333 Participants Needed

Nyxol Eye Drops + Low-Dose Pilocarpine Eye Drops for Presbyopia

(VEGA-2 Trial)

Recruiting at 26 trial locations
DC
Overseen ByDrey Coleman
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests eye drops to determine if they can help people with presbyopia, which is difficulty seeing things up close, such as when reading. Researchers are evaluating how well Nyxol, a phentolamine eye drop, works alone and with a low dose of pilocarpine (another type of eye drop) to improve near vision. The trial includes different groups that will test Nyxol, pilocarpine, and placebos (inactive treatments) in various combinations. People who have difficulty seeing up close and rely on reading glasses or bifocals might be suitable for this study. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants a chance to contribute to a potentially groundbreaking treatment for presbyopia.

Will I have to stop taking my current medications?

You will need to stop using any topical eye medications, except for certain over-the-counter products, at least 7 days before the trial and during the study. If you are taking any systemic adrenergic or cholinergic drugs, you should not change your dosage or start new ones within 7 days before the trial or during the study.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Earlier studies found Nyxol eye drops to be safe, with most users experiencing no issues. No new safety concerns emerged. Research also shows that combining Nyxol with a small amount of pilocarpine is generally safe. However, caution is advised for some individuals when driving at night after using pilocarpine. Although these treatments are in the final testing stages and are typically considered safe based on previous tests, awareness of potential risks remains important.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about Nyxol Eye Drops combined with low-dose pilocarpine for presbyopia because they offer a new way to improve near vision. Most treatments for presbyopia, like reading glasses or multifocal contacts, don't address the eye's underlying ability to focus. Nyxol works by using phentolamine ophthalmic solution 0.75%, which may help the eye's muscles to focus better. This combination also includes low-dose pilocarpine, known for its ability to constrict the pupil and enhance depth of focus. Together, they could provide a non-invasive alternative to glasses or contact lenses, potentially offering more natural vision improvement for those with presbyopia.

What evidence suggests that this trial's treatments could be effective for presbyopia?

Research has shown that Nyxol, an eye drop containing Phentolamine Ophthalmic Solution 0.75%, helps people with presbyopia improve near vision. One study found that 27.2% of participants using Nyxol improved by at least 15 letters on a near vision test, demonstrating its effectiveness. In this trial, some participants will receive Nyxol alone, while others will receive a combination of Nyxol with a small amount of another eye drop, pilocarpine, to assess if this combination enhances results. This mix aims to help people see clearly up close while wearing glasses for distance vision. While Nyxol alone has shown good results, the combination might offer even more benefits for those with presbyopia.25678

Are You a Good Fit for This Trial?

Inclusion Criteria

Males or females ≥ 40 and ≤ 64 years of age
BCDVA of 0.1 LogMAR (20/25 Snellen equivalent) or better in each eye in photopic conditions
Photopic PD of ≥ 3 mm in either eye
See 2 more

Exclusion Criteria

Recent or current evidence of ocular infection or inflammation in either eye
Known allergy, hypersensitivity, or contraindication to any component of the phentolamine, pilocarpine, or vehicle formulations
Use of any topical prescription or over-the-counter (OTC) ophthalmic medications of any kind within 7 days of Screening until study completion, with the exception of lid scrubs with OTC products and artificial tears as specified in Exclusion # 2 below
See 20 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Nyxol alone or with adjunctive low dose pilocarpine to improve distance-corrected near visual acuity

8 weeks
5 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Low dose pilocarpine
  • Low dose pilocarpine vehicle
  • Phentolamine Ophthalmic Solution 0.75%
  • Placebo
How Is the Trial Designed?
6Treatment groups
Experimental Treatment
Group I: Placebo + low dose pilocarpine vehicleExperimental Treatment2 Interventions
Group II: Placebo + low dose pilocarpineExperimental Treatment2 Interventions
Group III: Nyxol placeboExperimental Treatment1 Intervention
Group IV: Nyxol + low dose pilocarpine vehicleExperimental Treatment2 Interventions
Group V: Nyxol + low dose pilocarpineExperimental Treatment2 Interventions
Group VI: NyxolExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Ocuphire Pharma, Inc.

