Postoperative Ocular Inflammation: A Single Subconjunctival Injection of XG-102 Compared to Dexamethasone Drops in a Randomized Trial

Am J Ophthalmol. 2017 Feb:174:76-84. doi: 10.1016/j.ajo.2016.10.012. Epub 2016 Nov 1.

Abstract

Purpose: To evaluate the efficacy and safety of XG-102 (brimapitide) compared to dexamethasone eye drops in the treatment of postoperative ocular inflammation.

Design: Multicenter, randomized, parallel group, double-masked, noninferiority clinical trial.

Methods: Patients who underwent anterior and posterior segments combined surgery or glaucoma surgery or complex posterior segment surgery were eligible to participate. Patients were administered a single subconjunctival injection of 250 μL XG-102 90 μg (n = 47) or 900 μg (n = 48) or placebo (n = 50) at the end of ocular surgery. Subconjunctival injection for each group (XG-102 90 μg, XG-102 900 μg, or placebo) was followed by eye drops instilled 4 times per day for 21 days with placebo, placebo, or dexamethasone solution, respectively. The primary outcome measure was anterior chamber cell grades at day 28 comparing XG-102 900 μg with dexamethasone.

Results: The anterior cell grades for both XG-102 groups were noninferior to dexamethasone (-0.054 anterior cell grade [95% confidence interval -0.350-0.242]; P < .001 for noninferiority) for XG-102 900 μg and -0.086 anterior cell grade (95% confidence interval -0.214-0.385; P = .003 for noninferiority) for XG-102 90 μg. Rescue medication was introduced for 10 (21%), 7 (15%), and 2 (4%) patients allocated to the XG-102 90 μg, XG-102 900 μg, and dexamethasone groups, respectively. The difference between XG-102 90 μg and dexamethasone was statistically significant (P = .013). The number of patients for whom adverse events were reported and the nature of the events reported was similar between the 3 treatment groups.

Conclusions: A single subconjunctival injection of XG-102 at the end of ocular surgery is noninferior to dexamethasone eye drops in the treatment of postoperative ocular inflammation.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Conjunctiva
  • Dexamethasone / administration & dosage*
  • Dexamethasone / pharmacokinetics
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / pharmacokinetics
  • Humans
  • Injections
  • Male
  • Neuroprotective Agents / administration & dosage
  • Neuroprotective Agents / pharmacokinetics
  • Ophthalmic Solutions
  • Ophthalmologic Surgical Procedures / adverse effects*
  • Peptides / administration & dosage*
  • Peptides / pharmacokinetics
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / etiology
  • Postoperative Complications / metabolism
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Uveitis, Anterior / drug therapy*
  • Uveitis, Anterior / etiology
  • Uveitis, Anterior / metabolism

Substances

  • Glucocorticoids
  • Neuroprotective Agents
  • Ophthalmic Solutions
  • Peptides
  • Dexamethasone
  • D-JNKI-1