SCORE2 Comparative Trial (SCT)

描述（由申请人提供）：本比较有效性研究计划（研究视网膜静脉阻塞的比较治疗2 [SC0RE2]研究）旨在根据最近的随机试验结果，支持视网膜中央静脉阻塞（CRVO）继发黄斑水肿导致视力下降的替代治疗方案。这项被称为“SCORE2比较试验”（SCT）的拟议研究将确定贝伐单抗在治疗RVO引起的黄斑水肿方面是否优于阿非利西普。非劣效性界限将设定为早期治疗糖尿病视网膜病变研究视力字母评分为5分。SCT还将为最初6个月后的治疗方案提供见解，以确定是否可以减少对治疗反应良好的眼睛的玻璃体内注射频率（这将是一种更具成本效益的治疗方案，对患者的注射相关不良事件风险更小，对患者和提供者的后勤治疗负担更小）。以及替代治疗策略（玻璃体内地塞米松）对初始抗vegf治疗反应不佳的眼睛的影响。因此，除了测试贝伐单抗对阿非利赛在6个月时眼睛视力结果的非劣效性的主要目的外，次要目的将研究不同的

DESCRIPTION (provided by applicant): This comparative effectiveness research proposal (Studies of Comparative Treatments for Retinal Vein Occlusion 2 [SC0RE2] Study) aims to support alternative treatment protocols for decreased vision due to macular edema secondary to central retinal vein occlusion (CRVO) based on results of recent randomized trials. This proposed study called the "SCORE2 Comparative Trial" (SCT) will determine if bevacizumab is non-inferior to aflibercept for the treatment of macular edema due to RVO. The non-inferiority margin will be set at an Early Treatment Diabetic Retinopathy Study visual acuity letter score of 5. The SCT will also provide insight into treatment regimens after the initial 6 months to determine if the frequency of intravitreal injections can be reduced in eyes that have responded well to treatment (which would represent a more cost-effective treatment regimen, with fewer risks to patients of injection-related adverse events and a lesser logistical treatment burden for patients and providers), and the impact of alternative treatment strategies (intravitreal dexamethasone) in eyes that have not responded well to initial treatment with anti-VEGF therapy. So, in addition to the primary aim of test for non-inferiority of bevacizumab to aflibercept in visual acuity outcome at Month 6 for eyes, secondary aims will investigate different dosing strategies after Month 6. In addition, secondary analyses will examine retinal thickening and other retinal outcomes based on SD-OCT and wide field fluorescein angiograms (within a subset of sites). The SCT will also add to our knowledge of the safety profile of these anti-vascular endothelial growth factor (anti-VEGF) medications. We propose to enroll 360 CRVO patients over a 24-month period, and follow for 13-months. This application is for The EMMES Corporation to serve as the Data Coordinating Center (DCC) for the SCT, with our primary focus to provide data management, statistical, and operational support over 5 years of support.