Allergan/AbbVie has received FDA approval for Vuity (pilocarpine HCl ophthalmic solution) 1.25%, marking the first prescription eye drops approved to treat presbyopia in adults. The breakthrough treatment offers a potential alternative to reading glasses for the estimated 128 million Americans affected by this common age-related vision condition.
Clinical Trial Results Demonstrate Efficacy
The approval was based on data from two pivotal Phase III clinical studies, GEMINI 1 and GEMINI 2, which enrolled 750 individuals aged 40-55 with presbyopia. In both studies, Vuity met the primary endpoint, reaching statistical significance in improvement in near vision in mesopic (low-light) conditions without a loss of distance vision, versus placebo, on day 30 at hour three.
Patients using Vuity were found on average to be able to read an extra three or more lines on an optometrist's vision chart in mesopic, high contrast, binocular Distance Corrected Near Visual Acuity (DCNVA), without losing more than 1 line (5 letters) of Corrected Distance Visual Acuity (CDVA) at day 30, hour 3, versus placebo.
Mechanism of Action and Duration
Vuity is a daily prescription drop that works as soon as 15 minutes after use and lasts up to six hours, as measured on day 30, to improve near and intermediate vision without impacting distance vision. The medication uses pilocarpine as its active ingredient, which stimulates the eye to reduce pupil size. This reduction in pupil size increases the depth of field, similar to how a smaller aperture in photography creates sharper images across different focal distances.
The formulation utilizes "pHast" technology, enabling the drop to rapidly adjust to the physiologic pH of the tear film, according to Allergan. Additionally, improvement was seen as early as 15 minutes and lasted through six hours in the clinical trials.
Safety Profile and Limitations
There were no serious adverse events observed in participants receiving Vuity in either the GEMINI 1 or GEMINI 2 study. The most common adverse events, occurring in less than 5 percent of patients, were headache and eye redness.
However, the company recommends against driving at night while using Vuity, or performing hazardous activities in poor lighting, due to the pupil-constricting effects. The drops are also less likely to be helpful past the age of 65. Vuity can be used with other eye drop medications, provided they are applied five minutes apart.
Addressing an Unmet Medical Need
Presbyopia is a normal part of the aging process where the eye's lens begins to harden, making it increasingly difficult for eye muscles to change the lens shape for focusing on near objects. This results in the need to squint or hold objects at arm's length to read them clearly.
The approval of Vuity represents a significant advancement in presbyopia treatment, offering patients a non-invasive option that could delay or supplement the need for reading glasses. The medication is now available by prescription in the United States, providing ophthalmologists and patients with a new therapeutic option for managing this prevalent age-related vision condition.
