The primary objective of this study is to assess the safety and tolerability of a single short-term and a multiple dose scheme of rhNGF when administered as eye drops in healthy subjects of Japanese ethnicity. The secondary objective of this study is to assess the pharmacokinetics of single and multiple doses of rhNGF when administered as eye drops in healthy subjects of Japanese ethnicity.
This is a Phase I, randomized, double-masked, placebo-controlled eye drops administration study of rhNGF in healthy male and female subjects of Japanese Ethnicity to evaluate the Safety, Tolerability and Pharmacokinetics of Recombinant Human Nerve Growth Factor Eye Drops (rhNGF 20 μg/mL -formulation containing L-methionine as excipient) versus vehicle (vehicle control containing L-methionine as excipient) in Healthy Male and Female Volunteers of Japanese Ethnicity. The IMP was administered in the study Eye with the following scheme: Day 1: One drop instilled into study eye (35 μL, corresponding to 0.70 μg of rhNGF). Day 2, 3, 4, 5, 6: One drop six times a day (every 2h) into study eye (210 μL, corresponding to 4.20 μg of rhNGF). Total dose in the study eye will be 31 drops (1085 μL, equivalent to 21.7 μg rhNGF) over 6 days. The reference product (vehicle) was administered in the study eye with the following scheme: Day 1: One drop instilled into study eye (35 μL, corresponding to 0 μg of rhNGF\]. Day 2, 3, 4, 5, 6: One drop six times a day (every 2h) into study eye (210 μL, corresponding to 0 μg of rhNGF). A total dose of placebo vehicle in the study eye will be 31 drops (1085 μL, 0 μg rhNGF) over 6 days. For the Fellow (Non-Study) Eye for all subjects, the scheme was the following: Day 1: One drop instilled into a fellow eye (35 μL, corresponding to 0 μg of rhNGF). Day 2, 3, 4, 5, 6: One drop six times a day (every 2h) into a fellow eye (210 μL, corresponding to 0 μg of rhNGF). A total dose of placebo vehicle in the fellow eye will be 31 drops (1085 μL, 0 μg rhNGF) over 6 days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
30
Study Eye (For subjects randomized to rhNGF group) Day 1: One drop instilled into study eye (35 μL, corresponding to 0.70 μg of rhNGF). Day 2, 3, 4, 5, 6: One drop six times a day (every 2h) into study eye (210 μL, corresponding to 4.20 μg of rhNGF). Total dose in the study eye will be 31 drops (1085 μL, equivalent to 21.7 μg rhNGF) over 6 days.
Vehicle: formulation containing L-methionine as excipient.
WCCT Global
Cypress, California, United States
Number of Treatment Emergent Adverse Events (TEAEs).
TEAEs were defined as an adverse event (AE), which started after the first dose of study treatment. These comprise AEs during the treatment and follow-up period. For TEAE the number of events was provided.
Time frame: On Day 1 (single dose scheme), Days 2-6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3), and Day 35-42 (FU 4)
Number of Treatment Emergent Adverse Events During First Dose Schedule (TEAEs Dose 1).
TEAEs Dose 1 were defined as TEAEs, which started after the first dose of study treatment and before administration of the first dose at Treatment Day 2. For TEAE the number of events was provided.
Time frame: During first dose schedule (TEAE Dose 1, which started after first dose of study treatment at Day 1 till before administration of the first dose at Treatment Day 2)
Number of Treatment Emergent Adverse Events During Second Dose Schedule (TEAEs Dose 2).
TEAEs Dose 2 were defined as TEAEs, which started on/after the first dose at Treatment Day 2 and before Follow-Up Day 7 visit.
Time frame: During second dose schedule (TEAE Dose 2, which started on/after the first dose at Treatment Day 2 till before Follow-Up Day 7 (FU1) visit
Change From Baseline in Visual Analogue Scale (VAS) Ocular Tolerability Score in Study Eye: Single Dose
Change from baseline in VAS ocular tolerability score in study eye at Treatment Day 2 predose (Tolerability of 1x0.70 μg rhNGF per day) for overall is presented. In this context, "Baseline" was defined as the pre-treatment assessment at the Baseline (D-1) visit. A ocular tolerability score was determined using a 100 mm VAS on which 0 meant No symptoms and 100 meant the Worst possible discomfort. The patients subjectively evaluated their ocular symptoms (foreign body sensation, burning or stinging, itching, pain, sticky feeling, blurred vision and photophobia) using the VAS giving the value they were feeling from none to an extreme value. The ocular symptoms were evaluated by the patients through the scale.
