Full Press Release Details
Corporate Presentation | March 2018
Forward-Looking Statements This
presentation contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. The words "may," "will," "could," "would," "should,"
"expect," "plan," "anticipate," "intend," "believe," "estimate," "predict," "project," "potential," "continue,"
"target" and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Clearside Biomedical, Inc.'s views as of the date of this
presentation about future events and are subject to risks, uncertainties, assumptions, and changes in circumstances that may cause Clearside's actual results, performance, or achievements to differ significantly from those expressed or implied
in any forward looking statement. Although Clearside believes that the expectations reflected in the forward looking statements are reasonable, Clearside cannot guarantee future events, results, performance, or achievements. Some of the key factors
that could cause actual results to differ from Clearside's expectations include its plans to develop and potentially commercialize its product candidates; Clearside's planned clinical trials and preclinical studies for its product
candidates; the timing of and Clearside's ability to obtain and maintain regulatory approvals for its product candidates; the extent of clinical trials potentially required for Clearside's product candidates; the clinical utility and
market acceptance of Clearside's product candidates; Clearside's commercialization, marketing and manufacturing capabilities and strategy; Clearside's intellectual property position; and Clearside's ability to identify
additional product candidates with significant commercial potential that are consistent with its commercial objectives. For further information regarding these risks, uncertainties and other factors you should read the "Risk Factors"
section of Clearside's Annual Report on Form 10-K for the year ended December 31, 2017, filed with the SEC on March 16, 2018 and Clearside's other Periodic Reports filed with the SEC. Clearside expressly disclaims any obligation to
update or revise the information herein, including the forward-looking statements, except as required by law. This presentation also contains estimates and other statistical data made by independent parties and by Clearside relating to market size
and growth and other data about its industry. This data involves a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates. In addition, projections, assumptions and estimates of Clearside's
future performance and the future performance of the markets in which Clearside operates are necessarily subject to a high degree of uncertainty and risk. |
| Developing advanced clinical and
preclinical product candidates, using a proprietary suprachoroidal treatment approach: We see a world without blindness; relentlessly pursuing transformative, elegant, precise solutions to restore and preserve vision A World Without Blindness Unmet
or underserved blinding eye diseases Pathologies manifest in the choroid and retina
Privileged Organ Requiring Local
Therapy Limitations of Current Approaches to Local Administration Include: Corticosteroids reach unintended tissues, causing cataracts and glaucoma Multi-kinase inhibitors and gene therapies require precise placement at diseased tissue Certain drugs
like complement inhibitors require improved exposure to the choroid ~5 M patients in the U.S. with target indications treated by approx. 1,900 uveitis and retinal specialists Retinal Diseases | Lens Anterior Chamber Posterior Chamber Retina Choroid
Exclusive and Proprietary Access to the
Back of the Eye Through the Suprachoroidal Space ("SCS") VS Intravitreal & Periocular Suprachoroidal | Fluid flows instantaneously and posteriorly Designed consistent suprachoroidal injection procedure Fluid with drug is absorbed
into the choroid, RPE and retina 50 L bolus at injection site Drug diffuses to all areas of the eye including the anterior chamber and lens 0.5 mL-1 mL injected into periocular space Highly variable drug diffusion across the sclera into
Concentration (ng/g) Time, days
SUPRACHOROIDAL CLS-TA The anterior segment is relatively spared following suprachoroidal dosing when compared to intravitreal dosing Designed to Improve Ocular Distribution of Triamcinolone Acetonide (TA) | Over 10X the amount of TA remaining in the
choroid and RPE following suprachoroidal administration compared to intravitreal injection Potentially providing improved visual outcomes, increased durability, reduced treatment burden that can lead to improved benefit to risk *Based on
pre-clinical studies Concentration (ng/mL) Time, days Concentration (ng/mL) Time, days
INDICATION STUDY DRUG CURRENT STATUS
Uveitis (macular edema associated with non-infectious uveitis) Suprachoroidal CLS-TA (corticosteroid triamcinolone acetonide) RVO (retinal vein occlusion) Suprachoroidal CLS-TA with anti-VEGF (Intravitreal Eylea ) DME (diabetic macular edema)
