Allergan has announced new data, including the full results from the Phase 3 GEMINI 1 clinical study, evaluating the efficacy, safety and tolerability of investigational AGN-190584 (pilocarpine 1.25%) ophthalmic solution for the treatment of presbyopia.
Multiple data presentations at the 2021 ASCRS (American Society of Cataract and Refractive Surgery) Annual Meeting demonstrated that AGN-190584 met both its primary and key secondary efficacy endpoints with patients achieving near and intermediate vision gains. In addition, AGN-190584 showed no loss of distance vision, a rapid onset of action and sustained vision gains of up to six hours. Further details including additional efficacy and safety results are included in the "GEMINI 1 Study Results" section below.
GEMINI 1 data, in combination with data from the GEMINI 2 study, formed the basis of the AGN-190584 New Drug Application (NDA) currently under review with the U.S. Food and Drug Administration, which the agency is expected to act on by the end of 2021.
"Building upon our heritage in eye care, we are proud to be leading the development of a first-of-its-kind potential treatment option for those living with presbyopia. If approved by the FDA, AGN-190584 is expected to be the first eye drop specifically designed for presbyopia," said Michael R. Robinson, M.D., vice president, global therapeutic area head, eye care, AbbVie. "We are pleased with the favorable safety and efficacy results, as well as the rapid onset and duration of improvement in near and intermediate vision without impacting distance vision, from the Phase 3 GEMINI 1 clinical study."
Patient-reported outcomes presented at the meeting showed that patients who received AGN-190584 versus the vehicle (placebo) reported clinically meaningful and statistically significant greater improvement in ability and satisfaction related to near-vision reading as well as reduction in use of presbyopia coping mechanisms during the last seven days of the trial.
"Presbyopia is a common and progressive eye condition that makes it more difficult to focus on things up close and affects most adults over the age of 40. While not often known by name, the 128 million Americans living with presbyopia feel the condition's impact throughout their daily lives, often when looking at their cell phones, reading or trying to see a menu in a dimly lit restaurant. Additionally, our ever-increasing time spent on digital devices, from smart watches to smart phones, has put unprecedented demands on our vision," said George O. Waring IV, M.D., FACS, medical director, Waring Vision Institute, South Carolina, and GEMINI principal study investigator. "The positive GEMINI 1 findings support the potential of AGN-190584 as a first-line option for people living with presbyopia."
AGN-190584 is an investigational, novel optimized formulation of pilocarpine specifically designed for the treatment of presbyopia as a topical, once-daily drop delivered by a proprietary vehicle. The primary mechanism of action is through pupil constriction to enhance depth of focus and improve near and intermediate vision while maintaining pupillary response to different lighting conditions – an effect known as dynamic pupil modulation.
GEMINI 1 Study Results
The GEMINI 1 clinical study evaluated 323 participants randomized in a one-to-one ratio of vehicle (placebo) to AGN-190584 (pilocarpine 1.25%). AGN-190584 was instilled bilaterally (in both eyes), once daily, for 30 days in GEMINI 1 participants with presbyopia. The primary and key secondary endpoints were met with a statistically significant greater proportion of participants treated with AGN-190584 who gained three lines or more (the ability to read three additional lines on a reading chart) in mesopic (in low light), high contrast, binocular Distance Corrected Near Visual Acuity (DCNVA) at Day 30, Hour 3 (22.5%, p < 0.0001) and Hour 6 (9.7%, p = 0.0114) versus the vehicle. The results demonstrated AGN-190584 had a rapid onset of 15 minutes and duration of up to six hours in mesopic DCNVA without loss of distance vision after administration at Day 30. Additional endpoints evaluated showed that 75% of participants treated with AGN-190584 achieved a ≥2-line improvement in mesopic DCNVA; and 93% of participants achieved ≥20/40 vision in photopic (daylight) DCNVA. Improvements were also observed in Distance Corrected Intermediate Visual Acuity (DCIVA) for up to 10 hours at Day 30.
There were no treatment emergent serious adverse events observed in any AGN-190584 treated participants. The most common treatment emergent non-serious adverse event in AGN-190584 treated participants occurring at a frequency of >5% was headache. Most side effects were mild and transient in nature with only 1.2% of patients discontinuing due to adverse events.
Full news release: news.abbvie.com/article_display.cfm?article_id=12309