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    Clinical Trial Results:
    A Randomized, Multicenter, Single-Masked, Parallel-Group Dose Finding Study Comparing the Safety and Efficacy of BOL-303259-X (0.006%, 0.012%, 0.024% and 0.040%) to Latanoprost 0.005% in Subjects With Open Angle Glaucoma or Ocular Hypertension

    Summary
    EudraCT number
    2010-022178-14
    Trial protocol
    PL   CZ   BG  
    Global end of trial date
    20 Dec 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    01 Jan 2020
    First version publication date
    01 Jan 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    659
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01223378
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Dr. Gerhard Mann Chem.-Pharm. Fabrik GmbH/Bausch & Lomb
    Sponsor organisation address
    Brunsbütteler Damm 165-173, Berlin, Germany, 13581
    Public contact
    Study Manager, Dr. Gerhard Mann Chem.-Pharm. Fabrik GmbH/Bausch & Lomb, natasa.orlic-pleyer@bausch.com
    Scientific contact
    Study Manager, Dr. Gerhard Mann Chem.-Pharm. Fabrik GmbH/Bausch & Lomb, natasa.orlic-pleyer@bausch.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    20 Dec 2011
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    20 Dec 2011
    Global end of trial reached?
    Yes
    Global end of trial date
    20 Dec 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to determine the most effective drug concentration(s) of BOL-303259-X in the reduction of intraocular pressure (IOP) in order to support further clinical development of an appropriate dose with regard to efficacy, and ocular and systemic safety.
    Protection of trial subjects
    This study was conducted in compliance with the protocol and in accordance with Good Clinical Practice (GCP), as described in the International Conference on Harmonisation (ICH) Guidelines for Good Clinical Practice (GCP) ICH E6 (R1), 21CFR Parts 11, 50, 54, 56, and 312, 42 USC 282(j), applicable local regulations, and the Declaration of Helsinki and its amendments.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    13 Dec 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 269
    Country: Number of subjects enrolled
    Bulgaria: 90
    Country: Number of subjects enrolled
    Poland: 35
    Country: Number of subjects enrolled
    Czech Republic: 19
    Worldwide total number of subjects
    413
    EEA total number of subjects
    144
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    246
    From 65 to 84 years
    163
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    First subject enrolled on 13 Dec 2010, Last subject exited on 20 Dec 2011. This study was conducted at 23 clinical sites (US [15 sites], Bulgaria [3 sites], Poland [3 sites], and Czech Republic [2 sites]).

    Pre-assignment
    Screening details
    Subjects who were currently under treatment with an IOP-lowering medication at Visit 1 were required to discontinue the IOP medication during the washout period (minimum of 28 days) between Visit 1 and Visit 3.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Single blind
    Roles blinded
    Investigator [1]

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    BOL-303259-X 0.006%
    Arm description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.006%, once daily (QD) 28 days
    Arm type
    Experimental

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops, solution
    Routes of administration
    Topical use
    Dosage and administration details
    ophthalmic solution, various concentrations, once daily (QD) 28 days

    Arm title
    BOL-303259-X 0.012%
    Arm description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.012%, once daily (QD) 28 days
    Arm type
    Experimental

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops, solution
    Routes of administration
    Topical use
    Dosage and administration details
    ophthalmic solution, various concentrations, once daily (QD) 28 days

    Arm title
    BOL-303259-X 0.024%
    Arm description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.024%, once daily (QD) 28 days
    Arm type
    Experimental

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops, solution
    Routes of administration
    Topical use
    Dosage and administration details
    ophthalmic solution, various concentrations, once daily (QD) 28 days

    Arm title
    BOL-303259-X 0.040%
    Arm description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.040%, once daily (QD) 28 days
    Arm type
    Experimental

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops, solution
    Routes of administration
    Topical use
    Dosage and administration details
    ophthalmic solution, various concentrations, once daily (QD) 28 days

    Arm title
    Latanoprost
    Arm description
    ophthalmic solution Latanoprost: 0.005% ophthalmic solution, QD 28 days
    Arm type
    Active comparator

    Investigational medicinal product name
    Latanoprost
    Investigational medicinal product code
    Other name
    Xalatan
    Pharmaceutical forms
    Eye drops, solution
    Routes of administration
    Topical use
    Dosage and administration details
    0.005% ophthalmic solution, QD 28 days

