A Study in the Treatment of Mild to Moderate Dry Eye Disease Comparing Saline to TTAX03.

A Phase 2 Randomized, Controlled, Multicenter, Dose Optimization Study of TTAX03 in the Treatment of Mild to Moderate Dry Eye Disease (DED)

The purpose of this randomized, controlled, multicenter study is to evaluate the safety and efficacy of TTAX03 in participants with mild to moderate DED.

The primary question it aims to answer is if TTAX03 is safe. The secondary is the effectiveness.

Researchers will compare 10mg of TTAX03 reconstituted in 150, 300, or 600 uL saline to the saline control group to look at effectiveness.

Participants will be randomized to a treatment group one time and be evaluated at 5 different study visits.

Study Overview

• Status: Completed
• Conditions: Dry Eye; Dry Eye Disease (DED); Dry Eye Disease With Severe Keratitis
• Intervention / Treatment: Biological: TTAX03; Biological: Saline (NaCl 0,9 %) (placebo)

Detailed Description

The purpose of this randomized, controlled, multicenter study is to evaluate the safety and efficacy of TTAX03 in participants with mild to moderate DED. After confirmation of inclusion and exclusion criteria, all eligible patients will be randomized in a 1:1:1:1 ratio to receive one of the three doses of TTAX03 (10 mg of TTAX03 reconstituted in 150, 300, or 600 uL saline, i.e., subgroup A, B, and C, respectively) or to the saline control group (subgroup D). For all four groups, the same volume of reconstituted solution will be applied into the concave bowl of a bandage contact lens and inserted into the eye. The more severe eye will serve as the study eye, which meets inclusion and exclusion criteria. The treatment period is 5 days of continuous bandage contact lens wear. Safety follow-up without further treatment will continue for twelve weeks. After baseline (day 1) and completion of treatment, enrolled patients will be evaluated for safety and efficacy at Day 6 ± 1, Day 29 ± 3, Day 57 ± 3, and Day 85 ± 3.

• Study Type: Interventional
• Enrollment (Actual): 74
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • California
    • Berkeley, California, United States, 94720
      • University California Berkeley
  • Florida
    • Deerfield Beach, Florida, United States, 33064
      • Advanced Research, LLC.
  • Minnesota
    • Chaska, Minnesota, United States, 55318
      • Southwest Eye Care
  • Mississippi
    • Jackson, Mississippi, United States, 39216
      • University of Mississippi Medical Center
  • New Jersey
    • Dover, New Jersey, United States, 07801
      • Eye Associates of North Jersey
    • South Orange, New Jersey, United States, 07079
      • Northern New Jersey Eye Institute
  • North Carolina
    • Leland, North Carolina, United States, 28451
      • Wilmington Eye at Brunswick Forest
    • Shelby, North Carolina, United States, 28150
      • CORE, Inc. / Vita Eye Clinic
  • Texas
    • Austin, Texas, United States, 78749
      • Westlake Eye Specialists

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Age ≥ 18 years old.
2. Provision of signed and dated informed consent form.
3. Baseline VAS Dryness score ≥40
4. Baseline Ocular Surface Disease Index (OSDI) score ≥ 13.
5. Baseline corneal fluorescein staining with a total score ≥ 4 but ≤13, and ≥ 2 in at least one region, by the NEI Grading System† in the study eye.
6. In the opinion of the investigator, the participant can follow oral and written instructions.
7. In the opinion of the investigator, the participant can complete all study procedures and visits.

Exclusion Criteria:

