A 36-month phase 2b clinical trial has demonstrated the potential for intraocular pressure (IOP) to be managed over multiple years with Glaukos’ iDose TR sustained-release travoprost implant.
Administered during a micro-invasive procedure, the iDose TR contains a novel formulation of travoprost, a prostaglandin analog used to reduce IOP, and was designed to continuously release therapeutic levels of the medication for at least one year. Once all travoprost is released, the iDose TR was designed to be removed and replaced with a new iDose TR, thus potentially offering an alternative to daily eye drop treatment.
These latest Phase 2 results further underscore the potential of iDose TR to safely provide multiple years of sustained dropless therapy
The 154-subject, multi-centre, randomised, double-blind Phase 2b trial was conducted under a U.S. Investigational New Drug (IND) protocol. It was designed to evaluate a single administration of one of two iDose TR models with different travoprost release rates compared to topical timolol ophthalmic solution, 0.5% BID (twice a day). The primary efficacy endpoint agreed on with the U.S. Food and Drug Administration (FDA) is the non-inferiority comparison to timolol over the first three months after a single implantation of iDose TR. The currently reported Phase 2b results are based on an analysis conducted at 36 months for all 154 subjects randomised into the trial, with 51, 54 and 49 subjects randomised to iDose TR fast-release arm, iDose TR slow-release arm and timolol active comparator arm, respectively. The subjects randomised to either iDoseTR arm received a single intracameral implant while the subjects randomised to the timolol active comparator received twice-daily eye drops over the 36-month evaluation period, which equates to approximately 2,190 eye drops per eye, per protocol.
Topline summary results and observations from the analysis of the iDose TR Phase 2b clinical trial at 36 months are as follows:
- 70% and 68% of subjects in the fast- and slow-release iDose TR arms, respectively, were well-controlled with the same or fewer IOP-lowering topical medications at 36 months versus screening, versus 46% of subjects in the timolol control arm.
- In this responder group, average IOP reductions from baseline observed at 36 months were 8.3 mmHg and 8.5 mmHg in the fast- and slow-release iDose TR arms, respectively, versus 8.2 mmHg in the timolol control arm.
- Overall, iDose TR subjects performed similarly to timolol subjects at 36 months in terms of mean IOP reductions with fewer topical medications versus timolol.
- The 36-month Phase 2 data also continued to demonstrate a favourable safety profile for iDose TR, with no clinically significant corneal endothelial cell loss, no serious corneal adverse events and no adverse events of periorbital fat atrophy and conjunctival hyperemia reported to date in either elution arm.
“These latest Phase 2 results further underscore the potential of iDose TR to safely provide multiple years of sustained dropless therapy and help tackle the significant problem of patient non-adherence to, and chronic side effects associated with, topical glaucoma medication regimens,” said Thomas Burns, Glaukos president and chief executive officer.
“We believe there is an important unmet clinical need and strong appetite within the ophthalmic community for safe, effective and durable dropless pharmaceutical alternatives to traditional topical medications. These data reaffirm our excitement about the potential commercial prospects of iDoseTR and mark another critical step forward in the advancement of our novel and comprehensive product pipeline designed to transform the treatment of chronic eye diseases for the benefit of patients worldwide.”
On June 10, 2021, Glaukos announced the completion of patient enrolment and randomisation in its ongoing Phase 3 clinical program for iDose TR. The Phase 3 program consists of two prospective, randomised, double-masked clinical trials designed to compare the safety and efficacy of iDose TR to topical timolol ophthalmic solution, 0.5%, in reducing elevated intraocular pressure in subjects with open-angle glaucoma (OAG) or ocular hypertension. The primary efficacy endpoint of the Phase 3 studies is non-inferiority comparison to topical timolol 0.5% BID over the first three months, and safety evaluations for up to 12 months. The Phase 3 trials randomised a total of 1,150 subjects across 89 clinical sites, the majority of which are in the United States. The 12-month iDose TR Phase 3 trial results are expected to support Glaukos’ targeted NDA submission in 2022 and FDA approval for iDose TR in 2023.