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PresbyopiaPhase 3GEMINI 1NCT03804268

Efficacy Study of Pilocarpine HCl Ophthalmic Solution (AGN-190584) in Participants With Presbyopia

A Phase 3 study testing Pilocarpine HCl Ophthalmic Solution in people with Presbyopia, run by Allergan at 36 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A study to evaluate the efficacy, safety, and pharmacokinetics of pilocarpine hydrochloride (HCl) ophthalmic solution (AGN-190584) when administered bilaterally, once daily for 30 days in participants with presbyopia. Read more about this study

Who is it for?
Ages 40 to 55 years
Conditions the study is for
Presbyopia
What is being tested?
Pilocarpine HCl Ophthalmic Solution
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
323 participants
Where
36 sitesUnited States
Study dates
21 Dec 2018to 31 Oct 2019
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Subjective complaints of poor near vision that impact activities of daily living

Who cannot join

  • History of cataract surgery, phakic intraocular lens surgery, corneal inlay surgery, radial keratotomy, or any intraocular surgery
  • Use of any topical ophthalmic medications, including artificial tears other than the study medications during the study
  • Use of temporary or permanent punctal plugs or history of punctal cautery in one or both eyes
  • Corneal abnormalities (including keratoconus, corneal scar, Fuchs' endothelial dystrophy, guttata, or edema) in either eye that are likely to interfere with visual acuity
  • Narrow iridocorneal angles (Shaffer grade ≤2 or lower on gonioscopy examination), history of angle-closure glaucoma, or previous iridotomy
  • Diagnosis of any type of glaucoma or ocular hypertension

Trial locations and contacts

36 sites in 1 country.

36 sites in 1 country

United States36 sites
  • Assil Eye Institute

    Beverly Hills, California, 90210

  • The Eye Associates

    Bradenton, Florida, 34209

  • Hill Country Eye Center

    Cedar Park, Texas, 78613

  • Arizona Eye Center

    Chandler, Arizona, 85224

  • Mundorf Eye Center

    Charlotte, North Carolina, 28204

  • Haas Vision Center

    Colorado Springs, Colorado, 80919

  • The Ohio State University

    Columbus, Ohio, 43212

  • Scott & Christie and Associates, PC

    Cranberry Township, Pennsylvania, 16066

  • Key-Whitman Eye Center

    Dallas, Texas, 75243

  • Danbury Eye Physicians and Surgeons P.C.

    Danbury, Connecticut, 06810

  • Bruce Segal, MD

    Delray Beach, Florida, 33484

  • Hoopes, Durrie, Rivera Research

    Draper, Utah, 84020

  • Seidenberg Protzko Eye Associates

    Havre de Grace, Maryland, 21078

  • Direct Helpers Research Center

    Hialeah, Florida, 33012

  • Research Centers of America

    Hollywood, Florida, 33024

  • Price Vision Group

    Indianapolis, Indiana, 46260

  • Tauber Eye Center

    Kansas City, Missouri, 64111

  • Sabates Eye Centers

    Leawood, Kansas, 66211

  • American Institute of Research

    Los Angeles, California, 90017

  • The Eye Care Institute

    Louisville, Kentucky, 40206

  • Florida Eye Associates

    Melbourne, Florida, 32901

  • Southern College of Optometry

    Memphis, Tennessee, 38104

  • Nashville Vision Associates

    Nashville, Tennessee, 37205

  • Eye Research Foundation

    Newport Beach, California, 92663

  • Devers Eye Institute

    Portland, Oregon, 97210

  • Alterman, Modi & Wolter

    Poughkeepsie, New York, 12603

  • EyeCare Professionals DWA Insight Research Clinic, LLC

    Powell, Ohio, 43065

  • Martel Eye Medical Group

    Rancho Cordova, California, 95670

  • Black Hills Regional Eye Institute

    Rapid City, South Dakota, 57701

  • Rochester Ophthalmological Group, PC

    Rochester, New York, 14618

  • Grutzmacher & Lewis, A Medical Corporation DBA Sacramento Eye Consultants

    Sacramento, California, 95815

  • PNV Clinical Research LLC

    San Antonio, Texas, 78229

  • R and R Eye Research, LLC

    San Antonio, Texas, 78229

  • Schwartz Laser Eye Center

    Scottsdale, Arizona, 85260

  • Vance Thompson Vision

    Sioux Falls, South Dakota, 57108

  • USF Eye Institute

    Tampa, Florida, 33612

Other trials in United States

About this study

Official title: A Phase 3, Multicenter, Double-Masked, Randomized, Vehicle-Controlled, Parallel-Group Study Evaluating the Safety and Efficacy of AGN-190584 in Participants With Presbyopia

