3/27/2025

speaker
Mr. Leszczyk
Conference Operator/Moderator

Greetings and welcome to the Clearside Biomedical fourth quarter 2024 financial results and corporate update call. At this time all participants are in a listen-only mode and a question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note, this conference is being recorded. I will now turn the conference over to your host, Jenny Coben of Investor Relations. Mom, the floor is yours.

speaker
Jenny Coben
Investor Relations Host

Good afternoon, everyone, and thank you for joining us on the call today. Before we begin, I would like to remind you that during today's call, we will be making certain forward-looking statements. Various remarks that we make during this call about the company's future expectations, plans, and prospects constitute forward-looking statements for purposes of the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the risk factors section of our annual report on Form 10-K, for the year ended December 31, 2024, and our other SEC filings available on our website. In addition, any forward-looking statements represent our views as of today and should not be relied upon as representing our views as of any subsequent date. While we may elect to update these forward-looking statements in the future, we specifically disclaim any obligation to do so even if our views change. On today's call, we have George Ledeske, our Chief Executive Officer, Dr. Victor Chong, our Chief Medical Officer and Head of Research and Development, and Charlie Degnan, our Chief Financial Officer. We also have accompanying slides that are available on Clearside's website in the Events and Presentations section. After our formal remarks, we will open the call for your questions. I would now like to turn the call over to George.

speaker
George Ledeske
Chief Executive Officer

Thank you, Jenny, and good afternoon, everyone. ClearSight is the proven leader in the delivery of drugs and drug candidates to the supracoroidal space. Our SES microinjector provides safe and reliable delivery with over 15,000 supracoroidal injections performed to date. We continue to have increasing interest among retinal specialists and leading pharmaceutical companies in applying our innovative delivery platform to treating serious retinal diseases. We are pleased to announce that the positive results from our Odyssey Phase IIb WET-AMD clinical trial led to a successful end-of-Phase II meeting with the FDA regarding the planned Phase III activities for CLSAX. Based on our interactions with the FDA, we are aligned on a pivotal Phase III program that we believe is positioned for success and maximizes the commercial potential for CLSAX and WET-AMD. Victor will elaborate on these plans shortly. Our commercial and development partners have made excellent progress over the last several months as they continue to validate the broad applicability of superchoroidal delivery in several indications. Across our partners, superchoroidal treatments being developed for delivery by our SCS microinjector are now approved in two Asian territories under regulatory review in China and involved in two ongoing or planned Phase III trials. Our partner, Arctic Vision, achieved several regulatory milestones in the Asia-Pacific region with Arcadis, or Zypyr, for the treatment of uveitic macular edema. This year, they announced that a new drug application is currently under regulatory review in China and that the product was approved in Australia and Singapore. Importantly, Arctic Vision also entered into a commercial collaboration with Santan Pharmaceuticals for the marketing and distribution rights to Arcadis in China. In addition, Regenexx Bio, in collaboration with AbbVie, announced in January that a global Phase III clinical program in diabetic retinopathy for their gene therapy candidate, RGX314, now referred to as Cerevec, is planned to start later this year using our SCS microinjector. In addition, their Phase II altitude superchoroidal trial is currently enrolling a cohort of patients with center-involved diabetic macular edema, and their Phase III AVH superchoroidal trial is enrolling a cohort in wet AMD at dose level 4. Our oncology partner, Aura Biosciences, is enrolling its global superchoroidal phase 3 trial of BELSAR for the first-line treatment of patients with choroidal melanoma delivered using our SCS microinjector. Aura has also initiated a phase 2 trial in metastases to the choroid. And finally, our partner Biochrist recently highlighted plans to initiate clinical testing in 2025 of Orlistat, its plasmacalocrine inhibitor using supracoroidal administration for the potential treatment of DME. With that, I would now like to turn over the call to our chief medical officer and head of research and development, Dr. Victor Chong, to outline the phase three plans for CLSAX and other opportunities with our supracoroidal pipeline. Victor?

