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    Clinical Trial Results:
    A Randomized, Multicenter, Double-Masked, Parallel-Group Study Comparing the Safety and Efficacy of BOL-303259-X 0.024% (Latanoprostene Bunod) Ophthalmic Solution With Timolol Maleate Ophthalmic Solution 0.5% in Subjects With Open-Angle Glaucoma or Ocular Hypertension – APOLLO Study

    Summary
    EudraCT number
    2013-000552-18
    Trial protocol
    CZ   BG  
    Global end of trial date
    02 Jun 2015

    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
    769
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01749904
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bausch & Lomb Incorporated
    Sponsor organisation address
    1400 N Goodman St, Rochester, NY, United States, 14609
    Public contact
    Director of Clinical Operations, Bausch & Lomb Incorporated, 011 9733606389, tuyen.ong@bausch.com
    Scientific contact
    Director of Clinical Operations, Bausch & Lomb Incorporated, 011 9733606389, tuyen.ong@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
    02 Jun 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 Jun 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Jun 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to demonstrate that the mean intraocular pressure (IOP) reduction after 3 months (90 days) of treatment with latanoprostene bunod ophthalmic solution 0.024% once daily (QD) was noninferior to timolol maleate 0.5% twice daily (BID).
    Protection of trial subjects
    This study was conducted in compliance with the study protocol and in accordance with Good Clinical Practices (GCPs), as described in the International Conference on Harmonisation (ICH) Harmonized Tripartite Guidelines for GCP E6(R1), the US Code of Federal Regulations (CFR) dealing with clinical studies (Title 21 CFR Parts 11, 50, 54, 56, and 312); Title 42 US Code 282(j); the ethical principles in the Declaration of Helsinki; and applicable local regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    31 Jan 2013
    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: 356
    Country: Number of subjects enrolled
    Bulgaria: 37
    Country: Number of subjects enrolled
    Czech Republic: 27
    Worldwide total number of subjects
    420
    EEA total number of subjects
    64
    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)
    207
    From 65 to 84 years
    207
    85 years and over
    6

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Of the 420 subjects randomized, 418 instilled at least one dose of study medication and were included in the safety population, whereas one subject did not have any post-baseline efficacy reading, hence 417 subjects were included in the Intent-to-treat population.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    BOL-303259-X
    Arm description
    BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) administered for 3 months (Visit 6) into the study eye(s). BOL-303259-X: Topical ocular BOL-303259-X will be administered QD in the evening and its vehicle administered QD in the morning for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)
    Arm type
    Experimental

    Investigational medicinal product name
    Vehicle
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops
    Routes of administration
    Ophthalmic use
    Dosage and administration details
    Topical ocular vehicle will be administered QD in the morning.

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops
    Routes of administration
    Ophthalmic use
    Dosage and administration details
    Topical ocular BOL-303259-X will be administered QD in the evening.

    Arm title
    Timolol
    Arm description
    Timolol maleate ophthalmic solution, 0.5%, administered BID for 3 months (Visit 6) into study eye(s). Timolol: Timolol will be administered BID once in the morning and once in the evening for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)
    Arm type
    Active comparator

    Investigational medicinal product name
    BOL-303259-X
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops
    Routes of administration
    Ophthalmic use
    Dosage and administration details
    All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months.

    Investigational medicinal product name
    Timolol
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Eye drops
    Routes of administration
    Ophthalmic use
    Dosage and administration details
    Timolol will be administered BID once in the morning and once in the evening.

