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The objectives of this study are:
Randomized, 2-arm cross-over, double-masked Phase 2b study in approximately 32 healthy subjects, evaluating safety and efficacy of Nyxol in subjects with pharmacologically induced mydriasis.
At the first visit subjects will be screened for study eligibility.
After screening, eligible subjects will be randomized 1:1 to one of the two treatment sequences:
Treatment sequence 1: Placebo (Visit 1), Nyxol (Visit 2).
Treatment sequence 2: Nyxol (Visit 1), Placebo (Visit 2).
Randomization will be stratified by mydriatic agent (2.5% phenylephrine or 1% tropicamide). Approximately one half of the randomized subjects will receive 2.5% phenylephrine and one half will receive 1% tropicamide. Subjects will receive their mydriatic agent 1 hour before treatment. Each subject will receive the same mydriatic agent throughout the study.
At each visit, pupil diameter (PD), accommodation, near and distance visual acuity (VA) and redness in each eye will be measured before (-1 hour/baseline) and 1 hour after (maximum/0 minutes) the mydriatic agent instillation in each eye (i.e., right before the study treatment is administered), and at 30 minutes, 1 hour, 2 hours, 4 hours and 6 hours after treatment dosing.
As needed, two hours post treatment, subjects may request the administration of Lumify® in the non-study eye.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phentolamine Mesylate Ophthalmic Solution 1% | Experimental | 1 drop in each eye, 1 hour post medically-induced mydriasis |
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| Phentolamine Mesylate Ophthalmic Solution Vehicle | Placebo Comparator | 1 drop in each eye, 1 hour post medically-induced mydriasis |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Phentolamine Mesylate Ophthalmic Solution 1% | Drug | 1% phentolamine mesylate ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist |
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| Measure | Description | Time Frame |
|---|---|---|
| Pupil Diameter (Change From Max) | Change in pharmacologically-induced mydriatic (maximum) pupil diameter at 2 hours post-treatment in the study eye. | 2 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Pupil Diameter (Change From Max) | Change in pharmacologically-induced mydriatic (maximum) pupil diameter at remaining timepoints (30 min, 1 hours, 4 hours, 6 hours) | 30 min, 1 hours, 4 hours, 6 hours |
| Pupil Diameter Return to Baseline |
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Inclusion Criteria:
Exclusion Criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kannar Eye Care | Pittsburg | Kansas | 66762 | United States | ||
| Kentucky Eye Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33633016 | Derived | Karpecki PM, Foster SA, Montaquila SM, Kannarr SR, Slonim CB, Meyer AR, Sooch MP, Jaber RM, Charizanis K, Yousif JE, Klapman SA, Amin AT, McDonald MB, Horn GD, Lazar ES, Pepose JS. Phentolamine Eye Drops Reverse Pharmacologically Induced Mydriasis in a Randomized Phase 2b Trial. Optom Vis Sci. 2021 Mar 1;98(3):234-242. doi: 10.1097/OPX.0000000000001656. |
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This is a crossover design study, so all 32 enrolled subjects were included in both treatment groups.
