Title

A Study to Evaluate AXR-159 Ophthalmic Solution in Patients With Dry Eye Disease
A Multicenter, Vehicle-controlled, Randomized Study to Evaluate the Safety, Tolerability, Systemic Pharmacokinetics, and Pharmacodynamics of AXR-159 Ophthalmic Solution 3 mg/mL, 30 mg/mL, and 50 mg/mL in Patients With Dry Eye Disease (DED)
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    AXR-159 ...
  • Study Participants

    102
Protocol AXR201701 is a multicenter, double-masked, vehicle-controlled, randomized, parallel group study carried out in 2 stages (Stage 1: AXR-159 Ophthalmic Solution (30 mg/mL or 50 mg/mL); Stage 2: AXR-159 Ophthalmic Solution (3 mg/mL, 30 mg/mL or 50 mg/mL) in approximately 430 patients diagnosed with dry eye disease (DED).
Protocol AXR201701 is designed with 2 stages. For both Stages 1 and 2, patients with signs and symptoms of DED will be randomly assigned to receive either a single concentration of AXR-159 Ophthalmic Solution or AXR-159 Ophthalmic Solution Vehicle.

A screening visit will be followed by a baseline period where subjects will dose with AXR-159 Ophthalmic Solution Vehicle for 14 days. At the end of the baseline period patients who still exhibit signs and symptoms of DED will be enrolled into a 3-month double-masked treatment period.
Study Started
Jun 26
2018
Primary Completion
Dec 28
2018
Study Completion
Jan 09
2019
Results Posted
Oct 13
2023
Last Update
Oct 13
2023

Drug AXR-159

AXR-159 Ophthalmic Solution

Drug Vehicle

AXR-159 Ophthalmic Solution Vehicle

AXR-159 Ophthalmic Solution 3 mg/mL Experimental

AXR-159 Low Dose

AXR-159 Ophthalmic Solution 30 mg/mL Experimental

AXR-159 Mid Dose

AXR-159 Ophthalmic Solution 50 mg/mL Experimental

AXR-159 High Dose

AXR-159 Ophthalmic Solution Vehicle Placebo Comparator

Control Group

Criteria

Inclusion Criteria:

Male or female, 18 years of age or older at screening visit
Best-corrected visual acuity (BCVA) of 20/100 or better (Snellen equivalent), using the logarithm of the minimum angle of resolution (LogMAR) in each eye
Reported history of dry eye for at least 6 months
Corneal fluorescein staining score ≥ 2
Eye dryness score ≥ 40
Total Ocular Surface Disease Index (OSDI) score > 18

Exclusion Criteria:

Uncontrolled ocular disease (except for dry eye disease/keratoconjunctivitis sicca) or uncontrolled systemic disease
Patient has glaucoma, ocular hypertension, on IOP-lowering medications or have previously undergone any glaucoma laser or surgical procedure.
Corneal abnormality or disorder that impacts normal spreading of the tear film (keratoconus, pterygia, scarring) or compromised corneal integrity
BCVA worse than 20/100 in either eye
Current use of punctal plugs, anticipated insertion during the study, or a history of punctal cautery in either eye
Keratoconjunctivitis sicca secondary to destruction of conjunctival goblet cells
Patients with clinically significant inflammation of the lid margin such as anterior blepharitis or ocular rosacea
Recent (within the past 3 months) ocular surgery, trauma or herpes
Use of contact lenses in either eye within one month prior to the screening visit or anticipated use during the study

Summary

AXR-159 Ophthalmic Solution 50 mg/mL

AXR-159 Ophthalmic Solution Vehicle

All Events

Event Type Organ System Event Term AXR-159 Ophthalmic Solution 50 mg/mL AXR-159 Ophthalmic Solution Vehicle

Inferior Corneal Staining Score

Change from Baseline in Ora Calibra® Corneal and Conjunctival Staining Scale with a range from 0 to 4 (0=None, 1=Trace, 2=Mild, 3=Moderate, 4=Severe) in the study eye. Higher negative scores mean a better outcome.

AXR-159 Ophthalmic Solution 50 mg/mL

-0.08
units on a scale (Mean)
Standard Deviation: 0.65

AXR-159 Ophthalmic Solution Vehicle

-0.03
units on a scale (Mean)
Standard Deviation: 0.447

Eye Dryness

Change from baseline in Eye Dryness score on a subject level across both eyes. Using the visual analogue scale (VAS) subjects rated eye dryness by placing a vertical mark on the horizontal line to indicate the level of discomfort with a range of 0 to 100. 0% corresponds to "no dryness" (no discomfort) and 100% corresponds to "maximal dryness" indicating maximal discomfort. A greater negative change from baseline score means a better outcome.

