Suprachoroidal Corticosteroid Administration: A Novel Route for Local Treatment of Noninfectious Uveitis

Debra A Goldstein, Diana Do, Glenn Noronha, Jennifer M Kissner, Sunil K Srivastava, Quan D Nguyen, Debra A Goldstein, Diana Do, Glenn Noronha, Jennifer M Kissner, Sunil K Srivastava, Quan D Nguyen

Abstract

Purpose: To evaluate the safety, tolerability, and preliminary efficacy of suprachoroidal injection of triamcinolone acetonide (TA) in patients with noninfectious uveitis.

Methods: In this Phase 1/2 open-label clinical study, a single suprachoroidal injection of 4-mg TA in 100 μL was performed in the study eye of patients with noninfectious intermediate, posterior, or pan-uveitis, and follow-up obtained for 26 weeks.

Results: Nine individuals with chronic uveitis were enrolled. There were 38 reported adverse events (AEs); most were mild or moderate in severity. Approximately half the AEs were ocular. The most common AE was reported by four subjects who experienced ocular pain at or near the time of the injection. All systemic AEs were unrelated to study drug. No steroid-related increases in intraocular pressure (IOP) were observed and no subject required IOP-lowering medication. All eight efficacy-evaluable subjects had improvements in visual acuity. Four subjects, who did not need additional therapy, had on average a greater than 2-line improvement in visual acuity through week 26. Three of four had macular edema at baseline, and two of three had at least a 20% reduction in macular edema at week 26.

Conclusions: The safety and preliminary efficacy data support further investigations of suprachoroidally administered TA as a therapeutic option for the treatment of noninfectious uveitis.

Translational relevance: Targeted suprachoroidal administration of corticosteroid is a potential local route for the treatment of ocular inflammatory disease, which merits further investigation. (www.ClinicalTrials.gov, NCT01789320).

Keywords: drug delivery; suprachoroidal space; triamcinolone acetonide; uveitis.

Figures

Figure 1
Figure 1
Injection into the suprachoroidal space.
Figure 2
Figure 2
IOP at each time-point: safety population.
Figure 3
Figure 3
Mean changes in visual acuity. No imputations were performed on the data.
Figure 4
Figure 4
Mean changes in ME. No imputations were performed on the data.

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