A study to evaluate the efficacy, safety, and pharmacokinetics of pilocarpine hydrochloride (HCl) ophthalmic solution (AGN-190584) when administered bilaterally, once daily for 30 days in participants with presbyopia.

Conditions
Presbyopia
Being tested
Vehicle, Pilocarpine HCl Ophthalmic Solution
Medical subject headings
Presbyopia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • VehicleOther

    Vehicle, one drop in each eye, once daily, for up to 30 days.

  • Pilocarpine HCl Ophthalmic SolutionDrug

    Also called AGN-190584, VUITY

    Pilocarpine HCl ophthalmic solution 1.25%, one drop in each eye, once daily, for up to 30 days.

Study groups in NCT03804268
Study groupRoleWhat they receive
VehiclePlacebo comparatorParticipants received one drop of vehicle in each eye, once daily, for up to 30 days.
Receives: Other: Vehicle
Pilocarpine HCl Ophthalmic SolutionExperimentalParticipants received one drop of pilocarpine HCl ophthalmic solution 1.25% in each eye, once daily, for up to 30 days.
Receives: Drug: Pilocarpine HCl Ophthalmic Solution

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Gaining 3 Lines or More in Mesopic, High-contrast, Binocular Distance-Corrected Near Visual Acuity (DCNVA) at Day 30, Hour 3

    Visual acuity for near (40 centimeters (cm)) target was measured in mesopic conditions using an eye chart. Mesopic condition was defined as low lighting 3.2 to 3.5 candelas per square meter (cd/m^2) measured at the target. Percentage of participants with 3 lines or more improvement from Baseline in mesopic, high-contrast DCNVA are reported.

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

Secondary outcomes (12)
  1. Percentage of Participants Gaining 3 Lines or More in Mesopic, High-contrast, Binocular Distance-Corrected Near Visual Acuity (DCNVA) at Day 30, Hour 6

    Visual acuity for near (40 cm) target was measured in mesopic conditions using an eye chart. Mesopic condition was defined as low lighting 3.2 to 3.5 candelas per square meter measured at the target. Percentage of participants with 3 lines or more improvement from Baseline in mesopic, high-contrast DCNVA are reported.

    Measured: Baseline (Day 1) to Day 30 (Hour 6)

  2. Percentage of Participants Gaining 3-lines or More in Mesopic, High-contrast, Binocular, DCNVA at Day 30, Hour 8

    Visual acuity for near (40 cm) target was measured in mesopic conditions using an eye chart. Mesopic condition was defined as low lighting 3.2 to 3.5 candelas per square meter measured at the target. Percentage of participants with 3 lines or more improvement from Baseline in mesopic, high-contrast DCNVA are reported.

    Measured: Baseline (Day 1) to Day 30 (Hour 8)

  3. Change From Baseline in Mesopic, High-contrast, Binocular DCNVA Letters at Day 30, Hour 0.5

    Visual acuity for near (40 cm) target was measured in mesopic conditions using an eye chart. Mesopic condition was defined as low lighting 3.2 to 3.5 cd/m^2 measured at the target. A positive change from Baseline indicates improvement in visual acuity. Mixed effect model for repeated measures (MMRM) was used for analyses.

    Measured: Baseline (Day 1) to Day 30 (Hour 0.5)

  4. Percentage of Participants Achieving 20/40 or Better in Photopic, High-contrast, Binocular, DCNVA at Day 30, Hour 1

    Visual acuity for near (40 cm) target was measured in photopic conditions using an eye chart. Photopic condition was defined as high lighting ≥80 cd/m^2 measured at the target. Percentage of participants achieving 20/40 or better in photopic, high-contrast, binocular, DCNVA are reported.

