PURPOSE:To evaluate the efficacy and safety of OT202, a first-in-class, dual-target kinase inhibitor of spleen tyrosine kinase (Syk) and vascular endothelial growth factor receptor 2 (VEGFR-2), for treating moderate-to-severe dry eye disease (DED).
DESIGN:A multicenter, randomized, double-blind, vehicle-controlled phase 2 trial.
PARTICIPANTS:Adults with moderate-to-severe DED for at least 6 months.
METHODS:Subjects who remained eligible after a 2-week run-in period were randomized 1:1:1 to receive 0.5% OT202, 1% OT202, or OT202 vehicle three times daily for 8 weeks.
MAIN OUTCOME MEASURES:The primary endpoint was the change from baseline to week 8 in the total corneal staining score (TCSS). Secondary endpoints included changes in ocular surface disease index (OSDI) score, visual analogue scale (VAS) score, symptom assessment in dry eye (SANDE) score, conjunctival hyperaemia score, conjunctival staining score, tear film breakup time, Schirmer I Test and corneal staining score for each region at week 4 and week 8.
RESULTS:The 1% OT202 group demonstrated a significantly higher reduction in TCSS score from baseline (least-squares mean [LSM]: -1.93 ± 0.23) compared with the vehicle group (LSM: -1.11 ± 0.23) at week 8 (treatment difference [Δ]: -0.82; 95% confidence interval [CI]: -1.46 to -0.18; P=0.0118). Additionally, 1% OT202 demonstrated significantly greater reduction at week 8 in OSDI score (LSM: -16.25 ± 1.77) compared with the vehicle group (Δ: -5.35; 95% CI: -10.16 to -0.54; P=0.0296), central corneal staining (Δ: -0.20; 95% CI: -0.38 to -0.02) and nasal corneal staining (-0.38; 95% CI: -0.66 to -0.11). However, the 0.5% OT202 group showed no significant changes in either primary or secondary outcomes. The most common treatment-related adverse events were ocular hyperaemia (0.9%), eye discharge (0.9%), and eye pruritus (0.9%).
CONCLUSIONS:1% OT202 significantly improved TCSS scores at week 8 versus the vehicle in subjects with DED. Additionally, OT202 exhibited favorable safety and tolerability. These results suggest that 1% OT202's potential in treating DED and support a further evaluation.