FDA Issues Complete Response Letter for Astellas' Avacincaptad Pegol; Aldeyra's Reproxalap NDA Accepted
Key Insights
The FDA issued a Complete Response Letter for Astellas Pharma's avacincaptad pegol intravitreal solution, indicating the sNDA cannot be approved in its current form.
Aldeyra Therapeutics' resubmitted NDA for topical ocular reproxalap, a first-in-class investigational candidate for dry eye disease (search), has been accepted by the FDA.
Aldeyra Therapeutics is expanding its option agreement with AbbVie (search), securing additional funding to support the commercialization of reproxalap.
Astellas Pharma Faces Setback with Avacincaptad Pegol CRL
Astellas Pharma has received a Complete Response Letter (CRL) from the FDA regarding its supplemental New Drug Application (sNDA) for avacincaptad pegol intravitreal solution. The FDA, in its November 15 CRL, stated that it could not approve the application in its present form. The Prescription Drug User Fee Act (PDUFA) date for the solution was expected to be November 19.
Aldeyra Therapeutics Advances with Reproxalap NDA Acceptance and AbbVie (search) Collaboration
In parallel news, the FDA has accepted the resubmitted New Drug Application (NDA) from Aldeyra Therapeutics for reproxalap, a topical ocular solution aimed at treating the signs and symptoms of dry eye disease (search). Reproxalap is considered a first-in-class investigational candidate.
To support the potential market launch of reproxalap, Aldeyra is expanding its option agreement with AbbVie (search), providing Aldeyra with additional capital. This collaboration aims to leverage AbbVie's resources to facilitate the drug's journey to market.
Ocular Imaging in Emergency Departments: A Paradigm Shift
Dr. Valerie Biousse, a neuro-ophthalmologist at Emory University, highlighted the benefits of using non-mydriatic fundus cameras in emergency departments. According to Dr. Biousse, these cameras facilitate fundus examinations by non-ophthalmologists and allow for remote interpretation of images by ophthalmologists. This approach has streamlined the diagnostic process, particularly in cases of acute central retinal artery occlusion (search), where immediate stroke alerts can be triggered without waiting for in-person ophthalmologist consultations.
"If an acute central retinal artery occlusion (search) is observed on ocular imaging, we do not even come to the hospital anymore, and instead, we trigger a stroke alert, which prompts neurology to take care of the patient immediately," Dr. Biousse explained. This protocol has significantly reduced the time to treatment, potentially allowing for thrombolysis within hours of vision loss.
Furthermore, the use of these cameras has reduced the length of stay in the emergency department for patients being evaluated for papilledema (search). Dr. Biousse noted that over 90% of patients were able to have papilledema ruled out remotely, without requiring an in-person consultation. The implementation of these cameras involves training ED staff, such as EKG technicians, to capture images using user-friendly devices. The images are then reviewed by ophthalmologists, often within 24 hours, to ensure accurate interpretation and billing.
Energy Drink Consumption Linked to Retinal Vascular Occlusions in Young Adults
Dr. Jonathan Brugger, a vitreoretinal surgeon, reported on a cohort of young adults presenting with central retinal vein occlusions (search) or branch retinal vein occlusions (search) with no apparent cause. Upon investigation, a common factor among these patients was the consumption of multiple energy drinks daily. Dr. Brugger's team is expanding their research to include patients with micro and macro aneurysms, exploring the potential link between energy drink consumption and retinal hemorrhaging in both younger and older populations.
"We have determined that these individuals drank a lot of energy drinks...maybe two, three, or four servings a day prior to their episode," Dr. Brugger stated. The research aims to gather data on patient outcomes, presentations, and behavioral changes to lower blood pressure, given the association between vein occlusions and blood pressure.