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The purpose of this study was to assess the safety and efficacy of AL-4943A ophthalmic solution for the treatment of ocular itching associated with allergic conjunctivitis using the Conjunctival Allergen Challenge (CAC) model.
This study consisted of 5 Visits. Eligible patients underwent allergy testing using the Conjunctival Allergen Challenge (CAC) model, which reproduces the signs and symptoms of Seasonal Allergic Conjunctivitis by replicating the natural disease process. Patients demonstrating a positive reaction to the CAC at Visit 1 (screening) and Visit 2 (confirmatory) were randomized to treatment at Visit 3 (Day 0). The test article was instilled at Visit 3, with treatment efficacy CAC performed at 24 hours duration of action. The test article was instilled again at Visit 4 (Day 14), with treatment efficacy CAC performed at 16 hours duration of action. The test article was instilled a final time at Visit 5 (Day 21), with treatment efficacy performed at onset of action.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AL-4943A | Experimental | AL-4943A ophthalmic solution, 1 drop to each eye, 3 nonconsecutive days |
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| Vehicle | Placebo Comparator | AL-4943A vehicle, 1 drop to each eye, 3 nonconsecutive days |
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| Pataday | Active Comparator | Olopatadine hydrochloride ophthalmic solution, 0.2%, 1 drop to each eye, 3 nonconsecutive days |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AL-4943A ophthalmic solution | Drug |
| ||
| AL-4943A vehicle |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Ocular Itching at Onset of Action | A treatment efficacy CAC was performed 27 minutes after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | 3, 5, and 7 minute timepoints, post-CAC on Day 21 of receiving treatment |
| Mean Ocular Itching at 16 Hours Duration of Action | A treatment efficacy CAC was performed 16 hours after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | 3, 5, and 7 minute timepoints, post-CAC on Day 14 of receiving treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Conjunctival Redness at Onset of Action | A treatment efficacy CAC was performed 27 minutes after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | 7, 15, and 20 minute timepoints, post-CAC on Day 21 of receiving treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Abhijit Narvekar, MS, MBBS | Alcon Research | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27466061 | Derived | Carr W, Schaeffer J, Donnenfeld E. Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief. Allergy Rhinol (Providence). 2016 Jan;7(2):107-14. doi: 10.2500/ar.2016.7.0158. Epub 2016 Jul 26. |
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Of the 397 enrolled, 195 subjects did not qualify for treatment and were exited without exposure to product. Participant flow and baseline characteristics are presented for the 202 subjects qualifying for treatment and randomized 1:1:1 to receive AL-4943A, Vehicle, or Pataday.
Patients were recruited from three US study centers.
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| ID | Title | Description |
|---|---|---|
| FG000 | AL-4943A | AL-4943A ophthalmic solution, 1 drop to each eye, 3 nonconsecutive days |
| FG001 | Vehicle | AL-4943A vehicle, 1 drop to each eye, 3 nonconsecutive days |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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Inactive ingredients used as placebo |
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| Olopatadine hydrochloride ophthalmic solution, 0.2% | Drug |
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| Mean Conjunctival Redness at 16 Hours Duration of Action | A treatment efficacy CAC was performed 16 hours after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | 7, 15, and 20 minute timepoints, post-CAC on Day 14 of receiving treatment |
| Mean Total Redness at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Total redness (0-12) is defined as the sum of ciliary redness (0-4 scale, from 0=none to 4=extremely severe), conjunctival redness (0-4 scale, from 0=none to 4=extremely severe), and episcleral redness (0-4 scale, from 0=none to 4=extremely severe). Average of total redness score over both eyes was analyzed. | 7, 15, and 20 minute timepoints, post-CAC on Day 1 of receiving treatment |
| Mean Ocular Itching at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | 3, 5, and 7 minute timepoints, post-CAC on Day 1 of receiving treatment |
| Mean Conjunctival Redness at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | 7, 15, and 20 minute timepoints, post-CAC on Day 1 of receiving treatment |
| FG002 | Pataday | Olopatadine hydrochloride ophthalmic solution, 0.2%, 1 drop to each eye, 3 nonconsecutive days |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | AL-4943A | AL-4943A ophthalmic solution, 1 drop to each eye, 3 nonconsecutive days |
