Efficacy and Safety of Efdamrofusp Alfa with Personalized Dosing Intervals in Neovascular Age-Related Macular Degeneration: A Phase II Trial
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Purpose: This study aims to evaluate the efficacy and safety of high-dose efdamrofusp alfa (IBI302, targeting VEGF and complement C3b/4b) with personalized dosing intervals in patients with neovascular age-related macular degeneration (nAMD). Design: A multicenter, randomized, double-masked, active-controlled, noninferiority phase II trial. Participants: A total of 132 anti-VEGF naïve or previously treated participants with nAMD were enrolled. Methods: Eligible participants were randomized (1:1:1) to receive IBI302 6.4 mg, IBI302 8.0 mg, or aflibercept 2.0 mg. Efdamrofusp alfa groups were dosed every 8 weeks (Q8W) or every 12 weeks (Q12W), based on disease activity assessment at week 20, after 4 monthly injections. The aflibercept 2.0-mg group was dosed Q8W, after 3 monthly injections. Main Outcome Measures: The primary endpoint was the mean change in best-corrected visual acuity (BCVA) from baseline to week 40. The prespecified noninferiority margin was 4 letters. Results: The least squares mean (standard error) changes in BCVA from baseline to week 40 were +10.5 (1.5) letters with IBI302 6.4 mg, +9.2 (1.5) letters with IBI302 8.0 mg, and +9.7 (1.5) letters with aflibercept 2.0 mg. The estimated differences were +0.8 (80% confidence interval: -1.9 to 3.6, noninferiority test: P = 0.0115) for IBI302 6.4 mg versus aflibercept 2.0 mg and -0.5 (-3.3 to 2.2, noninferiority test: P = 0.0123) for IBI302 8.0 mg versus aflibercept 2.0 mg. Over 80% of participants in IBI302 groups were dosed Q12W after week 20 and maintained their regimens until the end of study. Treatment-emergent adverse events (TEAEs) in the study eye were reported in 36.4% of participants receiving IBI302 6.4 mg, 37.8% receiving IBI302 8.0 mg, and 23.3% receiving aflibercept 2.0 mg. The most common ocular TEAE was conjunctival hemorrhage (9.1% for 6.4 mg and 11.1% for 8.0 mg) in both IBI302 groups, whereas cataract (7.0%) was the most frequent ocular TEAE in the aflibercept 2.0-mg group. Conclusions: Efdamrofusp alfa 6.4 and 8.0 mg dosed up to Q12W demonstrated noninferior visual gain to aflibercept 2.0 mg Q8W. Moreover, IBI302 groups were well tolerated. These findings suggested that high-dose IBI302 with extended dosing intervals could provide sustained visual benefits for patients with nAMD. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Source: Ophthalmology Science
Authors: Tong Li, Shiqi Yang, Qinghuai Liu, Yanping Song, Jianping Tong, Wenbin Wei, Weiqi Chen, Hong Dai, Wei Wang, Miaoqin Wu, Guohong Zhou, Xuan Xiao, Jinglin Zhang, Rongrong Zhu, Haoyu Li, Yafang Wang, Xiaoyu Chen, Shujie Lu, Haiwei Du, Han Han-Zhang, Jilong Hao, Chaopeng Li, Ying Wen, Jie Zhang, Junran Sun, Huixun Jia, Xiaodong Sun
Institutions: Shanghai Jiao Tong University, Shanghai First People's Hospital, Jiangsu Province Hospital, Nanjing Medical University, General Hospital of Central Theater Command, First Affiliated Hospital Zhejiang University, Beijing Tongren Hospital, Capital Medical University, Shantou University, Joint Shantou International Eye Center, Beijing Hospital, Hebei Eye Hospital, Zhejiang Provincial People's Hospital, Shanxi Eye Hospital, Wuhan University, Renmin Hospital of Wuhan University, Aier Eye Hospital Group (China), Affiliated Hospital of Nantong University, Innovent Biologics (China), First Hospital of Jilin University, First Bethune Hospital of Jilin University, Huaian First People’s Hospital, Shandong University of Traditional Chinese Medicine, Shandong University, Shandong Shierming Eye Hospital
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
Funder: Innovent Biologics
OpenAlex ID: W4414889477