AXR-159 Ophthalmic Solution 50 mg/mL

-12.5
units on a scale (Mean)
Standard Deviation: 22.62

AXR-159 Ophthalmic Solution Vehicle

-14.9
units on a scale (Mean)
Standard Deviation: 21.79

Tear Film Break-up Time (TBUT)

Change from baseline in the study eye with a greater positive increase indicating a better outcome. Following the instillation of a sodium fluorescein solution into the inferior conjunctival cul-de-sac of each eye and several blinks over 30 seconds, the examiner monitored the integrity of the tear film with the aid of a slit lamp, noting the time it takes to form micelles from the time that the eye is opened. TBUT was measured in seconds using a stopwatch and a digital image recording system for the right eye followed by the left eye. Values reported are for the study eye.

AXR-159 Ophthalmic Solution 50 mg/mL

-0.143
seconds (Mean)
Standard Deviation: 1.093

AXR-159 Ophthalmic Solution Vehicle

-0.178
seconds (Mean)
Standard Deviation: 1.105

Conjunctival Redness Score

Change from baseline of Ora Calibra® Conjunctival Redness Scale for Dry Eye. Scores range from 0 to 4 with 0=None, 1=Trace, 2=Mild, 3=Moderate, 4=Severe; with higher numbers indicating more conjunctival redness. Greater negative numbers indicate a better outcome. Values reported are for the study eye.

AXR-159 Ophthalmic Solution 50 mg/mL

0.04
units on a scale (Mean)
Standard Deviation: 0.673

AXR-159 Ophthalmic Solution Vehicle

0.26
units on a scale (Mean)
Standard Deviation: 0.518

Total Lissamine Green Conjunctival Staining

Change from baseline of Oxford Grading Scale measuring staining within a range from 0-5 (0=None, 1=Trace, 2=Mild, 3=Moderate, 4=Severe, 5=Confluent) for each panel (temporal and nasal) and 0-10 as the sum of both panel scores for the total exposed inter-palpebral conjunctiva. Larger negative numbers indicate reduced staining and a better outcome. Values reported are for the study eye.

AXR-159 Ophthalmic Solution 50 mg/mL

0.4
units on a scale (Mean)
Standard Deviation: 1.912

AXR-159 Ophthalmic Solution Vehicle

0.59
units on a scale (Mean)
Standard Deviation: 1.758

Schirmer's Test

Change from baseline in Schirmer's Test score in the study eye. Unanesthetized Schirmer's Test measures the length of the moistened area of a test strip, placed in the lower temporal lid margin of each eye, in mm following a 5-minute exposure period. Greater positive numbers indicate a better outcome.

AXR-159 Ophthalmic Solution 50 mg/mL

0.8
millimeters (Mean)
Standard Deviation: 5.13

AXR-159 Ophthalmic Solution Vehicle

1.9
millimeters (Mean)
Standard Deviation: 6.77

Total Ocular Surface and Disease Index (OSDI) © for Dry Eye

Change from baseline in OSDI © score on a subject level. The 12-question OSDI © is assessed on a total scale from 0 to 100, where higher scores represent greater disability. A greater negative change from baseline indicates a better outcome.

AXR-159 Ophthalmic Solution 50 mg/mL

-8.8
units on a scale (Mean)
Standard Deviation: 9.3

AXR-159 Ophthalmic Solution Vehicle

-5.0
units on a scale (Mean)
Standard Deviation: 16.93

Total

102
Participants

Age, Continuous

63.8
years (Mean)
Standard Deviation: 10.51

Conjunctival Redness Score

1.67
units on a scale (Mean)
Full Range: 1.0 to 3.0

Eye Dryness

76.9
units on a scale (Mean)
Full Range: 48.0 to 100.0

Inferior Corneal Staining Score

2.22
units on a scale (Mean)
Full Range: 1.0 to 4.0

Schirmer's Test

6.0
millimeters (Mean)
Full Range: 1.0 to 17.0

Tear Film Break-up Time (TBUT)

2.311
seconds (Mean)
Full Range: 0.82 to 6.77

Total Lissamine Green Conjunctival Staining

3.12
units on a scale (Mean)
Full Range: 0.0 to 8.0

Total Ocular Surface and Disease Index (OSDI) © for Dry Eye

47.6
units on a scale (Mean)
Full Range: 18.0 to 98.0

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

AXR-159 Ophthalmic Solution 50 mg/mL

AXR-159 Ophthalmic Solution Vehicle