    Notes
    [1] - The roles blinded appear inconsistent with a simple blinded trial.
    Justification: Investigator was the one party that was blinded.
    Number of subjects in period 1
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Started
    82
    85
    83
    81
    82
    Completed
    76
    81
    80
    80
    79
    Not completed
    6
    4
    3
    1
    3
         Failure to follow the required study procedures
    1
    1
    1
    -
    -
         Consent withdrawn by subject
    1
    -
    -
    1
    1
         Adverse event, non-fatal
    3
    1
    1
    -
    1
         Other than specified
    1
    1
    1
    -
    1
         Lost to follow-up
    -
    1
    -
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    BOL-303259-X 0.006%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.006%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.012%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.012%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.024%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.024%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.040%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.040%, once daily (QD) 28 days

    Reporting group title
    Latanoprost
    Reporting group description
    ophthalmic solution Latanoprost: 0.005% ophthalmic solution, QD 28 days

    Reporting group values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost Total
    Number of subjects
    82 85 83 81 82 413
    Age Categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    60.9 ± 11.39 61.6 ± 9.58 60.8 ± 11.47 60.3 ± 12.89 61.0 ± 11.92 -
    Gender Categorical
    Units: Subjects
        Female
    56 46 57 43 53 255
        Male
    26 39 26 38 29 158
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    5 2 8 6 11 32
        Not Hispanic or Latino
    77 83 75 75 71 381
        Unknown or Not Reported
    0 0 0 0 0 0
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 1 0 0 0 1
        Asian
    0 0 0 1 0 1
        Native Hawaiian or Other Pacific Islander
    0 0 0 0 0 0
        Black or African American
    21 23 21 23 16 104
        White
    61 61 62 56 66 306
        More than one race
    0 0 0 0 0 0
        Unknown or Not Reported
    0 0 0 1 0 1

    End points

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    End points reporting groups
    Reporting group title
    BOL-303259-X 0.006%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.006%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.012%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.012%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.024%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.024%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.040%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.040%, once daily (QD) 28 days

    Reporting group title
    Latanoprost
    Reporting group description
    ophthalmic solution Latanoprost: 0.005% ophthalmic solution, QD 28 days

    Primary: Change in Mean Diurnal IOP at Visit 6 (Day 28)

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    End point title
    Change in Mean Diurnal IOP at Visit 6 (Day 28)
    End point description
    Determine the most effective drug concentration(s) of BOL-303259-X in the reduction of intraocular pressure (IOP) and compared to latanoprost. Intent-to-treat population, observed data (study eye).
    End point type
    Primary
    End point timeframe
    Baseline and Visit 6 (Day 28)
    End point values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Number of subjects analysed
    81
    83
    83
    80
    80
    Units: mm Hg
        arithmetic mean (standard deviation)
    -7.829 ± 2.823
    -8.295 ± 2.864
    -8.952 ± 3.337
    -8.894 ± 2.666
    -7.800 ± 2.834
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Results obtained from an analysis of covariance model with treatment effect and baseline IOP.
    Comparison groups
    Latanoprost v BOL-303259-X 0.006%
    Number of subjects included in analysis
    161
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9125
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    0.048
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.817
         upper limit
    0.914
    Statistical analysis title
    Statistical Analysis 2
    Statistical analysis description
    Results obtained from an analysis of covariance model with treatment effect and baseline IOP.
    Comparison groups
    BOL-303259-X 0.012% v Latanoprost
    Number of subjects included in analysis
    163
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.2575
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    0.496
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.364
         upper limit
    1.357
    Statistical analysis title
    Statistical Analysis 3
    Statistical analysis description
    Results obtained from an analysis of covariance model with treatment effect and baseline IOP.
    Comparison groups
    BOL-303259-X 0.024% v Latanoprost
    Number of subjects included in analysis
    163
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0051
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    1.234
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.373
         upper limit
    2.095
    Statistical analysis title
    Statistical Analysis 4
    Statistical analysis description
    Results obtained from an analysis of covariance model with treatment effect and baseline IOP.
    Comparison groups
    BOL-303259-X 0.040% v Latanoprost
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0089
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    1.161
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.292
         upper limit
    2.03

