Less Burn, Less Bacteria in IVT Prep with IRX-101

Overview

Data from the STERILE and RELIEF trials presented at the 2025 AAO meeting suggest that IRX-101, a chlorine dioxide-based antiseptic, may offer superior bacterial kill and improved patient tolerance compared to povidone-iodine (Betadine) in intravitreal injection preparation. Patients reported significantly less burning sensation with IRX-101 while maintaining effective infection prevention.

Background

Povidone-iodine is the standard antiseptic used before intravitreal injections to prevent endophthalmitis but is often associated with patient discomfort, including burning sensations. Approximately one-third of patients tolerate it poorly, prompting investigation into alternative agents. IRX-101 is a novel aqueous chlorine dioxide solution designed to provide effective antisepsis with improved patient comfort. Early preclinical and clinical data have been evaluated in the STERILE and RELIEF trials to assess its efficacy and tolerability.

Data Highlights

Preclinical data demonstrated that IRX-101 was more effective at killing Staphylococcus epidermidis and Staphylococcus aureus compared to povidone-iodine. Clinical trial data showed that patients experienced significantly less burning sensation with IRX-101 during intravitreal injection preparation.

Key Findings

• IRX-101 is an aqueous chlorine dioxide antiseptic prepared from two components that form the active ingredient.
• Preclinical studies showed IRX-101 had superior bactericidal activity against common ocular pathogens compared to povidone-iodine.
• In clinical trials (STERILE and RELIEF), IRX-101 was better tolerated, causing less burning sensation in patients.
• Approximately one-third of patients dislike povidone-iodine due to discomfort, which IRX-101 may mitigate.
• The developers aim to make IRX-101 affordable and accessible for broad clinical use.

Clinical Implications

IRX-101 may represent a promising alternative to povidone-iodine for antisepsis prior to intravitreal injections, potentially improving patient comfort without compromising infection control. Adoption of IRX-101 could enhance the patient experience during routine retinal procedures. Further studies and commercialization efforts will determine its availability in clinical practice.

Conclusion

IRX-101 shows potential as a more effective and better-tolerated antiseptic for intravitreal injection preparation, addressing a significant patient comfort issue associated with current standards. Ongoing research and development will clarify its role in ophthalmic care.

References

1. Brown et al/AAO/2025 -- STERILE and RELIEF Trials on IRX-101