Date
2020-01-28- Confirmed statistical significance in both objective endpoint (Sign) and subjective endpoint (Symptom)
- Statistical significance achieved for the sign endpoints, CCSS (p=0.0239), a measure of improvement in central corneal damage, and TCSS (p=0.0452), a measure of improvement across all corneal regions.
- Statistical significance achieved for the symptom endpoint, EDS (Eye Dryness Score, p=0.0334)
HanAll Biopharma
and Daewoong Pharmaceutical announced topline results from the first US Phase 3
study of HL036 for treatment of dry eye (VELOS-2 study) at a press conference
on January 21st.
The VELOS-2
study was conducted in dry eye patients across 12 clinical sites in the United
States in collaboration with Ora Inc., a US-based ophthalmic CRO (Contract
Research Organization). 637 patients were divided into 2 groups to receive
HL036 ophthalmic solution 0.25% or Placebo twice daily for 8 weeks.
For efficacy
evaluations, the objective endpoint (Sign) was measured by assessing the improvement
of corneal damage at each corneal area including, superior (SCSS), central
(CCSS), and inferior (ICSS), and also the total sum of these corneal areas
(TCSS). The subjective endpoint (Symptom) was measured by the Ocular Discomfort
Score (ODS), a patient-reported assessment of eye discomfort, and Eye Dryness
Score (EDS), a patient-reported evaluation of eye dryness. Safety evaluations
included all adverse events, not limited to ophthalmic events, that occurred in
both groups during the dosing period and analyzed rates between the two groups
and association of adverse events to drug exposure.
The VELOS-2 study
confirmed statistical significance of HL036 0.25% ophthalmic solution in the
endpoints CCSS (p=0.0239), a measure of improvement in central corneal damage, and TCSS (p=0.0452), a
measure of improvement across
total corneal regions. Achievement of statistical significance in TCSS and CCSS
has higher clinical importance than significance observed in ICSS from the
HL036 Phase 2 (VELOS-1) study, because TCSS and CCSS reflect ocular surface
damage in the most sensitive areas of the cornea and its effect on vision, while
ICSS only reflects damage in the lower corneal zone where staining can occur
even in normal subjects.
In symptom
evaluations, HL036 ophthalmic solution 0.25% demonstrated significant improvement
in Ocular Discomfort Score (ODS) from week 2 (p=0.0624) and week 4 (p=0.0570)
compared to placebo, but did not achieve statistical significance (p<0.05)
at week 8 due to increased placebo effect commonly seen in dry eye studies. However,
the study confirmed statistical significance in improving Eye Dryness Score
(EDS) at week 8 (p=0.0334), which was used in competitor product Xiidra’s clinical
studies as a symptom endpoint.
Most adverse
events during the clinical study were mild in severity and there was no
difference in rates between
the HL036 0.25% ophthalmic solution and placebo groups.
HanAll Biopharma’s
CEO, Dr. Seung Kook Park commented, “The VELOS-2 study did not meet the primary
endpoint of ICSS, but the achievement of statistical significance in CCSS and
TCSS is a compelling milestone in HL036 development as these endpoints are more
clinically and commercially meaningful. As a competitor’s product Xiidra was
FDA-approved through ICSS (inferior), HL036 has potential to be a more
commercially competitive product if HL036 is approved by confirming
significance in CCSS or TCSS, which demonstrates efficacy across the total
corneal regions.
Based on the
results of this study, HanAll Biopharma and Daewoong Pharmaceutical will
proceed with a second Phase 3 study as planned, and in parallel, engage in
licensing-out to global partners.
The final results of the first Phase 3 (VELOS-2) study will be presented at upcoming international ophthalmologic meetings after completion of biomarker and sub-group analyses.