Bausch + Lomb drug fails in glaucoma, but a new use beckons

Eyecare company Bausch + Lomb has had a hole blown in its pharma pipeline, after disappointing trial results forced it to abandon a drug for improving vision in glaucoma that it had previously suggested could make peak sales of around $800 million a year.

The phase 2 trial of an eye drop formulation of BL1107 – described as a next-generation alpha2b adrenergic receptor agonist that can reduce the intraocular pressure that damages vision in glaucoma and also has neuroprotective properties – failed to show an improvement in visual function over 28 days in patients with primary open-angle glaucoma or ocular hypertension.

The study was unable to replace encouraging results with BL117 in a prior phase 1/2 trial, and also failed a series of secondary objectives, such as improving low-luminance best-corrected visual acuity responder rates. The safety profile was consistent with prior clinical experience with BL1107.

"Based on the totality of the data, the company has decided not to advance the programme in this indication as a topical eye drop," said the Canada-headquartered company in a statement.

Instead, it will turn its attention to its sustained-release implant formulation of BL1107 for geographic atrophy (GA), the second development for the asset, which Bausch + Lomb acquired when it took over Whitecap Biosciences last year.

The company has said it has "multiple shots on goal" in GA and age-related macular degeneration (AMD), another leading cause of sight loss, that could address a $1 billion-plus market.

It is developing the implant formulation of BL117 in partnership with Ripple Therapeutics, a specialist in controllable sustained delivery implants for use in the eye, and is planning to test intravitreal administration every three to six months in trials due to start in 2028. If all goes well, it could become the first small-molecule sustained-release implant for GA.

"Success in drug development is based on a portfolio, not a single programme," said Yehia Hashad, chief medical officer of Bausch + Lomb.

"We've intentionally built a diversified pipeline because we know innovation requires pursuing multiple scientific hypotheses simultaneously," he added. "Not every programme will succeed, but every study helps us make smarter decisions about where to invest."

The US-listed company – which is 88% owned by Bausch Health – has a pharma pipeline that also includes candidates for dry eye disease and ocular surface pain that it thinks could have collective peak sales potential of more than $2 billion.