Kala Pharmaceuticals announced positive topline results from STRIDE 3, a phase 3 clinical trial evaluating KPI-121 0.25%, which Kala plans to commercialize under the brand name Eysuvis (loteprednol etabonate ophthalmic suspension) 0.25%, for the treatment of dry eye disease.
STRIDE 3 met both of its primary efficacy endpoints, demonstrating a statistically significant improvement in the symptom endpoint of ocular discomfort severity (ODS) at day 15 in the overall intent-to-treat (ITT) population (P=0.0002) and in the predefined subgroup of ITT patients with more severe ocular discomfort at baseline (P=0.0007). Statistical significance was also achieved in the key secondary endpoints of conjunctival hyperemia at day 15 in the ITT population (P<0.0001) and ODS at day 8 in the ITT population (P=0.0282). Significant results were also observed for total corneal staining at day 15 in the ITT population (P=0.0042). Eysuvis was well tolerated, with adverse events and intraocular pressure increases comparable to vehicle.
Kala plans to utilize these data as the basis for a Class 2 resubmission of the new drug application (NDA) for Eysuvis in the second quarter of 2020, with an expected 6-month review timeline by the FDA.
“These data reinforce the potential of Eysuvis to transform the treatment landscape for dry eye disease,” Edward Holland, MD, Director of Cornea Services at Cincinnati Eye Institute and Professor of Ophthalmology at the University of Cincinnati, said in a company news release. “Eysuvis would be the first prescription dry eye product developed specifically to address the acute treatment needs of patients with dry eye disease, including dry eye flares that are experienced by the vast majority of patients. If approved, I believe Eysuvis would become a first-line therapy for patients at all stages of dry eye disease.”
“I’m pleased to hear the exciting news that Eysuvis has successfully achieved the primary and key secondary endpoints in the STRIDE 3 clinical trial,” Dr. Kelly Nichols, Dean of the University of Alabama at Birmingham School of Optometry, said in the news release “If approved, Eysuvis will address an important unmet need for dry eye patients. Most dry eye patients do not experience continual symptoms. I believe these patients will benefit greatly from an effective and well-tolerated short-term treatment that can be taken when they experience flares.”
“We are thrilled with the results of STRIDE 3, which build on our prior clinical experience with Eysuvis in our phase 2, STRIDE 1 and STRIDE 2 trials,” Mark Iwicki, Chairman, President and Chief Executive Officer of Kala Pharmaceuticals, said in the news release. “We would like to express our sincere appreciation to the investigators and nearly 3,000 patients who participated in the trials. We are now focusing on finalizing the NDA resubmission, which is targeted for the second quarter of 2020, and on preparing for a potential U.S. approval and launch by the end of the year. We look forward to delivering this important new medicine to patients.”
If approved, Kala intends to commercialize Eysuvis in the United States with its specialty sales force, which it plans to increase to a total of approximately 100 to 125 sales representatives, who will promote both Eysuvis and Inveltys (loteprednol etabonate ophthalmic suspension) 1%.
STRIDE 3 Topline Results:
STRIDE 3 was a multicenter, randomized, double-masked, placebo-controlled, parallel-arm study, comparing Eysuvis to vehicle (placebo), each dosed four times a day (QID) for two weeks in 901 patients with dry eye disease. The ITT population consisted of 447 patients in the Eysuvis treatment group and 454 patients receiving vehicle. Patients who met initial screening and inclusion/exclusion criteria then underwent a two-week run-in period with vehicle. Patients who continued to meet inclusion/exclusion criteria after the run-in were then randomized to receive either Eysuvis or vehicle for two weeks. ODS was graded daily by the patient over the entire course of the trial using a visual analog grading scale (measured on a scale ranging from 0 to 100 mm) recorded in a patient diary.
STRIDE 3 achieved both of its independent primary endpoints, demonstrating a statistically significant reduction in the symptom endpoint of ODS from baseline to day 15 compared to vehicle control in both the overall ITT population (P=0.0002) and in a pre-defined subgroup of ITT patients with more severe baseline ocular discomfort (P=0.0007), defined as patients who scored greater than or equal to 68 mm in baseline ocular discomfort. These data replicate the achievement of both primary symptom endpoints of STRIDE 1 (P<0.0001 in the overall ITT population and p=0.0008 in the pre-defined ITT subgroup with more severe ocular discomfort at baseline). Statistical significance was also achieved in the key secondary endpoint of conjunctival hyperemia at day 15 in the ITT population (P<0.0001). This result replicates the achievement of the results of STRIDE 1 and STRIDE 2, where statistical significance was demonstrated for conjunctival hyperemia at day 15 in the ITT population as a prespecified primary endpoint in each of those trials. Statistical significance was also achieved for the key secondary endpoint of ODS at day 8 in the ITT population (P=0.0282), which was consistent with STRIDE 1 (P=0.0011) and STRIDE 2 (P=0.0408). Significant improvement was also observed for corneal staining in the ITT population (P=0.0042), consistent with the result in STRIDE 2 (P=0.0314).
Eysuvis was well-tolerated in this trial, consistent with prior clinical trials. The most common adverse event observed in STRIDE 3 was instillation site pain, which was reported by 2.9% in the Eysuvis group compared to 1.5% in the vehicle group. Elevations in intraocular pressure (IOP), a known side effect with topical corticosteroid administration, were similar between the two groups, with no patients in either the EYSUVIS or vehicle group experiencing an increase in IOP of 5 mmHg or greater that resulted in an IOP of greater than 21 mmHg in the study eye.