KSI-301 Q24W | 109 |
Mean number of intravitreal injections from Day 1 to Week 60
| injections | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Mean Number of Intravitreal Injections | 5.8 ± 1.64 | 9.2 ± 1.91 |
Mean change in Optical Coherence Tomography (OCT) central subfield retinal thickness (CST) baseline to the average of Weeks 60 and 64
| Microns | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| Mean Change in OCT CST | -154.7 ± 128.03 | -194.2 ± 154.44 |
Collected over Time Frame Adverse Events (AEs) reported through Week 64 or Early Termination (ET) if occurred before Week 64.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| KSI-301 (Arm A) | 4/228 (1.8%) | 53/228 (23.2%) | 113/228 (49.6%) |
| Aflibercept (Arm B) | 6/229 (2.6%) | 57/229 (24.9%) | 104/229 (45.4%) |
| Event | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| PneumoniaInfections and infestations | 5/228 | 2/229 |
| Acute kidney injuryRenal and urinary disorders | 4/228 | 2/229 |
| Acute myocardial infarctionCardiac disorders | 3/228 | 4/229 |
| Cardiac failure congestiveCardiac disorders | 1/228 | 4/229 |
| COVID-19Infections and infestations | 3/228 | 4/229 |
| COVID-19 pneumoniaInfections and infestations | 2/228 | 4/229 |
| Ischaemic strokeNervous system disorders | 0/228 | 4/229 |
| OsteomyelitisInfections and infestations | 3/228 | 3/229 |
| Respiratory failureRespiratory, thoracic and mediastinal disorders | 3/228 | 2/229 |
| Myocardial infarctionCardiac disorders | 2/228 | 3/229 |
| Event | KSI-301 (Arm A) | Aflibercept (Arm B) |
|---|---|---|
| COVID-19Infections and infestations | 32/228 | 34/229 |
| Cataract - Study EyeEye disorders | 33/228 | 15/229 |
| Diabetic retinal oedema - Fellow EyeEye disorders | 14/228 | 24/229 |
| HypertensionVascular disorders | 23/228 | 23/229 |
| Conjunctival haemorrhage - Study EyeEye disorders | 22/228 | 8/229 |
| Diabetes mellitusMetabolism and nutrition disorders | 22/228 | 22/229 |
| Cataract - Fellow EyeEye disorders | 12/228 | 12/229 |
| Diabetic retinal oedema - Study EyeEye disorders | 12/228 | 4/229 |
Full analysis set defined as all randomized subjects who received any study treatment (KSI-301 or aflibercept). Subjects will be analyzed according to their randomized treatment.
| Age, Categorical(Participants) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 133 | 137 | 270 |
| >=65 years | 96 | 91 | 187 |
| Age, Continuous(years) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| Mean | 62.2 ± 9.34 | 61.6 ± 9.90 | 61.9 ± 9.62 |
| Sex: Female, Male(Participants) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| Female | 97 | 79 | 176 |
| Male | 132 | 149 | 281 |
| Ethnicity (NIH/OMB)(Participants) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| Hispanic or Latino | 42 | 58 | 100 |
| Not Hispanic or Latino | 182 | 161 | 343 |
| Unknown or Not Reported | 5 | 9 | 14 |
| Race (NIH/OMB)(Participants) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 1 | 1 |
| Asian | 3 | 1 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 22 | 12 | 34 |
| White | 194 | 201 | 395 |
| More than one race | 2 | 2 | 4 |
| Unknown or Not Reported | 8 | 11 | 19 |
| Geographic Region(Participants) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| North America | 149 | 147 | 296 |
| Rest of World | 80 | 81 | 161 |
| BCVA in the Study Eye, Letters(Letters) | KSI-301 (Arm A) | Aflibercept (Arm B) | Total |
|---|---|---|---|
| Mean | 64.2 ± 11.43 | 64.3 ± 11.21 | 64.2 ± 11.31 |
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Kodiak Sciences Inc