1. Has a corneal ectatic disorder or other ocular surface disease such as limbal stem cell deficiency or a cicatricial component (e.g., symblepharon, fornix foreshortening and lid margin/lashes abnormality) caused for example by oGVHD, irradiation, chemical burns, trachoma, Stevens Johnson syndrome/toxic epidermal necrolysis, ocular cicatricial pemphigoid, or the destruction of conjunctival goblet cells (as with vitamin A deficiency).
2. Has severe blepharitis or severe obvious inflammation of the lid margin.
3. Has severe conjunctivochalasis.
4. Has nocturnal exposure e.g. incomplete closure or lagophthalmos or floppy eyelid.
5. Has epithelial basement membrane dystrophy (i.e., map-dot-fingerprint dystrophy) or history of recurrent corneal erosion
6. Has neuropathic corneal pain
7. Has a sunken globe (due to the reduction or loss of orbital fat)
8. Has severe DED per corneal fluorescein staining with a total score ≥ 13by the NEI Grading System in either eye.
9. Prior history of intolerance or adverse events using BCL.
10. Have had dissolvable or temporary plug(s) (including hydrogel or Lacrifill®) inserted within 6 months prior to screening.
11. Is using a nasal cholinergic agonist such as Tyrvaya in the last 30 days.
12. Has had previous ocular surgery in the study eye within the past 12 weeks.
13. Plans to use autologous serum drops during the study period in either eye.
14. Has elevated intraocular pressure >21mmHg in either eye requiring topical therapy.
15. Is currently using or plans to use topical glaucoma medication in either eye.
16. Has a known allergy to topical ophthalmic sodium fluorescein dye.
17. Has a known intolerance to unbuffered normal saline.
18. Prior adverse events of using human birth tissue product.
19. Is currently incarcerated or anticipates possible incarceration during the time course of this study.
20. Has tested positive for COVID-19 within 28 days prior to screening.
21. Is currently participating in any other type of eye-related clinical or research study that in the opinion of the investigator would confound or would risk confounding study results.
22. Has a condition or is in a situation which, in the investigator's opinion, may put the participant at significant risk, may confound study outcomes, or may significantly interfere with the participant's participation in the study.
23. Prior amniotic membrane product used for dry eye therapy in the study eye in the past 6 months.
24. Has Strabismus (squint/crossed eyes) or Amblyopia (lazy eye).

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 10mg TTAX03 reconstituted in 150 uL saline; For all four groups, 100 mL of reconstituted solution will be applied into the concave bowl of a bandage contact lens and inserted into the study eye.	Biological: TTAX03; Lyophilized and Micronized Particulate Human Amniotic and Umbilical Cord
Active Comparator: 10mg TTAX03 reconstituted in 300 uL saline; For all four groups, 100 mL of reconstituted solution will be applied into the concave bowl of a bandage contact lens and inserted into the study eye.	Biological: TTAX03; Lyophilized and Micronized Particulate Human Amniotic and Umbilical Cord
Active Comparator: 10mg TTAX03 reconstituted in 600 uL saline; For all four groups, 100 mL of reconstituted solution will be applied into the concave bowl of a bandage contact lens and inserted into the study eye.	Biological: TTAX03; Lyophilized and Micronized Particulate Human Amniotic and Umbilical Cord
Placebo Comparator: 300 uL of saline; For all four groups, 100 mL of reconstituted solution will be applied into the concave bowl of a bandage contact lens and inserted into the study eye.	Biological: Saline (NaCl 0,9 %) (placebo); 300 mL Sterile, preservative free 0.9% NaCl

