CClinicalTrials.gg
RecruitingNCT07482176AQUARIUSUpdated Sep 24, 2026

Efficacy and Safety Study of Ixoberogene Soroparvovec (Ixo-vec) in Participants With Neovascular Age-related Macular Degeneration (AQUARIUS)

A Phase 3 interventional study of Ixo-vec and Aflibercept in Neovascular Age-Related Macular Degeneration (nAMD) and Wet AMD, sponsored by Adverum Biotechnologies, Inc.. Recruiting at 79 sites in United States. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by Adverum Biotechnologies, Inc. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
534
Allocation
Randomized
Ages
50 Years and older
Sex
All
01

Study summary

This is a multi-center, randomized, double-masked, active-comparator-controlled, Phase 3 study in a broad participant population (treatment-naïve and treatment-experienced) with neovascular (wet) age-related macular degeneration (nAMD). The study will evaluate a single intravitreal (IVT) injection of Ixo-vec compared to intravitreal aflibercept (active comparator). The primary endpoint of this study is the mean change in best corrected visual acuity (BCVA) of Ixo-vec compared to an active comparator measured as an average at Weeks 52 and 56.

Safety, tolerability, and efficacy will be evaluated throughout the study.

Read the detailed description

The primary objective of this study is to evaluate the non-inferiority in efficacy of a single IVT injection of Ixo-vec 6 x 10\^10 vector genome (vg)/eye compared to an active comparator. Non-inferiority will be evaluated using a pre-specified margin defined in the protocol.

Neovascular AMD is a degenerative ocular disease associated with the infiltration of abnormal blood vessels in the retina from the underlying choroid layer and is a leading cause of blindness in patients over 65 years of age. The abnormal angiogenic process in nAMD is stimulated and modulated by vascular endothelial growth factor (VEGF). Treatment of nAMD requires frequent IVT injections of VEGF inhibitors (anti-VEGF) administered every 4-16 weeks. Ixo-vec (also known as ADVM-022 or AAV.7m8-aflibercept) is an adeno-associated virus (AAV)-based gene therapy product being developed for the treatment of nAMD. Ixo-vec is designed to reduce the current treatment burden which often results in undertreatment and vision loss in patients with nAMD receiving anti-VEGF therapy in clinical practice.

Safety, tolerability, and efficacy will be evaluated throughout this study. The primary endpoint of this study is the mean change in BCVA of Ixo-vec compared to an active comparator measured as an average at Weeks 52 and 56 post-treatment.

Due to the long duration of the Screening period, this study will be considered fully enrolled when randomization has been completed.

02

Conditions studied

  • Neovascular Age-Related Macular Degeneration (nAMD)
  • Wet AMD

Keywords

  • Ixoberogene soroparvovec
  • Ixo-vec
  • Aflibercept
  • Neovascular age-related macular degeneration
  • nAMD
  • ADVM
  • ADVM-022
  • Wet AMD
  • wAMD
  • Wet Age-related Macular Degeneration
  • CNV
  • Neovascular AMD
  • AAV
  • AAV vector
  • AAV.7m8-aflibercept
  • AAV.7m8
  • Gene therapy
  • Eye disease
  • Blindness
  • Adeno-associated viruses
  • ADVM-022-13
03

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Able and willing to provide informed consent (or have a legally authorized representative who is able and willing to provide informed consent) prior to any study assessments and procedures and comply with the study requirements and visits.
  2. Male or female with a diagnosis of CNV secondary to nAMD in the study eye, with nAMD disease activity at Screening Visit 1.
  3. At least 50 years old at Screening Visit 1.
  4. An ETDRS BCVA letter score of 35 - 78 (approximate Snellen equivalent of 20/200 to 20/32) in the study eye at Screening Visit 1.
  5. Demonstrated a meaningful anatomic response to anti-VEGF therapy during screening.
  6. Able to reliably use eye drops per protocol.

