Per
Ocular to conduct interim
Complete AXPAXLI NDA package in wet AMD planned to be submitted in 4Q 2026
Ocular will evaluate superiority of AXPAXLI vs aflibercept (8mg) Q6M at Week 96 as a key secondary endpoint of the
New secondary endpoint addition to
In alignment with the FDA, Ocular plans to submit its NDA under the 505(b)(2) pathway, with potential to accelerate the review timeline by up to 60 days
Following strong
The event will begin at
“Our consistently strong execution has brought us to a pivotal milestone today. We are thrilled to announce that we have FDA alignment on our plans to submit the AXPAXLI NDA for wet AMD in the fourth quarter of 2026, based on
Investor Day Highlights
Wet Age-Related Macular Degeneration (wet AMD) Program Highlights
- During
May 2026 Type C Meeting, Ocular reached alignment withU.S . FDA to submit AXPAXLI New Drug Application (NDA) in wet AMD based onSOL-1 data plus confirmatory evidence under the 505(b)(2) pathway.SOL-1 constitutes an adequate and well-controlled study, as previously aligned through a Special Protocol Assessment (SPA) agreement, with a p-value for its primary endpoint (p=0.0006) that is highly supportive of a single trial approval. Based on its Type C Meeting with the FDA, Ocular plans to submit its NDA under the 505(b)(2) pathway. The 505(b)(2) pathway can accelerate the review timeline for new formulations, dosages, routes of administration, or indications of previously approved drugs by up to 60 days. - FDA indicates it will review the NDA submission based on a single pivotal trial in light of results from
SOL-1 at Week 52.SOL-1 demonstrated superiority on the pre-specified primary endpoint of maintenance of vision at Week 36, with strengthening effect size over time, consistent visual outcomes, and supportive anatomic benefits, which together create a highly persuasive data package around substantial evidence of efficacy. All six pre-specified sensitivity analyses for theSOL-1 primary endpoint at Week 36 were statistically significant, and the first three of five hierarchically controlled key secondary endpoints were also met with statistical significance. - Ocular plans to support its NDA submission for AXPAXLI with broad confirmatory evidence. The
U.S . FDA defines confirmatory evidence in itsSeptember 2023 draft guidance for industry titled “Demonstrating Substantial Evidence of Effectiveness with One Adequate and Well-Controlled Clinical Investigation and Confirmatory Evidence”. The AXPAXLI NDA is expected to be supported by strong confirmatory evidence, including mechanistic, pharmacodynamic, animal model, natural history, class consistency, and real-world evidence. - To meet FDA requirements for safety exposure, Ocular plans to conduct an interim safety analysis for
SOL-R in fourth quarter of 2026. TheU.S . FDA notes that one trial may establish effectiveness but still requires adequate safety exposure, defined in the 2023 guidance for neovascular AMD trials as a minimum of 300 patients at the time of NDA submission. With 170 subjects receiving AXPAXLI inSOL-1 , Ocular plans to conduct an interim safety analysis of patients completing one year inSOL-R during the fourth quarter of 2026 to reach an aggregate of greater than 300 patients with at least one year of treatment acrossSOL-1 andSOL-R . Because of the interim analysis,SOL-R will incur a 0.0001 alpha penalty during its statistical analysis. - Ocular plans to hold a pre-NDA meeting in third quarter of 2026 with
U.S . FDA. The meeting is intended to confirm the format and content of information to be submitted in the NDA and to ensure the FDA has exactly what it needs to review the drug for marketing approval. - The Company expects to submit a complete NDA package in fourth quarter of 2026. At the standard 120-day safety update following the submission of its NDA, Ocular plans to submit Year
2 SOL-1 safety data to the FDA to support repeat dosing on a potential label for AXPAXLI, if approved. - Because
SOL-R efficacy is no longer part of the planned NDA submission or review, Ocular intends to leverage the trial to best serve its long-term strategic objectives for AXPAXLI. This includes maintaining masking ofSOL-R to subjects, investigators, and the Company until Week 96 to evaluate new secondary endpoints, with topline data now expected in first quarter of 2028.
- A new key secondary endpoint is evaluating superiority to aflibercept (8 mg) in terms of mean change in BCVA from baseline to Week 96. Subjects in the masking arm of
SOL-R receive aflibercept (8 mg) every 24 weeks, matching the same cadence as the AXPAXLI arm. The aflibercept (8 mg) dosing interval in wet AMD was recently expanded for up to every five months dosing after one year of treatment. This new key secondary endpoint inSOL-R will be evaluated at Week 96 to align as closely with aflibercept (8 mg) Year 2 approved dosing interval as possible. - To show further differentiation from aflibercept (2 mg), dosed every eight weeks in
SOL-R , Ocular intends to evaluate prevention of fibrosis and atrophy at Week 96 in a masked manner, potentially enabling its inclusion on the AXPAXLI label. - The
SOL-R primary endpoint of non-inferiority in mean BCVA change from baseline between the AXPAXLI and on-label aflibercept (2 mg) arms at Week 56 remains unchanged. Ocular will not enroll additional subjects inSOL-R , and the Company does not plan to includeSOL-R efficacy data as part of its planned NDA submission in the fourth quarter of 2026 or during the subsequent review period.
