Fighting inflammation in the eye

Multiple diseases, from age-related macular degeneration to complications of diabetes, can damage our retinas and lead to blindness if left untreated. Although these diseases have different causes, several of them share common features that could serve as targets for new medicines.

One of these features is known as vascular permeability or leakage of the blood vessels, which can lead to vision loss, and can be stemmed with a therapy known as anti-VEGF. However, these therapies primarily treat the fluid that is building up due to leaky vessels. But these complex diseases have many other aspects that are not addressed at all.

That is why Roche scientists are developing medicines that target another common feature of many retinal diseases: inflammation. Steroids, which are used to control inflammation in other parts of the body, often have undesirable effects in the eye, potentially leading to cataract formation, intraocular pressure rise and even glaucoma after repeated use. Instead, Roche is testing a new, more targeted approach to avoid undesirable side effects.

"There was strong evidence to support a clinical trial of the new anti-inflammatory molecule, but even so, the scientists saw encouraging signs: Although designed to test safety, the new class of molecules also showed an effect on relevant outcome measures," says Marina Mesquida, Senior Medical Director of Ophthalmology, Roche Pharma Research and Early Development (pRED).

These early promising signals led to a diversified approach, and Roche is testing a new class of molecules for different eye conditions. Roche is focusing particularly on ocular diseases where inflammation is known or thought to be a major driver of vision loss, such as uveitic macular edema (UME) and diabetic macular edema (DME).

At the same time, the latest research is shedding new light on the biology of these diseases. “This is a system where we can learn a lot,” says Sascha Fauser, Global Head of Ophthalmology for Roche Pharma Research and Early Development (pRED). For example, Roche scientists discovered that certain patients have higher levels of the drug target in their eyes than others — potentially laying the groundwork for more accurately diagnosing patients, and ultimately providing them with the appropriate treatment for their disease.

Using new discoveries to better classify patients is a key component of Roche’s ophthalmology vision, because it will allow patients to receive the appropriate treatment for their disease.

Similarly, Roche hopes to provide more options for patients at different stages of multiple retinal diseases. Tackling inflammation — and concurrently sharpening diagnostic methods — is one possible way. With new treatments and diagnostics in place, patients will ultimately have access to a personalised medicine for their condition.

“We can sense the excitement from the scientific community,” Marina says about the new anti-inflammatory approach. “They need new treatment options for patients with high unmet medical needs. Our vision is to give the right treatment to the right patient at the right time, which would become a paradigm shift in ophthalmology.”