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. 2022 Jan 4:16:15-23.
doi: 10.2147/OPTH.S345324. eCollection 2022.

Reproxalap Improves Signs and Symptoms of Allergic Conjunctivitis in an Allergen Chamber: A Real-World Model of Allergen Exposure

David Clark  1 , Paul Karpecki  2 , Anne Marie Salapatek  3 , John D Sheppard  4 , Todd C Brady  1
Affiliations

Reproxalap Improves Signs and Symptoms of Allergic Conjunctivitis in an Allergen Chamber: A Real-World Model of Allergen Exposure

David Clark et al. Clin Ophthalmol. .

Abstract

Purpose: To assess the prophylactic and treatment activity of reproxalap, a novel reactive aldehyde species inhibitor, in a real-world model of allergen exposure.

Methods: In a randomized, double-masked, vehicle-controlled, crossover Phase 2 trial, 70 adult patients with ≥2 years of moderate to severe allergic conjunctivitis history, a positive skin test to ragweed pollen, and allergen chamber-induced ocular itching and redness scores of ≥2.5 and ≥2 (both scales range from 0 to 4), respectively, were randomized 1:1:1 to one of three sequences: 0.25% reproxalap, 0.5% reproxalap, and placebo; 0.5% reproxalap, placebo, and 0.25% reproxalap; or placebo, 0.25% reproxalap, and 0.5% reproxalap. Symptoms and conjunctival redness were assessed over 3.5 hours in an allergen chamber of aerosolized ragweed pollen (3500 grains/m3). Test article was administered bilaterally just before chamber entry and at 90 minutes after chamber entry.

Results: Reproxalap was safe and well tolerated; 66 of 70 enrolled patients completed all visits. Relative to vehicle, both concentrations of reproxalap demonstrated statistically significant and clinically relevant improvements in ocular itching, tearing, and redness over the duration of exposure in the chamber (P < 0.001 for all assessments). Prophylactic and treatment activity of drug were demonstrated.

Conclusion: In an allergen chamber, reproxalap, a novel reactive aldehyde species inhibitor, was statistically superior to vehicle across the typical symptoms and signs of allergic conjunctivitis. These data are among the first rigorous clinical results demonstrating drug improvement in allergic conjunctivitis in an allergen chamber, a real-world model of allergen exposure.

Keywords: RASP inhibitor; allergen chamber; allergic conjunctivitis; inflammation; reproxalap.

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Conflict of interest statement

D. Clark reports employment with and stock ownership in Aldeyra Therapeutics. P. Karpecki reports consulting for Aerie Pharmaceuticals, Akorn, Alcon Labs, Aldeyra Therapeutics, Allergan/AbbVie, Allysta, Aurinia, Azura Pharmaceuticals, Bausch & Lomb, BioTissue, BlephEx, Bruder Healthcare, Cambium, Dompe, Eyedetec, EyeGate, Eyevance, Imprimis, Kala Pharmaceuticals, Mallinckrodt, Novartis, Oasis Medical, Oyster Point, Regener-Eyes, ScienceBased Health, Sight Sciences, Silk Technologies, Sun Pharmaceutical Industries, Surface Pharmaceuticals, Tarsus Pharmaceuticals, Visant Medical, and Vital Tears. A. M. Salapatek reports employment with Cliantha Research. J.D. Sheppard reports consulting for Allergan, AbbVie, Alcon, Aldeyra Therapeutics, Bausch & Lomb, NovaBay, Novartis, Fidia, Clarios, Visus, Topivert, Noveome, Oyster Point, Santen, Sun Pharmaceutical Industries, Eyevance, ScienceBased Health, and Quidel; and ownership interest in Noveome, Eyedetec, Oyster Point, RPS, TearLab, EyeGate, EyeRx, Clarios, and CVP Partners. T. C. Brady reports employment with and patent interests and stock ownership in Aldeyra Therapeutics and stock ownership in F-star Therapeutics and Evoke Pharma. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Patient disposition. Sequence A = 0.25% reproxalap, 0.5% reproxalap, and vehicle; sequence B = 0.5% reproxalap, vehicle, and 0.25% reproxalap; sequence C = vehicle, 0.25% reproxalap, and 0.5% reproxalap.
Figure 2
Figure 2
Patient-reported ocular itching score. P values derived from mixed effect models for repeated measures analysis of change from baseline (just prior to chamber entry) over all time points in aggregate.
Figure 3
Figure 3
Patient-reported ocular tearing score. P values derived from mixed effect models for repeated measures analysis of change from baseline (just prior to chamber entry) over all time points in aggregate.
Figure 4
Figure 4
Investigator-assessed conjunctival redness score. P values derived from mixed effect models for repeated measures analysis of change from baseline (just prior to chamber entry) over all time points in aggregate.
Figure 5
Figure 5
Time to patient-reported ocular itching score of ≥2 for 0.25% reproxalap versus vehicle. P value derived from log-rank analysis.
Figure 6
Figure 6
Time to investigator-assessed conjunctival redness score of ≥2 for 0.25% reproxalap versus vehicle. P value derived from log-rank analysis.
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References

    1. Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988–1994. J Allergy Clin Immunol. 2010;126(4):778–783. doi:10.1016/j.jaci.2010.06.050 - DOI - PubMed
    1. Leonardi A, Piliego F, Castegnaro A, et al. Allergic conjunctivitis: a cross-sectional study. Clin Exp Allergy. 2015;45(6):1118–1125. doi:10.1111/cea.12536 - DOI - PubMed
    1. Palmares J, Delgado L, Cidade M, Quadrado MJ, Filipe HP; Season Study Group. Allergic conjunctivitis: a national cross-sectional study of clinical characteristics and quality of life. Eur J Ophthalmol. 2010;20(2):257–264. doi:10.1177/112067211002000201 - DOI - PubMed
    1. Mandell KJ, Clark D, Chu DS, Foster CS, Sheppard J, Brady TC. Randomized phase 2 trial of reproxalap, a novel reactive aldehyde species inhibitor, in patients with noninfectious anterior uveitis: model for corticosteroid replacement. J Ocul Pharmacol Ther. 2020;36(10):732–739. doi:10.1089/jop.2020.0056 - DOI - PMC - PubMed
    1. Clark D, Sheppard J, Brady TC. A randomized double-masked phase 2a trial to evaluate activity and safety of topical ocular reproxalap, a novel RASP inhibitor, in dry eye disease. J Ocul Pharmacol Ther. 2021;37(4):193–199. doi:10.1089/jop.2020.0087 - DOI - PMC - PubMed

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