- A new key secondary endpoint is evaluating superiority to aflibercept (8 mg) in terms of mean change in BCVA from baseline to Week 96. Subjects in the masking arm of
“The regulatory framework for single-trial approval requires an adequate and well-controlled study, a protocol that is aligned with the FDA, the primary endpoint to be met with high statistical significance, clinically meaningful results, a robust safety dataset, and supporting confirmatory evidence,” commented
Diabetic Retinopathy (DR) Program Highlights
- Ocular announced plans to streamline its diabetic retinopathy (DR) program to prioritize a single global registrational superiority study, HELIOS-3. Based on the strength of the
SOL-1 and prior HELIOS-1 data, along with emerging market research indicating strong physician preference for a once-yearly treatment paradigm in DR, the Company plans to advance a streamlined superiority trial evaluating AXPAXLI Q12M versus sham. In HELIOS-3, non-proliferative diabetic retinopathy (NPDR) subjects will receive either AXPAXLI or sham injections at randomization and Week 48. The primary endpoint for HELIOS-3, an ordinal =2-step change in diabetic retinopathy severity score (DRSS), will be measured at Week 56. The Company expects the streamlined approach to preserve its ability to achieve global regulatory objectives and maximize the commercial opportunity for AXPAXLI in diabetic retinal disease. The trial is intended to support a broad DR label, including patients with non-center-involved diabetic macular edema (non-CI DME).
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About AXPAXLI
AXPAXLI™ (also known as OTX-TKI) is an investigational, bioresorbable, intravitreal hydrogel incorporating axitinib, a small molecule, multi-target, tyrosine kinase inhibitor with anti-angiogenic properties, being evaluated for the treatment of wet AMD and diabetic retinal disease.
About the
The registrational Phase
The superiority trial has an eight-week loading segment prior to randomization. During the loading segment, subjects who have 20/80 vision or better and a central subfield thickness (CSFT) of =500 µm receive two doses of aflibercept (2 mg) at Week -8 and Week -4. Subjects who achieve best corrected visual acuity (BCVA) of 20/20 at Day 1 (baseline) or gain at least 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at Day 1 along with a CSFT of =350 µm were then randomized to receive a single dose of AXPAXLI (0.45 mg) or a single dose of aflibercept (2 mg). At Week 52 and at Week 76, all subjects are re-dosed with their respective initial treatment of AXPAXLI (0.45 mg) or aflibercept (2 mg). Subjects will be followed for safety until the end of Week 104.
Throughout the trial, subjects are assessed monthly. Trial subjects and designated trial personnel will remain masked through the end of Week 104. The clinical trial protocol requires that, during the trial, subjects in either arm meeting the pre-specified rescue criteria, which include a BCVA loss of =15 ETDRS letters from baseline or new vision-threatening macular hemorrhage, will receive a supplemental dose of aflibercept (2 mg). The protocol provides that after the first rescue injection, rescue therapy may be provided at investigator discretion per their clinical judgement.
The primary endpoint of
In
About the SOL-R Trial
The registrational Phase 3
This non-inferiority trial reflects a patient enrichment strategy over the six months prior to randomization that includes three screening doses of any anti-VEGF therapy, excluding brolucizumab-dbll, and monitoring to exclude those subjects with early persistent fluid or significant retinal fluid fluctuations. Subjects who continue to meet eligibility, defined as a CSFT of =350 µm at Week -12 and Week -8 with =35 µm CSFT increase from the lowest CSFT at any prior visit, entered a run-in period and received two loading doses of aflibercept (2 mg) prior to Day 1. Subjects in the first arm receive a single dose of AXPAXLI (0.45 mg) at Day 1 and are re-dosed at Weeks 24, 48, and 72. Subjects in the second arm receive aflibercept (2 mg) on Day 1 and per label every eight weeks thereafter. Subjects in the third arm receive a single dose of aflibercept (8 mg) at Day 1 and are re-dosed at Weeks 24, 48, and 72, aligned with the AXPAXLI treatment arm for adequate masking. Subjects will be followed for safety until the end of Week 96. Throughout the trial, subjects are assessed monthly. Trial subjects and designated trial personnel will remain masked through the end of Week 96. Subjects in any arm that meet pre-specified rescue criteria will receive a supplemental dose of aflibercept (2 mg). The pre-specified rescue criteria include a >5-letter loss in visual acuity plus a =75 µm increase in CSFT.