Exclusion criteria

Exclusion Criteria:

General Exclusion Criteria

  1. History of a medical condition giving reasonable suspicion of a condition that contraindicates the use of Ixo-vec, compromises the participant's ability to comply with the planned study activities, or that might affect the interpretation of the results of the study or render the participant at high risk for treatment complications in the opinion of the Investigator. History of severe coronavirus disease (COVID-19) infection may meet this exclusion criterion if, in the opinion of the Investigator, it is likely to lead to any important complications.
  2. Received any prior gene therapy.
  3. Prior treatment with any non-gene therapy investigational medicinal product (IMP) or medical device in the study eye within 3 months of Screening Visit 1 or 5 half-lives of the IMP prior to dosing with Ixo-vec, whichever is longer.
  4. Female participants who are pregnant or breastfeeding or who intend to become pregnant or breastfeed in the future.
  5. History or evidence of any of the following cardiovascular diseases:

    1. Myocardial infarction in the 6-month period prior to Week 1.
    2. Uncontrolled hypertension defined as systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg during screening.
    3. Stroke in the 6-month period prior to Week 1.
  6. History of ongoing bleeding disorders. The use of aspirin or other anticoagulants (e.g., Factor Xa inhibitors) is permitted.
  7. Use of systemic immunosuppressive drugs within 90 days prior to Screening Visit 1. Short courses of oral corticosteroids are permitted, as well as any inhaled, intra-articular, nasal or dermal steroid use.
  8. Evidence of poorly controlled diabetes or glycated hemoglobin (HbA1c) ≥ 8.0% during screening.

Ocular Exclusion Criteria

  1. Any active ocular or periocular infection in the study eye from Screening Visit 1.
  2. History or evidence of the following in the study eye:

    1. Intraocular or refractive surgery within 5 months prior to Week 1.
    2. Any previous penetrating keratoplasty or vitrectomy.
    3. Any previous panretinal photocoagulation.
    4. Any previous submacular surgery, other surgical intervention (including port delivery system) or laser treatment for age-related macular degeneration.
  3. Any history or evidence of retinal detachment (with or without repair) or retinal pigment epithelium rip/tear in the study eye, as determined by the Investigator during screening or at Week 1.
  4. Uncontrolled ocular hypertension or glaucoma in the study eye from Screening Visit 1 to Week 1 or current use of ≥ 2 intraocular pressure (IOP) lowering medications or normal tension glaucoma/suspect in the study eye or history of any of the following procedures in the study eye prior to Week 1:

    1. Incisional glaucoma surgery (i.e., glaucoma drainage implant/shunt or trabeculectomy)
    2. Ocular angle-based surgery (i.e., goniotomy or canaloplasty)
    3. Minimally Invasive Glaucoma Surgery (MIGS) in the study eye.
    4. Angle-based glaucoma surgery (e.g., Argon or Selective Laser Trabeculoplasty)
  5. Any history of IOP elevation related to topical steroid administration in either eye.
  6. Any history of uveitis or inflammation (grade trace or above) except mild anticipated post operative inflammation that resolved in either eye.
  7. Any history of treatment with complement inhibitors for geographic atrophy in the study eye.
  8. Known history of ocular herpes simplex virus, varicella-zoster virus, or cytomegalovirus, including viral uveitis, retinitis, or keratitis in either eye.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
534 participants (estimated)

Study arms

  • Experimental
    Ixo-vec

    Participants will receive 3 monthly loading doses of aflibercept 2 mg IVT, a single IVT injection of Ixo-vec 6 x 10\^10 vg/eye at Week 1, and sham injections every 8 weeks.

    Genetic: Ixo-vec · Drug: Aflibercept

  • Active comparator
    Aflibercept

    Participants will receive 3 monthly loading doses of aflibercept 2 mg IVT, a sham injection at Week 1, and aflibercept 2 mg IVT every 8 weeks.

    Drug: Aflibercept

Interventions

  • GeneticIxo-vec

    Ixo-vec will be administered intravitreally.

  • DrugAflibercept

    Aflibercept will be administered intravitreally.

05

What researchers measure

Primary outcomes

  1. Mean Change from Baseline in BCVA Based on an Average at Weeks 52 and 56

    BCVA will be measured using an Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart.

    Time frame: Baseline, Week 52 and Week 56

Secondary outcomes

  1. Mean Number of Aflibercept IVT Injections Received

    Time frame: Week 4 through Week 56

  2. Percentage of Participants with Worsened BCVA

    BCVA measured by ETDRS.

    Time frame: Through Week 56

  3. Percentage of Participants with Improved BCVA

    BCVA measured by ETDRS.

    Time frame: Through Week 56

  4. Mean Change from Baseline in BCVA Over Time Based on an Average at Weeks 52 and 56

    BCVA measured by ETDRS.

    Time frame: Baseline Through Week 56

  5. Mean Change from Week 1 in BCVA Based on an Average at Weeks 52 and 56

    BCVA measured by ETDRS.

    Time frame: Week 1 through Week 56

  6. Percentage of Participants with BCVA of 73 Letters or More from Week 4 Through Week 56

    Time frame: Week 4 through Week 56

  7. Mean Change in Central Subfield Thickness (CST) from Baseline Over Time Through Week 56

    CST as measured by spectral domain optical coherence tomography (SD-OCT).