    Number of subjects in period 1
    BOL-303259-X Timolol
    Started
    286
    134
    Completed
    264
    123
    Not completed
    22
    11
         Consent withdrawn by subject
    6
    1
         Adverse event, non-fatal
    4
    5
         Investigator decision
    1
    2
         Failure to follow study procedures
    2
    2
         Other than specified
    7
    1
         Lost to follow-up
    2
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    BOL-303259-X
    Reporting group description
    BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) administered for 3 months (Visit 6) into the study eye(s). BOL-303259-X: Topical ocular BOL-303259-X will be administered QD in the evening and its vehicle administered QD in the morning for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)

    Reporting group title
    Timolol
    Reporting group description
    Timolol maleate ophthalmic solution, 0.5%, administered BID for 3 months (Visit 6) into study eye(s). Timolol: Timolol will be administered BID once in the morning and once in the evening for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)

    Reporting group values
    BOL-303259-X Timolol Total
    Number of subjects
    286 134 420
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    64.7 ( 10.33 ) 63.1 ( 11.21 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    168 78 246
        Male
    118 56 174
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    30 13 43
        Not Hispanic or Latino
    256 121 377
        Unknown or Not Reported
    0 0 0
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    1 1 2
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    64 24 88
        White
    219 109 328
        More than one race
    0 0 0
        Unknown or Not Reported
    2 0 2

    End points

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    End points reporting groups
    Reporting group title
    BOL-303259-X
    Reporting group description
    BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) administered for 3 months (Visit 6) into the study eye(s). BOL-303259-X: Topical ocular BOL-303259-X will be administered QD in the evening and its vehicle administered QD in the morning for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)

    Reporting group title
    Timolol
    Reporting group description
    Timolol maleate ophthalmic solution, 0.5%, administered BID for 3 months (Visit 6) into study eye(s). Timolol: Timolol will be administered BID once in the morning and once in the evening for 3 months (Visit 6). BOL-303259-X: All participants will receive topical ocular BOL-303259-X QD in the evening for an additional 9 months from Visit 6 through Visit 9 (1 year)

    Subject analysis set title
    BOL-303259-X Safety Extension Phase
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Following completion of the efficacy phase, all subjects were converted to BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) for an additional 9 months from Visit 6 through Visit 9 (1 year) during the open label safety extension phase

    Primary: Mean IOP

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    End point title
    Mean IOP
    End point description
    Mean intraocular pressure (IOP) in study eye measured at the specified time points: 8 AM, 12 PM, and 4 PM at Visit 4 (Week 2), Visit 5 (Week 6), and Visit 6 (Month 3). Intent-to-treat population with last observation carried forward (LOCF).
    End point type
    Primary
    End point timeframe
    8 AM, 12 PM, and 4 PM at Visit 4 (Week 2), Visit 5 (Week 6), and Visit 6 (Month 3)
    End point values
    BOL-303259-X Timolol
    Number of subjects analysed
    284
    133
    Units: millimetres of mercury (mmHg)
    least squares mean (standard deviation)
        8 am week 2 (n=282,133)
    18.61 ( 3.544 )
    19.84 ( 3.651 )
        12 pm week 2 (n=282,131)
    18.00 ( 3.376 )
    19.37 ( 3.696 )
        4 pm week 2 (n=281,131)
    18.09 ( 3.293 )
    19.20 ( 3.359 )
        8 am week 6 (n=283,133)
    18.59 ( 3.525 )
    19.63 ( 3.243 )
        12 pm week 6 (n=283,131)
    17.84 ( 3.305 )
    19.09 ( 3.230 )
        4 pm week 6 (n=284,131)
    17.82 ( 3.513 )
    19.09 ( 3.492 )
        8 am Month 3 (n=283,133)
    18.71 ( 3.382 )
    19.73 ( 2.230 )
        12 pm Month 3 (n=283,131)
    17.88 ( 3.409 )
    19.15 ( 3.311 )
        4 pm Month 3 (n=284,131)
    17.83 ( 3.521 )
    19.15 ( 3.643 )
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Timolol v BOL-303259-X
    Number of subjects included in analysis
    417
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [1]
    P-value
    < 0.01 [2]
    Method
    ANCOVA
    Confidence interval
    Notes
    [1] - The 2 treatments were compared for each time point by visit. LS mean of each treatment group, the difference in the LS mean, and the 2-sided 95% CI for the difference were obtained. Non-inferiority could be claimed if the upper limit of the CIs <1.5 mmHg at all time points of each visit and <1.00 mmHg for at least 5 out of the 9 time points. If non-inferiority was determined, superiority at each time point could be claimed if the upper limit of the 95% CI<0 mmHg at all time points of each visit.
    [2] - The ANCOVA results for the comparison of LS means of mean IOP between treatment groups demonstrated non-inferiority of BOL-303259-X to timolol and also superiority of BOL-303259-X to timolol.