The primary endpoint of
About the HELIOS-3 Trial
The registrational Phase 3 HELIOS-3 trial (NCT07235085) is designed to evaluate the safety and efficacy of AXPAXLI in a multi-center, double-masked, randomized (1:1) two-arm superiority trial. The trial is designed to enroll approximately 620 subjects with moderately severe to severe non-proliferative diabetic retinopathy (NPDR) without center-involved diabetic macular edema (CI-DME). The first patient was randomized in the HELIOS-3 trial in
Subjects in the first arm receive a single dose of AXPAXLI at Day 1 and are re-dosed at Week 48. Subjects in the second arm receive a sham injection at Day 1 and Week 48 aligned with the AXPAXLI treatment arm for adequate masking. Throughout the trial, subjects are assessed every 4 weeks from Day 1 through Week 56 and every other month thereafter through Week 96.
The primary endpoint of HELIOS-3 is the ordinal diabetic retinopathy severity score (DRSS) 2-step change status at Week 56 from baseline (=2-step improvement, =2-step worsening, less than 2-step change in either direction).
About Wet AMD
Wet age-related macular degeneration (wet AMD) is a leading cause of severe, irreversible vision loss affecting approximately 14.8 million individuals globally and 1.7 million in
About Diabetic Retinal Disease
Diabetic retinal disease is an increasingly prevalent global health concern, driven by the rapidly rising number of individuals diagnosed with diabetes each year.
Diabetic retinopathy (DR) is the most common category of retinal diseases, affecting over an estimated 103 million people worldwide. DR is a progressive condition in which retinal blood vessels are damaged following a cascade of events triggered by chronically elevated levels of blood glucose. As many as half of all diabetic patients are expected to develop some form of DR in their lifetime. DR can progress from the non-proliferative (NPDR) stages to the proliferative (PDR) stage characterized by the growth of abnormal new blood vessels. Fewer than 1% of the 6.4 million NPDR patients in the
Diabetic macular edema (DME) is also a leading cause of vision loss in the working-age population. DME, the result of an accumulation of fluid in the macula that can afflict patients with diabetes, can occur at any stage of DR. In patients with DME, blood vessels in the eyes leak and start to swell, which can cause vision loss or blindness. Anti-VEGF drugs are approved to treat DME, but these treatments typically require frequent intravitreal injections, placing a significant burden on patients and physicians alike.
About Ocular Therapeutix, Inc.
Ocular Therapeutix, Inc. is an integrated biopharmaceutical company committed to redefining the retina experience. AXPAXLI™ (also known as OTX-TKI), Ocular’s investigational product candidate for retinal disease, is an axitinib intravitreal hydrogel based on its ELUTYX™ proprietary bioresorbable hydrogel-based formulation technology. AXPAXLI is currently in Phase 3 clinical trials for wet age-related macular degeneration (wet AMD) and diabetic retinal disease, including non-proliferative diabetic retinopathy (NPDR).
Ocular’s pipeline also leverages the ELUTYX technology in its commercial product DEXTENZA®, an FDA-approved corticosteroid for the treatment of ocular inflammation and pain following ophthalmic surgery in adults and pediatric patients and ocular itching associated with allergic conjunctivitis in adults and pediatric patients aged two years or older, and in its investigational product candidate OTX-TIC, which is a travoprost intracameral hydrogel that has completed a Phase 2 clinical trial for the treatment of open-angle glaucoma or ocular hypertension. Ocular is currently evaluating next steps for the OTX-TIC program.
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DEXTENZA® is a registered trademark of Ocular Therapeutix, Inc. The Ocular Therapeutix logo, AXPAXLI™, ELUTYX™, and Ocular Therapeutix™ are trademarks of Ocular Therapeutix, Inc.