Time frame: at Treatment Day 2 pre-dose
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Change From Baseline in Visual Analogue Scale (VAS) Ocular Tolerability Score in Study Eye: Multiple Dose
Change from baseline in VAS ocular tolerability score in study eye at Day 2 8h, Day 3 predose, Day 6 pre-dose, Day 6 8h, Day 7 (FU1), Day 8 (FU2), Day 16 (FU3) (Tolerability of 6x0.70 μg rhNGF per day) for overall is presented. In this context, "Baseline" was defined as the pre-treatment assessment at the Baseline (D-1) visit.A ocular tolerability score was determined using a 100 mm VAS on which 0 meant No symptoms and 100 meant the Worst possible discomfort. The patients subjectively evaluated their ocular symptoms (foreign body sensation, burning or stinging, itching, pain, sticky feeling, blurred vision and photophobia) using the VAS giving the value they were feeling from none to an extreme value. The ocular symptoms were evaluated by the patients through the scale.
Time frame: at Day 2 8h, Day 3 predose, Day 6 pre-dose, Day 6 8h, Day 7 (FU1), Day 8 (FU2), Day 16 (FU3)
Number of Follow-Up AEs (FUAE)
Follow-Up AEs (FUAE) were defined as TEAEs which start on or after Follow-Up Day 7 (FU1) visit
Time frame: on or after Follow-Up Day 7 (FU1)
Number of Ocular TEAEs by Eyes
Ocular TEAEs were defined as an adverse event (AE) interesting the study or the non-study eye, which started after the first dose of study treatment. These comprise ocular AEs during the treatment and follow-up period. For these AE, the number of events was provided for the study eye and the non-study eye, separately.
Time frame: On Day 1 (single dose scheme), Days 2-6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3), and Day 35-42 (FU 4)
Change From Baseline in Intraocular Pressure (IOP) by Eye Over All Visits
IOP was performed using either Goldmann applanation tonometry after the instillation of a topical anaesthetic. IOP was measured in both eyes after completion of all other slit lamp examinations to avoid potential interference with the other evaluations.
Time frame: on Day -1 and at Day 8 (Follow up [FU] 2) and Day 16 (FU3)
Change From Baseline in Visual Acuity Score for the Study Eye Over All Visits
Values of Best-Corrected Distance Visual Acuity (BCDVA) scores were measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) score. The ETDRS charts use letters, or a geometric progression in letter size from line to line, under standardized lighting conditions. The patient starts at the top of the chart, or on the last row where he or she can read all of the letters, and reads down the chart until he or she reaches a row where a minimum of three letters on a line cannot be read. The patient is scored by how many letters could be correctly identified. Therefore, the higher the number of letters the higher the visual acuity. Changes in the ETDRS score from baseline are summarised for the study eye.
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Change in Baseline in LogMAR [Derived as - Log (Snellen Equivalent Result)] for the Study Eye Over All Visits.
LogMAR is the logarithm of the minimal angle of resolution. The LogMAR was derived as - log (Snellen Equivalent result). LogMAR values range from 1.6 (20/800 Snellen Equivalent) to -0.2 (20/12 Snellen Equivalent). The lower the LogMAR value, the better the visual acuity.
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Change From Baseline in Tear Film Break-Up Time (TFBUT) for the Study Eye Over All Visits..
The TFBUT was performed after instillation of 5 μl of 2% preservative-free sodium fluorescein solution into the inferior conjunctival cul-de-sac of each eye. With the aid of a slit lamp at 10X magnification using cobalt blue illumination, the examiner will monitor the integrity of the tear film, noting the time it takes to form lacunae (clear spaces in the tear film) from the time that the eye is opened after the last blink. The range of TFBUT normality in this trial is \> 8' to 12' in either eye at screening or baseline. The longer the time the better the integrity of the tear film.
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Change From Baseline in Overall National Eye Institute (NEI) Score for the Study Eye Over All Visits.
Corneal Staining was derived as the sum of scores of the five corneal sectors (central, superior, inferior, nasal, and temporal) each of which was scored on a scale of 0-3, with a minimum score of 0 and a maximal score of 15 (sum \> 3 out of 15 is abnormal).
