Topical Insulin for Glaucoma (TING2)
A Phase 1/2 Dose Escalation Followed by a Masked, Randomized, Placebo-Controlled Study to Evaluate Topical Insulin for Neuroprotection in Open Angle Glaucoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Study Team
- Phone Number: 650-497-5942
- Email: glaucomatrials@stanford.edu
Study Locations
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California
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Palo Alto, California, United States, 94303
- Byers Eye Institute at Stanford University
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Principal Investigator:
- Jeffrey Goldberg, MD PhD
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Contact:
- Study Team
- Phone Number: 6504975942
- Email: glaucomatrials@stanford.edu
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Limited Inclusion Criteria - All Groups:
- Provide written informed consent approved by the appropriate ethics committee
- Age 18 years or older
- Understand study procedures and have the ability and willingness to abide by all procedures during the study
- Capable of providing informed consent
- Diagnosis of glaucoma
- Only one eye per patient will be selected as the study eye; if both eyes meet inclusion criteria, the eye with worse visual acuity and/or visual field will be selected
Limited Exclusion Criteria - All Groups:
- Pregnant or breastfeeding
- Presence of any ocular pathology other than glaucoma that contributes to severe vision loss (retinopathy, maculopathy, severe uveitis, keratopathy, etc.)
- Diagnosis of glucose intolerance, type 1 or type 2 diabetes mellitus
- Inability to perform reliable visual field testing
- Unable to provide informed consent
- Unable to complete the tests and follow-ups required by the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Group 1: Low-Dose EYED-002
N=5 participants with open-angle glaucoma.
Low-dose topical insulin (EYED-002), administered as one drop to the study eye once daily in-clinic for 5 consecutive days.
Open-label.
|
Sterile, preservative-free suspension of Human Insulin USP.
One drop to study eye for duration of study group.
Other Names:
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Experimental: Group 2: High-Dose EYED-002
N=5 participants with open-angle glaucoma.
High-dose topical insulin (EYED-002), administered as one drop to the study eye once daily in-clinic for 5 consecutive days.
|
Sterile, preservative-free suspension of Human Insulin USP.
One drop to study eye once daily in-clinic for duration of study group.
Other Names:
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Experimental: Group 3: Active EYED-002 (Randomized)
N=40 participants randomized to active EYED-002 at the highest tolerated dose from Groups 1 or 2, administered once daily at home for 12 months.
Double -masked.
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Highest tolerated dose of EYED-002 (721 U/mL or 1442 U/mL, determined from Groups 1 and 2 safety review).
Once daily at home for 12 months in single-use vials, dispensed at quarterly visits.
Other Names:
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Placebo Comparator: Group 3: Vehicle Placebo (Randomized)
N=20 participants randomized to vehicle-only placebo, administered once daily at home for 12 months.
double-masked.
Eligible participants may roll over to open-label active EYED-002 for an additional 12 months after Month 12.
|
Vehicle-only formulation without active insulin.
Single-use vials identical in appearance to active EYED-002.
Once daily at home for 12 months.
Other Names:
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Experimental: Group 4: Open-Label Access
N=20 participants ineligible for randomization due to glaucoma severity.
Receive highest tolerated dose of EYED-002 once daily for 12 months in an open-label access arm.
|
Highest tolerated dose of EYED-002 (721 U/mL or 1442 U/mL, determined from Groups 1 and 2 safety review).
Once daily at home for 12 months in single-use vials, dispensed at quarterly visits.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence and severity of ocular and systemic adverse events (AEs) and serious adverse events (SAEs)
Time Frame: From informed consent through end of participation (up to 27 months)
|
Safety of topical sterile human insulin (EYED-002) in patients with open-angle glaucoma.
AEs and SAEs classified using MedDRA nomenclature, assessed for severity (mild, moderate, severe) and causality.
Safety monitoring includes glycemia measurements before and 2 hours after in-clinic insulin administration, and serial serum electrolyte (potassium) measurements.
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From informed consent through end of participation (up to 27 months)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness by SD-OCT
Time Frame: Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in retinal thickness as measured by spectral domain optical coherence tomography (SD-OCT).
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Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in visual field by Humphrey 24-2 (mean deviation, VFI, pointwise analysis)
Time Frame: Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in visual field as measured by mean deviation, visual field index, and pointwise analysis on Humphrey 24-2 testing.
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Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
|
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Change in best corrected visual acuity (BCVA) by ETDRS
Time Frame: Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in visual acuity as measured by ETDRS chart.
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Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in contrast sensitivity by FrACT contrast test
Time Frame: Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
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Change in contrast sensitivity as measured by the computer-based FrACT contrast test.
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Baseline to 12 months (Groups 3 and 4); Baseline to Day 5 (Groups 1 and 2)
|
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Change in quality of life by GQL-15 questionnaire
Time Frame: Baseline, 6 months, and 12 months (Group 3)
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Change in patient-reported quality of life as measured by the Glaucoma Quality of Life-15 (GQL-15) questionnaire.
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Baseline, 6 months, and 12 months (Group 3)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jeffrey L Goldberg, MD PhD, Stanford University
Publications and helpful links
General Publications
- Agostinone J, Alarcon-Martinez L, Gamlin C, Yu WQ, Wong ROL, Di Polo A. Insulin signalling promotes dendrite and synapse regeneration and restores circuit function after axonal injury. Brain. 2018 Jul 1;141(7):1963-1980. doi: 10.1093/brain/awy142.
- Saludares M, Wennberg-Smith Z, Beykin G, Khatib TZ, Nunez M, Wang Q, Di Polo A, Goldberg JL. A Phase I Randomized Trial of Topical Insulin for Glaucoma: Safety and Efficacy Outcomes. Ophthalmol Sci. 2025 Dec 6;6(2):101032. doi: 10.1016/j.xops.2025.101032. eCollection 2026 Feb.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Eye Diseases
- Optic Nerve Diseases
- Uveal Diseases
- Ocular Hypertension
- Iris Diseases
- Glaucoma
- Glaucoma, Open-Angle
- Low Tension Glaucoma
- Exfoliation Syndrome
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Peptide Hormones
- Peptides
- Amino Acids, Peptides, and Proteins
- Insulins
- Pancreatic Hormones
- Proinsulin
- Insulin
Other Study ID Numbers
Other Study ID Numbers
- 73339
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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