Study to Compare the Safety and Efficacy of ALZ-1101 to Latanoprost in Patients With Intraocular Pressure Inadequately Controlled by Latanoprost

Inclusion Criteria:

1. Age 18 years or older.
2. Primary open-angle glaucoma or OH on treatment with latanoprost 0.005% QD.
3. At least one eye with IOP > 18 mm Hg but ≤ 28 mm Hg at all time points (8 AM, 10 AM, and 4 PM) while on latanoprost monotherapy QD at Screening and Baseline (Day 0) visits. Measurements will be taken each visit at 8 AM, 10 AM, and 4 PM (each ± 30 minutes), with AM measurements of IOP at least 2 hours apart. Screening must be at least one week before but within 2 weeks prior to Baseline.
4. On latanoprost 0.005% QD for at least 4 weeks prior to randomization.
5. Shaffer gonioscopic grade of ≥ 3 (in at least 3 quadrants) in both eyes.
6. Stable corrected Snellen visual acuity (VA) better than 20/200 in the study eye.
7. Central corneal thickness between 480-620 μm in the study eye.
8. Female subjects must be 1-year postmenopausal, surgically sterilized, or women of childbearing potential with a negative urine pregnancy test at Visit 1. Women of childbearing potential must use an acceptable form of contraception throughout the study. Acceptable methods include the use of at least one of the following: intrauterine (intrauterine device), hormonal (oral, injection, patch, implant, ring), barrier with spermicide (condom, diaphragm), or abstinence.
9. Provide signed written consent prior to participation in any study-related procedures.

Exclusion Criteria:

1. A mean deviation of < -20 dB on visual field (VF) assessment.
2. Presence of a scotoma within 5°of fixation on VF.
3. Aphakia.
4. Use of any antiglaucoma medication in addition to latanoprost QD within 2 weeks prior to Visit 1 or during the study period.
5. Use of any topical ophthalmic steroid or nonsteroidal anti-inflammatory drug (NSAID) within 2 weeks prior to Visit 1 or during the study period.
6. Use of systemic carbonic anhydrase inhibitor within 2 weeks prior to Visit 1 or during the study period.
7. Ocular surgery or ocular laser treatment of any kind within 3 months prior to Visit 1 or during the study period.
8. Any history of glaucoma surgery (laser or non-laser).
9. History of ocular allergy/inflammation and/or severe blepharitis and/or uveitis. Seasonal allergic conjunctivitis is acceptable (avoid enrollment of subjects who may experience seasonal flare-up during the study period). Mild blepharitis/blepharoconjunctivitis, typically associated with prostaglandin usage, is acceptable.
10. History of ocular trauma or ocular infection within 3 months of Visit 1.
11. History of herpes simplex keratitis.
12. Current proliferative diabetic retinopathy or age-related macular degeneration, unless deemed not clinically significant by the Investigator.
13. Severe dry eye (eg, clinically relevant superficial punctate keratitis, epithelial erosions of the cornea, and/or use of dry eye medication [including artificial tears] with a frequency exceeding 8 applications per day).
14. Contact lens wear within one week prior to Visit 1 or during the study period (contact lens wear in an untreated fellow eye is allowed).
15. Angle closure or occludable angles (Shaffer gonioscopic grade of < 3).
16. Cataract that compromises visualization of the fundus.
17. Cup-to-disc (C/D) ratio of > 0.8.
18. Any secondary glaucoma or OH (eg, congenital glaucoma, closed-angle glaucoma, uveitic glaucoma, or pseudoexfoliation syndrome).
19. Pregnancy or lactation.
20. Uncontrolled asthma (defined as asthma that does not respond to the maximum guideline directed therapy).
21. Allergy to prostaglandin analogues or carbonic anhydrase inhibitors.
22. Allergy to benzalkonium chloride.
23. History of moderate or severe renal or hepatic impairment.
24. Participation in any study of an investigational product within 30 days prior to Visit 1 or at any time during the study period.