    Measured: Day 30 (Hour 1)

  5. Mean Change From Baseline in Mesopic Near Vision Presbyopia Task-based Questionnaire (NVPTQ) Performance Score at Day 30, Hour 3

    NVPTQ had 12 questions on 4 reading tasks(reading a paragraph from book, excerpts from an article in newspaper, portion of a nutrition label, and a section from restaurant menu). Participants completed specific reading tasks under mesopic conditions without any near-vision correction and answered 3 questions for each task, rating their vision-related reading ability as 0=I could not read any text due to problems seeing up close,1=poor,2=fair,3=good,4=very good,5=excellent;impact of squinting on performance as 0=No,I did not squint, 1=Yes,squinting helped me read some/all text, 2=Yes,but I still could not read any of the text; and satisfaction as 0=very dissatisfied to 4=very satisfied. The score based on vision related ability and impact of squinting=(Book testlet+Newspaper testlet+Menu testlet+Nutrition Label testlet)/(testlets with non-missing responses), total possible score of 0-5. Higher scores=better outcomes;positive change from Baseline=improved performance(reading ability).

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

  6. Change From Baseline in Photopic, High-contrast, Binocular Distance-corrected Intermediate Visual Acuity (DCIVA) Letters at Day 30, Hour 3

    Visual acuity for intermediate (66 cm) target was measured in photopic conditions using an eye chart. Photopic condition was defined as high lighting ≥80 cd/m^2 measured at the target. A positive change from Baseline indicates improvement in visual acuity. MMRM was used for analyses.

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

  7. Percentage of Participants Gaining 3-lines or More in Mesopic, High-contrast, Binocular, DCNVA at Day 30, Hour 10

    Visual acuity for near (40cm) target was measured in mesopic conditions using an eye chart. Mesopic condition was defined as low lighting 3.2 to 3.5 cd/m^2measured at the target. Percentage of participants with 3 lines or more improvement from Baseline in mesopic, high-contrast, binocular DCNVA are reported.

    Measured: Baseline (Day1) to Day 30 (Hour 10)

  8. Change From Baseline in Mesopic, High-contrast, Binocular DCNVA Letters at Day 30, Hour 0.25

    Visual acuity for near (40 cm) target was measured in mesopic conditions. Mesopic condition was defined as low lighting 3.2 to 3.5 cd/m^2 measured at the target. A positive change from Baseline indicates improvement in visual acuity. MMRM was used for analyses.

    Measured: Baseline (Day 1) to Day 30 (Hour 0.25)

  9. Percentage of Participants Achieving 20/40 or Better in Photopic, High-contrast, Binocular, DCNVA at Day 30, Hour 3

    Visual acuity for near (40 cm) target was measured in mesopic conditions using an eye chart. Photopic condition was defined as high lighting ≥80 cd/m^2 measured at the target. Percentage of participants achieving 20/40 or better in photopic, high-contrast, binocular, DCNVA are reported.

    Measured: Day 30 (Hour 3)

  10. Mean Change From Baseline in Mesopic NVPTQ Satisfaction Score at Day 30, Hour 3

    NVPTQ had 12 questions on 4 reading tasks(reading a paragraph from book, excerpts from an article in newspaper, portion of a nutrition label, and a section from restaurant menu). Participants completed specific reading tasks under mesopic conditions without any near-vision correction and answered 3 questions for each task, rating their vision-related reading ability as 0=I could not read any text due to problems seeing up close to 5=excellent; impact of squinting on performance as 0=No, I did not squint, 1=Yes, squinting helped me read some/all text, 2=Yes, but I still could not read any of the text; and satisfaction as 0=very dissatisfied,1=dissatisfied,2=neither satisfied nor dissatisfied,3=satisfied, 4=very satisfied. The score based on satisfaction items=(Book testlet+Newspaper testlet+Menu testlet+Nutrition Label testlet)/(testlets with non-missing responses) for a total possible score of 0 to 4. Higher scores=better outcomes; a positive change from Baseline=higher satisfaction.

