Sosne Gabriel, Dunn Steven P, Kim Chaesik
Departments of *Ophthalmology, and †Anatomy and Cell Biology, Kresge Eye Institute, Wayne State University, School of Medicine, Detroit, MI; ‡Michigan Cornea Consultants, Southfield, MI; and §Kresge Eye Institute, Detroit, MI.
Cornea. 2015 May;34(5):491-6. doi: 10.1097/ICO.0000000000000379.
Standard therapies for severe dry eye are limited and fail to resolve the problem. The purpose of this study was to evaluate the safety and efficacy of Thymosin β4 eye drops (RGN-259) as a novel therapy for severe dry eye disease (including that associated with graft vs. host disease).
A small, multicenter, randomized, double-masked, placebo-controlled 56-day phase 2 clinical trial including a 28-day follow-up at 2 US sites. Nine patients with severe dry eye were treated with either RGN-259 (0.1%) or vehicle control 6 times daily over a period of 28 days. Dry eye sign and symptom assessments, such as ocular discomfort (using the OSDI questionnaire) and corneal fluorescein staining (using the NEI workshop grading system), were evaluated at various time points.
Statistically significant differences in both symptom and sign assessments, were seen at various time points throughout the study. Of particular note at day 56, the RGN-259-treated group (12 eyes) had 35.1% reduction of ocular discomfort compared with vehicle control (6 eyes) (P = 0.0141), and 59.1% reduction of total corneal fluorescein staining compared with vehicle control (P = 0.0108). Other improvements seen in the RGN-259-treated patients included tear film breakup time and increased tear volume production.
In this small trial, RGN-259 eye drops were safe and well tolerated and met key efficacy objectives with statistically significant symptom and sign improvements, compared with vehicle control, at various time intervals, including 28-days posttreatment. CLINICAL TRIAL REGISTRATION--URL: http://www.clinicaltrials.gov. Unique identifier: NCT01393132.
严重干眼症的标准治疗方法有限,无法解决该问题。本研究的目的是评估胸腺素β4滴眼液(RGN - 259)作为严重干眼症(包括与移植物抗宿主病相关的干眼症)新疗法的安全性和有效性。
一项小型、多中心、随机、双盲、安慰剂对照的56天2期临床试验,在美国2个地点进行了为期28天的随访。9名严重干眼症患者接受RGN - 259(0.1%)或赋形剂对照治疗,每天6次,持续28天。在不同时间点评估干眼体征和症状,如眼部不适(使用眼表疾病指数问卷)和角膜荧光素染色(使用美国国立眼科研究所研讨会分级系统)。
在整个研究的不同时间点,症状和体征评估均有统计学显著差异。特别值得注意的是,在第56天时,RGN - 259治疗组(12只眼)与赋形剂对照组(6只眼)相比,眼部不适减少了35.1%(P = 0.0141),角膜荧光素染色总量减少了59.1%(P = 0.0108)。RGN - 259治疗的患者还出现了其他改善,包括泪膜破裂时间延长和泪液分泌量增加。
在这项小型试验中,RGN - 259滴眼液安全且耐受性良好,在包括治疗后28天在内的不同时间间隔与赋形剂对照相比,达到了关键疗效目标,症状和体征有统计学显著改善。临床试验注册——网址:http://www.clinicaltrials.gov。唯一标识符:NCT01393132。