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warnings and cautions
5. WARNINGS AND PRECAUTIONS Intravitreal injections have been associated with endophthalmitis, eye inflammation, increased intraocular pressure, and retinal detachments. Patients should be monitored following the injection. ( 5.1 ) Use of corticosteroids may produce posterior subcapsular cataracts, increased intraocular pressure, glaucoma, and may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses. ( 5.2 ) The implant may migrate into the anterior chamber if the posterior lens capsule is not intact. ( 5.3 ) 5.1. Intravitreal Injection-related Effects Intravitreal injections, including those with YUTIQ, have been associated with endophthalmitis, eye inflammation, increased or decreased intraocular pressure, and choroidal or retinal detachments. Hypotony has been observed within 24 hours of injection and has resolved within 2 weeks. Patients should be monitored following the intravitreal injection [see Patient Counseling Information ( 17 )] . 5.2. Steroid-related Effects Use of corticosteroids including YUTIQ may produce posterior subcapsular cataracts, increased intraocular pressure and glaucoma. Use of corticosteroids may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses. Corticosteroids are not recommended to be used in patients with a history of ocular herpes simplex because of the potential for reactivation of the viral infection. 5.3. Risk of Implant Migration Patients in whom the posterior capsule of the lens is absent or has a tear are at risk of implant migration into the anterior chamber.
6. ADVERSE REACTIONS In controlled studies, the most common adverse reactions reported were cataract development and increases in intraocular pressure. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact EyePoint Pharmaceuticals US, Inc. at 1-833-EYEPOINT (1-833-393-7646) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1. Clinical Studies Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Adverse reactions associated with ophthalmic steroids including YUTIQ include cataract formation and subsequent cataract surgery, elevated intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects, secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the cornea or sclera. Studies 1 and 2 were multicenter, randomized, sham injection-controlled, masked trials in which patients with non-infectious uveitis affecting the posterior segment of the eye were treated once with either YUTIQ or sham injection, and then received standard care for the duration of the study. Study 3 was a multicenter, randomized, masked trial in which patients with non-infectious uveitis affecting the posterior segment of the eye were all treated once with YUTIQ, administered by one of two different applicators, and then received standard care for the duration of the study. Table 1 summarizes data available from studies 1, 2 and 3 through 12 months for study eyes treated with YUTIQ (n=226) or sham injection (n=94). The most common ocular (study eye) and non-ocular adverse reactions are shown in Table 1 and Table 2 . Table 1: Ocular Adverse Reactions Reported in ≥ 1% of Subject Eyes and Non-Ocular Adverse Reactions Reported in ≥ 2% of Patients Ocular ADVERSE REACTIONS YUTIQ (N=226 Eyes) n (%) Sham Injection (N=94 Eyes) n (%) 1. Includes cataract, cataract subcapsular and lenticular opacities in study eyes that were phakic at baseline. 113 of the 226 YUTIQ study eyes were phakic at baseline; 56 of 94 sham-controlled study eyes were phakic at baseline. Cataract 1 63/113 (56%) 13/56 (23%) Visual Acuity Reduced 33 ( 15%) 11 (12%) Macular Edema 25 ( 11%) 33 (35%) Uveitis 22 ( 10%) 33 (35%) Conjunctival Hemorrhage 17 ( 8%) 5 ( 5%) Eye Pain 17 ( 8%) 12 (13%) Hypotony Of Eye 16 ( 7%) 1 ( 1%) Anterior Chamber Inflammation 12 ( 5%) 6 ( 6%) Dry Eye 10 ( 4%) 3 ( 3%) Vitreous Opacities 9 ( 4%) 8 ( 9%) Conjunctivitis 9 ( 4%) 5 ( 5%) Posterior Capsule Opacification 8 ( 4%) 3 ( 3%) Ocular Hyperemia 8 ( 4%) 7 ( 7%) Vitreous Haze 7 ( 3%) 4 ( 4%) Foreign Body Sensation In Eyes 7 ( 3%) 2 ( 2%) Vitritis 6 ( 3%) 8 ( 9%) Vitreous Floaters 6 ( 3%) 5 ( 5%) Eye Pruritus 6 ( 3%) 5 ( 5%) Conjunctival Hyperemia 5 ( 2%) 2 ( 2%) Ocular Discomfort 5 ( 2%) 1 ( 1%) Macular Fibrosis 5 ( 2%) 2 ( 2%) Glaucoma 4 ( 2%) 1 ( 1%) Photopsia 4 ( 2%) 2 ( 2%) Vitreous Hemorrhage 4 ( 2%) 0 Iridocyclitis 3 ( 1%) 7 ( 7%) Eye Inflammation 3 ( 1%) 2 ( 2%) Choroiditis 3 ( 1%) 1 ( 1%) Eye Irritation 3 ( 1%) 1 ( 1%) Visual Field Defect 3 ( 1%) 0 Lacrimation Increased 3 ( 1%) 0 Non-ocular ADVERSE REACTIONS YUTIQ (N=214 Patients) n (%) Sham Injection (N=94 Patients) n (%) Nasopharyngitis 10 ( 5%) 5 ( 5%) Hypertension 6 ( 3%) 1 ( 1%) Arthralgia 5 ( 2%) 1 ( 1%) Table 2: Summary of Elevated IOP Related Adverse Reactions ADVERSE REACTIONS YUTIQ (N=226 Eyes) n (%) Sham (N=94 Eyes) n (%) IOP elevation ≥ 10 mmHg from Baseline 50 (22%) 11 (12%) IOP elevation > 30 mmHg 28 (12%) 3 (3%) Any IOP-lowering medication 98 (43%) 39 (41%) Any surgical intervention for elevated IOP 5 (2%) 2 (2%) Figure 1: Mean IOP During the Studies Figure 1