    Secondary: Response Rate - IOP ≤ 18 mmHg

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    End point title
    Response Rate - IOP ≤ 18 mmHg
    End point description
    Percentage of participants with IOP ≤18 mmHg consistently at all 9 time points in the first 3 months. Intent-to-treat population with LOCF.
    End point type
    Secondary
    End point timeframe
    8 AM, 12 PM, and 4 PM at Visit 4 (Week 2), Visit 5 (Week 6), and Visit 6 (Month 3).
    End point values
    BOL-303259-X Timolol
    Number of subjects analysed
    284
    133
    Units: participants
    65
    15
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    BOL-303259-X v Timolol
    Number of subjects included in analysis
    417
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    P-value
    = 0.005
    Method
    Chi-squared
    Confidence interval

    Secondary: Response Rate - IOP reduction ≥ 25%

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    End point title
    Response Rate - IOP reduction ≥ 25%
    End point description
    Percentage of participants with IOP reduction ≥ 25% consistently at all 9 time points in the first 3 months. Intent-to-treat with LOCF.
    End point type
    Secondary
    End point timeframe
    8 AM, 12 PM, and 4 PM at Visit 4 (Week 2), Visit 5 (Week 6), and Visit 6 (Month 3).
    End point values
    BOL-303259-X Timolol
    Number of subjects analysed
    284
    133
    Units: participants
    99
    26
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    BOL-303259-X v Timolol
    Number of subjects included in analysis
    417
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    P-value
    = 0.001
    Method
    Chi-squared
    Confidence interval

    Other pre-specified: Number of participants with Ocular and Systemic Adverse Events

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    End point title
    Number of participants with Ocular and Systemic Adverse Events
    End point description
    Following assessments through Visit 6 (Month 3), all participants, irrespective of previous randomization, converted to a single open label safety arm receiving BOL-303259-X QD in the evening. Adverse events were recorded throughout the comparative efficacy phase and open label extension phase. Safety population (analyzed as treated). Of the 420 subjects randomized, 418 instilled at least one dose of study medication and were included in the safety population; one subject randomized to BOL-303259-X received timolol in the efficacy phase and was therefore analyzed as part of the timolol treatment group. Hence, actual number of subjects analyzed for this endpoint are: 283 and 135 for BOL-303259-X and timolol arms, respectively.
    End point type
    Other pre-specified
    End point timeframe
    12 months
    End point values
    BOL-303259-X Timolol BOL-303259-X Safety Extension Phase
    Number of subjects analysed
    284
    134
    385
    Units: participants
        >/= 1 nonocular AE
    36
    19
    62
        >/= 1 ocular (Study eye) AE
    38
    16
    46
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    1 year
    Adverse event reporting additional description
    Safety Population (analyzed as treated). 1 subject randomized to BOL-303259-X received timolol and was therefore analyzed as part of the timolol group in the efficacy phase of the study. All subjects were converted to BOL-303259-X during the safety extension phase and AEs reported during that phase are presented below as a third arm.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.0
    Reporting groups
    Reporting group title
    Timolol
    Reporting group description
    Timolol maleate ophthalmic solution, 0.5%, administered BID for 3 months into study eye during the efficacy phase.

    Reporting group title
    BOL-303259-X
    Reporting group description
    BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) administered for 3 months into the study eye during the efficacy phase.

