The FDA has accepted for review Aldeyra Therapeutics' resubmitted New Drug Application (NDA) for reproxalap, assigning a Prescription Drug User Fee Act (PDUFA) date of April 2, 2025. Reproxalap is under development as a novel therapy for the signs and symptoms of dry eye disease, a condition affecting approximately 39 million people in the United States. The resubmission follows a Complete Response Letter from the FDA in November 2023, which cited the need for additional evidence supporting reproxalap's efficacy.
Mechanism of Action and Clinical Significance
Reproxalap represents a first-in-class approach to treating dry eye disease. It functions as a small-molecule modulator of reactive aldehyde species (RASP), which are implicated in the inflammatory processes that damage tear lipids and compromise the eye's moisture barrier. By targeting RASP, reproxalap aims to reduce inflammation and improve tear film stability, thereby alleviating the discomfort and visual disturbances associated with dry eye disease. Untreated, severe dry eye disease can lead to permanent vision impairment, highlighting the importance of effective treatments.
Phase 3 Trial Results
The resubmitted NDA includes data from a Phase 3 trial in which 132 participants were exposed to a controlled dry eye chamber to simulate environmental conditions that exacerbate dry eye symptoms. Participants were treated with either reproxalap or a vehicle control. The primary endpoint of the trial was the reduction of ocular discomfort between 80 and 100 minutes within the dry eye chamber. Results indicated that reproxalap achieved the primary endpoint, demonstrating a statistically significant reduction in ocular discomfort compared to the vehicle group.
Safety and Prior Studies
Reproxalap has been evaluated in over 2,500 patients across multiple clinical trials. The most commonly reported adverse event was mild and transient instillation site discomfort, consistent with previous studies. Notably, no treatment-related discontinuations were reported in the clinical trials. Aldeyra Therapeutics also conducted a Phase 3 trial evaluating reproxalap for allergic conjunctivitis, where it demonstrated decreased ocular symptoms and redness. The results of this trial were published in December 2023.
Commercialization Agreement
Aldeyra Therapeutics has an option agreement with AbbVie for the potential commercialization of reproxalap. If AbbVie exercises this option, they will contribute to commercialization activities, potentially expanding the reach of this novel therapy should it receive FDA approval.
