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Patrik De Haes, MD: What's Coming Down the Retina Pipeline

An anti-PIGF, a plasma kallikrein inhibitor, and a pan RGD integrin antagonist are some of the investigational treatments in the pipeline for diabetic retinopathy and diabetic macular edema.

At the 2018 American Academy of Ophthalmology Annual Meeting in Chicago, IL, Patrik De Haes, MD, CEO of Oxurion (formerly ThromboGenics) spoke about several investigational molecules his company is investigating for various retina conditions.

These include THR-317, an anti-PIGF, being investigated in conjunction with the anti-VEGF ranibizumab (Lucentis) for the treatment of diabetic retinopathy and diabetic macular edema (DME); THR-149, a plasma kallikrein inhibitor, being investigated for the treatment of DME; and THR-687, a pan RGD integrin antagonist, under investigation for the treatment of diabetic retinopathy and DME.

What gaps remain for the treatment of diabetic macular edema?

So, for diabetic eye disease the standard therapy nowadays is anti-VEGF treatment, but about 40% of patients do not or sub-optimally respond to anti-VEGFs.

What investigational drugs do you have in clinical trials?

So, we have 3 new molecules in [clinical trials]. One of them is a placental growth factor (PIGF) that is of the VEGF family and there in a [phase 1] study we have found some very interesting results—up to 30% of patients had their BCVA improve with 3 lines and that was a day 90, so 30 days after the last injection and even at day 150, which is 90 days after last injection, a subset still had improved visual acuity. The second molecule is a plasma kallikrein inhibitor. That's a strong anti-edema product. It is now in phase 1 and then the third molecule is an integrin inhibitor—also a strong molecule, possibly an alternative to anti-VEGFs and also in [a clinical trial].

What stood out in the results of your phase 1/2 study of the anti-PIGF THR-317?

Well in that study we had a group of what they call treatment naive patients that had not been treated before with anti-VEGFs and treatment resistance. On the treatment resistant side, we had some patients that responded quite well, but we are still analyzing, patient-by-patient, why the patient responded or not to see whether we can find elements to predict who could be a potential responder or not.

What drew you to the field of ophthalmology?

Into ophthalmology… You know I've been active in diabetes for like 20 years—I've been working in the diabetes field and we were working in ophthalmology and so the need the medical need in in diabetic eye disease is huge. So, I diagnosed my own son with type 1 diabetes and I do know that if you ask people with diabetes, their biggest concern—it's not about losing a toe or a foot, it is losing the eyesight. So, we as a company are very committed to make sure that we bring drugs with good value for the patient to the market.

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