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用于干眼症的全氟己基辛烷眼药水:两项3期临床试验的汇总分析

Perfluorohexyloctane ophthalmic solution for dry eye disease: pooled analysis of two phase 3 clinical trials.

作者信息

Fahmy Ahmad M, Harthan Jennifer S, Evans David G, Greiner Jack V, Tauber Joseph, Sheppard John D, Krösser Sonja, Vittitow Jason L

机构信息

Minnesota Eye Consultants, Minneapolis, MN, United States.

Illinois College of Optometry, Chicago, IL, United States.

出版信息

Front Ophthalmol (Lausanne). 2024 Nov 5;4:1452422. doi: 10.3389/fopht.2024.1452422. eCollection 2024.

Abstract

BACKGROUND

Dry eye disease (DED) is commonly caused by excessive tear film evaporation due to Meibomian gland dysfunction (MGD). There is a need for DED treatment options that address tear evaporation and benefit patients across a broad range of demographic and disease characteristics. This study evaluated treatment effects of perfluorohexyloctane ophthalmic drop (formerly NOV03) in the pooled dataset from 2 pivotal clinical trials in patients with DED associated with MGD, both in the overall population and in patient subgroups based on sex, age, and baseline severity of eye dryness.

METHODS

Pooled data from 2 similarly designed, phase 3, randomized controlled trials (GOBI, MOJAVE) were analyzed. Patients aged ≥18 years with DED administered perfluorohexyloctane (n=614) or hypotonic (0.6% solution) saline control (n=603) four times daily for 8 weeks. Primary endpoints were total corneal fluorescein staining (tCFS) score (National Eye Institute scale, 0-15) and eye dryness visual analog scale (VAS) score (0-100). Efficacy was evaluated using analysis of covariance among patient subgroups (male and female, older [≥65 years] and younger [18 to <65 years], tCFS score <7 and ≥7, VAS eye dryness score <70 and ≥70, MGD score <7 and ≥7, Schirmer I test <10 mm and ≥10 mm).

RESULTS

Reductions in tCFS and VAS eye dryness scores were greater for perfluorohexyloctane versus control. In the overall patient population, least-squares mean treatment difference was -1.1 (95% CI: -1.41 to -0.79; p<0.0001) for tCFS and -9.0 (95% CI: -11.90 to -6.00; p<0.0001) for VAS eye dryness. Treatment favored perfluorohexyloctane over control in all patient subgroup analyses of tCFS and VAS eye dryness. Overall, the most common adverse event with perfluorohexyloctane was blurred vision (2.1% of patients), which was mild and transient.

CONCLUSIONS

Compared with a hypotonic saline control, perfluorohexyloctane improved both the signs and symptoms of DED, including in patients with greater self-reported severity of eye dryness.

CLINICAL TRIAL REGISTRATION

This study represents an integrated analysis of 2 previous clinical trials: GOBI (ClinicalTrials.gov, NCT04139798) and MOJAVE (ClinicalTrials.gov, NCT04567329).

摘要

背景

干眼症(DED)通常由睑板腺功能障碍(MGD)导致泪膜过度蒸发引起。需要有针对泪液蒸发的干眼症治疗方案,且能使具有广泛人口统计学特征和疾病特征的患者受益。本研究在两项针对与MGD相关的干眼症患者的关键临床试验的汇总数据集中,评估了全氟己基辛烷滴眼液(原NOV03)的治疗效果,包括总体人群以及基于性别、年龄和干眼基线严重程度的患者亚组。

方法

分析了两项设计相似的3期随机对照试验(GOBI、MOJAVE)的汇总数据。年龄≥18岁的干眼症患者每天四次给予全氟己基辛烷(n = 614)或低渗(0.6%溶液)生理盐水对照(n = 603),持续8周。主要终点为角膜总荧光素染色(tCFS)评分(美国国立眼科研究所量表,0 - 15分)和干眼视觉模拟量表(VAS)评分(0 - 100分)。使用协方差分析在患者亚组(男性和女性、年龄较大[≥65岁]和年龄较小[18至<65岁]、tCFS评分<7分和≥7分、VAS干眼评分<70分和≥70分、MGD评分<7分和≥7分、Schirmer I试验<10 mm和≥10 mm)中评估疗效。

结果

与对照组相比,全氟己基辛烷组的tCFS和VAS干眼评分降低幅度更大。在总体患者人群中,tCFS的最小二乘均数治疗差异为 - 1.1(95% CI: - 1.41至 - 0.79;p < 0.0001),VAS干眼为 - 9.0(95% CI: - 11.90至 - 6.00;p < 0.0001)。在所有tCFS和VAS干眼的患者亚组分析中,治疗效果全氟己基辛烷优于对照组。总体而言,全氟己基辛烷最常见的不良事件是视力模糊(2.1%的患者),症状轻微且短暂。

结论

与低渗生理盐水对照相比,全氟己基辛烷改善了干眼症的体征和症状,包括自我报告干眼严重程度较高的患者。

临床试验注册

本研究代表了对两项先前临床试验的综合分析:GOBI(ClinicalTrials.gov,NCT04139798)和MOJAVE(ClinicalTrials.gov,NCT04567329)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c679/11575077/84b7b0f0f780/fopht-04-1452422-g001.jpg

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