Glaukos Corporation announced that its iDose® TR sustained-release travoprost implant continued to provide sustained substantial reductions in intraocular pressure (IOP) in a 36-month analysis of the 36-month Phase 2b clinical trial conducted under a U.S. Investigational New Drug (IND) protocol. Administered during a micro-invasive procedure, the iDose TR contains a novel formulation of travoprost, a prostaglandin analog used to reduce IOP, and was designed to continuously release therapeutic levels of the medication for at least one year. Once all travoprost is released, the iDose TR was designed to be removed and replaced with a new iDose TR, thus potentially offering an alternative to daily eye drop treatment.

The 154-subject, multi-center, randomized, double-blind Phase 2b trial was designed to evaluate a single administration of one of two iDose TR models with different travoprost release rates compared to topical timolol ophthalmic solution, 0.5% BID (twice a day). The primary efficacy endpoint agreed on with the U.S. Food and Drug Administration (FDA) is the non-inferiority comparison to timolol over the first three months after a single implantation of iDose TR. The currently reported Phase 2b results are based on an analysis conducted at 36 months for all 154 subjects randomized into the trial, with 51, 54 and 49 subjects randomized to iDose TR fast-release arm, iDose TR slow-release arm and timolol active comparator arm, respectively.

The subjects randomized to either iDoseTR arm received a single intracameral implant while the subjects randomized to the timolol active comparator received twice-daily eye drops over the 36-month evaluation period, which equates to approximately 2,190 eye drops per eye, per protocol. Topline summary results and observations from the analysis of the iDose TR Phase 2b clinical trial at 36 months are as follows: 70% and 68% of subjects in the fast- and slow-release iDose TR arms, respectively, were well-controlled with the same or fewer IOP-lowering topical medications at 36 months versus screening, versus 46% of subjects in the timolol control arm; In this responder group, average IOP reductions from baseline observed at 36 months were 8.3 mmHg and 8.5 mmHg in the fast- and slow-release iDose TR arms, respectively, versus 8.2 mmHg in the timolol control arm; Overall, iDose TR subjects performed similarly to timolol subjects at 36 months in terms of mean IOP reductions with fewer topical medications versus timolol; The 36-month Phase 2 data also continued to demonstrate a favorable safety profile for iDose TR, with no clinically significant corneal endothelial cell loss, no serious corneal adverse events and no adverse events of periorbital fat atrophy and conjunctival hyperemia reported to date in either elution arm. On June 10, 2021, Glaukos announced the completion of patient enrollment and randomization in its ongoing Phase 3 clinical program for iDose TR.

The Phase 3 program consists of two prospective, randomized, double-masked clinical trials designed to compare the safety and efficacy of iDose TR to topical timolol ophthalmic solution, 0.5%, in reducing elevated intraocular pressure in subjects with open-angle glaucoma (OAG) or ocular hypertension. The primary efficacy endpoint of the Phase 3 studies is non-inferiority comparison to topical timolol 0.5% BID over the first 3 months, and safety evaluations for up to 12 months. The Phase 3 trials randomized a total of 1,150 subjects across 89 clinical sites, the majority of which are in the United States.

The 12-month iDose TR Phase 3 trial results are expected to support Glaukos' targeted NDA submission in 2022 and FDA approval for iDose TR in 2023.