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Thank you, George, and good afternoon, everyone. As George described, we are excited about the results of Odyssey that supports CLS-AX as a Phase III ready asset for the treatment of Well-AMD. Today, I would like to share several slides outlining the Phase III plans that we believe will position CLS-AX as a leading maintenance treatment for Well-AMD if the results are positive. To begin, I will highlight two subgroup analysis from Odyssey that help inform the current Phase III trial design. Some of this data were presented at Angiogenesis and Macro Society last month, which provide an opportunity for us to continue to gather KOL feedback. The first analysis provided the basis for the targeted patient population and supports enrolling treatment 90 patients in phase 3 trials. On this graph, we showed that participants solely redosed with CLS-AX at week 24, meaning that they did not receive any additional interventional treatment before or after the second mandatory CLS-AX dose at week 24. As you can see, the subgroup analysis showed even more stable BCVA and CST in these participants to week 36. And we believe that by targeting treatment of naive patients in a Phase III trial, there may be an even greater percentage of patients reaching six months without the need for any intervention. On the next slide, a second subgroup analysis supports the planned Phase III design that excludes participants with non-disease-related changes in visual acuity prior to randomization. This chart excludes the data at which the visit where the patient's vision had a change of 10 or more later from their previous visit, but did not have a corresponding change in CST of at least 25 microns. What they mean is that the patient did not see as well that day on the eye chart, but with those significant OCT changes. This tells us the BCVA change on that day might not be disease-related, It may just be that the patient did not perform the test well on that day. In running this analysis, we again saw compelling BCA results. In the Phase III trial, by excluding patients who have a 10-letter change just prior to randomization, we may reduce BCVA variability unrelated to wet AMD activities. Now I'd like to walk you through the Phase III plans and trial design, discussed and agreed with the FDA at our recent end-of-Phase II meeting. The plan we presented to the FDA is for two pivotal non-inferiority trials. The trial design is similar to the most recent Phase III trial in WED-AMD that leads to the approval of Ideahyde dose and Vibismo. The design applies the redosing criteria generally utilized in real-world clinical practice we will feature the ability to flexibly dose CLS-AX, and we believe the ability to re-dose with CLS-AX versus rescuing patients with an anti-VEGF product is an important differentiator compared to other TKI programs currently in development. Slide 9 shows the current planned Phase III program designed to potentially reduce regulatory risk and maximize the commercial opportunity for CLSAAs in RENAMD. I will walk through this key design aspect. As I mentioned previously, the plan is to enroll treatment-naive patients, which we believe can potentially expand the commercial value of CLSAAs with a broader patient population. From a statistical perspective, We know it is important to reduce variability in a non-inferiority study. The plan is optimized our study population. We know from previous studies, patients with poor vision and or thicker retinas have higher variability in the outcome. Therefore, at screening, participants will be required to have a BCVA reading between 2080 to 20 over 32. In addition, the CST reading on the OCT must be less than 500 microns. These components are designed to minimize enrollment of highly variable patients to potentially increase the probability of success of the trial. Between the third and the fourth injection of Vipacem, we do not normally see a change of vision or anatomy. Therefore, the plan is to exclude participants who had more than a 10-letter change or a CSD increase of more than 100 micron from their previous visit. These criteria were strongly recommended by KOLs on our scientific advice report and are designed to increase the probability of success by further reducing variability. On day one, participants will then be randomized one-to-one to CLSAX 1 mg or Afibicept 2 mg. Participants in the Afibicept arm will receive treatment every eight weeks per standard dosing label up to the primary endpoint at week 52. In a CLSAX arm at week 12, 16, and 20, participants will undergo an assessment for disease activity to determine the personalized treatment interval, or PTI. Based on their PTI, participants will be assigned to a treatment regimen of every 12, 16, or 20 weeks. The plan is to employ in-office OCT biomarker that will be determined using an AI tool to improve consistency in assessing the need for redosing. For those patients who did not meet the criteria at week 20, they will be assigned to a treatment regimen of every 24 weeks. Once a dosing interval is established for each participant during the PTI period, the participant will stay at that interval until the primary endpoint at week 52. This is the fixed dosing period. For example, if the participant met the PTI criteria at week 16, they will be given CLS-AX every 16 weeks in a fixed dosing period. After the primary endpoint is reached, the trial will continue for another year as a safety follow-up period to produce the data required by the FDA for a new drug application. In a CRSA exam, the fixed dosing interval will end. The participant will then continue and be treated with variable dosing according to anatomical sign based on the PTI criteria. In a fibrocept arm, patients will cross over to receive CLSAX every 16 weeks, which will provide additional safety and efficacy data in an anti-VEGF treatment-experienced patient population. It will also provide experience in moving patients from eviprocept to CLSAX as a maintenance therapy. WebAMD is a chronic disease requiring numerous injections to maintain vision and stabilize the disease. We are targeting CRS as a maintenance treatment, which accounts for the majority of the wet AMD treatment market. We know from clinical experience that patients require differing frequency of treatment to achieve stable vision. We are the only TTI in development with multi-dosing data from our Phase IIb trial, and the only TTI in development with the ability to redose before six months. Therefore, we expect minimal to no anti-VEGF rescue in phase three, which could reduce our regulatory risk and prove to be a clear and important differentiator. All in, we believe this important feature of the phase three trial support a strong regulatory and commercial strategy for the success of CLF-AX. On slide 17, We have laid out the competitive landscape related to dosing flexibility in the wet AMD market. The initially approved anti-wet drift drug to treat wet AMD work well, but have lower durability and less flexibility in dosing regimen. The next generation have more direct durability and a more flexible dosing regimen. We have heard from numerous physicians that the dosing flexibility of one to four months was important to them. In contrast, the protocol for other TKI currently in development only allow for dosing at 24-week intervals, and participants will need to be rescued if they cannot go that long. With durability up to six months and flexible dosing regimen, we believe CIS-AX would have a potential versatile and commercially appealing label and would be well positioned to compete in the wet AMD market, which represents over $12 billion in annual sales. Before I turn the call to Charlie, I want to take a minute to review our pipeline opportunities. We continue to be excited about the board's potential for superchloroidal delivery with our SCS microinjector. Internally, I see a great potential opportunity beyond wet AMD where delivering of small molecules via the suprachoroidal space could make a tremendous impact in the treatment of retinal disease. Our research team is currently evaluating two approaches with certain specific small molecules for in vivo models for the potential suprachoroidal treatment of geographic atrophy. Our team is doing the necessary work to potentially advancing one or both of these candidates toward an investigational new drug application. In GA, we are currently evaluating two mechanisms of action that could potentially be used as an add-on to complement-based therapy. Administered superchloridally, this molecule suspension can treat both sides of the Brooks membrane, including the retina, LPE, and the choroid. And with triple choroidal administration of the agents, we expect to achieve higher concentration of drug in the choroid. As a result, we believe this molecule will improve choroidal perfusion to improve retinal function directly and slow progression. And moderating for the inflammatory cells can reduce the root cause of complement activation. With that, I will turn the call over to our CFO, Charlie Bennett, to provide a financial update.