    Reporting group title
    BOL-303259-X Safety extension phase
    Reporting group description
    Following completion of the efficacy phase, all subjects were converted to BOL-303259-X ophthalmic solution QD (PM) and vehicle QD (AM) for an additional 9 months from Visit 6 through Visit 9 (1 year) during the open label safety extension phase

    Serious adverse events
    Timolol BOL-303259-X BOL-303259-X Safety extension phase
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 135 (1.48%)
    3 / 283 (1.06%)
    8 / 385 (2.08%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Recurrence of breast cancer
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Right upper lobe lung cancer
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Spider bite
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    1 / 135 (0.74%)
    0 / 283 (0.00%)
    0 / 385 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ankle fracture
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fracture of right femoral neck
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    1 / 283 (0.35%)
    0 / 385 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Dizziness
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    1 / 283 (0.35%)
    0 / 385 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Leg disco-ordination
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aphasia
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Dislocation of intraocular lens
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Allergic angioedema due to Motrin
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Food allergy
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chest pain
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    1 / 283 (0.35%)
    0 / 385 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Hydronephrosis
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Torn rotator cuff
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    1 / 135 (0.74%)
    0 / 283 (0.00%)
    0 / 385 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
    alternative dictionary used: MedDRA 13.0
         subjects affected / exposed
    0 / 135 (0.00%)
    0 / 283 (0.00%)
    1 / 385 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 3%
    Non-serious adverse events
    Timolol BOL-303259-X BOL-303259-X Safety extension phase
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    3 / 135 (2.22%)
    11 / 283 (3.89%)
    5 / 385 (1.30%)
    Eye disorders
    Eye irritation
         subjects affected / exposed
    3 / 135 (2.22%)
    11 / 283 (3.89%)
    5 / 385 (1.30%)
         occurrences all number
    3
    11
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Feb 2013
    Significant changes included following: • Revision of a criterion to exclude subjects who had previously received latanoprostene bunod ophthalmic solution from participating in study; • Addition of a exclusion to exclude subjects with a current cancer diagnosis from participating in study; • Correction to exclusion criterion regarding the Best-Corrected Visual Acuity (BCVA); • Addition of the requirement of a visual fields assessment for eligibility; • Clarification that assessment of the primary objective after 3 months of treatment was to be done after 90 days of treatment; • Ophthalmoscopy was not required to be performed under dilation; • Revision of the order of performing pachymetry, slit-lamp examination, IOP measurements, installation of fluorescein agent, and visual fields for ease of performing assessments at study sites; • Revision that conjunctival hyperemia assessment did not have to be performed as part of the slit-lamp examination and should precede the slit-lamp examination; • Specification of which assessments had to be performed by an ophthalmologist; • Clarification that specular microscopy was to be performed only on the study eye; • Correction that mydriatic drugs were not to be used until after all vision testing was completed; • Revision of the instructions for AE and serious adverse event monitoring for increased subject safety; • Text revisions for clarification of the study endpoints, the timing of dosing, the inclusion and exclusion criteria, which subjects were required to undergo a washout period, the washout period required for different IOP-lowering medications (including addition of a tabular summary), the study schedule for subjects required to undergo a washout period, that study drug instillation was to be done by the subject, when subject dosing instructions should have been dispensed, that the pachymetry test was to be performed by a calibrated ultrasonic pachymeter, and the details of the statistical methods to be used.
    02 Aug 2013
    Significant changes included the following: • Text revisions for clarification of exclusion criteria; • Updated the number of investigative sites participating in the study (increased from 30 to 45 sites); • Revision of the instructions for unmasking in the event of an emergency, to be in line with ICH guidance and standards of practice; • Clarification that specular microscopy was to be performed in the study eye and at select US sites only; • Clarification of period during which diclofenac was disallowed.
    13 Aug 2013
    Significant changes included the following: • Clarification of the inclusion criterion regarding acceptable contraceptive methods for female subjects and male subjects with partners of childbearing potential.

    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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