Clearside Biomedical, Inc., a biopharmaceutical company revolutionizing the delivery of therapies to the back of the eye through the suprachoroidal space (SCS), announced the receipt of the formal meeting minutes from its recent End-of-Phase 2 meeting with the FDA relating to CLS-AX (axitinib injectable suspension) for the treatment of neovascular age-related macular degeneration (wet AMD). CLS-AX combines the flexible dosing of a biologic with the longer duration of a tyrosine kinase inhibitor (TKI) and is administered via suprachoroidal injection utilizing Clearside’s patented SCS Microinjector.
“We are pleased to report the positive outcome of our end-of-phase 2 meeting with the FDA,” said George Lasezkay, PharmD, JD, president and CEO “With a positive safety profile, extended duration, and proven re-dosing capability, CLS-AX has the potential to provide a compelling alternative in the $12+ billion wet AMD market. We look forward to highlighting our proposed Phase 3 program during our upcoming earnings call later this month.”
Victor Chong, MD, MBA, chief medical officer and EVP, head of Research and Development, commented, “Our interactions with the FDA have been very positive and productive and we are aligned on our proposed phase 3 program. Recognizing that wet AMD patients require individualized treatment schedules, our proposed phase 3 trials are designed to support a flexible maintenance dosing label of CLS-AX for every 3 to 6 months as needed based on patient disease assessments by the physician.”
The meeting and formal minutes confirmed key elements for two proposed phase 3, non-inferiority, pivotal trials, including agreement on the protocol design, patient population, primary and secondary endpoints, and use of sham injections.
CLS-AX proposed phase 3 program Highlights:
- Two concurrent, pivotal non-inferiority trials with a primary study endpoint of average change in best corrected visual acuity (BCVA) from baseline at Week 52, which ensures participants receive multiple doses of CLS-AX;
- Each trial will have two arms with ~225 participants per arm comparing CLS-AX (1 mg) to aflibercept (2 mg);
- Enrollment of treatment naïve participants, which represents a broader set of the general wet AMD population and enables quicker recruitment;
- Optimization of study population to reduce variability by using tight screening criteria and eliminating participants with highly variable visual acuity prior to randomization;
- Use of detailed re-dosing criteria for CLS-AX to minimize need for rescue treatment; and
- One-year safety follow up period to meet the registration requirement to submit two years of safety data.
About CLS-AX (axitinib injectable suspension)
Clearside is developing CLS-AX as a longer-acting therapy for the treatment of retinal diseases. CLS-AX (axitinib injectable suspension) is a proprietary suspension of axitinib for suprachoroidal injection. Axitinib is a tyrosine kinase inhibitor (TKI), currently approved as an oral tablet formulation to treat advanced renal cell carcinoma, that achieves pan-VEGF blockade, directly inhibiting VEGF receptors-1, -2, and -3 with high potency and specificity. Clearside believes this broad VEGF blockade may have efficacy advantages over existing retinal therapies by acting at a different level of the angiogenesis cascade and may benefit patients who sub-optimally respond to current, more narrowly focused anti-VEGF therapies. Suprachoroidal injection of this proprietary suspension of axitinib has demonstrated meaningful potential in Phase 1/2a and Phase 2b wet AMD clinical trials in which CLS-AX was well tolerated and demonstrated a positive safety profile. With suprachoroidal administration of axitinib, there is the potential to achieve prolonged duration and targeted delivery to affected tissue layers by compartmentalizing axitinib behind the retina, thereby limiting drug exposure to the front of the eye.
About Clearside’s suprachoroidal space (SCS) injection platform and SCS Microinjector
Clearside’s patent protected, proprietary suprachoroidal space (SCS®) injection treatment approach offers unprecedented access to the back of the eye, where sight-threatening disease often occurs. The Company’s unique platform is inherently flexible and intended to work with established and new formulations of medications. Clearside’s patented SCS Microinjector® can deliver a wide variety of drug candidates into the suprachoroidal space, providing targeted delivery to potentially improve efficacy and compartmentalization of medication to reduce or eliminate toxic effects on non-diseased cells. The SCS Microinjector is comprised of a syringe with a custom-designed hub and two 30-gauge hollow microneedles of varying lengths, each approximately one millimeter, optimizing insertion and suprachoroidal administration of drugs.