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| ID | Title | Description |
|---|---|---|
| FG000 | PMOS 1% First, Then PMOS Vehicle | Participant received Phentolamine Mesylate Ophthalmic Solution 1%: 1% phentolamine mesylate ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist at Visit 1. Then, after one week, they received Phentolamine Mesylate Ophthalmic Solution Vehicle (Placebo): Topical Sterile Ophthalmic Solution at Visit 2. 1 drop in each eye, 1 hour post medically-induced mydriasis at both visits. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jul 24, 2019 | Jun 20, 2022 |
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Parallel Assignment
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| Phentolamine Mesylate Ophthalmic Solution Vehicle (Placebo) | Other | Topical Sterile Ophthalmic Solution |
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Percent of Subjects Achieving Pupil Diameter No More Than 0.5 mm Above Baseline by Time Point with either phenylephrine or tropicamide
| 0 min, 1 hour, 2 hours, 4 hours, 6 hours |
| Accommodation Measured by the Near Point Rule (Diopters) (Change From Baseline), Percent With Unchanged Accommodation | Change from baseline (-1 hour) in accommodation at each time point (0 min, 2 hours, 4 hours) with Tropicamide and Phenylephrine Worsening of accommodation is defined as an amplitude decrease of greater than 1 diopter compared to baseline | 0 min, 2 hours, 4 hours |
| Conjunctival Hyperemia (Eye Redness) Assessed Visually With the Brien Holden Vision Institute (Formerly Corneal and Contact Lens Research Unit, or CCLRU) Bulbar Redness Scale (0-3) | Conjunctival hyperemia at each timepoint (0 min, 30 min, 1 hour, 2 hours, 4 hours, 6 hours), for study eye; in all subjects. Scale 0-3 (None, Mild, Moderate, Severe) | 0 min, 30 min, 1 hour, 2 hours, 4 hours, 6 hours |
| Best Corrected Distance Visual Acuity (BCDVA) Measured by Early Treatment Diabetic Retinopathy Study (ETDRS) Light Box Chart (Letters) at 4 Meters (Change From Baseline) | Change from baseline (-1 hour) in Best Corrected Distance Visual Acuity at each time point (0 min, 30 mins, 1 hour, 2 hours, 6 hours) in Study Eye | 0 mins, 30 mins, 1 hour, 2 hours, 4 hours, 6 hours |
| Distance-Corrected Near Visual Acuity (DCNVA) Measured by Standard Reading Card (Original Series Sloan Letter ETDRS Card at 16 Inches, LogMAR Units) (Change From Baseline) | Change from baseline (-1 hour) in Distance Corrected Near Visual Acuity at each time point (0 min, 30 mins, 1 hour, 2 hours, 6 hours) in Study Eye | 0 mins, 30 mins, 1 hour, 2 hours, 4 hours, 6 hours |
| Lexington |
| Kentucky |
| 40517 |
| United States |
| Athens Eye Care | Athens | Ohio | 45701 | United States |
| West Bay Eye Associates | Warwick | Rhode Island | 02888 | United States |
| FG001 | PMOS Vehicle First, Then PMOS 1% | Participants received Phentolamine Mesylate Ophthalmic Solution Vehicle (Placebo): Topical Sterile Ophthalmic Solution at Visit 1. Then, after one week, they received Phentolamine Mesylate Ophthalmic Solution 1%: 1% phentolamine mesylate ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist at Visit 2. 1 drop in each eye, 1 hour post medically-induced mydriasis for both visits. |
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| NOT COMPLETED |
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Subjects baseline values are included in the column to which they were randomized first in this crossover design trial. One subject in the PMOS Vehicle First, Then PMOS group was found to be pregnant after their first visit and was withdrawn from the trial and did not crossover to receive PMOS, resulting in an analytical sample of n = 31.
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| ID | Title | Description |
|---|---|---|
| BG000 | PMOS 1% First, Then PMOS Vehicle | 1 drop in each eye, 1 hour post medically-induced mydriasis Phentolamine Mesylate Ophthalmic Solution 1%: 1% phentolamine mesylate ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist |
| BG001 | PMOS Vehicle First, Then PMOS 1% | 1 drop in each eye, 1 hour post medically-induced mydriasis Phentolamine Mesylate Ophthalmic Solution Vehicle (Placebo): Topical Sterile Ophthalmic Solution |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
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| Iris Color | Count of Participants | Participants |
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| Mydriatic Agent Recieved | Count of Participants | Participants |
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| Baseline Pupil Diameter (Study Eye) | Mean | Standard Deviation | mm |
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| Maximum Dilated Pupil Diameter (Study Eye) | Mean | Standard Deviation | mm |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Pupil Diameter (Change From Max) | Change in pharmacologically-induced mydriatic (maximum) pupil diameter at 2 hours post-treatment in the study eye. | Crossover design study | Posted | Least Squares Mean | Standard Error | mm | 2 hours |