Suprachoroidal CLS-TA alone or with anti-VEGF (Intravitreal Eylea) Retinal Vascular Disease Proprietary Compound(s) Orphan Diseases Gene Therapy Focused Pipeline of SCS Treatments For Multiple Blinding Eye Diseases | PRECLINICAL PHASE 1 PHASE 2
PHASE 3 NDA PRECLINICAL PHASE 1 PHASE 2 PHASE 3 NDA PRECLINICAL PHASE 1 PHASE 2 PHASE 3 NDA PRECLINICAL PHASE 1 PHASE 2 PHASE 3 NDA PRECLINICAL PHASE 1 PHASE 2 PHASE 3 NDA
2018 2019 Uveitis RVO DME NDA review
Phase 3 (SAPPHIRE) P3 Data (PEACHTREE) Topline P2 Data (TYBEE) Phase 3 (TOPAZ) NDA Submission Publications | Major Near-Term Anticipated Milestones Provide Multiple Potential Value-Inflection Points Topline P3 Data
UVEITIS One of the World's
Leading Causes of Blindness |
Current Treatment Paradigm Note: TA
= triamcinolone acetonide. Corticosteroids = most common treatment for all uveitis complications, including macular edema Periocular (Sub-tenon) 20 mg TA Sustained release dexamethasone implant (Ozurdex ) Intravitreal 4 mg TA Topical steroid
for anterior uveitis 350,000 patients US uveitis patients Current treatments 115,500 patients 33% macular edema 210,000 eyes 82% disease in both eyes | Oral steroids
The Opportunity | In Treating
Macular Edema with Uveitis Primary Need An approved therapy that targets vision impairment due to the underlying macular edema associated with all non-infectious uveitis The Problem Inflammation creates sight threatening macular edema No approved
treatment for macular edema associated with uveitis No new local treatments for uveitis since 2009 Oral corticosteroids often prescribed when disease is local to the eye
PEACHTREE Design for Pivotal Phase 3
Clinical Trial 3:2 randomization of suprachoroidal CLS-TA vs. sham injection; 160 patients total Primary endpoint at 6 months; superiority of best corrected visual acuity outcome from treatment SHAM Week-2 Day 0 Day 0 Week 4 Week 8 Week 12 Week 16
Week 20 Week 24 Day 0 Week 4 Week 8 Week 12 Week 16 Week 20 Week 24 Screening (2 weeks) Active Arm: Suprachoroidal injection of 4 mg CLS-TA Control Arm: Sham injection procedure Randomization Phase (6 months) Enrollment Suprachoroidal CLS-TA
Suprachoroidal CLS-TA SHAM | Two-arm, randomized, controlled, double-masked, multi-center trial at ~60 clinical sites
46.9% (n=45) 15.6% (n=10) % patients
gaining 15 ETDRS letters in BCVA from baseline Primary Endpoint ETDRS BCVA Proportion of patients in each arm gaining 15 ETDRS letters in BCVA from baseline at Week 24 p<0.001 |
Secondary Endpoint Mean Change from
Baseline in CRT at Week 24 in microns Mean change from baseline at week 24 in central retinal thickness (microns) 479.8 m: active arm; 518.0 m: control arm p<0.001 | Baseline retinal thickness (microns) N=96 N=64 ITT
Table 14.2.3.3; Source: Listing
16.2.6.1 Summary of Best Corrected Visual Acuity by Visit, Study Eye (LOCF Method); ITT population Secondary Endpoint Mean Change in BCVA in ETDRS Letters by Visit | Mean change from baseline in BCVA in ETDRS letters read by visit Baseline ETDRS
letters read 54.7: active arm; 53.6: control arm
AE: Cataracts in CLS-TA and Sham
Arms Percentage of cataract AEs Mar-2018 | NIU program | P3, PEACHTREE, trial | Topline data | % Cataract AEs in Each Arm There were no treatments (i.e. surgeries) because of cataract AEs
PEACHTREE Safety Summary 97% of the
randomized patients completed the trial No serious adverse events related to treatment Through 24 weeks, steroid-related elevated IOP adverse events were reported for 11.5% of patients in the CLS-TA treatment group, compared to no patients in the
Next Steps Based on feedback from
end-of-Phase 2 meeting with the FDA, we believe PEACHTREE will be the only Phase 3 clinical trial required to support the filing of a New Drug Application (NDA) Detailed results from PEACHTREE will be presented at an upcoming medical conference
Positioning the company for potential transition to commercial-stage Hired new Chief Commercial Officer Changed Chairman of Board Currently expect to submit NDA to FDA in Q4 2018 |
RVO New Approach with CLS-TA +
| Current Treatment Paradigm Eylea,
Lucentis, and off-label Avastin Sustained release dexamethasone implant (Ozurdex ) Intravitreal Triamcinolone Acetonide 16.4 M patients Global RVO patients 2nd Line treatment 2.2 M patients US RVO patients 1 2 3 1st Line treatment
The Opportunity In Treating RVO |
Primary Needs More rapid and fuller resolution of macular edema to allow patients to recover as much vision as soon as possible The Problem Compared to uveitis and DME, macular edema following RVO is more severe, as is the attendant vision loss /
potential vision gain Multiple inflammatory cytokines are involved in addition to VEGF being upregulated Chronic, monthly anti-VEGF injections are necessary for many patients