    Time frame: Baseline Through Week 56

  8. Percentage of Participants with CST ≤ 300 μm Over Time Through Week 56

    CST will be assessed by a central reading center (CRC) using SD-OCT.

    Time frame: Through Week 56

  9. Mean Number of CST Fluctuations > 50 μm From Week 1 Over Time Through Week 56

    CST will be assessed by a CRC using SD-OCT images and the mean number of fluctuations with thickness of more than 50 μm will be summarized.

    Time frame: Week 1 through Week 56

  10. Percentage of Participants with CST Fluctuations > 50 μm from Week 1 Over Time Through Week 56

    CST will be assessed using SD-OCT.

    Time frame: Week 1 through Week 56

  11. Percent Reduction in Mean Rate of Annualized Anti-VEGF Injections

    Percent reduction in mean rate of annualized anti-VEGF injections will be assessed relative to the reduction in mean rate of annualized anti-VEGF injections received in the year prior to screening in treatment-experienced participants.

    Time frame: Through Week 56

  12. Percentage of Participants Who Were Aflibercept Injection-free

    Time frame: Week 4 through Week 56

  13. Percentage of Participants Who Received 0 or 1 Aflibercept Injection

    Time frame: Week 4 through Week 56

  14. Mean Change in Area of Choroidal Neovascularization (CNV) Lesion from Baseline Over Time Through Week 56

    CNV is the infiltration of abnormal blood vessels in the retina from the underlying choroid layer. It will be assessed by a CRC using SD-OCT.

    Time frame: Baseline through Week 56

  15. Mean Change in Macular Volume from Baseline Over Time Through Week 56

    Macular volume will be measured as part of the full ophthalmic examination.

    Time frame: Baseline through Week 56

  16. Percentage of Participants Without Intraretinal Fluid (IRF) Over Time Through Week 56

    IRF will be assessed using SD-OCT.

    Time frame: Through Week 56

  17. Percentage of Participants Without Subretinal Fluid (SRF) Over Time Through Week 56

    SRF will be assessed using SD-OCT.

    Time frame: Through Week 56

  18. Percentage of Participants Without IRF and/or SRF Over Time Through Week 56

    IRF and SRF will be assessed using SD-OCT.

    Time frame: Through Week 56

  19. Time to Dry Retina

    Dry retina is defined as no IRF or SRF (i.e., absence of both). IRF and SRF will be assessed using SD-OCT.

    Time frame: Through Week 56

  20. Time to Sustained Dry Retina

    Sustained dry retina is defined as no IRF or SRF (i.e., absence of both) maintained for 2 consecutive visits.

    Time frame: Through Week 56

  21. Number of Participants Who Experienced Ocular Adverse Events

    The number of participants who experience an ocular adverse event will be summarized.

    Time frame: Through Week 56

  22. Number of Participants Who Experienced Mild, Moderate or Severe Ocular Adverse Events

    The number of participants who experience a mild, moderate or severe ocular adverse event will be summarized.

    Time frame: Through Week 56

  23. Number of Participants Who Experienced Non-ocular Adverse Events

    The number of participants who experience a non-ocular adverse event will be summarized.

    Time frame: Through Week 56

  24. Number of Participants Who Experienced Mild, Moderate or Severe Non-ocular Adverse Events

    The number of participants who experience a mild, moderate or severe non-ocular adverse event will be summarized.

    Time frame: Through Week 56

  25. Mean Change in 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) Total and Subscale Scores

    The NEI VFQ-25 measures vision-targeted patient-reported outcomes of individuals with chronic eye diseases. It comprises 25 questions. The assessment generates an overall composite score and includes the following subscales: global vision rating, difficulty with near vision activities, difficulty with distance vision activities, limitations in social functioning due to vision, role limitations due to vision, dependency on others due to vision, mental health symptoms due to vision, driving difficulties, limitations with peripheral and color vision, and ocular pain. A decrease in the NEI VFQ-25 score represents an improvement in disease severity.

    Time frame: Day 1 to Week 28 and Week 56

  26. Mean Change in the 5-item Health-related Quality of Life Questionnaire (EQ-5D-5L)

    The EQ-5D-5L is a concise, generic self-reported health questionnaire which is weighted to reflect the relevant importance to patients of various different health problems. In retinal disease, the questionnaire is used to assess quality of life in the context of vision loss. It measures five parameters; mobility, self-care, usual activities, pain/discomfort and anxiety/depression. An increase in the EQ-5D-5L score represents an improvement in disease severity.

