Title

A Study to Evaluate the Safety, Tolerability and Preliminary Efficacy of APP13007 to Treat Inflammation and Pain After Cataract Surgery
A Multicenter, Randomized, Double-Masked, Two-Part, Placebo-Controlled Phase 2A Study to Evaluate the Safety, Tolerability and Preliminary Efficacy of APP13007 for the Treatment of Inflammation and Pain After Cataract Surgery
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Indication/Condition

    Pain ...
  • Study Participants

    165
This is a Phase 2a, 2-part study (designated Parts A and B) that will evaluate APP13007 dose strength and dosing frequency in a randomized double-masked fashion for comparison to the respective matching vehicle placebo. Part A will be conducted first to evaluate 0.05% APP13007 and matching vehicle placebo in an approximate 1:1 ratio in approximately 42 subjects who experience postoperative inflammation on the first day following routine, uncomplicated, cataract surgery and who meet all eligibility criteria. Based on the results of Part A, Part B of the study may be open for enrollment to evaluate 0.05% and/or 0.1% APP13007 at various dosing frequency in approximately 84 subjects, also in an approximate 1:1 ratio, active vs. placebo. In each Part, subjects will return periodically for study assessments during the treatment period and then for a follow-up visit approximately 1 week after stopping the study drug.
Study Started
Aug 13
2019
Primary Completion
Apr 07
2020
Study Completion
Apr 07
2020
Results Posted
Jun 27
2023
Last Update
Jun 27
2023

Drug APP13007, 0.05%

APP13007 eye drop, 0.05%

Drug APP13007, 0.1%

APP13007 eye drop, 0.1%

Drug APP13007 Placebo, 0.05%

APP13007 placebo eyedrop, 0.05%

Drug APP13007 Placebo, 0.1%

APP13007 placebo eyedrop, 0.1%

APP13007 0.05% twice daily (BID) [Part A] Experimental

1 drop 0.05% APP13007 twice daily for 21 days to the operated eye

APP13007 0.05% Placebo twice daily (BID) [Part A] Experimental

1 drop matching vehicle placebo for 0.05% APP13007 twice daily for 21 days to the operated eye

APP13007 0.05% twice daily (BID) and once daily (QD) [Part B] Experimental

1 drop 0.05% APP13007 twice daily for 3 days followed by 1 drop once daily for 11 days to the operated eye

APP13007 0.05% Placebo twice daily (BID) and once daily (QD) [Part B] Experimental

1 drop matching vehicle placebo for 0.05% APP13007 twice daily for 3 days followed by 1 drop once daily for 11 days to the operated eye

APP13007 0.1% twice daily (BID) and once daily (QD) [Part B] Experimental

1 drop 0.1% APP13007 twice daily for 3 days followed by 1 drop once daily for 11 days to the operated eye

APP13007 0.1% Placebo twice daily (BID) and once daily (QD) [Part B] Experimental

1 drop matching vehicle placebo for 0.1% APP13007 twice daily for 3 days followed by 1 drop once daily for 11 days to the operated eye

Criteria

Inclusion Criteria:

Expected to undergo unilateral uncomplicated cataract extraction via phacoemulsification and posterior chamber intraocular lens implantation in one eye.
In Investigator's opinion, have Early Treatment Diabetic Retinopathy Study estimated potential of 0.7 (20/100) or better in study eye.
Have > 10 and ≤ 30 cells in anterior chamber.
Have an intraocular pressure ≤ 30 mmHg.

Exclusion Criteria:

Have an anterior chamber cell count > 0 or any evidence of intraocular inflammation.
Have a score > 0 on Ocular Pain Assessment in either eye.

Summary

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

All Events

Event Type Organ System Event Term APP13007 0.05% Twice Daily (BID) APP13007 0.05% Placebo Twice Daily (BID) APP13007 0.05% Twice Daily (BID) and Once Daily (QD) APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD) APP13007 0.1% Twice Daily (BID) and Once Daily (QD) APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Number of Treatment Emergent Adverse Events

Number of treatment emergent adverse events and number of participants.

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Intraocular Pressure - Change From Baseline (POD1 Prior to Dosing) to End-of-Treatment in the Operated Study Eye

Intraocular pressure is measured in mm Hg at each study visit with a Goldmann applanation tonometer. The change from baseline is calculated by subtracting the pretreatment measurement value from the value at each visit.

APP13007 0.05% Twice Daily (BID)

1.1
mmHg (Mean)
Standard Deviation: 4.2

APP13007 0.05% Placebo Twice Daily (BID)

-2.3
mmHg (Mean)
Standard Deviation: 4.0

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

-2.37
mmHg (Mean)
Standard Deviation: 3.71

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

-2.38
mmHg (Mean)
Standard Deviation: 3.14

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

-1.28
mmHg (Mean)
Standard Deviation: 4.36

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

-1.0
mmHg (Mean)
Standard Deviation: 2.30

Absolute Anterior Chamber Cell Count - Change From Baseline (POD1 Prior to Dosing) to POD 15 in the Operated Study Eye

The number of cells in the anterior chamber of the eye are counted using slit-lamp biomicroscopy at each study visit and the results are reported as number of cells in a 1mm x 1mm area.