Lead Sponsor

Trials
13
Recruited
2,200+

Published Research Related to This Trial

Ophthalmic pilocarpine (1.25%) can improve near vision in early presbyopes, with 12-22% of patients achieving better visual acuity compared to a placebo, making it a potential treatment option for those with failing accommodation.
The drug is well tolerated, acts quickly within minutes, and its effects last for several hours, although it may cause reduced night vision and minor distance acuity issues due to smaller pupil size.
Topical Review: Pilocarpine-induced Miosis as Help for Early Presbyopes?Westheimer, G.[2022]
The combination of pilocarpine and oxymetazoline ocular drops showed a significant dose-dependent improvement in uncorrected near visual acuity (UNVA) in individuals with presbyopia, particularly with pilocarpine concentrations between 1.16% and 1.32%.
The most common side effect reported was headache, and while pilocarpine was effective, oxymetazoline did not significantly enhance efficacy or reduce headache severity when added to pilocarpine.
Combinations of Pilocarpine and Oxymetazoline for the Pharmacological Treatment of Presbyopia: Two Randomized Phase 2 Studies.Price, FW., Hom, M., Moshirfar, M., et al.[2022]
In a Phase 2b trial involving 39 patients with elevated intraocular pressure (IOP), phentolamine mesylate ophthalmic solution (PMOS) did not significantly lower IOP compared to placebo, but showed a trend towards greater decreases in patients with lower baseline IOP.
PMOS significantly reduced pupil diameter by 20% and improved distance-corrected near visual acuity in many patients, indicating potential benefits for those with presbyopia and dim light vision disturbances, while being well tolerated with no significant side effects.
Phentolamine Mesylate Ophthalmic Solution Provides Lasting Pupil Modulation and Improves Near Visual Acuity in Presbyopic Glaucoma Patients in a Randomized Phase 2b Clinical Trial.Pepose, JS., Hartman, PJ., DuBiner, HB., et al.[2022]

Citations

NCT05646719 | Safety and Efficacy of Nyxol Eye Drops as ...The objectives of this study are: To evaluate the safety and efficacy of Nyxol alone and with adjunctive low dose pilocarpine to improve distance-corrected near ...
Phentolamine Eyedrop Significantly Improves Near Visual ...Findings showed that 27.2% of patients treated with phentolamine ophthalmic solution 0.75% achieved an at least 15 letter improvement in DCNVA, ...
Opus Genetics Announces VEGA-3 Phase 3 Trial Met its ...27.2% of participants treated with Phentolamine Ophthalmic Solution 0.75% achieved a ≥15-letter improvement in DCNVA, with less than a 5-letter ...
Phase 3 trial of phentolamine for presbyopia achieves ...According to the release, 27.2% of participants who received phentolamine achieved the primary endpoint vs. 11.5% of participants who received ...
Opus Genetics reports positive phase 3 results for ...VEGA-3 trial showed significant efficacy of phentolamine ophthalmic solution 0.75% in improving near vision in presbyopia patients compared to ...
Safety and Efficacy of Nyxol With Pilocarpine Eye Drops in ...Safety and Efficacy of Nyxol With Pilocarpine Eye Drops in Subjects With Presbyopia. ClinicalTrials.gov ID NCT04675151. Sponsor Ocuphire Pharma, Inc.
Ocuphire Pharma Announces Publication of Full Phase 3 ...Published data from two Phase 3 clinical trials demonstrated rapid reversal of pharmacologically-induced mydriasis with favorable safety profile.
Phentolamine Eyedrop Significantly Improves Near Visual ...The safety profile of phentolamine ophthalmic solution 0.75% was consistent with previous trials, with no new safety signals identified and no ...
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