    Secondary: Change in Mean Diurnal IOP at Visits 4, 5, and 7

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    End point title
    Change in Mean Diurnal IOP at Visits 4, 5, and 7
    End point description
    Determine the most effective drug concentration(s) of BOL-303259-X in the reduction of intraocular pressure (IOP) and compared to latanoprost. Intent-to-treat population, observed data (study eye).
    End point type
    Secondary
    End point timeframe
    Baseline and Visit 4 (Day 7), Visit 5 (day 14), and Visit 7 (Day 29)
    End point values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Number of subjects analysed
    79
    82
    81
    80
    80
    Units: mm Hg
    arithmetic mean (standard deviation)
        Visit 4 (Day 7) (n=79,82,81,80,80)
    -6.850 ± 2.768
    -7.707 ± 3.192
    -8.230 ± 3.286
    -8.456 ± 2.892
    -7.325 ± 2.699
        Visit 5 (Day 14) (n=76,80,80,80,79)
    -7.607 ± 2.204
    -7.934 ± 3.065
    -8.859 ± 3.300
    -8.606 ± 2.878
    -7.719 ± 3.035
        Visit 7 (Day 29) (n=76,81,80,80,79)
    -6.188 ± 2.782
    -6.202 ± 3.001
    -7.177 ± 3.615
    -6.846 ± 3.135
    -6.276 ± 2.941
    No statistical analyses for this end point

    Secondary: IOP </=18mm Hg

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    End point title
    IOP </=18mm Hg
    End point description
    Determine the number of subjects with mean diurnal IOP </=18 mm Hg with BOL-303259-X versus latanoprost ophthalmic solution. Intent-to-treat population, observed data (study eye).
    End point type
    Secondary
    End point timeframe
    Visit 4 (Day 7), Visit 5 (day 14), Visit 6 (Day 28) and Visit 7 (Day 29)
    End point values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Number of subjects analysed
    82
    85
    83
    81
    82
    Units: participants
        Visit 4 (Day 7) (n=79,82,81,80,80)
    30
    37
    47
    46
    29
        Visit 5 (Day 14) (n=76,80,80,80,79)
    34
    42
    52
    45
    39
        Visit 6 (Day 28) (n=81,83,83,80,80)
    41
    44
    57
    51
    38
        Visit 7 (Day 29) (n=76,81,80,80,79)
    25
    24
    37
    25
    23
    No statistical analyses for this end point

    Secondary: Change in IOP at Specified Time Points (8 AM, 12 PM, 4 PM) at Visit 6 (Day 28)

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    End point title
    Change in IOP at Specified Time Points (8 AM, 12 PM, 4 PM) at Visit 6 (Day 28)
    End point description
    The change in the observed mean study eye IOP from baseline (Visit 3, Day 1) at specified time points (8 AM, 12 PM, 4 PM) at Visit 6 (Day 28). Intent to treat, data as observed (study eye).
    End point type
    Secondary
    End point timeframe
    Baseline and Visit 6 (Day 28)
    End point values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Number of subjects analysed
    82
    85
    83
    81
    82
    Units: mm Hg
    arithmetic mean (standard deviation)
        Change from Baseline (8 am) (n=81,83,83,80,80)
    -8.42 ± 3.69
    -8.91 ± 3.24
    -9.46 ± 4.01
    -9.61 ± 2.95
    -8.76 ± 3.24
        Change from Baseline (12 pm) (n=79,83,82,80,79)
    -7.82 ± 3.34
    -8.33 ± 3.35
    -8.98 ± 3.50
    -8.60 ± 3.23
    -7.63 ± 3.55
        Change from Baseline (4 pm) (n=79,83,82,80,79)
    -7.23 ± 2.97
    -7.65 ± 3.37
    -8.59 ± 3.54
    -8.47 ± 3.28
    -6.99 ± 3.52
    No statistical analyses for this end point

    Secondary: Change in IOP at Specified Time Points (8 AM, 12 PM, 4 PM) at Visits 4, 5, and 7 (Days 7, 14, and 29)

