OKG-0301 for the Treatment of Acute Adenoviral Conjunctivitis (RUBY)

A Phase 2, Multi-centeR, Randomized, DoUBle-Masked, Placebo-Controlled StudY to Evaluate the Clinical Safety and Efficacy of OKG-0301 in the Treatment of Acute Adenoviral Conjunctivitis

Acute adenoviral conjunctivitis is a highly contagious, widespread endemic disease associated with frequent outbreaks, significant patient discomfort, lost productivity, and in some cases permanent visual compromise from long-term immune mediated sequelae. OKG-0301 is a novel ophthalmic solution with a potent ribonuclease that has broad-spectrum antiviral properties relevant for the treatment of acute adenoviral conjunctivitis. This randomized, double masked, multi-center Phase 2 study is being conducted entirely within Australia and is designed to support the safety and efficacy of OKG-0301 for the treatment of acute adenoviral conjunctivitis. The study intends to show superiority of OKG-0301 Ophthalmic Solution compared to vehicle for the primary efficacy endpoint of mean change from baseline in viral titre in patients with acute adenoviral conjunctivitis. Secondary efficacy endpoints including adenoviral eradication, clinical cure of acute adenoviral conjunctivitis, subepithelial infiltrates, other clinical signs and symptoms, and rate of cross-over infection to the other eye will also be assessed. Safety will also be evaluated.

Study Overview

• Status: Active, not recruiting
• Conditions: Adenoviral Conjunctivitis
• Intervention / Treatment: Drug: OKG-0301

• Study Type: Interventional
• Enrollment (Anticipated): 219
• Phase: Phase 2

Contacts and Locations

Study Locations

• Australia
  • New South Wales
    • Albury, New South Wales, Australia, 2640
      • Albury Eye Clinic
    • Sydney, New South Wales, Australia, 2000
      • Sydney Eye Hospital
  • South Australia
    • Adelaide, South Australia, Australia, 5000
      • The Royal Adelaide Hospital
  • Tasmania
    • Hobart, Tasmania, Australia, 7000
      • Hobart Eye Surgeons
  • Victoria
    • Melbourne E., Victoria, Australia, 3002
      • The Royal Victorian Eye and Ear Hospital
  • Western Australia
    • Nedlands, Western Australia, Australia, 6009
      • Lions Eye Institute Day Surgery Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Each patient MUST:

1. Be willing and able to provide informed consent either written, or if the patient is not able to read, provide consent as stipulated by local laws and Human Research Ethics Committee (HREC) guidelines.
2. Be willing and able to follow all instructions and attend all study visits.

3. Have a clinical diagnosis of suspected acute adenoviral conjunctivitis in at least 1 eye and the presence of both of the following minimal clinical signs in that same eye:

   • Bulbar conjunctival redness: a minimum grade of '1' on 0-3 scale
   • Watery ocular discharge: a minimum grade of '1' on a 0-3 scale
4. Patient reported presence of signs and symptoms consistent with adenoviral conjunctivitis equal to or less than 3 days in same eye prior to Visit 1.
5. Have a positive AdenoPlus® test at Visit 1 in the same eye that meets the minimum 1+ grade for bulbar conjunctival redness and watery ocular discharge.
6. Be willing to discontinue contact lens wear for the duration of the study.

Exclusion Criteria:

Each patient MUST NOT:

