- Veligrotug met all primary and secondary endpoints with high statistical significance in THRIVE-2, achieving a week 15 proptosis responder rate (PRR) of 56% (placebo-adjusted PRR of 48%, p < 0.0001) -
- THRIVE-2 is the first global phase 3 study in patients with chronic TED to demonstrate a statistically significant and clinically meaningful 56% diplopia responder rate (placebo-adjusted rate of 31%, p = 0.0006) and 32% rate of diplopia complete resolution (placebo-adjusted rate of 18%, p = 0.0152) -
- Veligrotug was generally well-tolerated with 94% of patients completing their treatment course and a 9.6% placebo-adjusted rate of hearing impairment -
- BLA submission for veligrotug on track for second half of 2025; potential to transform the standard of care in TED with differentiated clinical profile demonstrated in the broadest population studied in a global phase 3 study across active and chronic TED patients to date -
- REVEAL-1 and REVEAL-2, global phase 3 clinical trials of subcutaneous VRDN-003 evaluating every four-week (Q4W) or every eight-week (Q8W) regimens, are both currently dosing and on track for topline data in 1H 2026; VRDN-003 is a half-life-extended anti-IGF-1R antibody with the same binding domain as veligrotug -
- Strong cash position of $753 million as of September 30, 2024; provides cash runway into the second half of 2027 through the anticipated commercial launch of veligrotug, topline results and BLA submission for subcutaneous VRDN-003, and multiple FcRn inhibitor clinical catalysts -
Viridian Therapeutics, Inc. announced positive topline data from the THRIVE-2 phase 3 clinical trial of veligrotug (veli), an intravenously (IV) delivered anti-insulin-like growth factor-1 receptor (IGF-1R) antibody, in patients with chronic thyroid eye disease (TED). TED is an autoimmune condition characterized by inflammation, growth, and damage to tissues around and behind the eyes.
“We are extremely pleased to announce better-than-expected THRIVE-2 results generated in the broadest population of chronic TED patients studied in a global phase 3 study to date. We believe that these efficacy and safety results in only five infusions, combined with our compelling data from THRIVE, confirm the potential of veli to be the treatment-of-choice for all forms of active and chronic TED,” said Steve Mahoney, Viridian’s President and CEO. “The robustness and consistency of our data, similar to THRIVE, showed strong and rapid responses in categories that we believe matter most to patients including proptosis reduction, diplopia resolution and improvements in Clinical Activity Scores. This is the first product candidate to demonstrate a diplopia response and resolution rate in a global chronic TED phase 3 study. Our BLA preparation work is underway, and, if approved, we now believe veli will offer a differentiated commercial product profile to patients. The combined results of THRIVE and THRIVE-2, give us even higher conviction that our subcutaneous VRDN-003 program will deliver positive topline data in the first half of 2026, which would enable a BLA submission in the second half of 2026.”
“These data represent an incredible step forward for TED patients. I’ve been treating TED for over 30 years, and these results in the broadest population of TED patients are highly encouraging. Resolving double vision or even improving it in chronic TED patients can really change their lives,” said Steven Leibowitz, MD, associate clinical professor of Ophthalmology, Stein Eye Institute, University of California Los Angeles and THRIVE-2 investigator. “I see veligrotug’s potential product profile as highly compelling with a rapid onset of treatment effect, diplopia benefit across a broad TED population, shorter dosing regimen, and favorable safety profile.”
THRIVE-2 phase 3 topline results
THRIVE-2 Clinical Activity Data
THRIVE-2 met all primary and secondary endpoints at the 15-week primary analysis timepoint after five infusions of veligrotug, showing statistically significant responses on all of the measured signs and symptoms of TED: proptosis, CAS, and diplopia. THRIVE-2 enrolled a total of 188 patients, randomized to veligrotug (n = 125) and placebo (n = 63). The mean time since onset of TED in this patient population was 69.8 months.
The key data at the primary efficacy analysis timepoint of 15 weeks are as follows:
Proptosis:
- Proptosis Responder Rate (PRR): 56% in veligrotug patients, compared with 8% in placebo patients (48% placebo-adjusted, p < 0.0001). PRR was statistically significant at all time points, including as early as 3 weeks after just one infusion, demonstrating a rapid onset of response. PRR is defined as at least a 2-millimeter (mm) reduction in proptosis from baseline in the study eye without worsening in the fellow eye (≥ 2 mm increase), as measured by exophthalmometry. PRR results as measured by MRI/CT were consistent with those measured by exophthalmometry at the primary efficacy analysis timepoint.