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| Secondary | Pupil Diameter (Change From Max) | Change in pharmacologically-induced mydriatic (maximum) pupil diameter at remaining timepoints (30 min, 1 hours, 4 hours, 6 hours) | Crossover design trial | Posted | Least Squares Mean | Standard Error | mm | 30 min, 1 hours, 4 hours, 6 hours |
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| Secondary | Pupil Diameter Return to Baseline | Percent of Subjects Achieving Pupil Diameter No More Than 0.5 mm Above Baseline by Time Point with either phenylephrine or tropicamide | Posted | Count of Participants | Participants | 0 min, 1 hour, 2 hours, 4 hours, 6 hours |
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| Secondary | Accommodation Measured by the Near Point Rule (Diopters) (Change From Baseline), Percent With Unchanged Accommodation | Change from baseline (-1 hour) in accommodation at each time point (0 min, 2 hours, 4 hours) with Tropicamide and Phenylephrine Worsening of accommodation is defined as an amplitude decrease of greater than 1 diopter compared to baseline | Crossover Design Trial | Posted | Count of Participants | Participants | 0 min, 2 hours, 4 hours |
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| Secondary | Conjunctival Hyperemia (Eye Redness) Assessed Visually With the Brien Holden Vision Institute (Formerly Corneal and Contact Lens Research Unit, or CCLRU) Bulbar Redness Scale (0-3) | Conjunctival hyperemia at each timepoint (0 min, 30 min, 1 hour, 2 hours, 4 hours, 6 hours), for study eye; in all subjects. Scale 0-3 (None, Mild, Moderate, Severe) | All randomized participants who recieved the medication. | Posted | Mean | Standard Deviation | score on a scale (0-3) | 0 min, 30 min, 1 hour, 2 hours, 4 hours, 6 hours |
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| Secondary | Best Corrected Distance Visual Acuity (BCDVA) Measured by Early Treatment Diabetic Retinopathy Study (ETDRS) Light Box Chart (Letters) at 4 Meters (Change From Baseline) | Change from baseline (-1 hour) in Best Corrected Distance Visual Acuity at each time point (0 min, 30 mins, 1 hour, 2 hours, 6 hours) in Study Eye | Posted | Mean | Standard Error | Letters Read | 0 mins, 30 mins, 1 hour, 2 hours, 4 hours, 6 hours |
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| Secondary | Distance-Corrected Near Visual Acuity (DCNVA) Measured by Standard Reading Card (Original Series Sloan Letter ETDRS Card at 16 Inches, LogMAR Units) (Change From Baseline) | Change from baseline (-1 hour) in Distance Corrected Near Visual Acuity at each time point (0 min, 30 mins, 1 hour, 2 hours, 6 hours) in Study Eye | Posted | Mean | Standard Deviation | LogMar | 0 mins, 30 mins, 1 hour, 2 hours, 4 hours, 6 hours |
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2 weeks.
All AEs/adverse reactions occurring during the study (ie, once the subject had signed the informed consent) were documented on the CRF, regardless of the assumption of causal relationship. All TEAEs/adverse reactions were documented from the time the subject received the first dose of study medication until the subject's participation in the study had completed.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Phentolamine Mesylate Ophthalmic Solution 1% | 1 drop in each eye, 1 hour post medically-induced mydriasis Phentolamine Mesylate Ophthalmic Solution 1%: 1% phentolamine mesylate ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist | 0 | 31 | 0 | 31 | 11 | 31 |
| EG001 | Phentolamine Mesylate Ophthalmic Solution Vehicle | 1 drop in each eye, 1 hour post medically-induced mydriasis Phentolamine Mesylate Ophthalmic Solution Vehicle (Placebo): Topical Sterile Ophthalmic Solution | 0 | 32 | 0 | 32 | 1 | 32 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Conjunctival Hyperemia | Eye disorders | Systematic Assessment |
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| Abdominal Pain, Upper | Gastrointestinal disorders | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Drey Coleman | Ocuphire Pharma, Inc. | 8134041993 | dcoleman@ocuphire.com |
| Prot_002.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Oct 10, 2019 | Jun 20, 2022 | SAP_003.pdf |
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| ID | Term |
|---|---|
| D015878 | Mydriasis |
| D004108 | Dilatation, Pathologic |
| ID | Term |
|---|---|
| D011681 | Pupil Disorders |
| D005128 | Eye Diseases |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Changed Accommodation (≥1 D) |
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| Changed Accommodation (≥1 D) |
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| Changed Accommodation (≥1 D) |
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| Changed Accommodation (≥1 D) |
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| Changed Accommodation (≥1 D) |
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