Presentation by Ocular Therapeutix at OIS@ASRS 2016.
Participant:
Jonathan Talamo, MD, Chief Medical Officer- Ocular Therapeutix
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1. Jonathan H. Talamo, M.D.
Chief Medical Officer
1
Sustained Intravitreal
Drug Delivery
OIS at ASRS - August 8, 2016
2. Forward-Looking Statements
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This presentation contains forward-looking statements about future expectations, plans and prospects for the
Company, including statements about the development and regulatory status of the Company’s product
candidates, such as the Company’s expectations and plans regarding regulatory submissions for and the timing
and conduct of clinical trials of DEXTENZA for post-surgical inflammation and pain, DEXTENZA for allergic
conjunctivitis, DEXTENZA for dry eye disease and OTX T-P for glaucoma and ocular hypertension, the ongoing
development of the Company’s sustained released hydrogel depot technology, pre-commercial activities, the
potential commercialization of DEXTENZA, the potential utility of any of the Company’s product candidates, the
advancement of the Company's other product candidates and earlier stage pipeline, future sales of ReSure®
Sealant, the sufficiency of the Company’s cash resources and other statements containing the words
"anticipate," "believe," "estimate," "expect," "intend", "goal," "may," "might," "plan," "predict," "project," "target,"
"potential," "will," "would," "could," "should," "continue," and similar expressions, constitute forward-looking
statements within the meaning of The Private Securities Litigation Reform Act of 1995. Actual results may differ
materially from those indicated by such forward-looking statements as a result of various important factors.
Such forward-looking statements involve substantial risks and uncertainties that could cause Ocular
Therapeutix’s clinical development programs, future results, performance or achievements to differ significantly
from those expressed or implied by the forward-looking statements. Such risks and uncertainties include,
among others, those related to the timing and costs involved in commercializing ReSure® Sealant and
DEXTENZA, the initiation and conduct of clinical trials, availability of data from clinical trials and expectations for
regulatory submissions and approvals, the Company’s scientific approach and general development progress,
the availability or commercial potential of the Company’s product candidates, the sufficiency of cash resources
and need for additional financing or other actions and other factors discussed in the “Risk Factors” section of
the Company’s filings with the Securities and Exchange Commission, including the Company’s most recent
Annual Report on Form 10-Q. In addition, the forward-looking statements included in this presentation represent
the Company’s views as of the date of this presentation. The Company anticipates that subsequent events and
developments will cause the Company’s views to change. However, while the Company may elect to update
these forward-looking statements at some point in the future, the Company specifically disclaims any obligation
to do so. These forward-looking statements should not be relied upon as representing the Company’s views as
of any date subsequent to the date of this presentation.
3. Proprietary Hydrogels
• Ocular Therapeutix and other
companies with licensed technology
• Across multiple specialties
• Millions of patients treated
Controlled Release
• Multiple assets in clinical development
• DEXTENZA™
– post-op pain*
– allergy
– dry eye
• OTX- TP
– glaucoma
• OTX-IV
– protein-based (anti-VEGF)
– Tki (anti-VEGF/PDGF)
Ocular Therapeutix Expertise
3*NDA pending resolution of CRL
4. Ocular Therapeutix
Intravitreal Depot Technology
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• Fine needle injection (25-27g)
• Compact geometry (designed to avoid
optical impact)
• Payload designed for 6-month delivery
• Sustained, consistent therapeutic levels
(zero-order kinetics) in pre-clinical testing
• Biocompatible and absorbable
• Strong IP (potential commercial viability)
Ocular Therapeutix depot technology has been
tested with a range of anti-angiogenesis drugs
in multiple preclinical models
Depot formats to scale
6. • Implant resides free floating within the vitreous
• Dissolves after 6-7 months
• Other intravitreal implants use rigid plastics,
such as PLA, or non-degradable materials
OTX-BIV
Bevacizumab-loaded Coil
Coiling action forms compact depot in situDepot presents a smooth, hydrophilic, biocompatible surface to tissues
Depot is soft, lubricious biodegradable hydrogel composed of >50% drug
7
1 mm1 mm
Fiber hydrates and coils
as it exits needle
7. 0
1
2
3
4
0 2 4 6 8 10 12 14