Intent-to-treat (ITT) population: N
= 46 (23:23) Additional Intravitreal Eylea Injections p=0.013 Control arm: Intravitreal Eylea Active arm: Intravitreal Eylea + Suprachoroidal CLS-TA | Number of Additional Injections 60% fewer additional intravitreal Eylea injections in the
suprachoroidal CLS-TA + intravitreal Eylea arm versus control over 3 months
1 Based on post-hoc analysis Number
of patients who received additional Intravitreal Eylea p=0.003 Intent-to-treat (ITT) population: N = 46 (23:23) 1 Control arm: Intravitreal Eylea Active arm: Intravitreal Eylea + Suprachoroidal CLS-TA | Number of Patients Requiring Additional
Treatment Reduced 69% fewer patients required additional Eylea treatments
Aflibercept Arm; N=23 Combination
Arm; N=23 Baseline: 49 ETDRS letters read in each arm * Note: Bars are standard error of the mean; * only month 2 showed p<0.05 Improved Visual Acuity Suprachoroidal CLS-TA + intravitreal Eylea resulted in improved visual acuity at months 1, 2, 3
vs. intravitreal Eylea alone | Changes in BCVA
Baseline 728 m and 731 m
in the Aflibercept and Combination arms Aflibercept Arm; N=23 Combination Arm; N=23 Month 2 Month 1 Month 3 310 m | Retinal Thickness Reductions Suprachoroidal CLS-TA + intravitreal Eylea resulted in sustained retinal thickness reductions at
months 1, 2, 3 vs. intravitreal Eylea alone Note: Bars are one-sided standard deviations
Combination (n=20) 3 (15%) including
Month 3 patients re-treated Monotherapy (n=11) 6 (55%) re-treated Eylea arm: 17% (n=4/23) | Post-TANZANITE Evaluation 74% of patients who received combination therapy did not receive additional treatment through a minimum 9 months Combination arm:
| SAPPHIRE Control arm Intravitreal
Eylea; Q4Wk Combination arm Suprachoroidal CLS-TA + Intravitreal Eylea; Q12Wk Day 0 Week 4 Week 8 Week 12 Week 16 Week 20 Week 24 Week ww Week xx Week yy Week zz 2 Month primary efficacy endpoint Submit with 6 months data Continue to follow subjects
out to 1 year PRN Enrollment Day 0 Week 4 Week 8 Week 12 Week 16 Week 20 Week 24 Week ww Week xx Week yy Week zz Suprachoroidal CLS-TA + Intravitreal Eylea Intravitreal Eylea Two-arm, randomized, controlled, double-masked, multi-center trial at ~150
clinical sites 1:1 randomization of suprachoroidal CLS-TA + intravitreal Eylea vs. intravitreal Eylea alone; 230 per arm One year study with primary outcome at 2 months; superiority of best corrected visual acuity Design for First Phase 3 RVO
If the primary endpoint is met in
SAPPHIRE and TOPAZ, where CLS-TA has been used in combination with one of three anti-VEGF agents - Eylea, Lucentis and Avastin - the objective will be to seek a class label in the US where suprachoroidal CLS-TA can be used with any intravitreal
anti-VEGF agent for the treatment of macular edema associated with RVO Two-arm, randomized, controlled, double-masked, multi-center global trial; 460 patients 1:1 randomization of suprachoroidal CLS-TA + intravitreal anti-VEGF1 vs. intravitreal
anti-VEGF1 alone Primary outcome at 2 months; superiority of best corrected visual acuity | TOPAZ Control arm Intravitreal anti-VEGF1; Q4Wk Combination arm Suprachoroidal CLS-TA + Intravitreal anti-VEGF1; Q12Wk Day 0 Week 4 Week 8 Week 12 Week 16
Week 20 Week 24 Week ww Week xx Week yy Week zz 2 Month primary efficacy endpoint Submit with 6 months data Continue to follow subjects out to 1 year PRN 1 Lucentis or Avastin Enrollment Day 0 Week 4 Week 8 Week 12 Week 16 Week 20 Week 24 Week ww
Week xx Week yy Week zz Suprachoroidal CLS-TA + Intravitreal anti-VEGF Intravitreal anti-VEGF Second Phase 3 Clinical Trial in RVO Designed to Support a Potential anti-VEGF Class Label
DME Suprachoroidal CLS-TA Alone or
in Combination with an Anti-VEGF Agent |
| Steroids Given Frequently to Treat
DME CSME = Clinically significantly macular edema DME = diabetic macular edema National Center for Chronic Disease Preventions and Health Promotion: Division of Diabetes Translation. National Diabetes Statistical Report, 2014 International Diabetes
Federation. IDF Diabetes Atlas: 5th Edition. 2011; 2. International Diabetes Federation. IDF Diabetes Atlas: 6th Edition. 2013; 3. IDF Europe. www.idf.org/sites/default/files/idf-europe/IDF%20Toolkit_Backgrounder_FINAL.pdf CSME 0.3 M - 0.9 M (0.6 M
- 1.7 M in EU) DME 1.1 M (5.8 M in EU) Diabetic Retinopathy 8.3 M (16 M in EU) Diabetes 29.1 M (55 M in EU) Current Treatments Anti-VEGF Steroids: Ozurdex, Iluvien or TA LASER
Primary Need Rapid reduction of
edema to maximize vision gain early in course of treatment The Opportunity In Treating DME | The Problem Protocol T demonstrated that greater visual gains in the first three months result in improved long-term outcome in DME patients DME is response
to anti-VEGF injection is largely variable Some patients do not respond well to anti-VEGF
| Background Corticosteroid Therapy