    Time frame: Day 1 to Week 28 and Week 56

06

Study locations

79 of 79 sites recruiting
  • Adverum Clinical Site 245
    Mesa, Arizona 85206, United States
    Recruiting
  • Adverum Clinical Site 126
    Phoenix, Arizona 85014, United States
    Recruiting
  • Adverum Clinical Site 178
    Phoenix, Arizona 85020, United States
    Recruiting
  • Adverum Clinical Site 223
    Phoenix, Arizona 85020, United States
    Recruiting
  • Adverum Clinical Site 229
    Scottsdale, Arizona 85255, United States
    Recruiting
  • Adverum Clinical Site 242
    Sun City, Arizona 85351, United States
    Recruiting
  • Adverum Clinical Site 198
    Springdale, Arkansas 72764, United States
    Recruiting
  • Adverum Clinical Site 109
    Bakersfield, California 93309, United States
    Recruiting
  • Adverum Clinical Site 100
    Beverly Hills, California 90211, United States
    Recruiting
  • Adverum Clinical Site 201
    Campbell, California 95008, United States
    Recruiting
  • Adverum Clinical Site 172
    Encino, California 91436, United States
    Recruiting
  • Adverum Clinical Site 169
    Fullerton, California 92835, United States
    Recruiting
  • Adverum Clinical Site 224
    Huntington Beach, California 92647, United States
    Recruiting
  • Adverum Clinical Site 130
    Poway, California 92064, United States
    Recruiting
  • Adverum Clinical Site 215
    Redlands, California 92374, United States
    Recruiting
  • Adverum Clinical Site 140
    Sacramento, California 95825, United States
    Recruiting
  • Adverum Clinical Site 212
    Sacramento, California 95841, United States
    Recruiting
  • Adverum Clinical Site 175
    Santa Barbara, California 93103, United States
    Recruiting
  • Adverum Clinical Site 202
    Torrance, California 90503, United States
    Recruiting
  • Adverum Clinical Site 189
    Walnut Creek, California 94598, United States
    Recruiting
  • Adverum Clinical Site 200
    Denver, Colorado 800222, United States
    Recruiting
  • Adverum Clinical Site 116
    Denver, Colorado 80207, United States
    Recruiting
  • Adverum Clinical Site 165
    Waterford, Connecticut 06385, United States
    Recruiting
  • Adverum Clinical Site 124
    Deerfield Beach, Florida 33064, United States
    Recruiting
  • Adverum Clinical Site 184
    Deerfield Beach, Florida 33064, United States
    Recruiting
  • Adverum Clinical Site 176
    Fort Lauderdale, Florida 33308, United States
    Recruiting
  • Adverum Clinical Site 221
    Fort Myers, Florida 33912, United States
    Recruiting
  • Adverum Clinical Site 236
    Gainesville, Florida 32607, United States
    Recruiting
  • Adverum Clinical Site 214
    Lakeland, Florida 33805, United States
    Recruiting
  • Adverum Clinical Site 168
    Miami Springs, Florida 33166, United States
    Recruiting
  • Adverum Clinical Site 213
    Orlando, Florida 32806, United States
    Recruiting
  • Adverum Clinical Site 206
    Plantation, Florida 33324, United States
    Recruiting
  • Adverum Clinical Site 183
    South Miami, Florida 33143, United States
    Recruiting
  • Adverum Clinical Site 120
    St. Petersburg, Florida 33711, United States
    Recruiting
  • Adverum Clinical Site 148
    Tampa, Florida 33609, United States
    Recruiting
  • Adverum Clinical Site 238
    Winter Haven, Florida 33880, United States
    Recruiting
  • Adverum Clinical Site 182
    Augusta, Georgia 30909, United States
    Recruiting
  • Adverum Clinical Site 246
    Chicago, Illinois 60616, United States
    Recruiting
  • Adverum Clinical Site 179
    Oak Forest, Illinois 60452, United States
    Recruiting
  • Adverum Clinical Site 207
    Oak Park, Illinois 60304, United States
    Recruiting
  • Adverum Clinical Site 195
    Carmel, Indiana 46032, United States
    Recruiting
  • Adverum Clinical Site 205
    Carmel, Indiana 46032, United States
    Recruiting
  • Adverum Clinical Site 253
    Carmel, Indiana 46032, United States
    Recruiting
  • Adverum Clinical Site 197
    Hagerstown, Maryland 21740, United States
    Recruiting
  • Adverum Clinical Site 204
    Hagerstown, Maryland 21740, United States
    Recruiting
  • Adverum Clinical Site 216
    Jackson, Mississippi 39202, United States
    Recruiting
