FDA approves iDose TR from Glaukos for reduction of IOP in OAG or ocular hypertension

(Image credit: Adobe Stock / monticellllo)

Glaukos announced the FDA has approved the New Drug Application (NDA) for a single administration per eye of travoprost intracameral implant (iDose TR) 75 mcg, a prostaglandin analog indicated for the reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG).¹ Travoprost intracameral implant is a long-duration, intracameral procedural pharmaceutical therapy designed to deliver around-the-clock therapeutic levels of a proprietary formulation of travoprost inside the eye for extended periods of time. The therapy is intended to improve the standard of care by addressing the ubiquitous patient non-compliance issues and chronic side effects associated with topical glaucoma medications.¹

Made from medical-grade titanium, iDose TR is implanted through the trabecular meshwork and back wall of Schlemm canal, directly into scleral tissue. Once implanted, 75 mcg of a novel, preservative-free, proprietary formulation of travoprost continuously elutes into the anterior chamber via membrane-controlled diffusion, allowing for 24/7 release of medication.

In the news release, Thomas Burns, Glaukos chairman and CEO, noted the approval of travoprost intracameral implant is a key milestone for the company after a lengthy journey since the inception of the original idea nearly 15 years ago.¹

“Today’s approval ushers in a new era of interventional glaucoma therapy by enabling a more proactive and reliable approach for patients in need,” Burns said in the news release.

Moreover, Burns noted travoprost intracameral implant could move the needle in glaucoma treatment.

“We believe iDose TR can be a transformative, novel technology able to fundamentally improve the treatment paradigm for patients with open-angle glaucoma or ocular hypertension,” he added in the news release. “We are grateful to the clinical investigators and study participants in the clinical trials for their instrumental roles in helping us reach this important advancement for glaucoma patient care.“

According to the news release, the FDA approval is based on results from two prospective, randomized, multicenter, double-masked, phase 3 pivotal trials (GC-010and GC-012) designed to compare the safety and efficacy of a single administration of 1 of 2 iDose TR models with different travoprost release rates (referred to as the fast- and slow release iDose TR models, respectively) to topical timolol ophthalmic solution, 0.5% BID (twice a day), in reducing IOP in subjects with open-angle glaucoma or ocular hypertension.¹

In total, the phase 3 trials randomized 1,150 subjects across 89 clinical sites. The FDA approval and phase 3 data referenced below is for the slow-release iDose TR model, consistent with the company’s NDA submission and commercialization plans.

Both phase 3 trials successfully achieved the pre-specified primary efficacy endpoints through 3 months and demonstrated a favorable tolerability and safety profile through 12 months. IOP reductions from baseline over the first 3 months were 6.6-8.4 mmHg in the iDose TR arm, versus 6.5-7.7 mmHg in the timolol control arm (mmHg range represents IOP reduction means across the 6 US FDA pre-specified timepoints of 8 am and 10 am at Day 10, week 6 and month 3). Based on these outcomes, the FDA concluded in the prescribing information that iDose TR demonstrated non-inferiority to timolol ophthalmic solution in IOP reduction during the first 3 months.

The FDA also noted that subsequently iDose TR did not demonstrate non-inferiority over the next 9 months.

At 12 months, 81% of iDose TR subjects were completely free of IOP-lowering topical medications across both trials. In both trials, iDose TR demonstrated excellent tolerability and subject retention with 98% of iDose TR subjects continuing in the trial at 12 months, versus 95% of timolol control subjects. In controlled studies, the most common ocular adverse reactions reported in 2% to 6% of iDose TR patients were increases in intraocular pressure, iritis, dry eye, and visual field defects, most of which were mild and transient in nature.

iDose TR is also supported by positive results from a phase 2b clinical trial, which were recently highlighted in a peer-reviewed publication in Drugs.² The study authors concluded, “The travoprost intraocular implant demonstrated robust IOP-lowering and substantially reduced topical IOP-lowering medication burden for up to 36 months following a single administration, while maintaining a favorable safety profile.”

Glaukos intends to commence initial commercial launch activities for iDose TR in the latter part of the first quarter of 2024. Glaukos has established a wholesale acquisition cost for iDose TR of $13,950, per dose (or implant).

John Berdahl, MD, a clinician and researcher at Vance Thompson Vision, noted the approval offers a new treatment option for eye care providers to consider.

“With the next generation of procedural pharmaceutical solutions for glaucoma such as iDose TR, we now have a new tool that will confront the standard legacy practice of relying on topical drops, which are known to cause uncomfortable side effects and present a myriad of challenges, such as treatment adherence, complex dosing regimens, and difficulty with self-administration,” Berdahl said in the news release. “The clinical data suggest that iDose TR is not only effective with a favorable safety profile, but it has potential to relieve patients from the burdens of prescription eye drops for an extended period of time. I look forward to adding this novel therapy into my treatment toolbox for the benefit of my patients.”

Alongside the iDose TR approval announcement, Glaukos is proud to introduce the iDose Your Dose Initiative. For every iDose TR sold, Glaukos pledges to make available an equal number of iDose TR units for qualifying charitable donation requests in the US and around the globe for recipients that satisfy independent eligibility requirements.

References

1. Glaukos announces FDA approval of iDose TR (travoprost intracameral implant.) news release Published December 14, 2023. Accessed December 14, 2023.

2. Berdahl JP, Sarkisian SR, Ang RE, et al. Efficacy and safety of the travoprost intraocular implant in reducing topical IOP-lowering medication burden in patients with open-angle glaucoma or ocular hypertension. Drugs (2023). https://doi.org/10.1007/s40265-023-01973-7