APP13007 0.05% Twice Daily (BID)

-16.64
cells/mm^2 (Mean)
Standard Deviation: 5.80

APP13007 0.05% Placebo Twice Daily (BID)

-9.24
cells/mm^2 (Mean)
Standard Deviation: 10.34

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

-11.48
cells/mm^2 (Mean)
Standard Deviation: 8.65

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

-5.67
cells/mm^2 (Mean)
Standard Deviation: 11.73

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

-11.9
cells/mm^2 (Mean)
Standard Deviation: 4.73

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

-7.43
cells/mm^2 (Mean)
Standard Deviation: 11.15

Visual Acuity - Change From Baseline (POD1 Prior to Dosing) to End-of Treatment in the Operated Study Eye

The visual acuity in each eye is corrected using the pinhole method and the acuity is quantified on a logMAR (minimal angle of resolution) scale using the 'Early Treatment Diabetic Retinopathy Study' [ETDRS] charts for right and left eyes. A logMAR Score is calculated using the number of incorrect letters.

APP13007 0.05% Twice Daily (BID)

-0.179
logMAR score (Mean)
Standard Deviation: 0.266

APP13007 0.05% Placebo Twice Daily (BID)

-0.073
logMAR score (Mean)
Standard Deviation: 0.174

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

-0.106
logMAR score (Mean)
Standard Deviation: 0.184

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

-0.024
logMAR score (Mean)
Standard Deviation: 0.133

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

-0.13
logMAR score (Mean)
Standard Deviation: 0.165

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

-0.025
logMAR score (Mean)
Standard Deviation: 0.192

Ocular Pain Grade - Change From Baseline (POD1 Prior to Dosing) to POD15 in the Operated Study Eye

Ocular pain is measured in each eye using a subject-reported five-point (0-4) ocular pain grade scale (0 = no pain; 4 = severe pain).

APP13007 0.05% Twice Daily (BID)

-0.8
grade (Mean)
Standard Deviation: 1.0

APP13007 0.05% Placebo Twice Daily (BID)

-0.4
grade (Mean)
Standard Deviation: 1.1

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

-1.1
grade (Mean)
Standard Deviation: 1.0

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

-0.4
grade (Mean)
Standard Deviation: 2.0

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

-0.6
grade (Mean)
Standard Deviation: 1.2

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

-0.3
grade (Mean)
Standard Deviation: 1.5

Subjects With Anterior Chamber Cell Count = 0 at POD15 in the Operated Study Eye Without Rescue Medication

The number of cells in the anterior chamber of the eye are counted using slit-lamp biomicroscopy at each study visit and the results are reported as number of cells in a 1mm x 1mm area.

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Subjects With Ocular Pain Grade = 0 at POD 15 in the Operated Study Eye Without Rescue Medication

Ocular pain is measured in each eye using a subject-reported five-point (0-4) ocular pain grade scale (0 = no pain; 4 = severe pain).

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Anterior Chamber Flare - Change From Baseline (POD1 Prior to Dosing) to End-of Treatment in the Operated Study Eye

The degree of turbidity (flare) in the anterior chamber of the eye is measured using slit-lamp biomicroscopy and quantified on a five-point (0-4) anterior chamber flare grade scale (0 = none; 4 = Intense). The change from baseline is calculated by subtracting the pretreatment measurement value from the value at each visit.

APP13007 0.05% Twice Daily (BID)

-1.05
grade (Mean)
Standard Deviation: 0.58

APP13007 0.05% Placebo Twice Daily (BID)

-0.39
grade (Mean)
Standard Deviation: 0.94

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

-0.77
grade (Mean)
Standard Deviation: 0.81

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

-0.48
grade (Mean)
Standard Deviation: 0.96

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

-0.64
grade (Mean)
Standard Deviation: 0.49

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

-0.1
grade (Mean)
Standard Deviation: 1.04

Subjects Using of Anti-inflammatory 'Rescue' Medication Through End-of-Treatment

Subjects who do not respond to study treatment after randomization (anterior chamber cell count > 30 cells or an increase in anterior chamber cell count by > 15 cells from pre-dose baseline or ≥ 2 grade of increase in anterior chamber flare from pre-dose baseline) are started on anti-inflammatory medication (referred to as 'Rescue' medication). The number of subjects starting 'Rescue' medication is recorded at each study visit.

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Total

132
Participants

Age, Continuous

67.9
years (Mean)
Standard Deviation: 6.7

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)

Drop/Withdrawal Reasons

APP13007 0.05% Twice Daily (BID)

APP13007 0.05% Placebo Twice Daily (BID)

APP13007 0.05% Twice Daily (BID) and Once Daily (QD)

APP13007 0.05% Placebo Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Twice Daily (BID) and Once Daily (QD)

APP13007 0.1% Placebo Twice Daily (BID) and Once Daily (QD)