  • Adverum Clinical Site 240
    Bloomfield, New Jersey 07003, United States
    Recruiting
  • Adverum Clinical Site 171
    Teaneck, New Jersey 07666, United States
    Recruiting
  • Adverum Clinical Site 225
    Liverpool, New York 13088, United States
    Recruiting
  • Adverum Clinical Site 244
    Rochester, New York 14620, United States
    Recruiting
  • Adverum Clinical Site 196
    Asheville, North Carolina 28803, United States
    Recruiting
  • Adverum Clinical Site 234
    Cary, North Carolina 27511, United States
    Recruiting
  • Adverum Clinical Site 211
    Greensboro, North Carolina 27401, United States
    Recruiting
  • Adverum Clinical Site 219
    Greensboro, North Carolina 27401, United States
    Recruiting
  • Adverum Clinical Site 220
    Hickory, North Carolina 28602, United States
    Recruiting
  • Adverum Clinical Site 209
    Wake Forest, North Carolina 27587, United States
    Recruiting
  • Adverum Clinical Site 248
    Beachwood, Ohio 44122-5846, United States
    Recruiting
  • Adverum Clinical Site 247
    Cleveland, Ohio 44130, United States
    Recruiting
  • Adverum Clinical Site 254
    Edmond, Oklahoma 73013, United States
    Recruiting
  • Adverum Clinical Site 252
    Portland, Oregon 97225, United States
    Recruiting
  • Adverum Clinical Site 181
    Erie, Pennsylvania 16505, United States
    Recruiting
  • Adverum Clinical Site 239
    Philadelphia, Pennsylvania 19102, United States
    Recruiting
  • Adverum Clinical Site 110
    Philadelphia, Pennsylvania 19107, United States
    Recruiting
  • Adverum Clinical Site 241
    Bluffton, South Carolina 29910, United States
    Recruiting
  • Adverum Clinical Site 222
    Ladson, South Carolina 29456, United States
    Recruiting
  • Adverum Clinical Site 101
    Nashville, Tennessee 37203, United States
    Recruiting
  • Adverum Clinical Site 145
    Arlington, Texas 76012, United States
    Recruiting
  • Adverum Clinical Site 127
    Austin, Texas 78705, United States
    Recruiting
  • Adverum Clinical Site 243
    Austin, Texas 78750, United States
    Recruiting
  • Adverum Clinical Site 107
    Conroe, Texas 77384, United States
    Recruiting
  • Adverum Clinical Site 194
    Dallas, Texas 75231, United States
    Recruiting
  • Adverum Clinical Site 162
    McAllen, Texas 78503, United States
    Recruiting
  • Adverum Clinical Site 185
    San Antonio, Texas 78240, United States
    Recruiting
  • Adverum Clinical Site 232
    San Marcos, Texas 78666, United States
    Recruiting
  • Adverum Clinical Site 228
    Schertz, Texas 78154, United States
    Recruiting
  • Adverum Clinical Site 231
    The Woodlands, Texas 77384, United States
    Recruiting
  • Adverum Clinical Site 237
    Tyler, Texas 75703, United States
    Recruiting
  • Adverum Clinical Site 199
    Lynchburg, Virginia 24502, United States
    Recruiting
  • Adverum Clinical Site 249
    Silverdale, Washington 98383, United States
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — Adverum is committed to transparency. Appropriately de-identified participant-level data and supporting documents may be shared under appropriate conditions (e.g. when contractually permitted and when participants provide appropriate consent). Individual patient-level data would only be shared following completion of this study (and any associated studies), completion of applicable regulatory submissions, and in accordance with applicable regulations and laws, as well as criteria established by Adverum, our collaborators and/or industry best practices. Shared datasets and/or documents may be de-identified and/or redacted to protect participant identity and to protect sensitive and confidential information. For inquiries, please contact us at datasharing@adverum.com.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07482176
Lead sponsor
Adverum Biotechnologies, Inc.
Responsible party
Sponsor
First posted
Mar 19, 2026
Start date
Mar 16, 2026
Primary completion
Nov 15, 2027 (estimated)
Completion
Oct 20, 2031 (estimated)
Last update
Sep 24, 2026

Study contacts

Adverum Study Contact
Contact
ADVM02213ClinOp@adverum.com
650-656-9323
Adam Turpcu, PhD
study director · Adverum Biotechnologies, Inc.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion