Inotek Pharmaceuticals announced topline results of the phase 2 fixed-dose combination trial of trabodenoson and latanoprost for the treatment of glaucoma. The trial was designed to assess the benefit/risk profile of the different fixed-dose combinations being evaluated. It was not powered for statistical differences among doses. After 28 days of once-daily morning treatment (QAM), the fixed combination of trabodenoson 3% and latanoprost 0.005% showed a 1.2 mmHg improvement in IOP reduction compared to the latanoprost 0.005% alone (P=0.061 for the mean comparison, P=0.020 for the median comparison). However, at day 56, after 4 additional weeks of treatment and night-time dosing (QPM), no meaningful clinical advantage in IOP reduction for the fixed dose combinations was observed.
“While the topline results, which we received and analyzed over the past week, demonstrated a good safety and tolerability profile of the fixed-dose combinations of trabodenoson and latanoprost, the efficacy of the fixed-dose combination was only marginally differentiated from that of latanoprost alone. When dosed in the AM and examined on day 28, the trabodenoson 3%/latanoprost 0.005% combination showed 1.2 mmHg additivity to commercial latanoprost. However by day 56, while the IOP lowering effect of latanoprost improved by 1.3 mmHg, the fixed dose combination of trabodenoson/latanoprost remained unchanged. Therefore, the addition of trabodenoson to latanoprost offered no clinically meaningful advantage in eye pressure reduction over latanoprost alone,” David P. Southwell, President and Chief Executive Officer of Inotek, said in a company news release. “Based on these results and the results previously reported for our phase 3 MATrX-1 monotherapy trial, we are evaluating the future clinical potential of trabodenoson, as well as other strategic options.”
Mr. Southwell continued, “We remain focused on the interests of Inotek shareholders and are committed to enhancing shareholder value. Inotek is well-capitalized with an estimated $109M in cash and marketable securities as of the end of the second quarter of 2017.”
Inotek also announced today that it is exploring its strategic alternatives. It has engaged Perella Weinberg Partners as a financial advisor to assist with the strategic review process. There can be no assurance a transaction will result from this process and Inotek does not intend to disclose additional details unless and until it has entered into a specific transaction or otherwise determines that further disclosure is appropriate.
About the Phase 2 Fixed-dose Combination Trial of Trabodenoson and Latanoprost
The randomized, double-masked, phase 2 dose-ranging trial assessed the overall benefit/risk profile of binocular topical application of different daily doses of trabodenoson (3.0% and 6.0%) when combined with latanoprost (0.005% or 0.0025%) for 8 weeks in patients with ocular hypertension or primary open-angle glaucoma.
Three fixed-dose combinations of trabodenoson and latanoprost were investigated as well as two separate concentrations of latanoprost alone. The treatments were: trabodenoson 6%/latanoprost 0.005%, trabodenoson 3%/latanoprost 0.005%; trabodenoson 6%/latanoprost 0.0025%; latanoprost 0.005%; and latanoprost 0.0025%. Trabodenoson doses were selected to optimize IOP lowering, while maintaining the favorable tolerability and safety profile observed to date. Latanoprost doses were selected based on efficacy and safety profiles, which vary based on dose.
The trial enrolled 201 subjects (original enrollment was exceeded due to a lower than anticipated screen failure rate) with an IOP greater than or equal to 25 mmHg and less than or equal to 34 mmHg; which represents the patients most likely to receive treatment for glaucoma or ocular hypertension. Following a placebo run-in period, treatment was administered to both eyes for a total of eight weeks.
The primary endpoint of the fixed-dose combination trial measured IOP reduction from diurnal baseline for a 2-month treatment period. The treatment period was divided into two 4-week periods consisting of double-masked AM or PM dosing.
Top-line results suggest that after 28 days of AM dosing, the fixed-dose combination composed of trabodenoson 3%/latanoprost 0.005% provided greater IOP lowering when compared to latanoprost alone. However, by day 56, after 4 weeks of PM dosing, no clinical meaningful additivity was observed. This was driven by the fact that the efficacy of PM latanoprost improved by 1.3 mmHg from Day 28 to Day 56.
There were no significant safety or tolerability events reported, consistent with previous trials of trabodenoson. The most common adverse event for the fixed-dose combination was urinary tract infection (12.7% in overall trabodenoson/latanoprost combinations, 12.2% in latanoprost 0.005%, and 11.9% in latanoprost 0.0025%). Only 1 subject discontinued the trial due to a treatment-related adverse event, and this subject was randomized to the latanoprost 0.0025% monotherapy group (2.4% of this group). There were no discontinuations in any of the FDC groups and the incidence of hyperemia between the overall trabodenoson/latanoprost combinations and the latanoprost alone groups were similar which continues to support that trabodenoson is not associated with hyperemia.
For more information on the trial, visit www.clinicaltrials.gov/ct2/show/NCT02829996.