speaker
Charlie Degnan
Chief Financial Officer

Thank you, Victor, and good afternoon, everyone. Our financial results for the fourth quarter and year-ended 2024 were published earlier in our press release and are available on our website. Therefore, I will just provide a summary of our financial status on today's call. As of December 31, 2024, our cash and cash equivalents totaled approximately $20 million. We believe we have sufficient resources to fund our planned operations into the fourth quarter of 2025. We are actively pursuing options to fund the CLS AX Phase III program, including potentially partnering with one or more third parties. We look forward to participating in the Needham Virtual Healthcare Conference and the Jones Trading Conference next month. I will now turn the call back to George for his closing remarks.

speaker
George Ledeske
Chief Executive Officer

Thank you, Charlie. We remain focused on our small molecule superchoroidal pipeline led by CLSAX for the treatment of wet AMD. We have seen increasing interest among retinal specialists and leading pharmaceutical companies in applying the superchoroidal delivery approach to treat serious retinal diseases. Our broad formulation, development, and regulatory expertise and the delivery of agents to the suprachoroidal space makes us well-positioned in the overall treatment landscape for retinal diseases. We are grateful for the hard work and dedication of our ClearSight team and the ongoing support from our stakeholders as we continue to advance our suprachoroidal delivery pipeline. I would now like to ask the operator to open the call up for questions.

speaker
Mr. Leszczyk
Conference Operator/Moderator

thank you at this time we'll be conducting our question and answer session if you would like to ask a question please press star 1 on your telephone keypad the confirmation tone will indicate your line is in the question queue and you may press star 2 if you would like to remove your question from the queue for participants using speaker equipment it may be necessary to pick up your handset before pressing the starter keys one moment please while we pull for questions Thank you. Our first question is coming from John Wallaban with Citizens. Your line is live.

speaker
John Wallaban
Questioner, Citizens

Hey, good afternoon, and thanks for taking the questions. Hi, John. Hi, George. The subpopulation and the amendments you're making to the Plan Phase 3, I'm wondering if you could give any context about how you think that might improve the results from what you saw in Phase 2.

speaker
Paul
Questioner (Affiliation Unknown)

Victor, there? Sure. Okay. Can you hear me, Paul?