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Determine 12 week ocular and general safety after application of TTAX03.	Incidence and nature of treatment emergent adverse events (TEAE) between TTAX03 and saline.	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of participants who show complete resolution of superficial punctate keratopathy, i.e., absence of corneal fluorescein staining, on Day 6 by group.	Determine the relationship between TTAX03 doses and efficacy per changes from baseline in complete resolution of superficial punctate keratopathy (defined by corneal fluorescein staining) at Day 6 when compared to the saline control.	Day 6
Mean change from baseline to Day 6 in corneal fluorescein staining (National Eye Institute (NEI) score) by group.	Examine the relationship between TTAX03 doses and changes from baseline in corneal epithelial staining at Day 6 when compared to the saline control.	Baseline to Day 6
Proportion of participants with clinically meaningful reduction in corneal fluorescein staining (NEI ≥ 3) from baseline to Day 6 by group.	Examine the relationship between TTAX03 doses and clinically meaningful changes from baseline vs. saline in corneal staining during the follow up to 12 weeks.	Baseline to Day 6
Proportion of participants with clinically meaningful reduction in corneal fluorescein staining (NEI ≥ 3) from baseline to Day 29 by group.	Examine the relationship between TTAX03 doses and clinically meaningful changes from baseline vs. saline in corneal staining during the follow up to 12 weeks.	Baseline to Day 29
Proportion of participants with clinically meaningful reduction in corneal fluorescein staining (NEI ≥ 3) from baseline to Day 57 by group.	Examine the relationship between TTAX03 doses and clinically meaningful changes from baseline vs. saline in corneal staining during the follow up to 12 weeks.	Baseline to Day 57
Proportion of participants with clinically meaningful reduction in corneal fluorescein staining (NEI ≥ 3) from baseline to Day 85 by group.	Examine the relationship between TTAX03 doses and clinically meaningful changes from baseline vs. saline in corneal staining during the follow up to 12 weeks.	Baseline to Day 85
Mean change in dry eye symptoms (measured by OSDI) from baseline on Day 6 by group.	Examine the relationship between TTAX03 doses and change of dry eye symptoms from baseline when compared to saline at Day 6.	Baseline to Day 6
Mean change in dry eye symptoms (measured by VAS) from baseline on Day 6 by group.	Examine the relationship between TTAX03 doses and change of dry eye symptoms from baseline when compared to saline at Day 6.	Baseline to Day 6
Mean change from baseline in BCVA (logMAR) measured by ETDRS chart on Day 6 by group.	Examine the relationship between TTAX03 doses and change of best corrected visual acuity (BCVA) from baseline when compared to saline at Day 6.	Baseline to Day 6
Proportion of participants who show complete resolution of superficial punctate keratopathy, i.e., absence of corneal fluorescein staining, on Day 29 by group.	Examine the relationship between TTAX03 doses and percentages of participants showing complete resolution of corneal staining from baseline when compared to saline during the follow up 12 weeks.	Day 29
Proportion of participants who show complete resolution of superficial punctate keratopathy, i.e., absence of corneal fluorescein staining, on Day 57 by group.	Examine the relationship between TTAX03 doses and percentages of participants showing complete resolution of corneal staining from baseline when compared to saline during the follow up 12 weeks.	Day 57
Proportion of participants who show complete resolution of superficial punctate keratopathy, i.e., absence of corneal fluorescein staining, on Day 85 by group.	Examine the relationship between TTAX03 doses and percentages of participants showing complete resolution of corneal staining from baseline when compared to saline during the follow up 12 weeks.	Day 85
Mean change from baseline in corneal fluorescein staining (National Eye Institute (NEI) score) on Day 29 by group.	Examine the relationship between TTAX03 doses and change of corneal epithelial staining from baseline between when compared to saline during the follow up to 12 weeks.	Baseline to Day 29
Mean change from baseline in corneal fluorescein staining (National Eye Institute (NEI) score) on Day 57 by group.	Examine the relationship between TTAX03 doses and change of corneal epithelial staining from baseline between when compared to saline during the follow up to 12 weeks.	Baseline to Baseline to Day 57
Mean change from baseline in corneal fluorescein staining (National Eye Institute (NEI) score) on Day 85 by group.	Examine the relationship between TTAX03 doses and change of corneal epithelial staining from baseline between when compared to saline during the follow up to 12 weeks.	Baseline to Baseline to Day 85
Mean change in dry eye symptoms (measured by OSDI) from baseline on Day 29 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 29
Mean change in dry eye symptoms (measured by OSDI) from baseline on Day 57 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 57
Mean change in dry eye symptoms (measured by OSDI) from baseline on Day 85 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 85
Mean change in dry eye symptoms (measured by VAS) from baseline on Day 29 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 29
Mean change in dry eye symptoms (measured by VAS) from baseline on Day 57 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 57
Mean change in dry eye symptoms (measured by VAS) from baseline on Day 85 by group.	Examine the relationship between TTAX03 doses and change of ocular dry eye symptoms from baseline when compared to saline during the follow up to 12 weeks.	Baseline to Day 85
Mean change from baseline in BCVA (logMAR) measured by ETDRS chart on Days 29 by group.	Examine the relationship between TTAX03 doses and change of BCVA from baseline when compared to saline during the follow up to 12 weeks.	Day 29
Mean change from baseline in BCVA (logMAR) measured by ETDRS chart on Day 57 by group.	Examine the relationship between TTAX03 doses and change of BCVA from baseline when compared to saline during the follow up to 12 weeks.	Day 57
Mean change from baseline in BCVA (logMAR) measured by ETDRS chart on Day 85 by group.	Examine the relationship between TTAX03 doses and change of BCVA from baseline when compared to saline during the follow up to 12 weeks.	Day 85

Collaborators and Investigators

• Sponsor: BioTissue Holdings, Inc

Study record dates

Study Major Dates

• Study Start (Actual): December 12, 2024
• Primary Completion (Actual): January 30, 2026
• Study Completion (Actual): January 30, 2026

Study Registration Dates

• First Submitted: January 13, 2025
• First Submitted That Met QC Criteria: January 16, 2025
• First Posted (Actual): January 17, 2025

Study Record Updates

• Last Update Posted (Actual): February 11, 2026
• Last Update Submitted That Met QC Criteria: February 9, 2026
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Dry Eye Disease
• Additional Relevant MeSH Terms: Eye Diseases; Lacrimal Apparatus Diseases; Dry Eye Syndromes; Inorganic Chemicals; Chlorine Compounds; Sodium Compounds; Chlorides; Hydrochloric Acid; Sodium Chloride
• Other Study ID Numbers: TTAX03-CR010

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No