A Multicenter, Vehicle-controlled, Double-Masked, Randomized Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Exploratory Efficacy of AGN-242428 and AGN-231868 in Participants With Dry Eye Disease
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- 入组人数
- 292
- 试验地点
- 11
- 主要终点
- Stage 1: Number of Participants With Adverse Events
研究概览
简要总结
This was a 2-stage study in which Stage 1 evaluated the safety of AGN-242428 and AGN-231868, how well they are tolerated, and how they move through the body when administered. After the sponsor's determination of adequate safety and tolerability of the interventions in Stage 1, Stage 2 began. Stage 2 also evaluated the safety and tolerability of AGN-242428 and AGN-231868, how effective they are in treating dry eye disease (DED), and assessed the plasma and tear exposure of both ophthalmic solutions.
详细描述
Participants with DED in Cohort 1A were randomized 3:3:1:1 to receive AGN-242428 (Low Dose), AGN-231868 (Low Dose), or their respective vehicles (4 treatment groups total) to the left eye on Day 1 (Visit 2). If there were no significant study drug-related safety findings, starting on Day 2, participants administered the same randomized study drug twice daily to both eyes through Day 14, followed by a single dose administration to both eyes on Day 15 (Visit 5).
Upon completion of Cohort 1A, an independent data monitoring committee reviewed the data before proceeding to the next cohort. Cohort 1B participants were randomized 3:3:1:1 to receive AGN-242428 (High Dose), AGN-231868 (High Dose), or their respective vehicles (4 treatment groups total) and followed the same dosing regimen used in Cohort 1A.
All subjects enrolled in Stage 2 had DED. In addition, subjects were selected based on their response to a controlled adverse environment (CAE). Only subjects with DED who responded to the CAE exposure with an increase in the signs and symptoms of DED were enrolled in Stage 2.
During Stage 2, participants were randomized in a 1:1:1:1:1 ratio (within each site), to receive AGN-242428 (High Dose), AGN-242428 vehicle, AGN-231868 (High Dose), AGN-231868 vehicle, or Lifitegrast Ophthalmic Solution (Xiidra). Participants administered the assigned study drug in each eye twice daily for 41 days, followed by a single administration during the morning on Day 42.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Stage 1 & Stage 2:
- •Male participants willing to minimize the risk of inducing pregnancy for the duration of the clinical study.
- •Female participants willing to minimize the risk of inducing pregnancy for the duration of the clinical study.
- •Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol.
- •Both of the following signs of DED in at least 1 eye at Screening and Baseline visits (the same eye does not need to qualify at both visits):
- •Total corneal fluorescein staining score ≥ 2 and ≤ 9 based on the NEI grading scale, with no score > 2 in any 1 region;
- •Schirmer test with topical anesthesia score ≥ 1 and ≤ 10 mm/5 min.
- •ALL of the following in at least 1 eye at both the Screening and Baseline visits and the same eye must qualify at both Screening and Baseline visits:
- •Corneal fluorescein staining score ≥ 2 in at least 1 eye region and a total corneal fluorescein staining score of ≥ 4 and ≤ 12 based on NEI grading scale;
- •Schirmer test with topical anesthesia score ≥ 2 and ≤ 10 mm/5 min;
- •Mean TBUT of ≥ 2 and ≤ 10 seconds.
- •Symptoms of DED at both the Screening and Baseline visits as defined by an OSDI total score of ≥ 13 with ≤ 3 responses of "not applicable (NA)."
- •Symptoms of DED at both the Screening and Baseline visits as defined by both:
- •OSDI score of ≥ 23 with ≤ 3 responses of "not applicable (NA)" in at least 1 eye;
- •Eye Dryness Score (assessed using the Visual Analog Scale [VAS] Symptom Items score ≥ 30).
排除标准
- •Current diagnosis of glaucoma or ocular hypertension; evidence of glaucoma or mean intraocular pressure > 21 mm Hg determined by Goldmann applanation tonometry, in either eye.
- •Diagnosis of recurrent, ongoing, or active ocular infection including, but not limited to herpes simplex or zoster, vaccinia, varicella, tuberculosis of the eye, acanthamoeba, or fungal disease.