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

You there, Victor? Okay. Can you hear me?

speaker
John Wallaban
Questioner, Citizens

Yes. I can.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Yeah. Yeah, so can you, so I think that from our, in the plan to phase three, that we try to exclude the patient with higher variability. I think they want to think about it is on the phase two, we're deliberately selecting the patients who are very difficult to treat, and we believe that moving to a more general population, we would have better results. And one of the group analysis, the first one that we mentioned, that those who actually doesn't need any extra treatment. And so one of the concern was that could be undertreated But in fact, they were not. They were actually doing extremely well. So we believe that when we move the general population, that segment, that only every six months injection, will be actually higher. I don't know whether that is what you're referring to, because the second subgroup analysis changed the population slightly in a different way.

speaker
John Wallaban
Questioner, Citizens

It's sort of helpful. I'm wondering, you know, maybe, It's a difficult question to answer, but maybe moving on to two other ones. How long do you think it could take to enroll the treatment-naive population? And then last one for me, did FDA say you need a certain number of patients in each of these treatment intervals to have a sufficient size to show efficacy and safety, or will it be purely on the individual assessment of the response?

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Yeah, I think the first question first is how long do we expect it to enroll? And usually this kind of trial will be around 12 months or slightly under 12 months. And indeed, we see the recent trial in other phase three doing pretty well. So we were expecting that would be probably just under 12 months. In terms of the agency that this is the type of analysis, very, very similar to what the two recent approval with ID high-dose and furosemab. So we did not expect that they would be separating the adverse event rate in different group on different frequency. And it's really the drug as the overall. And it's just a similar expectation that we're using the drug when we get to market would be on different intervals. So we will not expect that. I think the agency was quite clear that it would be considered as one arm. So the whole event assessment will be merged together. And I think that's a very similar modality that they use for ID high dose and abysmal.

speaker
John Wallaban
Questioner, Citizens

Okay. Got it. All right. Thanks for taking the questions.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Thank you. Our next question is coming from Serge Bellinger with Needham. Your line is live.

speaker
Serge Bellinger
Questioner, Needham

Hi, good afternoon. I guess my first question now that the phase three trial plan has been finalized, can you give us an estimate of the overall cost of such a program? And I guess, is it feasible? You know, we're talking about 900 patients total here. for ClearSight to run such a large program. Thanks.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

So I'll answer the second part, and I'll let Charlie answer the first part. And yes, we would, using a global CRO, so we believe that is something that we would be able to manage. And although it's a relatively large trial, but at the same time that where the MD trial is relatively straightforward from both the endpoint and the investigation needed. And I'll let Charlie to answer the first part about the cost.

speaker
Charlie Degnan
Chief Financial Officer

Yeah, and Serge, I'll also just remind you, you know, back we ran two Phase III concurrent RVO studies years ago, so, you know, we know how to run Phase III trials here. In terms of cost, you know, we're not giving specifics on the cost, but, you know, I think, you know, some of the other Phase IIIs I think I've seen, you know, they're around $55 million, $60 million for each study. But, you know, we haven't given out an estimate for our numbers, for our trials.

speaker
Serge Bellinger
Questioner, Needham

Okay, thanks. And I guess one for Victor. I'm just curious, as you set up the design of the Phase III, whether you considered emulating one of your potential competitors in running a superiority trial, and why you, what were the pros and cons, and why you decided to go forward with two non-inferiority studies? Thanks.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

The two non-inferiority study was true and tested, and the agency have reflected that multiple times, and this is a lot more risky if the two trial is not the same. And I can't comment on our competitor why they decided to do something different, and that is their decision. And I think from our point of view and also our interaction with the agency, the two non-neutrality trials is proven tested in virtually, if not every single retinal drug was approved based on the two non-neutrality trials other than obviously the first one, Lucentis, was a superior trial.

speaker
Paul
Questioner (Affiliation Unknown)

Thank you.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Thank you. Our next question is coming from Devanjana Chatterjee with Jones Trading. Your line is live.

speaker
Devanjana Chatterjee
Questioner, Jones Trading

Hi, thanks for taking my question. I was wondering if you could provide any additional color on the, you know, your financing strategy for the phase two, sorry, phase three, and how should we think about the timeline of the study initiation? I know you were planning initiation in the second half. Is that still the plan?

speaker
Charlie Degnan
Chief Financial Officer

George, want me to take this?

speaker
George Ledeske
Chief Executive Officer

Yeah, go ahead, Charlie. That's fine.

speaker
Charlie Degnan
Chief Financial Officer

Yeah, so we're still, in terms of study, we're gearing up to continue to be ready to start the study in the second half of the year. Obviously, you know, we need to fund the clinical part of the study. You know, as we said, we're pursuing all our options. to get the study funded, including potentially partnering with one or more third parties. So that's about all the information I gave you at this point. And as soon as we have some clarity, we'll let everybody know. But that's all we can say right now.

speaker
Devanjana Chatterjee
Questioner, Jones Trading

Thanks for that. I have a quick follow-up. So if I understood correctly, the chance in the study, is it being administered monthly? And I was just curious as to the design of why would you choose that instead of like every two weeks? Is that to kind of merge it with the PTI phase?

