Article
作者: Tang, Luosheng ; Liang, Xiaoling ; Li, Suyan ; Chen, Youxin ; Wang, Xian ; Zhou, Zhanyu ; Wang, Jing ; Peng, Hui ; Li, Bing ; Wu, Zhifeng ; Fan, Ke ; Wu, Miaoqin ; Zheng, Dongping ; Liu, Xiaoling ; Lei, Chunling ; Wang, Feng ; Ke, Min ; Yuan, Huiping ; Cai, Shanjun ; Li, Qiuming ; Wang, Hui ; Wang, Lifei ; Yan, Yang ; Song, Yanping ; Zhang, Hong ; Zhong, Jingxiang ; Yi, Jinglin ; Hao, Jilong ; Yu, Fangliang ; Ye, Jian ; Li, Chaopeng ; Liu, Lin ; Zhang, Tonghe ; Zeng, Siming ; Pei, Cheng ; Han, Mei ; Ren, Qian ; Wang, Zenghua ; Zhao, Mingwei ; Zhu, Mengli
INTRODUCTION:This trial aimed to compare the efficacy and safety between biosimilar QL1207 and the reference aflibercept for the treatment of neovascular age-related macular degeneration (nAMD).
METHODS:This randomized, double-blind, phase 3 trial was conducted at 35 centers in China. Patients aged ≥ 50 years old with untreated subfoveal choroidal neovascularization secondary to nAMD and best-corrected visual acuity (BCVA) letter score of 73-34 were eligible. Patients were randomly assigned to receive intravitreous injections of QL1207 or aflibercept 2 mg (0.05 ml) in the study eye every 4 weeks for the first 3 months, followed by 2 mg every 8 weeks until week 48, stratified by baseline BCVA ≥ or < 45 letters. The primary endpoint was BCVA change from baseline at week 12. The equivalence margin was ± 5 letters. The safety, immunogenicity, pharmacokinetics (PK), and plasma vascular endothelial growth factor (VEGF) concentration were also evaluated.
RESULTS:A total of 366 patients were enrolled (QL1207 group, n = 185; aflibercept group, n = 181) from Aug 2019 to Jan 2022 with comparable baseline characteristics. The least-squares mean difference in BCVA changes was - 1.1 letters (95% confidence interval - 3.0 to 0.7; P = 0.2275) between the two groups, within the equivalence margin. The incidences of treatment-emergent adverse events (TEAE; QL1207: 71.4% [132/185] vs. aflibercept: 71.8% [130/181]) and serious TEAE (QL1207: 14.1% [26] vs. aflibercept: 12.7% [23]) appeared comparable between treatment groups, and no new safety signal was found. Anti-drug antibody, PK profiles, and VEGF concentration were similar between the two groups.
CONCLUSIONS:QL1207 has equivalent efficacy to aflibercept for nAMD with similar safety profiles. It could be used as an alternative anti-VEGF agent for clinical practice.
TRIAL REGISTRATION:ClinicalTrials.gov: NCT05345236 (retrospectively registered on April 25, 2022); National Medical Products Administration of China: CTR20190937 (May 20, 2019).