Effectiveness and safety of 0.15% ganciclovir in situ ophthalmic gel for herpes simplex keratitis – a multicenter, randomized, investigator-masked, parallel group study in Chinese patients

Tong Lin,¹ Lan Gong,¹ Xing-huai Sun,¹ Nai-qing Zhao,² Wei Chen,³ Hui-ping Yuan,⁴ Yan Shao,⁵ Ming-hong Gao,⁶ Hai Tang<sup>7

1</sup>Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People’s Republic of China; ²Department of Biostatistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People’s Republic of China; ³The School of Ophthalmology and Optometry Affiliated with Wenzhou Medical College, Wenzhou, People’s Republic of China; ⁴The Second Affiliated Hospital of Haerbin Medical University, Haerbin, People’s Republic of China; ⁵The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China; ⁶General hospital of Shenyang Military Command, Shenyang, People’s Republic of China; ⁷Shenyang SINQI Pharmaceutical Co Ltd, Shenyang, People’s Republic of China

Objectives: Parallel comparison with 0.15% ganciclovir (GCV) ophthalmic gel to evaluate the effectiveness and safety of 0.15% GCV in situ ophthalmic gel for the treatment of herpes simplex keratitis (HSK).
Methods: This was a multicenter, randomized, investigator-masked, parallel group study. HSK patients were randomly divided into two groups, with the corresponding treatment of 0.15% GCV ophthalmic gel or 0.15% GCV in situ ophthalmic gel. Symptoms and signs were observed before administration, and 3 (±1), 7 (±1), 14 (±2), and 21 (±3) days after the administration. The clinical effective rate was considered as the primary outcome. The safety profile was evaluated by AEs, visual acuity, and ocular tolerance.
Results: The clinical effective rate in the per-protocol (PP) dataset for the treatment group and the control group were 95.10% and 93.00%, respectively (P = 0.5282). The noninferiority test showed significant differences (P = 0.000305, P < 0.025), indicating that the tested drug was noninferior to the control. Patients in the PP dataset of both groups experienced decreases in the total scores of clinical indicators. Ocular AEs were few but similar between the two groups. There were no significant differences between patients’ visions between the two groups before and after administration in the safety analysis set. In terms of drug tolerance, the rates of patients without transient blurred vision during all the visits in the treatment group were higher than those for the control group (P < 0.05). During the third and fourth visits, the rates of patients with eye itching were 4.08% and 1.22% in the treatment group, and 13.59% and 8.14% in the control group, respectively (P < 0.05). During the second visit, the rates of patients with eye irritation were 14.42% in the treatment group and 25.71% in the control group (P < 0.05).
Conclusion: The 0.15% GCV in situ ophthalmic gel was effective and safe for the treatment of HSK, and was not inferior to 0.15% GCV ophthalmic gel. The 0.15% GCV in situ ophthalmic gel presented superior ocular tolerance.

Keywords: virus keratitis, herpes simplex virus 1, ganciclovir in situ ophthalmic gel, treatment