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    End point title
    Change in IOP at Specified Time Points (8 AM, 12 PM, 4 PM) at Visits 4, 5, and 7 (Days 7, 14, and 29)
    End point description
    The change in the observed mean study eye IOP from baseline (Visit 3, Day 1) at specified time points (points 8 AM, 12 PM, and 4 PM) at Visits 4, 5, and 7 (Days 7, 14, and 29). Intent-to-treat, observed data (study eye).
    End point type
    Secondary
    End point timeframe
    Baseline and Visits 4, 5 and 7 (Days 7, 14, and 29)
    End point values
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Number of subjects analysed
    79
    82
    81
    80
    80
    Units: mm Hg
    arithmetic mean (standard deviation)
        Visit 4 (Day 7) (8 am) (n=79,82,81,80,80)
    -7.203 ± 3.634
    -8.396 ± 3.935
    -8.667 ± 3.827
    -8.869 ± 3.384
    -8.125 ± 2.826
        Visit 4 (Day 7) (12 pm) (n=79,82,81,80,80)
    -6.665 ± 3.046
    -7.823 ± 3.409
    -8.247 ± 3.643
    -8.219 ± 3.338
    -7.200 ± 3.386
        Visit 4 (Day 7) (4 pm) (n=79,82,81,80,80)
    -6.684 ± 3.246
    -6.902 ± 3.371
    -7.778 ± 3.479
    -8.281 ± 3.172
    -6.650 ± 3.312
        Visit 5 (Day 14) (8 am) (n=76,80,80,80,79)
    -8.270 ± 3.399
    -8.538 ± 3.518
    -9.569 ± 3.597
    -9.006 ± 3.031
    -8.519 ± 3.444
        Visit 5 (Day 14) (12 pm) (n=76,80,80,80,79)
    -7.500 ± 2.653
    -8.381 ± 3.518
    -8.700 ± 3.579
    -8.556 ± 3.529
    -7.519 ± 3.437
        Visit 5 (Day 14) (4 pm) (n=76,79,79,80,79)
    -7.053 ± 2.519
    -6.905 ± 3.354
    -8.310 ± 3.667
    -8.256 ± 3.410
    -7.120 ± 3.744
        Visit 7 (Day 29) (8 am) (n=76,81,80,80,79)
    -6.969 ± 3.245
    -6.796 ± 3.379
    -7.675 ± 4.198
    -7.406 ± 3.26
    -7.006 ± 3.131
        Visit 7 (Day 29) (12 pm) (n=76,81,80,79,79)
    -6.039 ± 3.591
    -6.235 ± 3.626
    -7.119 ± 3.791
    -6.791 ± 3.246
    -6.108 ± 3.228
        Visit 7 (Day 29) (4 pm) (n=73,81,80,78,79)
    -5.575 ± 3.464
    -5.574 ± 3.615
    -6.738 ± 3.769
    -6.090 ± 4.142
    -5.715 ± 3.514
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The period of observation for collection of AEs extended from the time the subject gave informed consent until the last study visit (Visit 7).
    Adverse event reporting additional description
    The safety population included one less subject in the BOL-303259-X 0.012% group than the ITT population. Hence the safety population included 412 subjects in total whereas the ITT population included 413 in total.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.0
    Reporting groups
    Reporting group title
    BOL-303259-X 0.006%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.006%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.012%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.012%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.024%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.024%, once daily (QD) 28 days

    Reporting group title
    BOL-303259-X 0.040%
    Reporting group description
    ophthalmic solution Experimental: BOL-303259-X: ophthalmic solution, 0.040%, once daily (QD) 28 days

    Reporting group title
    Latanoprost
    Reporting group description
    ophthalmic solution Latanoprost: 0.005% ophthalmic solution, QD 28 days