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Course of Visual Analogue Scale (VAS) Ocular Tolerability Score for the Study Eye Over All Visits.
The course of VAS ocular tolerability score by eye over all visits was assessed. Only data "Overall" for study's eye are reported hereunder. A ocular tolerability score was determined using a 100 mm VAS on which 0 meant No symptoms and 100 meant the Worst possible discomfort. The patients subjectively evaluated their ocular symptoms (foreign body sensation, burning or stinging, itching, pain, sticky feeling, blurred vision and photophobia) using the VAS giving the value they were feeling from none to an extreme value. The ocular symptoms were evaluated by the patients through the scale.
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Intraindividual Change in VAS Ocular Tolerability Scores Between Study Eye and Fellow (Non-study) Eye at All Study Visits
Intraindividual differences between study eye and non-study (fellow) eye at all study visits were assessed. Data "overall" are reported hereunder.A ocular tolerability score was determined using a 100 mm VAS on which 0 meant No symptoms and 100 meant the Worst possible discomfort. The patients subjectively evaluated their ocular symptoms (foreign body sensation, burning or stinging, itching, pain, sticky feeling, blurred vision and photophobia) using the VAS giving the value they were feeling from none to an extreme value. The ocular symptoms were evaluated by the patients through the scale.
Time frame: On Day 1 (single dose scheme), Days 2,3,6 (multiple dose scheme), Day 7 (Follow-up [FU] 1), Day 8 (FU 2); Day 16 (FU 3)
Kinetics of rhNGF Plasma Levels After Single-dose Administration and Multiple-dose Administration Through Enzyme-Linked Immunosorbent Assay I (ELISA I)
Time points for rhNGF plasma levels measurement were the following: Day 1 (Pre-Dose, 0.5, 2, 4, 8, 9, 10, 11, 12, 14, 16 hr), Day 2 (Pre-Dose, 0.5, 2, 4, 6, 8, 10, 10.5, 11, 12, 13, 14, 16 hr), Day 3 (Pre-Dose, 2, 4, 6, 8, 10 hr), Day 4 Pre-Dose, Day 5 Pre-Dose, Day 6 (Pre-Dose, 4, 8, 10, 10.5, 11, 12, 13, 14, 16 hr), FU 1 0 hr, FU 2 (0 and 8 hr), and FU 3 0 hr. Values are reported for the single-dose regimen (Day 1) and the first day of the multiple-dose regimen (Day 2). From Day 1, most values were below the detectable level (i.e. \<32 pg/ml). Values below this value are reported as not applicable (NA).
Time frame: Day 1 (Pre-Dose, 0.5, 2, 4, 8, 9, 10, 11, 12, 14, 16 hr) and Day 2 (Pre-Dose, 0.5, 2, 4, 6, 8, 10, 10.5, 11, 12, 13, 14, 16 hr),
Kinetics of rhNGF Plasma Levels After Single-dose Administration and Multiple-dose Administration Through Enzyme-Linked Immunosorbent Assay II (ELISA II)
Time points for rhNGF plasma levels measurement were the following: Day 1 (Pre-Dose, 0.5, 2, 4, 8, 9, 10, 11, 12, 14, 16 hr), Day 2 (Pre-Dose, 0.5, 2, 4, 6, 8, 10, 10.5, 11, 12, 13, 14, 16 hr), Day 3 (Pre-Dose, 2, 4, 6, 8, 10 hr), Day 4 Pre-Dose, Day 5 Pre-Dose, Day 6 (Pre-Dose, 4, 8, 10, 10.5, 11, 12, 13, 14, 16 hr), FU 1 0 hr, FU 2 (0 and 8 hr), and FU 3 0 hr. Values are reported for the single-dose regimen (Day 1) and the first day of the multiple-dose regimen (Day 2). From Day 1, most values were below the detectable level (i.e. \<15 pg/ml). Values below this value are reported as not applicable (NA).
Time frame: Day 1 (Pre-Dose, 0.5, 2, 4, 8, 9, 10, 11, 12, 14, 16 hr) and Day 2 (Pre-Dose, 0.5, 2, 4, 8, 9, 10, 10.5, 11, 12, 13, 14, 16 hr)