Study of the Safety and Efficacy of OmegaD Softgels in the Treatment of Dry Eye Disease

• Sponsor: OmegaD LLC (Industry)
• Overall Status: Completed
• CT.gov ID: NCT02980224
• Collaborator: (none)
• Enrollment: 180
• Locations: 11
• Arms: 2
• Actual Duration (Months): 4
• Patients Per Site: 16.4
• Patients Per Site Per Month: 4

Study Details

Study Description

Brief Summary

This is a phase 3 study to evaluate the safety and efficacy of OmegaD softgels for the treatment of dry eye disease. A daily dose of 2 OmegaD softgels dosed orally BID will be compared to 2 placebo softgels dosed orally BID for 84 days. Approximately 164 subjects will be evaluated for their signs and symptoms of dry eye disease and for safety throughout the study.

Condition or Disease	Intervention/Treatment	Phase
Dry Eye	Drug: OmegaD; Drug: Placebo	Phase 3

Detailed Description

Inflammation is a key component of dry eye disease. Increasing the systemic levels of omega-3 fatty acids relative to omega-6 levels can mediate immune responses. Evaluating whether omega-3 supplementation can improve dry eye disease signs, symptoms and associated measures of inflammation may present a new therapeutic option for dry eye disease.

The primary objective of this study is to evaluate the safety and efficacy of twice daily (BID) dosing of OmegaD softgels in subjects with dry eye disease.

Male and female subjects between 18 years and 90 years of age, with patient-reported dry eye symptoms and a clinical diagnosis of dry eye disease supported by global clinical assessment will be screened and enrolled. Each subject must have, in at least one eye, tear osmolarity of ≥ 312 mOsm/L and meibomian gland dysfunction as defined by a grade of 1 or 2 on the meibomian orifice size scale at both Screening and Baseline in at least one eye. In addition, Tear break up time (TBUT) must be ≤ 7 seconds in both eyes at both Screening and Baseline and the Schirmer's test score in both eye(s) must be ≥ 5 mm at Baseline.

Approximately 164 subjects will be randomized (1:1) to 1 of 2 treatment arms and treated for 84 days (12 weeks) with either OmegaD softgels; 2 softgels BID or placebo softgels; 2 softgels BID. The study will be double-masked with OmegaD and placebo being identical-appearing softgels.

Subjects will participate in safety and efficacy assessments throughout the study. Efficacy assessments will include, tear osmolarity, meibomian gland dysfunction grading, TBUT, Schirmer's Test, and dry eye symptoms based on the OSDI questionnaire, Safety assessments will include, slit lamp examination and adverse events.

Study Design

• Study Type: Interventional
• Actual Enrollment: 180 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Randomized, Multicenter, Double-Masked, Placebo-Controlled Study of the Safety and Efficacy of OmegaD Softgels in the Treatment of Dry Eye Disease
• Actual Study Start Date: Oct 1, 2016
• Actual Primary Completion Date: Feb 1, 2017
• Actual Study Completion Date: Feb 1, 2017

Arms and Interventions

Arm	Intervention/Treatment
Experimental: OmegaD OmegaD Softgels	Drug: OmegaD; OmegaD Softgels
Placebo Comparator: Placebo Placebo Softgels	Drug: Placebo; Placebo Softgels

Outcome Measures

Primary Outcome Measures

1. Change From Baseline in Tear Break up Time(TBUT ) at Day 84 [Baseline and 84 Days]

   The difference between Baseline (Day 1) and Day 84 in Tear Break Up Time. TBUT is a clinical test used to assess for evaporative dry eye disease. To measure TBUT, fluorescein is instilled into the patient's tear film and the patient is asked not to blink while the tear film is observed under a broad beam of cobalt blue illumination. The TBUT is recorded as the number of seconds that elapse between the last blink and the appearance of the first dry spot in the tear film, as observed via slit lamp examination.

2. Change From Baseline in Dry Eye Symptom Scores (OSDI Questionnaire) [Baseline and 84 Days]

   Difference from Baseline (Day 1) to Day 84 in the OSDI Questionnaire (dry eye symptom score). Responses evaluate a subjects experience of a symptom on the following scale: 0 (none of the time) (some of the time) (half of the time) (most of the time) (all of the time) The 12 questions are as follows: Have you experienced any of the following during the last week: Eyes that are sensitive to light Eyes that feel gritty Painful or sore eyes Blurred vision Poor vision Have problems with your eyes limited you in performance of any of the following during the last week: Reading Driving at night Working with a computer or bank machine (ATM) Watching TV Have your eyes felt uncomfortable in any of the following situations during the last week: Windy conditions Places or areas with low humidity (very dry) Areas that are air conditioned A higher score means a worse outcome. The scores for the 12 questions are added together.

