Randomized Trial to Evaluate Tandospirone in Geographic Atrophy Secondary to Age-Related Macular Degeneration: The GATE Study

Am J Ophthalmol. 2015 Dec;160(6):1226-34. doi: 10.1016/j.ajo.2015.08.024. Epub 2015 Aug 24.

Abstract

Purpose: To determine the safety and efficacy of AL-8309B (tandospirone) in the management of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) and obtain standardized data on GA lesion growth progression.

Design: Prospective, controlled, double-masked, randomized, multicenter phase 3 clinical trial.

Methods: setting: Forty-eight clinical sites.

Patients: Patients with GA associated with AMD were enrolled. All patients were followed for a minimum of 30 months, and up to 36 months. intervention procedures: Patients were randomized (1:1:1) to receive AL-8309B ophthalmic solution 1.0%, 1.75%, or vehicle, administered as a twice-daily topical ocular drop.

Main outcome measures: The primary efficacy endpoint was mean annualized lesion enlargement from baseline as assessed with fundus autofluorescence (FAF) imaging.

Results: A total of 768 eyes of 768 patients were enrolled and treated with AL-8309B 1.0% (n = 250), AL-8309B 1.75% (n = 258), or vehicle (n = 260). An increase in mean lesion size was observed in both the AL-8309B and vehicle treatment groups, and growth rates were similar in all treatment groups. Annualized lesion growth rates were 1.73, 1.76, and 1.71 mm(2) for AL-8309B 1.0%, AL-8309B 1.75%, and vehicle, respectively.

Conclusions: AL-8309B 1.0% and 1.75% did not affect lesion growth in eyes with GA secondary to AMD. There were no clinically relevant safety issues identified for AL-8309B. The large natural history dataset from this study is a valuable repository for future comparisons.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Geographic Atrophy / diagnosis
  • Geographic Atrophy / drug therapy*
  • Geographic Atrophy / etiology
  • Humans
  • Isoindoles / administration & dosage*
  • Macular Degeneration / complications*
  • Macular Degeneration / diagnosis
  • Male
  • Ophthalmic Solutions
  • Piperazines / administration & dosage*
  • Prospective Studies
  • Pyrimidines / administration & dosage*
  • Serotonin Receptor Agonists / administration & dosage
  • Treatment Outcome

Substances

  • Isoindoles
  • Ophthalmic Solutions
  • Piperazines
  • Pyrimidines
  • Serotonin Receptor Agonists
  • tandospirone

Supplementary concepts

  • Macular Degeneration, Age-Related, 2