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

  11. Mean Change From Baseline in Presbyopia Impact and Coping Questionnaire (PICQ) Coping Score at Day 30, Hour 3

    PICQ=20 questions about impact experienced by participants due to their problems over past 7 days.PICQ Coping domain had 8 items: 1:Normal-sized text,2:Small-sized text,3:Information on a computer,4:Information on a cell phone,5:Increase font size,6:Use glasses to read close,12:Hold reading materials farther out/closer,13:Squint to read. Each item had response categories:0=never to 4=all the time. Items 3, 4, 5, and 6 had additional response categories with values of 9/10 to indicate the question is not applicable to participant and were assigned missing values.PICQ Coping Score:(Item 1,2 Testlet+Item 3,4 Testlet+Item 5+Item 6+Item 12+Item 13)/non-missing responses to the 6 components of coping score where Items 1,2 Testlet=(Item1+Item2)/non-missing responses to Items 1,2;Items 3,4 Testlet=(Item3+Item4)/non-missing responses to Items 3, 4. Score ranges:0=to least amount of coping to 4=greatest amount of coping. Higher scores=poorer outcome; a negative change from Baseline=improvement.

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

  12. Mean Change From Baseline in PICQ Impact Score at Day 30, Hour 3

    PICQ had 20 questions about impact experienced by participants due to their problems seeing up over past 7 days. PICQ Impact domain had 6 items: Item 9:Rely on others,15:rest eyes,16:Feel older,17:Feel self-conscious,19:Take longer to complete a task,20:Inconvenient. First 5 impacts items included response categories: 0=never to 4=all the time. Item 20 had response categories: 0=not at all to 4=extremely. Item 9 included an additional response category with a value of 9 to indicate question was not applicable to participant and the responses were assigned missing values. PICQ Impacts Score=[(Item9+Item15+Items16,17Testlet+Item19+Item20)/(nonmissing responses to 5 components of impacts score)] where Items 16,17 Testlet=(Item16+Item17)/non-missing responses to Items 16 and 17. PICQ Impact score ranges from 0 to 4; with 0=least amount of impacts to 4=greatest amount of impacts. Higher scores correspond to poorer outcomes. A negative change from Baseline=improvement.

    Measured: Baseline (Day 1) to Day 30 (Hour 3)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jan 2019
  2. Study start21 Dec 2018
  3. Primary completion31 Oct 2019
  4. Study completion31 Oct 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
323 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03804268
Sponsor's protocol ID
1883-301-013
Acronym
GEMINI 1
Status last verified
Nov 2021
First submitted
11 Jan 2019
Last updated
28 Dec 2021
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lievens CW, Hom MM, McLaurin EB, Yuan J, Safyan E, Liu H. Pilocarpine HCl 1.25% for treatment of presbyopia after laser vision correction: pooled analysis of two phase 3 randomized trials (GEMINI 1 and 2). J Cataract Refract Surg. 2024 Jan 1;50(1):57-63. doi: 10.1097/j.jcrs.0000000000001313.

    PubMed 37702453
  • Westheimer G. Topical Review: Pilocarpine-induced Miosis as Help for Early Presbyopes? Optom Vis Sci. 2022 Aug 1;99(8):632-634. doi: 10.1097/OPX.0000000000001924. Epub 2022 Jul 14.

    PubMed 35848990
  • Waring GO 4th, Price FW Jr, Wirta D, McCabe C, Moshirfar M, Guo Q, Gore A, Liu H, Safyan E, Robinson MR. Safety and Efficacy of AGN-190584 in Individuals With Presbyopia: The GEMINI 1 Phase 3 Randomized Clinical Trial. JAMA Ophthalmol. 2022 Apr 1;140(4):363-371. doi: 10.1001/jamaophthalmol.2022.0059.

    PubMed 35238902

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Pilocarpine HCl Ophthalmic Solution in people with Presbyopia, run by Allergan at 36 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Dec 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Gaining 3 Lines or More in Mesopic, High-contrast, Binocular Distance-Corrected Near Visual Acuity (DCNVA) at Day 30, Hour 3 (time frame: Baseline (Day 1) to Day 30 (Hour 3)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03804268, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Dec 2021.

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