Secondary Outcome Measures

1. The Frequency and Severity of Adverse Events [84 Days]

   Number and Percentage of Subjects Reporting Adverse Events

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 90 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

1. Subjects age ≥ 18 years and ≤ 90 years on the date of informed consent.

2. All subjects must provide signed written consent prior to participation in any study related procedures.

3. Patient-reported dry eye symptoms.

4. Clinical diagnosis of dry eye disease supported by global clinical assessment.

5. Presence of tear osmolarity in at least one eye ≥ 312 mOsm/L at both Screening and Baseline.

6. Presence of meibomian gland dysfunction as defined by a grade of 1 or 2 on the meibomian orifice size scale in at least one eye at both Screening and Baseline. The qualifying osmolarity level and meibomian orifice size grade must be present in the same eye at both Screening and Baseline if only one eye qualifies.

7. Female subjects of childbearing potential must have a negative urine pregnancy test at Screening. Women of childbearing potential (i.e., women who are not either postmenopausal for one year or surgically sterile) must use an acceptable form of contraception throughout the study.

Exclusion Criteria:

1. Allergy to fish oil or safflower oil (component of placebo softgels) or any component of the softgel material.

2. Schirmer's test score < 5 mm at Screening in either eye.

3. Tear break-up time > 7 seconds at Screening or Baseline in either eye.

4. Clinically significant eyelid deformity or eyelid movement disorder that is caused by conditions such as notch deformity, incomplete lid closure, entropion, ectropion, hordeolum or chalazion.

5. Active seasonal and/or perennial allergic conjunctivitis or rhinitis.

6. Previous ocular disease leaving sequelae or requiring current topical eye therapy other than for dry eye disease, including, but not limited to: active corneal or conjunctival infection of the eye and ocular surface scarring.

7. History or presence of abnormal nasolacrimal drainage.

8. Laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) performed within one year prior to Screening and throughout the study period.

9. Ophthalmic drop use within 2 hours prior to any study visit. Any over-the-counter (OTC) artificial tear should be continued at the same frequency and with no change in drop brand.

10. Contact lens wear within 12 hours prior to any study visit; subjects determined to have worn contact lenses within 12 hours must be rescheduled.

11. Punctal cauterization or punctal plug placement within 60 days prior to Screening and throughout the study period.

12. Started or changed the dose of systemic medications known to affect tear production within 30 days prior to Screening and throughout the study period. These include but are not limited to the following medications:

• Immunomodulators

• Antihistamines

• Tricyclic antidepressants

• Diuretics

• Corticosteroids (intranasal, inhaled, topical dermatological, and perianal steroids are permitted).

1. Use of any topical prescription ophthalmic medications (including cyclosporine [Restasis®, steroids, nonsteroidal anti-inflammatory drugs [NSAIDs], anti-glaucoma medications), oral tetracyclines or topical macrolides, oral nutraceuticals [fish, flax, black currant seed oils, etc.] within 21 days prior to Screening and throughout the study period.

2. Chronic daily use (defined as > 7 consecutive days at the recommended dosing frequency) of oral NSAIDs during the study period. ANY use of oral NSAIDS during the study period must be discussed with the Medical Monitor.

3. Participation in any drug or device clinical investigation within 30 days prior to entry into this study and/or during the period of study participation.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1		Artesia	California	United States
2		Mission Hills	California	United States
3		Rancho Cordova	California	United States
4		Danbury	Connecticut	United States
5		Crystal River	Florida	United States
6		Deerfield Beach	Florida	United States
7		Fort Myers	Florida	United States
8		Pittsburg	Kansas	United States
9		Edgewood	Kentucky	United States
10		Cincinnati	Ohio	United States
11		Cleveland	Ohio	United States

Sponsors and Collaborators

• OmegaD LLC

Investigators

None specified.

Study Documents (Full-Text)

• Study Protocol - Jun 24, 2016
• Statistical Analysis Plan - Jun 6, 2017

More Information

Publications

None provided.

• Responsible Party: OmegaD LLC
• ClinicalTrials.gov Identifier: NCT02980224
• Other Study ID Numbers: OmegaD-2016-001
• First Posted: Dec 2, 2016
• Last Update Posted: Dec 13, 2019
• Last Verified: Nov 1, 2019

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Additional relevant MeSH terms: Dry Eye Syndromes; Keratoconjunctivitis Sicca; Eye Diseases

Study Results

Participant Flow

Arm/Group Title	OmegaD	Placebo
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels	Placebo Softgels Placebo: Placebo Softgels
Period Title: Overall Study
STARTED	89	91
COMPLETED	85	88
NOT COMPLETED	4	3