1. Have known sensitivity or poor tolerance to any component of the study medications or diagnostics.
2. Have a history of ocular surgical intervention or trauma within 12 weeks prior to Visit 1 or planned for the period of the study.
3. Have presence of any active ocular inflammation (e.g., uveitis, allergic conjunctivitis, ocular rosacea, or iritis), other than acute adenoviral conjunctivitis.
4. Have clinical signs or presence of an ocular infection other than acute adenoviral conjunctivitis (e.g., bacterial, fungal or other ocular viral infection, such as herpes).
5. Have the presence of corneal subepithelial infiltrates at baseline.
6. Have a history of recurrent corneal erosion syndrome, ulcerative keratitis or dry eye, including meibomian gland dysfunction and other ocular surface diseases.
7. Have presence of blepharitis, lid abnormality, significant inflammation of the lid margin, or ptosis.
8. Have lacrimal duct obstruction in either eye.
9. Have presence of any other clinically significant findings during the slit lamp exam that may interfere with study parameters or otherwise confound the data as determined by the investigator
10. Have any clinically significant retinal or optic nerve findings (as observed in the non-dilated fundus exam) or prior diagnoses in either eye that may interfere with study parameters or otherwise confound the data as determined by the investigator).
11. Have used any topical ocular or systemic anti-viral or topical ocular or systemic corticosteroid within 7 days of enrollment and do not plan to start any topical ocular or systemic anti-viral during study duration. Inhaled, intranasal, and topical dermatologic steroids (except on the face) are allowed during the study.
12. Initiate or continue the use of warm or cold compresses for the duration of the trial.
13. Have used any topical ophthalmic solutions, including tear substitutes and diagnostics, within 2 hours of Visit 1 and be unable to discontinue all topical ophthalmic solutions (including diagnostics, except as required by this protocol and antibiotics) for the duration of the study. In addition, if the patient has used an artificial tear or other topical ophthalmic formulated in a hydrogel within the past 72 hours.
14. Be currently pregnant, nursing, or planning a pregnancy; or be a woman that has a positive pregnancy test.
15. Have any uncontrolled (not on a stable regimen for the past 30 days) systemic disease or debilitating disease (e.g., cardiovascular disease, hypertension, diabetes, or cystic fibrosis) or taking medications known to impact the ocular surface and/or tear film.
16. Have a planned overnight hospitalization during the period of the study.
17. Have any uncontrolled (not on a stable regimen for the past 30 days) autoimmune disease or taking medications known to impact the ocular surface and/or tear film.
18. Have prior (within 30 days of beginning study treatment) or anticipated concurrent use of an investigational drug or device.
19. Have a condition or a situation which, in the investigator's opinion, may put the patient at increased risk, confound study data, or interfere significantly with the patient's study participation.
20. Be unlikely to follow study instructions or to complete all required study visits or has a condition or situation that in the investigator's opinion, may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Vehicle Control	Drug: OKG-0301; OKG-0301 is an experimental ophthalmic antiviral and immunomodulatory therapeutic
Experimental: OKG-0301 0.012% w/v	Drug: OKG-0301; OKG-0301 is an experimental ophthalmic antiviral and immunomodulatory therapeutic
Experimental: OKG-0301 0.03% w/v	Drug: OKG-0301; OKG-0301 is an experimental ophthalmic antiviral and immunomodulatory therapeutic

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change from baseline in viral titre levels in the study eye	PFU	Day 7

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Cure as Measured by the Absence of Bulbar Conjunctival Injection	Clinical cure of acute adenoviral conjunctivitis as measured by the absence (score = 0) of bulbar conjunctival redness (graded using the validated Ora Calibra Scale 16.2: Bulbar Conjunctival Redness Grading Scale)	Day 4, 7 and 14
Clinical Cure as Measured by the Absence of Watery Conjunctival Discharge	Clinical cure of acute adenoviral conjunctivitis as measured by the absence (score = 0) of watery conjunctival discharge (graded on a scale of 0-3 based on severity, developed specifically for this trial)	Day 4, 7 and 14
Adenoviral eradication (CC-IFA)	Adenoviral eradication is defined as negative CC-IFA. CC-IFA will be conducted using conjunctival swab samples collected at each visit to determine the presence or absence of adenovirus.	Day 4, 7 and 14
Adenoviral eradication (PFU)	Adenoviral eradication is defined as zero plaques in cultures of ocular samples. PFU will be conducted using conjunctival swab samples collected at each visit to determine the presence or absence of adenovirus.	Day 4, 7 and 14
Severity of subepithelial infiltrates	Evaluation of SEIs in study eye, assessed under slit lamp exam with Investigator grading on a 0-3 semi-quantitative scale (developed specifically for this study).	Day 4, 7 and 14
The rate of cross-over infection	Clinical signs in contra-lateral eye that initially presented with no signs or symptoms of adenoviral conjunctivitis	Day 4, 7 and 14

Collaborators and Investigators

• Sponsor: Okogen

Publications and helpful links

Helpful Links

• Registration number: ACTRN12619000177156

Study record dates

Study Major Dates

• Study Start (Actual): February 11, 2019
• Primary Completion (Anticipated): June 30, 2022
• Study Completion (Anticipated): June 30, 2022

Study Registration Dates

• First Submitted: February 21, 2019
• First Submitted That Met QC Criteria: February 25, 2019
• First Posted (Actual): February 27, 2019

Study Record Updates

• Last Update Posted (Actual): April 21, 2022
• Last Update Submitted That Met QC Criteria: April 20, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections; Eye Diseases; Gram-Negative Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Conjunctival Diseases; Chlamydiaceae Infections; Eye Infections, Bacterial; Eye Infections; Chlamydia Infections; Conjunctivitis, Bacterial; Conjunctivitis; Conjunctivitis, Inclusion
• Other Study ID Numbers: OKO-210

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: Yes