Phase 3 Randomized Clinical Trial of the Safety and Efficacy of Travoprost Intraocular Implant in Patients with Open-Angle Glaucoma or Ocular Hypertension

Steven R Sarkisian Jr; Robert E Ang; Andy M Lee; John P Berdahl; Sebastian B Heersink; James H Burden; Long V Doan; Kerry G Stephens; Angela C Kothe; Dale W Usner; L Jay Katz; Tomas Navratil; GC-010 Travoprost Intraocular Implant Investigators

doi:10.1016/j.ophtha.2024.02.022

Phase 3 Randomized Clinical Trial of the Safety and Efficacy of Travoprost Intraocular Implant in Patients with Open-Angle Glaucoma or Ocular Hypertension

Ophthalmology. 2024 Feb 27:S0161-6420(24)00161-1. doi: 10.1016/j.ophtha.2024.02.022. Online ahead of print.

Collaborators

GC-010 Travoprost Intraocular Implant Investigators:
Robert E Ang, Sebastian B Heersink, Steven Vold, Neil Atodaria, Jacob Brubaker, Damien Goldberg, Christopher Lin, Betsy Nguyen, Mitchell Schultz, Bruce Silverstein, Robert Sorenson, Kent Bashford, James H Burden, Mohammed ElMallah, Joshua Kim, Benjamin Lambright, Cathleen McCabe, Rajesh Shetty, Steven Smith, Farrell Tyson, Jason Jones, Francis D'Ambrosio, Bin Wu, Mahdi Basha, Ralph Chu, Joseph Gira, Russell Swan, Brandon Baartman, Kent Wellish

Affiliations

¹ Oklahoma Eye Surgeons, PLLC, Oklahoma City, Oklahoma.
² Asian Eye Institute, Makati City, Philippines.
³ Total Eye Care, Duncanville, Texas.
⁴ Vance Thompson Vision, Sioux Falls, South Dakota.
⁵ Eye Center South, DBA Trinity Research Group, Dothan, Alabama.
⁶ Skyline Vision Clinic and Laser Center, Colorado Springs, Colorado.
⁷ Glaukos Corporation, Aliso Viejo, California.
⁸ Glaukos Corporation, Aliso Viejo, California. Electronic address: tnavratil@glaukos.com.

PMID: 38423216
DOI: 10.1016/j.ophtha.2024.02.022

Abstract

Purpose: To evaluate the safety and intraocular pressure (IOP)-lowering efficacy of 2 models of the travoprost intraocular implant (fast-eluting [FE] and slow-eluting [SE] types) from 1 of 2 phase 3 trials (the GC-010 trial).

Design: Multicenter, randomized, double-masked, sham-controlled, noninferiority trial.

Participants: Patients with open-angle glaucoma or ocular hypertension having an unmedicated baseline mean diurnal IOP (average of 8 am, 10 am, and 4 pm time points) of ≥ 21 mmHg, and IOP of ≤ 36 mmHg at each of the 8 am, 10 am, and 4 pm timepoints at baseline.

Methods: Study eyes were randomized to the travoprost intraocular implant (FE implant [n = 200] or SE implant [n = 197] model) or to timolol ophthalmic solution 0.5% twice daily (n = 193).

Main outcome measures: The primary outcome was mean change from baseline IOP in the study eye at 8 am and 10 am, at each of day 10, week 6, and month 3. Safety outcomes included adverse events (AEs) and ophthalmic assessments.

Results: Mean IOP reduction from baseline over the 6 time points ranged from 6.6 to 8.4 mmHg for the FE implant group, from 6.6 to 8.5 mmHg for the SE implant group, and from 6.5 to 7.7 mmHg for the timolol group. The primary efficacy end point was met; the upper limit of the 95% confidence interval of the difference between the implant groups and the timolol group was < 1 mmHg at all 6 time points. Study eye AEs, most of mild or moderate severity, were reported in 21.5%, 27.2%, and 10.8% of patients in the FE implant, SE implant, and timolol groups, respectively. The most common AEs included iritis (FE implant, 0.5%; SE implant, 5.1%), ocular hyperemia (FE implant, 3.0%; SE implant, 2.6%), reduced visual acuity (FE implant, 1.0%; SE implant, 4.1%; timolol, 0.5%), and IOP increased (FE implant, 3.5%; SE implant, 2.6%; timolol, 2.1%). One serious study eye AE occurred (endophthalmitis).

Conclusions: The travoprost intraocular implant demonstrated robust IOP reduction over the 3-month primary efficacy evaluation period after a single administration. The IOP-lowering efficacy in both implant groups was statistically and clinically noninferior to that in the timolol group, with a favorable safety profile.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Drug delivery system; Intracameral implant; Intraocular pressure; Prostaglandin analog; Travoprost intraocular implant.