Bispecific vs. Bispecific: Innovent Announces First Patient Dosed in the Phase 2 Clinical Study of Efdamrofusp Alfa (IBI302), a First-in-class Anti-VEGF and Anti-Complement Bispecific Fusion Protein for the Treatment of Diabetic Macular Edema
This randomized, double-masked, multi-center, active-controlled Phase 2 clinical study (NCT06908876) aims to evaluate the efficacy and safety of intravitreal injections of efdamrofusp alfa in DME patients. A total of 150 participants will be enrolled and randomized in a 1:1:1 ratio to the IBI302 4 mg group, the IBI302 8 mg group, and the Faricimab (anti-VEGF/ANG-2 bispecific antibody) 6 mg group. The primary endpoint is the change in best corrected visual acuity (BCVA) from baseline in the study eye at week 16.
DME has become the leading cause of vision impairment among the diabetic population in
DME development is primarily driven by microvascular damage mediated by VEGF upregulation and inflammatory factors2. Complement activation is also involved in the development of DME by damaging the neurovascular units through cytolysis, opsonization, and promotion of proinflammatory microenvironment, leading to retinal microvascular lesions, neurodegeneration, and macular edema3. At present, intravitreal injections of anti-VEGF agents or glucocorticoids are key treatment strategies, effectively improving visual acuity and retinal edema. However, frequent intravitreal injections (every 4 to 8 weeks) can result in poor patient compliance and increased risk of complications such as cataract and elevated intraocular pressure, making it challenging to achieve sustained visual acuity benefits with long-term treatment4,5. In recent years, bispecific antibodies represented by Faricimab have demonstrated significant efficacy and extended dosing intervals in patients with DME; Faricimab currently represents the highest global treatment standard for DME.
Efdamrofusp alfa, the first-in-class bispecific fusion protein targeting VEGF and complement, can simultaneously inhibit angiogenesis and vascular leakage mediated by VEGF, and inflammatory responses mediated by complement activation. To date, multiple clinical studies of efdamrofusp alfa have been conducted in patients with neovascular age-related macular degeneration (nAMD) and DME, among which high-dose (8 mg) efdamrofusp alfa has shown significant efficacy in improving visual acuity and retinal edema. Meanwhile, efdamrofusp alfa has demonstrated the potential for extended dosing intervals (up to 12-16 weeks), with favorable safety and tolerability.
Dr.
About diabetic macular edema
Diabetic retinopathy (DR) is a series of lesions caused by retinal microvascular damage resulting from diabetes and is the main microvascular complication of diabetes. Diabetic macular edema (DME), featuring retinal edema, thickening and exudation, is caused by capillary leakage in the macular area. It is the result of the blood-retinal barrier (BRB) destruction and mainly affects central vision. At present, DR has become the leading cause of blindness among the working-age population worldwide, while DME has become the main cause of visual impairment among the diabetic population6.
The pathological mechanisms of DR and DME are multifactorial, involving metabolic abnormalities related to hyperglycemia, oxidative stress, and inflammation. These processes lead to the upregulation of vasoactive factors such as VEGF, which subsequently disrupt the BRB and increase vascular permeability, manifesting clinically as retinal edema and exudation. When the macular area is involved, it develops into DME2. Additionally, complement system activation contributes to disease progression by damaging the neurovascular units through cytolysis, opsonization, and promotion of proinflammatory microenvironment, causing retinal microvascular lesions, neurodegeneration, macular edema, and retinal neovascularization3.
About Effamrofusp Alfa (IBI302)
Efdamrofusp alfa is a recombinant, fully human bispecific fusion protein developed by
About Innovent
Innovent is a leading biopharmaceutical company founded in 2011 with the mission to empower patients worldwide with affordable, high-quality biopharmaceuticals. The company discovers, develops, manufactures and commercializes innovative medicines that target some of the most intractable diseases. Its pioneering therapies treat cancer, cardiovascular and metabolic, autoimmune and eye diseases. Innovent has launched 15 products in the market. It has 3 new drug applications under regulatory review, 4 assets in Phase III or pivotal clinical trials and 15 more molecules in early clinical stage. Innovent partners with over 30 global healthcare companies, including Eli Lilly, Sanofi, Incyte,
Guided by the motto, "Start with Integrity, Succeed through Action," Innovent maintains the highest standard of industry practices and works collaboratively to advance the biopharmaceutical industry so that first-rate pharmaceutical drugs can become widely accessible.
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References
1. 中华医学会眼科学分会眼底病学组, 中国医师协会眼科医师分会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2022年). 中华眼底病杂志. 2023;39(02):99-124.
2. Kusuhara S, Fukushima Y, Ogura S, Inoue N, Uemura A. Pathophysiology of Diabetic Retinopathy: The Old and the New. Diabetes Metab J. 2018;42(5):364-376.
3. Jiang F, Lei C, Chen Y, Zhou N, Zhang M. The complement system and diabetic retinopathy. Surv Ophthalmol. 2024;69(4):575-584.
4. Ehlken C, Ziemssen F, Eter N, et al. Systematic review: non-adherence and non-persistence in intravitreal treatment. Graefes Arch Clin Exp Ophthalmol. 2020;258(10):2077-2090.
5. Ciulla TA, Bracha P, Pollack J, Williams DF. Real-world Outcomes of Anti-Vascular Endothelial Growth Factor Therapy in Diabetic Macular Edema in
6. Tan GS, Cheung N, Simó R, et al. Diabetic macular oedema. Lancet Diabetes Endocrinol, 2017, 5(2): 143-155.
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