- •Participation in a blood or plasma donation program within 60 or 30 days, respectively, prior to study intervention administration.
- •Positive test results for anti-HIV type 1 and 2, hepatitis B surface antigen, or anti-hepatitis C virus at the Screening visit.
- •Positive test results for benzoylecgonine (cocaine), methadone, barbiturates, amphetamines, benzodiazepines, alcohol, cannabinoids, opiates, or phencyclidine at the Screening or Baseline visits.
- •Positive pregnancy test at Screening or Baseline visits.
- •Currently breastfeeding or plans to breastfeed during the study.
- •History or presence of any ocular disorder or condition (other than DED) in either eye that would, in the opinion of the investigator, likely interfere with the interpretation of the study results or participant safety.
研究组 & 干预措施
Stage 1 Cohort 1B: AGN-231868 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-231868 Vehicle (Other)
Stage 2 Cohort 2: AGN-242428 High Dose
Administration of AGN-242428 ophthalmic solution
干预措施: AGN-242428 (Drug)
Stage 2 Cohort 2: AGN-242428 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-242428 Vehicle (Other)
Stage 1 Cohort 1A: AGN-242428 Low Dose
Administration of AGN-242428 ophthalmic solution
干预措施: AGN-242428 (Drug)
Stage 1 Cohort 1A: AGN-242428 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-242428 Vehicle (Other)
Stage 1 Cohort 1A: AGN-231868 Lose Dose
Administration of AGN-231868 ophthalmic solution
干预措施: AGN-231868 (Drug)
Stage 1 Cohort 1A: AGN-231868 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-231868 Vehicle (Other)
Stage 1 Cohort 1B: AGN-242428 High Dose
Administration of AGN-242428 ophthalmic solution
干预措施: AGN-242428 (Drug)
Stage 1 Cohort 1B: AGN-242428 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-242428 Vehicle (Other)
Stage 1 Cohort 1B: AGN-231868 High Dose
Administration of AGN-231868 ophthalmic solution
干预措施: AGN-231868 (Drug)
Stage 2 Cohort 2: AGN-231868 High Dose
Administration of AGN-231868 ophthalmic solution
干预措施: AGN-231868 (Drug)
Stage 2 Cohort 2: AGN-231868 Vehicle
Administration of matching placebo (vehicle) ophthalmic solution
干预措施: AGN-231868 Vehicle (Other)
Stage 2 Cohort 2: Lifitegrast Ophthalmic Solution
Administration of Lifitegrast ophthalmic solution
干预措施: Lifitegrast 5% Ophthalmic Solution (Drug)
结局指标
主要结局
Stage 1: Number of Participants With Adverse Events
时间窗: Day 1 to Day 15
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment.
Stage 1: Maximum Tear Drug Concentration (Cmax) After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the tear Cmax (Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the tear Cmax (Visit 5) was calculated.
Stage 1: Terminal Elimination Half-life of the Study Drugs (T1/2) in Plasma After Repeat Dose Administration
时间窗: Day 15 (Predose and up to 12 hours postdose)
Following repeat dose administration twice daily for 14 days, plasma T1/2 (Day 15; Visit 5) was calculated.
Stage 1: Area Under the Plasma Concentration Versus Time Curves After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the area under the plasma concentration versus time curves from time 0 to time of the last measurable concentration (AUC0-tlast; Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the area under the plasma concentration versus time curves from time 0 to the end of the dosing interval (AUC0-τ; Visit 5) was calculated. For Visit 3 and Visit 5, tlast was 12 hours post-dose.
Stage 1: Area Under the Tear Concentration Versus Time Curves After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the area under the tear concentration versus (vs) time curves from time 0 to time of the last measurable concentration (AUC0-tlast; Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the area under the tear concentration versus time curves from time 0 to the end of the dosing interval (AUC0-τ; Visit 5) was calculated. For Visit 3 and Visit 5, tlast was 12 hours post-dose.
Stage 1: Terminal Elimination Half-life of the Study Drugs (T1/2) in Plasma After Single Dose Administration
时间窗: Day 2 (Predose and up to 12 hours postdose).