| BG001 | Vehicle | AL-4943A vehicle, 1 drop to each eye, 3 nonconsecutive days |
| BG002 | Pataday | Olopatadine hydrochloride ophthalmic solution, 0.2%, 1 drop to each eye, 3 nonconsecutive days |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Number | participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Mean Ocular Itching at Onset of Action | A treatment efficacy CAC was performed 27 minutes after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 3, 5, and 7 minute timepoints, post-CAC on Day 21 of receiving treatment |
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| Primary | Mean Ocular Itching at 16 Hours Duration of Action | A treatment efficacy CAC was performed 16 hours after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 3, 5, and 7 minute timepoints, post-CAC on Day 14 of receiving treatment |
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| Secondary | Mean Conjunctival Redness at Onset of Action | A treatment efficacy CAC was performed 27 minutes after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 7, 15, and 20 minute timepoints, post-CAC on Day 21 of receiving treatment |
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| Secondary | Mean Conjunctival Redness at 16 Hours Duration of Action | A treatment efficacy CAC was performed 16 hours after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 7, 15, and 20 minute timepoints, post-CAC on Day 14 of receiving treatment |
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| Secondary | Mean Total Redness at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Total redness (0-12) is defined as the sum of ciliary redness (0-4 scale, from 0=none to 4=extremely severe), conjunctival redness (0-4 scale, from 0=none to 4=extremely severe), and episcleral redness (0-4 scale, from 0=none to 4=extremely severe). Average of total redness score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 7, 15, and 20 minute timepoints, post-CAC on Day 1 of receiving treatment |
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| Secondary | Mean Ocular Itching at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Ocular itching was assessed by the patient on a 0-4 scale (0=none to 4=incapacitating itch). Average of ocular itching score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 3, 5, and 7 minute timepoints, post-CAC on Day 1 of receiving treatment |
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| Secondary | Mean Conjunctival Redness at 24 Hours Duration of Action | A treatment efficacy CAC was performed 24 hours after drop instillation. Conjunctival redness was assessed by the investigator on a 0-4 scale (0=none to 4=extremely severe). Average of conjunctival redness score over both eyes was analyzed. | Intent to treat (ITT). The analysis population included all randomized patients who received treatment and had post CAC data. | Posted | Mean | Standard Deviation | Units on a scale | 7, 15, and 20 minute timepoints, post-CAC on Day 1 of receiving treatment |
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Adverse events were collected for the duration of the study. All randomized patients who received study medication were evaluable for the safety analysis.
At each visit, after the patient had the opportunity to spontaneously mention any problems, the investigator inquired about adverse events by asking the standard questions: "Have you had any health problems since your last study visit?" "Have there been any changes in the medicines you take since your last study visit?"
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | AL-4943A | AL-4943A ophthalmic solution, 1 drop to each eye, 3 nonconsecutive days | 0 | 66 | 0 | 66 | ||
| EG001 | Vehicle | AL-4943A vehicle, 1 drop to each eye, 3 nonconsecutive days | 0 | 68 | 0 | 68 | ||
| EG002 | Pataday | Olopatadine hydrochloride ophthalmic solution, 0.2%, 1 drop to each eye, 3 nonconsecutive days | 0 | 68 | 0 | 68 |
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Sponsor reserves the right of prior review of any publication or presentation of information related to the study.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Abhijit Narvekar, MS, MBBS | Alcon Research, Ltd. | 1-888-451-3937 | alcon.medinfo@alcon.com |
| ID | Term |
|---|---|
| D003233 | Conjunctivitis, Allergic |
| ID | Term |
|---|---|
| D003231 | Conjunctivitis |
| D003229 | Conjunctival Diseases |
| D005128 | Eye Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000069605 | Olopatadine Hydrochloride |
| ID | Term |
|---|---|
| D003990 | Dibenzoxepins |
| D006575 | Heterocyclic Compounds, 3-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| >=65 years |
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| Male |
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| 7 min post-CAC |
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