Safety and Efficacy of Phenylephrine 2.5%-Tropicamide 1% Microdose Ophthalmic Solution for Pupil Dilation

NCT03751098 — Phase 3, Completed, 76 participants, Eyenovia Inc.

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A Multi-Center, Double-Masked, Placebo-Controlled, Phase 3 Study of the Safety and Efficacy of Fixed Combination Phenylephrine 2.5%-Tropicamide 1% Ophthalmic Solution Administered With a Microdose Dispenser for Dilation of the Pupil

RegistryNCT03751098, acronym MIST-2
StatusCompleted
PhasePhase 3
Study typeInterventional; randomized, crossover, masking: double, diagnostic
Enrollment76 (Actual)
SponsorEyenovia Inc. (Industry)
ConditionsMydriasis
InterventionsTropicamide/Phenylephrine ophthalmic solution (TR/PE), Placebo (Drug)
Datesstart 2018-12-01, primary completion 2019-01-21, completion 2019-01-21, first posted 2018-11-23, last updated 2022-03-18
Locations2 sites in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Mydriasis All trials of Tropicamide/Phenylephrine ophthalmic solution (TR/PE) All trials of Placebo

-Summary

This study evaluated pupil dilation after administration of fixed combination tropicamide-phenylephrine (TR/PH) vs. placebo. Participants attended 3 visits. At each visit, after baseline measurements, either the study drug or placebo was administered to both eyes, then pupil dilation and safety assessments were performed at specific time intervals.

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+Detailed description

Volunteer participants were screened for study eligibility during a Screening Visit and enrolled after signing the study-specific informed consent form. Subjects meeting all inclusion/exclusion criteria were scheduled for 3 treatment visits, which were at least 2 days, but no more than 7 days apart. At each treatment visit, baseline measurements were taken, then either the study drug or placebo was administered to both eyes. Afterwards, efficacy and safety assessments were performed at 20, 35, 50, 65, 80, 120, and 180 minutes. Participants' treatment assignments for each treatment visit were equally randomized using 1 of 2 sequences - ABB or BAA, where A was the study drug and B was the placebo.

+Arms and interventions

ArmTypeInterventionsDescription
1-TR/PE, 2-Placebo, 3-PlaceboOtherDrug: Tropicamide/Phenylephrine ophthalmic solution (TR/PE); Drug: PlaceboParticipants were dosed once at 3 separate clinic visits in accordance with this sequence. Each participant received 2 sprays of the designated treatment in each eye.
1-Placebo, 2-Placebo, 3-TR/PEOtherDrug: Tropicamide/Phenylephrine ophthalmic solution (TR/PE); Drug: PlaceboParticipants were dosed once at 3 separate clinic visits in accordance with this sequence. Each participant received 2 sprays of the designated treatment in each eye.
  • Tropicamide/Phenylephrine ophthalmic solution (TR/PE) (Drug), also known as Mydcombi: Tropicamide 1%/phenylephrine 2.5% ophthalmic solution administered with the Optejet microdose dispenser
  • Placebo (Drug): Eyewash administered with the Optejet microdose dispenser

+Outcome measures

Primary outcomes

  • Change in Pupil Diameter From Baseline [35 minutes after initial dose]: Difference in 35-minute pupil diameter vs. baseline measured using pupillometry in highly photopic conditions. Pupil diameter is reported in millimeters. For the change in pupil diameter, larger measurements indicate a better outcome.

Other outcomes

  • Proportion of Eyes Achieving Pupil Diameter 6.0 mm or Larger After Receipt of Each Medication [35 minutes after initial dose]: The percent of eyes with pupil diameter 6.0 mm or larger as measured using pupillometry in highly photopic conditions. As this is a cross-over study, each of the 69 participants received each medication. Data is reported separately for the right and left eyes of the 69 participants. A higher percentage indicates a better outcome.
  • Proportion of Eyes Achieving Pupil Diameter 7.0 mm or Larger After Receipt of Each Medication [35 minutes after initial dose]: The percent of eyes with pupil diameter 7.0 mm or larger as measured using pupillometry in highly photopic conditions. As this is a cross-over study, each of the 69 participants received each solution. Data is reported separately for the right and left eyes of the 69 participants. A higher percentage indicates a better outcome.

+Eligibility

Sex: All, accepts healthy volunteers

Inclusion Criteria:

* Ability to provide written consent and return for all study visits
* Photopic pupil diameter <= 3.5 mm in each eye

Exclusion Criteria:

* Allergy to phenylephrine hydrochloride, tropicamide, or benzalkonium chloride
* History of benign prostatic hyperplasia
* Use of a benzodiazepine, monoamine oxidase inhibitor, tricyclic antidepressant, anticonvulsant, or cholinergic drug
* History of closed-angle glaucoma
* Anatomically narrow anterior chamber angles
* Ocular surgery or laser treatment of any kind
* History of chronic or acute uveitis
* History of traumatic iritis or hyphema
* History of traumatic mydriasis or angle recession
* History of heterochromia
* Irregularly-shaped pupil secondary to ocular trauma or congenital defect.
* History of neurogenic pupil disorder
* History of anterior chamber intraocular lens (IOL) or iris-fixated IOL
* History of iris surgery, iris atrophy, or iris-cornea apposition/touch
* Unwilling or unable to discontinue use of contact lenses at treatment visits.
* Current active eye disease for which topical or systemic ophthalmic medication is necessary, except for dry eye disease managed using artificial tears.
* Presence of a severe/serious ocular condition, or any other unstable medical condition that, in the Investigator's opinion, may preclude study treatment and/or follow-up
* Pregnancy or lactation

+Posted results

Participant flow

Milestone1-TR/PE, 2-Placebo, 3-Placebo1-Placebo, 2-Placebo, 3-TR/PE
Started3733
Completed3732
Not completed01

Outcome results

  • Change in Pupil Diameter From Baseline (Primary), Mean, millimeters: TR/PE - Right Eye 4.747 +/- 0.7301; TR/PE - Left Eye 4.779 +/- 0.8032; Placebo - Right Eye 0.134 +/- 0.4972; Placebo - Left Eye 0.032 +/- 0.4983
  • Proportion of Eyes Achieving Pupil Diameter 6.0 mm or Larger After Receipt of Each Medication (Other pre specified), Number, percentage of eyes: TR/PE - Right Eye 92.8; TR/PE - Left Eye 94.2; Placebo - Right Eye 0; Placebo - Left Eye 0
  • Proportion of Eyes Achieving Pupil Diameter 7.0 mm or Larger After Receipt of Each Medication (Other pre specified), Number, percentage of eyes: TR/PE - Right Eye 69.6; TR/PE - Left Eye 68.1; Placebo - Right Eye 0; Placebo - Left Eye 0

Adverse events

Time frame: Adverse event data was collected over each participant's study participation period, which was a maximum of 14 days.

ArmDeathsSerious adverse eventsOther adverse events
Tropicamide/Phenylephrine0/69 (0.0%)0/69 (0.0%)2/69 (2.9%)
Placebo0/70 (0.0%)0/70 (0.0%)0/70 (0.0%)

Other adverse events by term

TermOrgan systemTropicamide/PhenylephrinePlacebo
PhotophobiaEye disorders1/690/70
Instillation site painGeneral disorders1/690/70

+Locations (2)

FacilityCityCountryStatus
Keystone ResearchAustin, TexasUnited States
R&R ResearchSan Antonio, TexasUnited States

+Study documents

+Investigators