    Serious adverse events
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 82 (1.22%)
    0 / 84 (0.00%)
    0 / 83 (0.00%)
    0 / 81 (0.00%)
    2 / 82 (2.44%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Cardiac disorders
    Acute myocardial infarction
    Additional description: Acute myocardial infarction
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 84 (0.00%)
    0 / 83 (0.00%)
    0 / 81 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastric Ulcer Hemorrhage
    Additional description: Bleeding gastric ulcer
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 84 (0.00%)
    0 / 83 (0.00%)
    0 / 81 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric Ulcer
    Additional description: Gastric Ulcer
         subjects affected / exposed
    1 / 82 (1.22%)
    0 / 84 (0.00%)
    0 / 83 (0.00%)
    0 / 81 (0.00%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal Hemorrage
    Additional description: Gastrointestinal bleed
         subjects affected / exposed
    1 / 82 (1.22%)
    0 / 84 (0.00%)
    0 / 83 (0.00%)
    0 / 81 (0.00%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    BOL-303259-X 0.006% BOL-303259-X 0.012% BOL-303259-X 0.024% BOL-303259-X 0.040% Latanoprost
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    14 / 82 (17.07%)
    17 / 84 (20.24%)
    13 / 83 (15.66%)
    20 / 81 (24.69%)
    9 / 82 (10.98%)
    Eye disorders
    Ocular hyperemia
         subjects affected / exposed
    1 / 82 (1.22%)
    5 / 84 (5.95%)
    2 / 83 (2.41%)
    4 / 81 (4.94%)
    7 / 82 (8.54%)
         occurrences all number
    1
    5
    2
    5
    7
    Instillation site pain
         subjects affected / exposed
    12 / 82 (14.63%)
    14 / 84 (16.67%)
    10 / 83 (12.05%)
    14 / 81 (17.28%)
    5 / 82 (6.10%)
         occurrences all number
    12
    15
    10
    15
    6
    Eye irritation
         subjects affected / exposed
    1 / 82 (1.22%)
    2 / 84 (2.38%)
    3 / 83 (3.61%)
    5 / 81 (6.17%)
    0 / 82 (0.00%)
         occurrences all number
    1
    3
    3
    5
    0

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Oct 2010
    Changes made included the following: - Replaced “BOL-303259-X latanoprostinod” with “BOL 303259-X” since latanoprostinod is not an approved compound name. - Increased the baseline IOP in the study to be able to examine the difference between the IOP-lowering effects of the test article and the active comparator, one of the 3 mean/median IOP measurements in Inclusion Criterion was changed from ≥24 mmHg to ≥26 mmHg at a minimum of 1 time point in the same eye. - Removed the requirement for a negative urine pregnancy test at Visit 2 (mid-washout). - Maximum central corneal thickness was changed from 600 μm to 590 μm in Exclusion Criterion to avoid enrolling subjects with artificially highly IOPs. - Added “in either eye” to Exclusion Criterion to clarify that subjects with very narrow angles, angle closure, congenital and secondary glaucoma, and history of angle closure in either eye should be excluded. - Removed instructions to perform vital signs in the standing position. - Added a description of the subject dosing instruction sheet. - Removed events occurring from any failure of expected pharmacological action from the definition of an AE since this was a dose-ranging study and collection of lack of effect events was not required. - Revised serious adverse event definition to be more consistent with global standards. - Clarified that non-serious AEs that were ongoing upon early discontinuation from the study were also to be followed by the Investigator for 30 days after the subject exited the study. - Removed the Snellen fraction information from the Recording and Scoring of logMar values.
    27 Oct 2010
    Changes included the following: - Revised Inclusion Criterion to indicate that the mean/median IOP should be ≤32 mmHg in both eyes at all 3 measurement time points. - Revised Exclusion Criterion to include subjects expected to require treatment with systemic corticosteroids. - Removed performing vital signs in the standing position from the Study Procedures section in the synopsis and removed the description of collecting measurements for different body postures in Appendix. - Clarified that the unmasked designee should weight study medication bottles and dispense study medication. - Clarified that the comparator’s screw cap was turquoise in the US and white in the EU. - Clarified that if the 2 systolic or diastolic values of the blood pressure measurements differed by more than 5 mmHg, a third reading should be taken and the average of the 3 measurements should be averaged.
    18 May 2011
    Changes included the following: - Revised the maximum allowed central corneal thickness in either eye in Exclusion Criterion from 590 μm to 600 μm. After review of the screening failures in this study, a high rate of exclusion was shown to be due to the maximum allowed central corneal thickness of 590 μm. Although increased central corneal thickness may give artificially high IOP measurements, an increase of 10 μm is very small and its effect on IOP would be minimal and negligible. This change did not affect the study objective or endpoints and did not create any safety concerns for the study subjects. - Removed calcium channel blockers as an example medication that could interact with the safety or efficacy of a NO-donating compound from the disallowed therapies in Exclusion Criterion. The subject population in this study was older by nature, tended to have hypertension, and had higher rates of calcium channel blocker use, as shown during screening. Since the interim safety data review of the enrolled and dosed subjects showed no safety signals for hypotension, the study drug was not expected to potentiate the hypotensive effect of calcium channel blockers used in the study. To be able to have a good representation of the general glaucoma population, calcium channel blocker use was permitted in the study.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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