Baseline Characteristics

Arm/Group Title	OmegaD	Placebo	Total
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels	Placebo Softgels Placebo: Placebo Softgels	Total of all reporting groups
Overall Participants	89	91	180
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	59.6 (12.78)	61.5 (12.53)	60.6 (12.66)
Sex: Female, Male (Count of Participants)
Female	78 87.6%	71 78%	149 82.8%
Male	11 12.4%	20 22%	31 17.2%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino	29 32.6%	23 25.3%	52 28.9%
Not Hispanic or Latino	60 67.4%	68 74.7%	128 71.1%
Unknown or Not Reported	0 0%	0 0%	0 0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native	0 0%	0 0%	0 0%
Asian	3 3.4%	5 5.5%	8 4.4%
Native Hawaiian or Other Pacific Islander	0 0%	0 0%	0 0%
Black or African American	7 7.9%	4 4.4%	11 6.1%
White	79 88.8%	82 90.1%	161 89.4%
More than one race	0 0%	0 0%	0 0%
Unknown or Not Reported	0 0%	0 0%	0 0%
Region of Enrollment (Count of Participants)
United States	89 100%	91 100%	180 100%

Outcome Measures

1. Primary Outcome

Title	Change From Baseline in Tear Break up Time(TBUT ) at Day 84
Description	The difference between Baseline (Day 1) and Day 84 in Tear Break Up Time. TBUT is a clinical test used to assess for evaporative dry eye disease. To measure TBUT, fluorescein is instilled into the patient's tear film and the patient is asked not to blink while the tear film is observed under a broad beam of cobalt blue illumination. The TBUT is recorded as the number of seconds that elapse between the last blink and the appearance of the first dry spot in the tear film, as observed via slit lamp examination.
Time Frame	Baseline and 84 Days

Outcome Measure Data

Analysis Population Description

Intent to Treat Population

Arm/Group Title	OmegaD	Placebo
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels	Placebo Softgels Placebo: Placebo Softgels
Measure Participants	89	91
Least Squares Mean (Standard Error) [seconds]	1.45 (0.261)	1.23 (0.260)

2. Primary Outcome

Title	Change From Baseline in Dry Eye Symptom Scores (OSDI Questionnaire)
Description	Difference from Baseline (Day 1) to Day 84 in the OSDI Questionnaire (dry eye symptom score). Responses evaluate a subjects experience of a symptom on the following scale: 0 (none of the time) (some of the time) (half of the time) (most of the time) (all of the time) The 12 questions are as follows: Have you experienced any of the following during the last week: Eyes that are sensitive to light Eyes that feel gritty Painful or sore eyes Blurred vision Poor vision Have problems with your eyes limited you in performance of any of the following during the last week: Reading Driving at night Working with a computer or bank machine (ATM) Watching TV Have your eyes felt uncomfortable in any of the following situations during the last week: Windy conditions Places or areas with low humidity (very dry) Areas that are air conditioned A higher score means a worse outcome. The scores for the 12 questions are added together.
Time Frame	Baseline and 84 Days

Outcome Measure Data

Analysis Population Description

Intent to Treat Population

Arm/Group Title	OmegaD	Placebo
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels	Placebo Softgels Placebo: Placebo Softgels
Measure Participants	89	91
Least Squares Mean (Standard Error) [score on a scale]	-13.39 (1.804)	-15.04 (1.794)

3. Secondary Outcome

Title	The Frequency and Severity of Adverse Events
Description	Number and Percentage of Subjects Reporting Adverse Events
Time Frame	84 Days

Outcome Measure Data

Analysis Population Description

Safety Population

Arm/Group Title	OmegaD	Placebo
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels	Placebo Softgels Placebo: Placebo Softgels
Measure Participants	89	91
Number of Subjects Reporting AEs	23 25.8%	16 17.6%
Number of Subjects Reporting 0 AEs	66 74.2%	75 82.4%
Number of Subjects Reporting 1 AE	17 19.1%	9 9.9%
Number of Subjects Reporting >1 AE	6 6.7%	7 7.7%
Number of Serious AEs	0 0%	0 0%
Subjects Reporting AEs leading to Discontinuation	4 4.5%	1 1.1%
Subjects with AEs leading to Drug Interrupti	1 1.1%	0 0%
Deaths	0 0%	0 0%

Adverse Events

Time Frame	84 Days
Arm/Group Title	OmegaD		Placebo
Arm/Group Description	OmegaD Softgels OmegaD: OmegaD Softgels		Placebo Softgels Placebo: Placebo Softgels
All Cause Mortality
	OmegaD		Placebo
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/89 (0%)		0/91 (0%)
Serious Adverse Events
	OmegaD		Placebo
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/89 (0%)		0/91 (0%)
Other (Not Including Serious) Adverse Events
	OmegaD		Placebo
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	12/89 (13.5%)		1/91 (1.1%)
Gastrointestinal disorders
Diarrhoea	4/89 (4.5%)	4	0/91 (0%)	0
Abdominal discomfort	2/89 (2.2%)	2	0/91 (0%)	0
Abdominal Pain	2/89 (2.2%)	2	0/91 (0%)	0
Infections and infestations
Upper Respiratory Tract Infection	4/89 (4.5%)	4	1/91 (1.1%)	1

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.