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A mobile international CAE<jats:sup>\u00ae<\/jats:sup> DE Model was used for patient selection with a standardized challenge endpoint. Primary efficacy endpoint was fluorescein inferior corneal staining score (ICSS) pre- to post-CAE challenge from baseline. Secondary endpoints included Schirmer\u2019s Tear Test, Tear-Film Break-Up Time, Ocular Discomfort Score, Ora Calibra<jats:sup>\u00ae<\/jats:sup> Ocular Discomfort and 4-Symptom Questionnaire, total corneal staining score (TCSS), and drop comfort. Signs and symptoms were assessed both pre- and post-CAE to evaluate the efficacy of tanfanercept on both environmental and CAE endpoints.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The tanfanercept treatment group showed improvement in ICSS pre- to post-CAE change from baseline scores when compared to placebo (\u2212\u00a00.61\u2009\u00b1\u20090.11 and \u2212\u00a00.54\u2009\u00b1\u20090.11, respectively; mean difference\u2009=\u20090.07, <jats:italic>p<\/jats:italic>\u2009=\u20090.65). TCSS pre\u2013post-CAE change from baseline scores was also in favor of active when compared to placebo (\u2212\u00a01.03\u2009\u00b1\u20090.21 and \u2212\u00a00.67\u2009\u00b1\u20090.21, respectively; mean difference\u2009=\u20090.37, <jats:italic>p<\/jats:italic>\u2009=\u20090.23). Schirmer\u2019s score improvement was demonstrated in favor of active (1.87\u2009\u00b1\u20090.62\u00a0mm) as compared to placebo (1.28\u2009\u00b1\u20090.62\u00a0mm; mean difference\u2009=\u20090.59\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.50). Change from baseline in mean Tear-Film Break-up Time favored active treatment over placebo (mean difference\u2009=\u20091.21\u00a0s, <jats:italic>p<\/jats:italic>\u2009=\u20090.45). Notably, the tanfanercept showed more obvious benefits for each DED sign in a subgroup of subjects \u2265\u200935\u00a0years of age. Tanfanercept was well tolerated with no serious adverse events occurring during the study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Tanfanercept demonstrated improvements in favor of active as compared to placebo in the signs of DED, being safe and well tolerated. These data support further evaluation of tanfanercept for the treatment of DED in China.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>This study was retrospectively registered at ClinicalTrials.gov (NCT04092907) on September 17, 2019.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10792-022-02245-1","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T13:02:44Z","timestamp":1645534964000},"page":"2459-2472","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["TNF-\u03b1 inhibitor tanfanercept (HBM9036) improves signs and symptoms of dry eye in a phase 2 trial in the controlled adverse environment in China"],"prefix":"10.1007","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct04092907","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yanling","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Cong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongfang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-0254","authenticated-orcid":false,"given":"Stephen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George W.","family":"Ousler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"issue":"2","key":"2245_CR1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.08.020503","volume":"8","author":"P Song","year":"2018","unstructured":"Song P, Xia W, Wang M, Chang X, Wang J, Jin S, Wang J, Wei W, Rudan I (2018) Variations of dry eye disease prevalence by age, sex and geographic characteristics in China: a systematic review and meta-analysis. 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