Piiloset Trehalose Emulsion Eye Drop Study in Moderate or Severe Dry Eye

The study evaluates the safety, ocular tolerability and efficacy of emulsion eye drops with sacha inchi seed oil, trehalose and hyaluronic acid in the treatment of moderate or severe dry eye in adult patients. The investigative device is studied in comparison with control eye drops containing hyaluronic acid for up to 30 days.

According to the current view on dry eye disease, tear film instability, tear film hyperosmolarity, and ocular surface inflammation and damage are identified as etiological factors. The first-line medicinal management options include ocular lubricants such as eye drops and sprays. Emulsion eye drops are a relatively recent entity among topical therapies with an intention to account for deficiencies in the outermost lipid layer of the tear film.

Piiloset Trehalose Emulsion Eye Drops was developed to target and restore the three main layers (mucin, aqueous, and lipid) of the tear film and to counteract the key etiological factors leading to dry eye. Hyaluronic acid and the oil component are intended to restore tear film instability, the hypo-osmolar composition and trehalose as an osmoprotectant are intended to protect the ocular epithelium against hyperosmolarity, and ocular surface inflammation and cellular damage are prevented by the cytoprotective and/or anti-oxidative action of hyaluronic acid, trehalose, and sacha inchi oil components. Additional water binding in the tear film is provided by hyaluronic acid, trehalose, and glycerol. Lubricating the ocular surface by high-molecular-weight hyaluronic acid will extend the precorneal retention time. Adjustments made to certain physical and chemical parameters in the formulation are anticipated to improve tear film spreading and adhesion. The optically clear o/w emulsion formulation is free of preservatives, materials of animal origin, phosphates, or alcohol. The combined action of the individual components is expected to produce clinically relevant mitigation of the signs and symptoms of dry eye.

The study comprises three Parts with scheduled visits on Day 1 (all Parts) and on end-of-study date (Parts 2 and 3) to the study centre. Each study subject will participate in no more than one Part of the study.

Eligibility Criteria:
Inclusion Criteria:

1. Ability and willingness to give informed written consent prior to any screening procedure after explanation of the nature and possible consequences of the study.
2. Age between 18 and 80 years.
3. At least two the following conditions (A and B):

   A. Symptomatic dry eye with OSDI score ≥20. AND B1. Tear film break-up time (TBUT) \<10 seconds. OR B2. Positive ocular (corneal and conjunctival) staining pattern
4. Body weight at least 45 kg.
5. Under stable topical and/or systemic therapy for at least 4 weeks before the study procedures and apparent ability and willingness to abstain from other therapies until completion of the study period.
6. Ability and willingness to self-administer eye drops.
7. Ability and willingness to understand and fill in the OSDI questionnaire.
8. Ability and willingness to comply with the study protocol and other study-related procedures.

Exclusion Criteria:

1. History of ocular surgery, trauma, or refractive laser vision correction procedure less than 3 months earlier.
2. Evidence of acute or chronic infection in the cornea or conjunctiva.
3. Diagnosis of Sjögren's syndrome.
4. Unwillingness or apparent disability to discontinue contact lens use during study period and at least one week before the first dosing day.
5. Current ocular allergy symptoms.
6. Known allergy to any constituent of the trehalose emulsion eye drops or control eye drops.
7. Currently pregnant, nursing or planning to become pregnant before completion of the study period.
8. Any other condition that may, in the Investigator's opinion, jeopardize the safety or availability of the subject or adherence to the study protocol or may interfere with the interpretation of the results and would thus make the subject inappropriate for entry in the study.