Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2)

Completed · Phase 3

Conditions studied: Central Retinal Vein Occlusion

In brief

SCORE2 is a multicenter, prospective, randomized, phase III clinical trial in which all participants enrolled will be followed for up to 2.5 years. SCORE2 is designed as a non-inferiority trial, with study eyes randomized to intravitreal bevacizumab (1.25 mg) every 4 weeks vs. intravitreal aflibercept (2.0 mg) every 4 weeks. SCORE2 aims to determine if bevacizumab is non-inferior to aflibercept for the treatment of macular edema associated with central retinal vein occlusion (CRVO), with the primary outcome of visual acuity measured at Month 6.

Key facts

Study ID

NCT01969708

Run by

The Emmes Company, LLC

People needed

362

Starts

2014-09-01

Expected to finish

2021-03-01

Last updated by the study team

2021-06-22

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Participants must have center-involved macular edema secondary to CRVO. Eyes may be enrolled as early as the time of diagnosis of the macular edema. The definition of CRVO used in SCORE will also be used for the purposes of SCORE2: a CRVO is defined as an eye that has retinal hemorrhage or other biomicroscopic evidence of retinal vein occlusion (e.g., telangiectatic capillary bed) and a dilated venous system (or previously dilated venous system) in all 4 quadrants.
• Due to the similarities of a hemiretinal vein occlusion (HRVO) to CRVO,HRVO will be classified as CRVO for the purposes of this clinical trial. Eyes classified as having a HRVO will be limited to no more than 25% of the planned sample size. A HRVO is defined as an eye that has retinal hemorrhage or other biomicroscopic evidence of retinal vein occlusion (e.g. telangiectatic capillary bed) and a dilated venous system (or previously dilated venous system) in 5 or more clock hours but less than all 4 quadrants. Typically, a HRVO is a retinal vein occlusion that involves 2 altitudinal quadrants.
• E-Early Treatment Diabetic Retinopathy Study (ETDRS)visual acuity score of greater than or equal to 19 letters (approximately 20/400) and less than or equal to 73 letters (approximately 20/40) by the ETDRS visual acuity protocol. The investigator must believe that a study eye with visual acuity between 19 and 33 letters is perfused.
• Retinal thickness on SD-OCT measurement, defined as central subfield thickness of 300 µm or greater. If the SD-OCT measurement is taken from a Heidelberg Spectralis Machine, the central subfield thickness should be 320 µm or greater.
• Media clarity, pupillary dilation and participant cooperation sufficient for adequate fundus photographs.

You may not qualify if…

• A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., chronic alcoholism or drug abuse, personality disorder or use of major tranquilizers indicating difficulty in long term follow-up, likelihood of survival of less than 12 months).
• Participation in an investigational trial within 30 days of study entry that involved treatment with any drug that has not received regulatory approval at time of study entry.
• History of allergy to any anti-VEGF agent, corticosteroid, or component of the delivery vehicle.
• The participant will be moving out of the area of the clinical site to an area not covered by another clinical site during the 12 months of the study.
• Positive urine pregnancy test: all women of childbearing potential (those who are pre-menopausal and not surgically sterilized) may participate only if they have a negative urine pregnancy test, and if they do not intend to become pregnant during the timeframe of the study. Women who are sexually active with a male partner must agree to use at least one of the following birth control methods: hormonal therapy such as oral, implantable or injectable chemical contraceptives; mechanical therapy such as spermicide in conjunction with a barrier such as a condom or diaphragm; intrauterine device (IUD); or surgical sterilization of partner.
• Women who are breast-feeding.
• Examination evidence of vitreoretinal interface disease (e.g., vitreomacular traction, epiretinal membrane), either on clinical examination or OCT thought to be contributing to macular edema.
• An eye that, in the investigator's opinion, would not benefit from resolution of macular edema such as eyes with foveal atrophy, dense pigmentary changes or dense subfoveal hard exudates.
• Presence of an ocular condition that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the course of the study (e.g., age-related macular degeneration, uveitis or other ocular inflammatory disease, neovascular glaucoma, iris neovascularization, Irvine-Gass Syndrome, prior macula-off rhegmatogenous retinal detachment).
• Presence of a substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by 3 lines or more (i.e., a 20/40 cataract).
• History of laser photocoagulation for macular edema within 3 months prior to randomization.
• History of intravitreal corticosteroid within 4 months of randomization.
• Intravitreal anti-VEGF injection within 2 months of randomization. Note: Enrollment will be limited to no more than 25% of the planned sample size with any history of anti-VEGF treatment. Once this number of eyes has been enrolled, any history of anti-VEGF treatment will be an exclusion criterion. For enrollment of study eyes with prior intravitreal anti-VEGF agents, in the opinion of the investigator, the treatment response to prior anti-VEGF treatment must be either incomplete or the study eye had developed recurrent CRVO-associated macular edema, such that the study eye would benefit from additional anti-VEGF treatment.
• History of peribulbar or retrobulbar corticosteroid use for any reason within 2 months prior to randomization.
• History of panretinal scatter photocoagulation (PRP) or sector laser photocoagulation within 3 months prior to randomization or anticipated within the next 3 months following randomization.
• History of major ocular surgery (including cataract extraction, scleral buckle, any intraocular surgery, etc.) within 4 months prior to randomization or anticipated within the next 6 months following randomization.
• History of yttrium aluminum garnet (YAG) capsulotomy performed within 2 months prior to randomization.
• Aphakia.
• Presence of an anterior chamber intraocular lens
• Examination evidence of external ocular infection, including conjunctivitis, chalazion or significant blepharitis.
• History of macular detachment.
• Examination evidence of any diabetic retinopathy.

Where it is running

• Retina Centers, P.C. — Tucson, Arizona, United States
• Northern California Retina Vitreous Associates — Mountain View, California, United States
• East Bay Retina Consultants, Inc. — Oakland, California, United States
• Southern California Desert Retina Consultants — Palm Desert, California, United States
• University of California Davis, Medical Center — Sacramento, California, United States
• Retinal Consultants Medical Group, Inc. — Sacramento, California, United States
• University of California, San Francisco — San Francisco, California, United States
• New England Retina Associates — New London, Connecticut, United States
• Retina Group of Florida — Fort Lauderdale, Florida, United States
• National Ophthalmic Research Institute — Fort Myers, Florida, United States
• University of Florida, Dept of Ophthalmology — Jacksonville, Florida, United States
• Florida Retina Consultants — Lakeland, Florida, United States
• Sarasota Retina Institute — Sarasota, Florida, United States
• Center for Retina and Macular Disease — Winter Haven, Florida, United States
• Florida Retina Consultants — Winter Haven, Florida, United States
• Emory University Eye Center — Atlanta, Georgia, United States
• Southeast Retina Center — Augusta, Georgia, United States
• Georgia Retina, P.C. — Marietta, Georgia, United States
• Illinois Eye and Ear Infirmary UIC Dept. of Ophthalmology — Chicago, Illinois, United States
• Thomas A. Ciulla, MD, PC — Indianapolis, Indiana, United States
• Sabates Eye Centers — Leawood, Kansas, United States
• Retina Associates, PA — Shawnee Mission, Kansas, United States
• Retina Associates of Kentucky — Lexington, Kentucky, United States
• University of Kentucky — Lexington, Kentucky, United States
• Retinal Consultants of AZ — Phoenix, Arizona, United States

Full record on ClinicalTrials.gov

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