Following single dose administration, the plasma T1/2 (Day 2; Visit 3) was calculated.
Stage 1: Maximum Plasma Drug Concentration (Cmax) After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the plasma Cmax (Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the plasma Cmax (Visit 5) was calculated.
Stage 1: Time of Maximum Plasma Drug Concentration (Tmax) After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the plasma Tmax (Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the plasma Tmax (Visit 5) was calculated.
Stage 1: Time of Maximum Tear Drug Concentration (Tmax) After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the tear Tmax (Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, the tear Tmax (Visit 5) was calculated.
Stage 1: Terminal Elimination Half-life of the Study Drugs (T1/2) in Tear After Single and Repeat Dose Administration
时间窗: Day 2 and Day 15 (Predose and up to 12 hours postdose)
Following single dose administration, the tear T1/2 (Visit 3) was calculated. Following repeat dose administration twice daily for 14 days, tear T1/2 (Visit 5) was calculated.
Stage 1: Minimum Plasma Drug Concentration at Steady State (Cmin,ss) After Repeat Dose Administration
时间窗: Day 15 (Predose and up to 12 hours postdose)
Following repeat dose administration twice daily for 14 days, the plasma Cmin,ss (Visit 5) was calculated.
Stage 1: Mean Accumulation Index of Drug Concentration (AI) After Repeat Dose Administration
时间窗: Day 15 (up to 12 hours) / Day 1 (up to 12 hours)
Following repeat dose administration, the mean plasma and tear AI(area under curve \[AUC\]) was calculated. AI(AUC) is reported as the ratio of exposure (AUC) at steady state (Day 15) to the exposure after a single daily dose (Day 1). Values greater than one are indicative of drug accumulation with repeat dosing.
Stage 1: Mean Drop Tolerability Questionnaire Scores
时间窗: Day 15
Acute overall tolerability attributes of study interventions on an 8-question visual analog scale (VAS) Drop Tolerability Questionnaire. Visual scale ranges from 0 = not at all comfortable to 100 = very comfortable. Higher mean scores indicate higher levels of comfort with the assigned intervention.
Stage 1: Percentage of Participants Who Met Criteria for Potentially Clinically Significant (PCS) Clinical Laboratory Values
时间窗: Day 1 to Day 15
The percentage of participants with non-PCS baseline value and met PCS criterion at least once postbaseline for clinical laboratory values.
Stage 1: Minimum Tear Drug Concentration at Steady State (Cmin,ss) After Repeat Dose Administration
时间窗: Day 15 (Predose and up to 12 hours postdose)
Following repeat dose administration twice daily for 14 days, the tear Cmin,ss (Visit 5) was calculated.
Stage 1: Percentage of Participants Who Met Criteria for PCS Vital Sign Values (Blood Pressure, Pulse Rate, Weight, Respiration Rate, and Temperature)
时间窗: Day 1 to Day 15
The percentage of participants who met PCS criteria at least once postbaseline for vital sign values (sitting systolic and diastolic blood pressure, pulse rate, weight, respiration rate, and temperature)
Stage 1: Percentage of Participants Who Met Criteria for PCS Electrocardiogram (ECG) Values
时间窗: Day 1 to Day 15
The percentage of participants with PCS postbaseline (but not at baseline) ECG values for QRS interval, PR interval, and QTc (Fridericia)
Stage 1: Mean Change From Baseline in Intraocular Pressure (IOP)
时间窗: Day 1 to Day 15
At least 2 measurements were taken by qualified study site personnel using a Goldmann applanation tonometer affixed to a slit lamp with the participant seated.
Stage 1: Mean Change From Baseline in Best-corrected Visual Acuity (BCVA)
时间窗: Day 1 to Day 15
BCVA was quantified using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity protocol.
Stage 1: Biomicroscopy: Percentage of Participants With Any Severity Increase From Baseline
时间窗: Day 1 to Day 15
The number of participants with any ophthalmoscopy findings of any severity increase from baseline at one or more visit.
