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The objectives of this study are:
A randomized, parallel arm, double-masked, placebo-controlled Phase 3 study in at least 330 randomized subjects, evaluating the safety and efficacy of Nyxol in subjects with pharmacologically-induced mydriasis.
Following the successful completion of screening, each subject will be stratified by eye color and then simultaneously be randomized to mydriatic agent (unmasked) and treatment (masked). Treatment randomization will be 2:1, Nyxol or placebo (vehicle). Stratification by iris color will be 1:1, light or dark rides. The mydriatic agent randomization will be 3:1:1 (2.5% phenylephrine, 1% tropicamide, and Paremyd).
At the treatment visit, subjects who have been randomized and stratified by iris color (1:1 [light/dark]) will receive one of three approved mydriatic agents approximately 1 hour prior to receiving study treatment. Measurements will be measured before (-1 hour /baseline) and 60 minutes after (maximum/0 minutes) the mydriatic agent instillation in each eye (i.e. right before the study treatment is administered), and at 30 minutes, 60 minutes, 90 minutes, 2 hours, 3 hours, 4 hours, and 6 hours after treatment dosing. Measurements will include pupil diameter (PD), distance and near visual acuity (VA), accommodation, and redness in each eye.
Blood sampling for Nyxol PK measurements will be conducted in a subset of approximately 30 adult subjects at approximately two select study sites.
At the Follow-Up Visit, which is 1 day after Visit 1, measurements will again be recorded 24 hours after treatment dosing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phentolamine Ophthalmic Solution 0.75% | Active Comparator | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis |
|
| Phentolamine Ophthalmic Solution Vehicle | Placebo Comparator | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Phentolamine Ophthalmic Solution 0.75% | Drug | 0.75% phentolamine ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Subjects' Study Eyes With Pupil Diameter Returning to Baseline | Percentage of subjects' study eyes returning to less than or equal to 0.2 mm from baseline pupil diameter | 90 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Subjects' Study Eyes With Pupil Diameter Returning to Baseline | Percentage of subjects' study eyes returning to less than or equal to 0.2 mm from baseline pupil diameter | 30 minutes to 24 hours |
| Pupil Diameter (Change From Max) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Site 10 | Newport Beach | California | 92663 | United States | ||
| Clinical Site 12 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41743463 | Derived | Pepose JS, Foster S, Pearson C, Brigell M, Charizanis K. Reversal of Pharmacologic Mydriasis in Pediatric Subjects with Ryzumvi (0.75% Phentolamine Ophthalmic Solution): A Post-Hoc Pooled Analysis from Three Randomized, Placebo-Controlled Phase 3 Trials. Clin Ophthalmol. 2026 Feb 20;20:563499. doi: 10.2147/OPTH.S563499. eCollection 2026. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Phentolamine Ophthalmic Solution Vehicle | 2 drops in study eye and 1 drop in non-study eye, administered 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution Vehicle: Phentolamine Ophthalmic Solution Vehicle |
| FG001 | Phentolamine Ophthalmic Solution 0.75% |
| 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 | Sep 23, 2021 | Jun 22, 2023 |
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|
| Phentolamine Ophthalmic Solution Vehicle | Drug | Phentolamine Ophthalmic Solution Vehicle |
|
Change (mm) from maximum pharmacologically-induced mydriatic pupil diameter (0 minutes)
| 30 minutes to 24 hours |
| Percent of Subjects With Unchanged Accommodation From Baseline | Percentage of subjects with unchanged accommodation from baseline (-1 hour) | 90 minutes to 6 Hours |
| Change From Baseline in Best-Corrected Distance Visual Acuity (BCDVA) Under Normal Photopic Lighting Without Glare Conditions | Change from Baseline in best-corrected distance visual acuity (BCDVA) under normal photopic lighting without glare conditions | 6 hours |
| Westminster |
| California |
| 92655 |
| United States |
| Clinical Site 9 | Delray Beach | Florida | 33484 | United States |
| Clinical Site 8 | Longwood | Florida | 32779 | United States |
| Clinical Site 6 | Morrow | Georgia | 30260 | United States |
| Clinical Site 1 | Roswell | Georgia | 30009 | United States |
| Clinical Site 13 | Lake Villa | Illinois | 60046 | United States |
| Clinical Site 5 | Pittsburg | Kansas | 66762 | United States |
| Clinical Site 2 | Bloomington | Minnesota | 55420 | United States |
| Clinical Site 15 | Garner | North Carolina | 27529 | United States |
| Clinical Site 4 | Athens | Ohio | 45701 | United States |
| Clinical Site 14 | Shrewsbury | Pennsylvania | 17349 | United States |
| Clinical Site 7 | Warwick | Rhode Island | 02888 | United States |
| Clinical Site 11 | Sioux Falls | South Dakota | 57101 | United States |
| Clinical Site 3 | Memphis | Tennessee | 38119 | United States |
2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution 0.75%: 0.75% phentolamine ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist |
| COMPLETED |
|
| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Phentolamine Ophthalmic Solution 0.75% | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution 0.75%: 0.75% phentolamine ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist |
| BG001 | Phentolamine Ophthalmic Solution Vehicle | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution Vehicle: Phentolamine Ophthalmic Solution Vehicle |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
|
| 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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent of Subjects' Study Eyes With Pupil Diameter Returning to Baseline | Percentage of subjects' study eyes returning to less than or equal to 0.2 mm from baseline pupil diameter | Posted | Count of Participants | Participants | 90 minutes |
|
|
| ||||||||||||||||||||||||||||||||
| Secondary | Percent of Subjects' Study Eyes With Pupil Diameter Returning to Baseline | Percentage of subjects' study eyes returning to less than or equal to 0.2 mm from baseline pupil diameter | Posted | Count of Participants | Participants | 30 minutes to 24 hours |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Pupil Diameter (Change From Max) | Change (mm) from maximum pharmacologically-induced mydriatic pupil diameter (0 minutes) | Posted | Mean | Standard Deviation | millimeters | 30 minutes to 24 hours |
|
| ||||||||||||||||||||||||||||||||
| Secondary | Percent of Subjects With Unchanged Accommodation From Baseline | Percentage of subjects with unchanged accommodation from baseline (-1 hour) | Posted | Count of Participants | Participants | 90 minutes to 6 Hours |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Best-Corrected Distance Visual Acuity (BCDVA) Under Normal Photopic Lighting Without Glare Conditions | Change from Baseline in best-corrected distance visual acuity (BCDVA) under normal photopic lighting without glare conditions | Posted | Mean | Standard Deviation | letters | 6 hours |
|
|
2 Days
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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 Ophthalmic Solution 0.75% | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution 0.75%: 0.75% phentolamine ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist | 0 | 244 | 0 | 244 | 43 | 244 |
| EG001 | Phentolamine Ophthalmic Solution Vehicle | 2 drops in study eye and 1 drop in non-study eye, 1 hour post pharmacologically-induced mydriasis Phentolamine Ophthalmic Solution Vehicle: Phentolamine Ophthalmic Solution Vehicle | 0 | 124 | 0 | 124 | 0 | 124 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Conjunctival Hyperaemia | Eye disorders | Systematic Assessment |
| ||
| Instillation site erythema | General disorders | Systematic Assessment |
| ||
| Dysgeusia | Nervous system disorders | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Drey Coleman, VP of Clinical Operations | Ocuphire | 813-404-1993 | dcoleman@ocuphire.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 14, 2022 | Jul 13, 2023 | SAP_002.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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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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