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基于磷脂纳米乳剂的眼用润滑剂治疗不同亚型干眼疾病的疗效和安全性:一项IV期多中心试验

Efficacy and Safety of Phospholipid Nanoemulsion-Based Ocular Lubricant for the Management of Various Subtypes of Dry Eye Disease: A Phase IV, Multicenter Trial.

作者信息

Yeu Elizabeth, Silverstein Steven, Guillon Michel, Schulze Marc-Matthias, Galarreta David, Srinivasan Sruthi, Manoj Venkiteshwar

机构信息

Virginia Eye Consultants, Norfolk, VA 23502, USA.

Silverstein Eye Centers, Kansas City, MO 64133, USA.

出版信息

Clin Ophthalmol. 2020 Sep 1;14:2561-2570. doi: 10.2147/OPTH.S261318. eCollection 2020.

Abstract

PURPOSE

To evaluate the clinical efficacy and safety of propylene glycol/hydroxypropyl-guar (PG-HPG)-based nanoemulsion (Systane Complete) lubricant eye drops in participants with dry eye disease (DED).

PARTICIPANTS AND METHODS

In this phase IV, open-label, single-arm, interventional, multicenter study, adult participants with DED - subtyped into aqueous deficient, evaporative, and mixed dry eye - were instructed to instill one drop of PG-HPG in each eye twice a day for 28 days. Endpoints included change from baseline in tear film break-up time (TFBUT) (primary) and ocular discomfort visual analog scale (VAS) score at Day 14 and TFBUT at Day 28 (secondary). Safety was assessed throughout the study. Data were analyzed for overall patient cohort and by DED subtypes.

RESULTS

A total of 134 participants received treatment (mean age: 56.6 years; female: 75.4%). At Day 14, the mean (standard deviation [SD]) TFBUT increased from 2.6 (1.00) seconds at baseline to 4.2 (2.92) seconds (mean change: 1.5 [2.80] seconds); median change was 0.8 seconds (95% CI: 0.52, 1.19) for the overall cohort; the change was maintained at Day 28 (mean change: 1.4 (2.80) seconds, median change: 0.8 seconds (95% CI: 0.49, 1.17). Subgroup analysis showed a mean change (SD) from baseline in TFBUT of 1.1 (2.41) seconds for aqueous deficient, 2.4 (3.17) seconds for evaporative, and 1.2 (2.63) seconds for mixed dry eye at Day 14, respectively. The ocular discomfort VAS score improved (decreased) from baseline at Day 14 (mean [SD] change: -17.3 [24.80]) for the overall cohort, -22.0 [21.73] for aqueous deficient, -17.6 [24.17] for evaporative and -13.1 [27.49] for mixed dry eye subgroups). Adverse events (AEs) were reported in 9 (6.7%) participants. No serious AEs were reported during the study.

CONCLUSION

Our study findings demonstrated that PG-HPG-based nanoemulsion lubricant eye drops were effective and well tolerated in participants with DED and all of its subtypes.

摘要

目的

评估基于丙二醇/羟丙基瓜尔胶(PG-HPG)的纳米乳剂(思然全效)润滑滴眼液对干眼症(DED)患者的临床疗效和安全性。

参与者与方法

在这项IV期、开放标签、单臂、干预性、多中心研究中,将DED患者(分为水液缺乏型、蒸发过强型和混合型干眼)分为成人参与者,指导他们每天双眼各滴入一滴PG-HPG,持续28天。观察指标包括泪膜破裂时间(TFBUT)相对于基线的变化(主要指标)以及第14天的眼部不适视觉模拟量表(VAS)评分和第28天的TFBUT(次要指标)。在整个研究过程中评估安全性。对整个患者队列和DED各亚型的数据进行分析。

结果

共有134名参与者接受了治疗(平均年龄:56.6岁;女性:75.4%)。在第14天,平均(标准差[SD])TFBUT从基线时的2.6(1.00)秒增加到4.2(2.92)秒(平均变化:1.5[2.80]秒);整个队列的中位数变化为0.8秒(95%CI:0.52,1.19);该变化在第28天得以维持(平均变化:1.4(2.80)秒,中位数变化:0.8秒(95%CI:0.49,1.17)。亚组分析显示,在第14天,水液缺乏型TFBUT相对于基线的平均变化(SD)为1.1(2.41)秒,蒸发过强型为2.4(3.17)秒,混合型干眼为1.2(2.63)秒。整个队列在第14天眼部不适VAS评分相对于基线有所改善(降低)(平均[SD]变化:-17.3[24.80]);水液缺乏型为-22.0[21.73],蒸发过强型为-17.6[24.17],混合型干眼亚组为-13.1[27.49]。9名(6.7%)参与者报告了不良事件(AE)。研究期间未报告严重AE。

结论

我们的研究结果表明,基于PG-HPG的纳米乳剂润滑滴眼液对DED及其所有亚型患者有效且耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/486d/7478376/36fe5b6b0ce0/OPTH-14-2561-g0001.jpg

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