Forward-Looking Statements
This press release contains forward-looking statements of the Company regarding its future expectations, plans, and prospects; statements regarding the development and regulatory status of the Company’s product candidate AXPAXLI (also known as OTX-TKI), including the Company’s intention to submit a new drug application for AXPAXLI for the treatment of wet AMD based on Week 52 efficacy and safety data from the Company’s SOL-1 Phase 3 clinical trial and Week 52 data from an interim safety analysis to be conducted in the Company’s SOL-R clinical trial and planned amendments to the clinical trial protocols of the Company’s SOL-R and HELIOS-3 clinical trials; statements regarding the timing, design, enrollment, randomization, conduct and retention of subjects in the Company’s ongoing and planned clinical trials for AXPAXLI, including the SOL-1 and SOL-R Phase 3 clinical trials for the treatment of wet AMD and the HELIOS-3 trial for non-proliferative diabetic retinopathy; statements regarding the commercial potential of AXPAXLI; statements regarding the timing of the availability of data from the SOL-R trial; statements regarding the potential commercialization of AXPAXLI, including statements regarding the potential label of AXPAXLI, if approved; statements regarding the Company’s cash runway and the sufficiency of the Company’s cash resources; statements regarding the potential utility or adoption, if approved, of any of the Company’s product candidates, including AXPAXLI; and other statements containing the words “anticipate”, “believe”, “estimate”, “expect”, “intend”, “designed”, “goal”, “may”, “might”, “plan”, “position”, “predict”, “project”, “target”, “potential”, “will”, “would”, “could”, “should”, “continue”, and similar expressions, all of which constitute forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by such forward-looking statements as a result of various important factors. Such forward-looking statements involve substantial risks and uncertainties that could cause the Company’s development programs, future results, performance, or achievements to differ significantly from those expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others, uncertainties regarding the initiation, design, timing, conduct and outcomes of the Company’s ongoing clinical trials, including the Company’s SOL-1 trial, SOL-R trial, HELIOS-3 trial, and SOL-X trial; the timing and costs involved in commercializing any product or product candidate that receives regulatory approval; the risk that the U.S. Food and Drug Administration, or FDA, will not agree with the Company’s interpretation of the written agreements under the Special Protocol Assessments for AXPAXLI, including for the SOL-1 trial; uncertainty as to whether the FDA will accept a new drug application for AXPAXLI on the basis of a single pivotal clinical trial, notwithstanding discussions the Company has had with the FDA regarding its planned NDA submission; uncertainty as to the minimum clinical data required to demonstrate the safety of a proposed product candidate such as AXPAXLI, even if the FDA recognizes that only one pivotal clinical trial may be required to demonstrate efficacy; the risk that even though the FDA has agreed with the overall design of the SOL-1 trial, the FDA may not find that the data generated by the trial and submitted by the Company are sufficient to demonstrate the safety and efficacy of AXPAXLI to the degree necessary to support marketing approval for wet AMD; the risk that the FDA might not agree to the Company’s design, protocol, and statistical analysis plan of any of its clinical trials for which the Company has not obtained a Special Protocol Assessment, including the SOL-R trial; the risk that the Company and the FDA may not agree on, or maintain agreement with respect to, the registrational pathway for any of its product candidates, including AXPAXLI; uncertainty as to whether the Company will be able to timely satisfy the FDA’s other requirements for regulatory approval of AXPAXLI, including the FDA’s Chemistry, Manufacturing and Control’s requirements, even if the Company can satisfy the FDA’s clinical requirements to demonstrate safety and efficacy; uncertainty as to whether the Company’s NDA will qualify for, or whether the FDA will agree to review the NDA, if accepted for filing, under the 505(b)(2) pathway, notwithstanding discussions the Company has had with the FDA regarding its planned regulatory pathway, and whether the 505(b)(2) pathway will provide any time-savings as compared to the traditional 505(b)(1) pathway; uncertainty as to what restrictions, if any, may be imposed on the label for AXPAXLI, if approved, pending the receipt of additional clinical data or otherwise; uncertainty as to whether the data from earlier clinical trials will be predictive of the data of later clinical trials, particularly later clinical trials that have a different design or utilize a different formulation than the earlier trials, whether preliminary or interim data from a clinical trial will be predictive of final data from such trial, or whether data from a clinical trial assessing a product candidate for one indication will be predictive of results in other indications; uncertainty as to the Company’s ability to retain regulatory approval of any product or product candidate that receives regulatory approval; uncertainty as to whether data from the Company’s SOL-X trial will demonstrate additional clinically meaningful, long-term benefits; uncertainties regarding the potential commercial advantages and/or position of the Company’s product candidates; uncertainty regarding the implementation and impact of most-favored-nation and other reference pricing regimes on the commercial potential of AXPAXLI, especially in markets outside the United States; availability of data from clinical trials and expectations for regulatory submissions and approvals; the Company’s scientific approach and general development progress; uncertainties inherent in estimating the Company’s cash runway, future expenses and other financial results, including its ability to fund future operations, including clinical trials; the Company’s existing indebtedness and the ability of the Company’s creditors to accelerate the maturity of such indebtedness upon the occurrence of certain events of default; and other factors discussed in the “Risk Factors” section contained in the Company’s quarterly and annual reports on file with the Securities and Exchange Commission. In addition, the forward-looking statements included in this press release represent the Company’s views as of the date of this press release. The Company anticipates that subsequent events and developments may cause the Company’s views to change. However, while the Company may elect to update these forward-looking statements at some point in the future, the Company specifically disclaims any obligation to do so, whether as a result of new information, future events or otherwise, except as required by law. These forward-looking statements should not be relied upon as representing the Company’s views as of any date subsequent to the date of this press release.
Investors & Media
Ocular Therapeutix, Inc.
Bill Slattery
Vice President, Investor Relations
bslattery@ocutx.com
Source: Ocular Therapeutix, Inc.
