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EyePoint fails to meet primary goal in phase 2 NPDR trial

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EyePoint Pharmaceuticals, Inc. reported new topline interim data from its phase 2 PAVIA study assessing its newly-named DURAVYU, an investigational candidate for the treatment of non-proliferative diabetic retinopathy (NPDR).

The results were a mixed bag of positive and negative data—read below for our rundown.

Let’s start with DURAVYU.

DURAVYU (vorolanib intravitreal insert)—formerly named EYP-1901, in case it doesn’t sound familiar to you— is a small-molecule, selective and potent pan-vascular endothelial growth factor (VEGF) receptor inhibitor for the treatment of retinal disease.

What it does: incorporates a bioerodible formulation of EyePoint’s proprietary DURASERT delivery technology (DURASERT E; more on that later) with vorolanib (a tyrosine kinase inhibitor [TKI]).

  • Refresh: Vorolanib can provide potent and selective pan-VEGF receptor inhibition by blocking downstream signaling of all three VEGF receptors

What’s it being developed for?

The therapeutic is in clinical development as a twice-yearly, single-dose intravitreal injection for:

  • NPDR → 9-month maintenance therapy
  • Wet age-related macular degeneration (AMD) → 6-month maintenance therapy
  • Diabetic macular edema (DME) → 6-month maintenance therapy

Gotcha. Now explain DURASERT E.

EyePoint’s DURASERT technology is a miniaturized, injectable, sustained-delivery system designed to provide a continuous, stable release of therapeutics within the eye over an extended period of time (weeks, months, and potentially even years).

Moving on to this phase 2 study.

The multicenter, prospective, double-masked, parallel PAVIA phase 2 study (NCT05383209) is assessing the ocular efficacy and safety of EYP-1901 (DURAVYU) as a single intravitreal injection compared to sham.

Study duration: 12 months

The participants: 77 participants (aged 18+) with the following criteria:

  • Hemoglobina A1c  ≤12%
  • Best-corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) score in study eye of ≥69 letters (approximate Snellen equivalent of 20/40 or better)

And the dosings?

Patients are being randomized to receive either of the following single injected doses every 8 weeks:

  • DURAVYU 2,060 µg (2.06 mg; rounded to 2 mg)
  • DURAVYU 3,090 µg (3.09 mg; rounded to 3 mg)
  • Sham

What’s being measured?

Primary outcome: patients improving ≥2 steps in the Diabetic Retinopathy Severity Scale (DRSS) score in each DURAVYU dose group vs sham group, measured at baseline and Week 36.

Secondary outcomes:

  • ≥2 steps in the DRSS score for each DURAVYU dosage vs sham
    • Measured at baseline, Week 24, and Week 48
  • Patients who developed vision-threatening complication due to DR
    • Measured at Weeks 24, 36, and 48
  • Rates of ocular and nonocular treatment-emergent adverse events (TEAEs) in the study and fellow eyes
    • Measured at Weeks 24, 36, and 48

Didn’t the company already report phase 2 data?

Yes… back in December 2023. However, that was for wet AMD in the DAVIO-2 trial (NCT05381948)So: same drug, different indication. See here for the full rundown.

At last… this new data.

Let’s get the bad news out of the way first: The trial did not meet its primary endpoint.

Despite this, EyePoint’s CEO Jay Duker, MD, noted that the data indicated “DURAVYU continues to be well-tolerated and appears to reduce rates of NPDR progression at 9 months.”

Give me some stats.

At 9 months (36 weeks):

  • 86% (3 mg dosed) and 80% (2 mg dosed) of patients demonstrated stable or improved disease vs only 70% of patients in the control arm

In regards to ≥2-step in the DRSS score:

  • None of the 3 mg patients and 5% of 2 mg patients worsened vs 10% for control
  • 5% of the 3 mg patients and none of the 2 mg achieved improvement vs 5% for control

Any adverse events noted?

No TEAEs (ocular or systemic) were reported. In fact, DURAVYU demonstrated a continued favorable safety and tolerability profile.

Plus: EyePoint noted no occurrences of endophthalmitis or retinal vasculitis.

Gotcha. So what are the company’s next steps?

Dr. Duker noted that EyePoint plans to report full 12-month data on DURAVYU for NPDR following a full review.

Further, the company is also reportedly still on track to reach its additional milestones for the candidate:

  • Expected initiation of the phase 3 LUGANO pivotal trial
    • Indication: wet AMD
    • Timeframe: H2 2024
  • Expected initiation of the second global phase 3 LUCIA trial
    • Indication: wet AMD
    • Timeframe: following H2 2024
  • Topline data from the phase 2 VERONE trial
    • Indication: DME
    • Timeframe: Expected Q1 2025

And for this PAVIA trial, when can we expect that 12-month data?

Likely not until 2025, as the study is slated to conclude in August 2025.

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