A Safety and Efficacy Study of 2 Dosing Regimens of Recombinant Human Nerve Growth Factor (rhNGF) Eye Drop Solution Compared With Vehicle in Patients With Dry Eye Disease.

This was a phase 2, multi-center, randomized, double-masked, parallel-arm, vehicle-controlled, dose-finding, clinical study to evaluate the safety and efficacy of 2 concentrations (5 μg/mL and 10 μg/mL) of a reconstituted lyophilized formulation of rhNGF, administered as 1 drop of an ophthalmic solution 3 times a day (TID) in both eyes for 4 weeks in participants with DED. Participants were evaluated at the screening visit (day -12 ± 2; visit 1), baseline (day 1; visit 2), week 2 (day 13 ± 1; visit 3), week 4 end of treatment (EOT; day 28 ± 1; visit 4), and week 8 end of follow-up and end of study (EOS; day 56 ± 2; visit 5). At the screening visit (visit 1), participants who signed informed consent and met all eligibility criteria were enrolled and instructed to discontinue all topical ophthalmic medications; during the run-in period, they were only allowed to use investigational product (vehicle) ophthalmic solution provided by the sponsor. The first eye drop of the vehicle was applied to both eyes of participants at the site by the investigator during visit 1. Participants were instructed on how to prepare the investigational product (vehicle) daily at home and then how to self-administer 1 drop TID in both eyes. A Patient Diary for the run-in phase was supplied to the participant. At the conclusion of the day 1 baseline visit (visit 2), participants still meeting all eligibility criteria were randomly assigned 1:1:1 to a 4-week treatment regimen of investigational product (vehicle, or rhNGF \[5 μg/mL or 10 μg/mL\]), administered as follows: * 1 drop of rhNGF ophthalmic solution at 5 μg/mL in each eye TID, at approximately 6-hour intervals, for 4 weeks * 1 drop of rhNGF ophthalmic solution at 10 μg/mL in each eye TID, at approximately 6-hour intervals, for 4 weeks * 1 drop of vehicle in each eye, TID, at approximately 6-hour intervals, for 4 weeks. Eligible participants were also dispensed a 2-week supply of the investigational product (vehicle or rhNGF) to administer at home between visits 2 and 3. They received another 2-week supply during visit 3. A Patient Diary for recording the treatment phase was supplied to the participant. At visit 2 (baseline visit) a study eye was determined. Namely, the study eye was the worse eye. Assuming that all inclusion/exclusion criteria were met in both eyes, the worse eye (study eye) was determined based on the lower Schirmer-I (without anesthesia) score. If the Schirmer-I score was identical in both eyes, the study eye was determined based on the worse score for corneal and conjunctival NEI staining (total score for corneal staining followed by total score for conjunctival). If the staining score was identical in both eyes, then the right eye was assigned as the study eye. Participants who prematurely discontinued the treatment (for any reason) were asked to complete the remaining assessments planned by the protocol and received commercially available preservative-free AT, TID, provided by the sponsor. In case of withdrawal from the study, participants were asked to complete the assessment expected for visit 4 as an Early Exit Visit. Following the completion of the treatment period, participants were followed up for an additional 4 weeks and were evaluated at 8 weeks (visit 5). During the 4-week follow-up period, no treatment was allowed except for commercially available preservative free AT TID provided by the sponsor. A Patient Diary for the follow-up period was supplied to the patient.