LeakageScore
Time (Weeks)
Hydrogel
OTX-BI
Avas n
Rabbit VEGF Challenge Model
OTX-BIV showed continued inhibition up to 12
weeks compared to less than 6 weeks from
single human Avastin dose (1.25mg)
Control Eye
No Inhibition
Leakage score = 4
Fluorescein
leaking from
vessels
Representative FA Images
OTX-BIV suppressed vascular leakage for 3 months
8
OTX-BIV Eye – 1 month
Inhibition
Leakage score = 1
OTX-BIV
8. OTX-IV Anti-VEGF Release Profiles
Highly
stable in
hydrogel
Meets 4-6
month
target
ELISA shows continued activity at 4-6 months
9. Previous TKI Clinical Attempts
Challenges with oral or eye drop formulations of TKIs:
• Low solubility
• Liquid formulations must be suspensions
• Low bioavailability from drops, injections problematic
• Off target effects of systemic administration
• Short half-life of dissolved drug in eye (hours – not days) – quickly cleared
Company Drug Form Phase Date
Targegen TG100801 Drop BID I 2007
Targegen TG100801 Drop BID II 2010
GSK Pazopanib Oral (15mg/day) I/II 2012
GSK Pazopanib Drops (5mg/ml) I/II 2013
GSK Pazopanib Drops (10mg/ml) I/II 2014
Bayer Regorefanib Drops IIa/IIb 2015
PanOptica PAN90806 Drops I 2016
Tyrogenex X-82 (CM082) Oral(25mg/day) I 2015
Tyrogenex X-82 (CM082) Oral II current
Solution: Local AND sustained delivery
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10. OTX-TKiIV
DL-AAA Rabbit Model
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Continuous leakage model - measured by fluorescein angiography
Avastin injection OTX-TKiIV*
Pre- injection
2 weeks
8 weeks
• Avastin leakage in resumed at 8 weeks while OTX-TKiIV was still effective (ongoing)
• *Also effective in VEGF challenge model (rabbit) through 6 months
11. OTX-IV
Tolerability @12 Weeks (rabbit)
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Score (0-5)
Mean SD
Vitreous chamber inflammation 0.20 0.15
Retinal, scleral or episcleral
inflammation
0.28 0.21
Fibrosis around the injected material 0.17 0.14
Histopathology Scores
Score Description
0 No change; normal
1 Rare foci of change; Minimal
2
Mild diffuse change or more pronounced focal
change
3 Moderate diffuse change
4 Marked diffuse change
5 Severe diffuse change
Hydrogel residue
No inflammatory cells
Blank depot suspended in vitreous at 12
weeks with no associated inflammation
12. • Compact, resorbable depots designed to avoid optical side effects
• Large drug payloads possible (protein and Tki)
• Tolerability of vehicle through 12 weeks (protein and Tki)
• Protein delivery for 4-6 months in vitro (4 anti-VEGF proteins)
• OTX-TKiIV shows robust effect in 2 animal models as long as 6 months
• Hydrogel platform used in other FDA-approved and currently marketed
medical products, strong IP
OTX-IV Summary
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Ocular Therapeutix technology provides a sustained release vehicle designed to work well with common intravitreal injection practice – and with known anti-angiogenesis drugs
Help
Antibody drugs act to intercept VEGF, PDGF to prevent engagement with their receptors: VEGFR2, PDGFRβ
TKIs inhibit the activity of kinases associated with VEGFR2, PDGFRβ
Ocular Therapeutix has recently developed a proprietary technology for a coiling fiber depot that forms a compact shape in situ after ejection from a needle. This is a soft, smooth and lubricious hydrogel, containing embedded drug particles.
We have used a modification of a VEGF angiogenesis induction model in dutch belted rabbits to determine if the anti-angiogenic activity can be sustained beyond the normal Avastin formulation. This model uses repeated challenges at various time points following the single injection of the test article - as long as the rabbits remain protected from VEGF. This particular bevacizumab depot was designed to deliver for 3 months.
We have worked with several antibodies, including anti-angiogenic antibody drugs. The hydrogel has been found to work with a wide molecular weight range from Fab fragments to full antibodies. Aggregation is the first form of protein change seen, in which antibody molecules reversibly join to form mostly dimers, and some trimers. These aggregates are referred to collectively as high molecular weight species. They are not formed from the PEG vehicle. The anti-VEGF molecules we have tested have shown good stability, as evidenced by this low aggregation, which has been minimal and does not result in loss of protein activity.
Several attempts have been made to test the safety and efficacy of TKIs in human trials. In all cases the TKIs were administered as drops or tablets. Several other companies have done extensive animal testing, including intravitreal injection. Our intravitreal sustained delivery technology is unique among the approaches that have been made to date.