- Proptosis Mean Reduction: 2.34mm mean reduction in proptosis from baseline in veligrotug patients, compared with 0.46mm reduction in placebo patients (1.9mm placebo-adjusted, p < 0.0001).
Diplopia:
- Diplopia Response: 56% of veligrotug patients achieved a diplopia response, compared with 25% of placebo patients (31% placebo-adjusted, p = 0.0006). Rapid onset was observed as early as 6 weeks after just two infusions. Diplopia response is defined as patients achieving a reduction of at least 1 on the Gorman subjective diplopia scale at week 15, for those patients with diplopia at baseline (n = 102).
- Diplopia Complete Resolution: 32% of veligrotug patients achieved complete resolution of diplopia, compared with 14% of placebo patients (18% placebo-adjusted, p = 0.0152). Rapid onset was observed as early as 6 weeks after just two infusions. Diplopia resolution is defined as patients achieving a score of 0 on the Gorman subjective diplopia scale at week 15, for those patients with diplopia at baseline.
Clinical Activity Score (CAS):
CAS measures inflammatory signs and symptoms of TED, providing a composite score of pain, as well as redness and swelling of the eyelids and conjunctiva, on a scale from 0 to 7.
- CAS Reduction to 0 or 1: 54% of veligrotug patients achieved maximal or near-maximal therapeutic effect on CAS, compared with 24% of placebo patients (29% placebo-adjusted, p = 0.006), defined as reaching a CAS of 0 or 1, among patients with a CAS of ≥ 3 at baseline (n = 104).
- CAS Mean Reduction: 2.9-point mean reduction in CAS from baseline in veligrotug patients, compared with 1.3-point reduction in placebo patients (1.6-point placebo-adjusted, p < 0.0001), among patients with a CAS of ≥ 3 at baseline.
Overall Response:
- Overall Responder Rate: 56% of veligrotug patients achieved an overall response, compared with 7% of placebo patients (50% placebo-adjusted, p < 0.0001). Overall Responder Rate is defined as achieving a proptosis response without worsening of CAS from baseline (≥ 1 point increase) and without worsening in the fellow eye in either proptosis (2 mm increase) or CAS.
THRIVE-2 Safety Data
- Generally Well-Tolerated: Veligrotug was generally well-tolerated with a safety profile consistent with previous veligrotug studies including THRIVE. The majority of adverse events (AEs) were mild, and 94% of veligrotug-treated patients completed their treatment course.
- Low Rate of Hearing Impairment: There was a 9.6% placebo-adjusted rate of hearing impairment AEs (12.8% incidence in veligrotug patients, compared with 3.2% incidence in placebo patients).
“Seeing the strong data presented today demonstrating that diplopia can in fact be improved in patients with long standing chronic TED is exciting. Together with the robust activity in both THRIVE and THRIVE-2, favorable safety profile, and a shorter dosing regimen, we believe veli is positioned to become a market leading TED therapeutic,” said Tony Casciano, Chief Commercial Officer. “Veli has the potential to be the only approved therapy with data in chronic patients included in the labeling. We believe the strength and completeness of veli’s pivotal program, the largest to date in TED, could not only ensure advantageous market access, but also expand utilization in patients unaddressed by current therapies. Veli’s profile itself is inspiring, and if approved, our commercial team is eager to get veli to patients.”
Subcutaneous VRDN-003, a Potential Best-In-Class Anti-IGF-1R, On Track to Report Topline 1H 2026
VRDN-003 is an IGF-1R antibody with the same binding domain as veligrotug and is believed to be the only anti-IGF-1R in development with an extended half-life.
Based on this shared binding domain, Viridian believes the topline results from THRIVE-2, in addition to the previously reported THRIVE results, reinforces the potential best-in-class profile of VRDN-003 to deliver clinical activity and safety consistent with veligrotug in a low-volume, infrequent, self-administered, subcutaneous injection that patients take at home.
Viridian is currently dosing patients in two global phase 3 clinical trials for VRDN-003, REVEAL-1 and REVEAL-2, in active and chronic TED, respectively. Viridian anticipates reporting topline data from these studies in the first half of 2026 and submitting a BLA for VRDN-003 for the treatment of TED by year-end 2026.