Stage 1: Percentage of Participants With Any Clinically Significant Postbaseline Findings During Dilated Fundus Examination
时间窗: Day 1 to Day 15
The fundus (posterior pole; periphery, when dilated) was evaluated for pathology. Ophthalmoscopy with clinically significant findings (per investigator assessment) postbaseline are reported.
Stage 2: Number of Participants With Adverse Events
时间窗: Day 1 to Day 42
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment.
Stage 2: Percentage of Participants With Potentially Clinically Significant (PCS) Clinical Laboratory Values
时间窗: Day 42
The percentage of participants who have PCS postbaseline clinical laboratory values at Day 42 (Visit 6).
Stage 2: Percentage of Participants Who Met Criteria for PCS Vital Sign Values (Blood Pressure, Pulse Rate, Weight, Respiration Rate, and Temperature)
时间窗: Day 42
The percentage of participants who met PCS criteria at least once postbaseline for vital sign values at Day 42 (Visit 6) (sitting systolic and diastolic blood pressure, pulse rate, weight, respiration rate, and temperature). The numerator for the incidence is the number of participants with non-PCS baseline and at least one post-baseline value meeting the specific criterion at the visit. The denominator is the number of participants with non-PCS baseline and at least one post-baseline assessment at the visit. If a participant did not have a baseline value, but met the criterion post-baseline, then the participant is counted in the numerator.
Stage 2: Percentage of Participants Who Met Criteria for PCS Electrocardiogram (ECG) Values
时间窗: Day 42
The percentage of participants who have PCS ECG at Visit 6 (but not baseline) pre and post-controlled adverse environment (CAE). The numerator for the incidence is the number of participants with non-PCS baseline and at least one post-baseline value meeting the specific criterion at the visit. The denominator is the number of participants with non-PCS baseline and at least one post-baseline assessment at the visit. If a participant did not have a baseline value, but met the criterion post-baseline, then the participant is counted in the numerator.
Stage 2: Mean Change From Baseline in Intraocular Pressure (IOP)
时间窗: Day 1, Day 42
At least 2 IOP measurements were taken by qualified study site personnel using a Goldmann applanation tonometer affixed to a slit lamp with the participant seated. Average intraocular pressure = mean of the 2 (or 3) measures in the study eye and non-study eye. Total fluorescein scores and Schirmer values were used to determine the study eye, and if both eyes qualified, the right eye was designated by default.
Stage 2: Mean Change From Baseline in Best-corrected Visual Acuity (BCVA)
时间窗: Day 1, Day 42
BCVA was quantified using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity protocol in the study eye and the non-study eye. Total fluorescein scores and Schirmer values were used to determine the study eye, and if both eyes qualified, the right eye was designated by default.
Stage 2: Slit-lamp Biomicroscopy: Percentage of Participants With Any Clinically Significant Finding Postbaseline
时间窗: Day 1 to Day 42
Percentage of participants with a clinically significant finding postbaseline, post-CAE. A clinically significant finding is defined as more than one severity grade increase (worsening) from baseline or positive status change from absence at baseline to presence at postbaseline (not associated with a severity grade) in one or both eyes.
Stage 2: Percentage of Participants With Any Clinically Significant Postbaseline Findings During Dilated Fundus Examination
时间窗: Day 1 to Day 42
The fundus (posterior pole; periphery, when dilated) was evaluated for pathology. Ophthalmoscopy with clinically significant findings (per investigator assessment) postbaseline are reported.
Stage 2: Drop Tolerability Questionnaire Score (Post-controlled Adverse Environment)
时间窗: Day 42 (Post-CAE)
Acute overall tolerability attributes of study interventions on an 8-question visual analog scale (VAS) Drop Tolerability Questionnaire. Participants completed questionnaires after exposure to a controlled adverse environment (CAE) for approximately 90 minutes. Visual scale ranges from 0 = not at all comfortable to 100 = very comfortable. Higher mean scores indicate higher levels of comfort with the assigned intervention.
次要结局
- Stage 2: Trough Plasma Concentration (Ctrough) and Plasma Concentration at 0.5 Hours Postdose (C0.5h)(Day 42)
- Stage 2: Trough Tear Concentration (Ctrough) and Tear Concentration at 0.5 Hours Postdose (C0.5h)(Day 42)