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

So the way that we want to do the study is in every single visit, the patient will be given a assessment. And then after that assessment, then they will have a procedure. So that will be how that we agree with the agency of masking the study so that the patient would not know which arm they would be in. So from a patient perspective, they will have an assessment and then they would then have a procedure. And the procedure could be a suprachoroidal injection, could be a sham, and could be a hiperset injection. And again, that is depending on the PTI that I mentioned earlier. or if they have met the rescue criteria. So throughout the study, there will be a patient that has a 3-percept injection. Sometimes it could be just in the beginning, only just in the beginning for the AA exam, and then the patient would have the injection in the 3-percept arm. So we have discussed that in detail with the agency, and the agency felt that would be an adequate masking. or blind in the way that some other therapeutic area use. So that's how we think that was the right thing to do. I'm not sure about the two weeks that you mentioned, but this is going to be done every month, every visit, and other than some visits, there will be no procedure needed.

speaker
Paul
Questioner (Affiliation Unknown)

Okay. Thank you so much.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Thank you. Our next question is coming from Yi Chen with HC Wainwright. Your line is live.

speaker
Yi Chen
Questioner, HC Wainwright

Thank you for taking my questions. My first question is, what are the potential factors that could contribute to a ECVA change over a 10-letter without the CST change?

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Yeah, so what we have known in the clinic In fact, a lot of clinicians don't even believe the vision in the clinic because it's just that it's such a high variability. BCVA is slightly more reliable. And in fact, the agency also always talk about this 15 letter, it's only 15 letter is real. And so I think that it's understanding that, you know, a lot of our patients are pretty elderly and then you could have in a bad day that they couldn't really see better that day or the test, they just couldn't deal with it. And that is something that we know in routine clinical practice. In a clinical trial, that some of these data points affecting our data. So what we have done in the subgroup analysis that I show is that, you know, the OCT and anatomy have not changed at all. And normally that, you know, if your vision got worse, your OCT will get worse or vice versa. And the 25 micron is just a kind of a way to think that, well, if you have not given a 25 micron change, which is a very small change, and then your vision might not be reliable. And so we could think that this was the POHOC analysis. So we took that out, but just that, not the whole patient, obviously that would take out a lot of data points, but just that one data point. And then as you can see on the chart, that make our results even better, although all our results are already good anyway, but this is just making it even better, explaining that sometimes that some patients just don't do it well, you know, could be a problem. So translating to our phase three design, now obviously that we can't do this in a real study because it's a post hoc analysis to understand. And what we decided that, you know, as I mentioned in the call, between the third and the fourth injection. And again, we have a lot of historic data that during those two visits, the vision doesn't change normally. So again, you know, if they did change, that means that that patient is unreliable patient. And so we believe that by removing those patients before randomization will help us to reducing the variability.

speaker
Yi Chen
Questioner, HC Wainwright

Okay. And by implementing these criteria before randomization, do you expect to have any negative impact on enrollment speed or future market adoption when the CLS-6 eventually reaches the market? Thank you.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Yeah, so I didn't think that. It was affecting the label in a meaningful way. And again, obviously, that is something that we can't really discuss in detail now. We have seen that in other approved subprobe that they have particular inclusion exclusion criteria, but then the label is still the same as WED-AMD or the OVASTA-AMD. We discussed with the agency and the agency didn't really raise any concern on the way that we want to do the study. And in fact, I think that reducing variability to truly show whether drugs work or not are scientifically justified. So I think from that point of view, the label discussion is too early to talk about it, but we believe from past experience that should not be a key problem. In terms of the recruitment and other things, we actually did some analysis on the data set that I have access to during my academic time, the number of patients that would get rejected, you know, between the third and the fourth injection should be less than 10%. And so it won't be a major impact, but we believe that 10% can create a lot of variability. And so by removing them would give us a better, more consistent result. And again, the agency agreed to this.

speaker
Paul
Questioner (Affiliation Unknown)

Okay, thank you very much. Thank you.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Our next question is coming from Andreas Argarides with Oppenheimer. Your line is live.

speaker
Andreas Argarides (via Eka)
Questioner, Oppenheimer

Hi, thanks for taking our questions. This is Eka on for Andreas. Can you talk about the powering assumption in the Phase III trial? And also, if you would share, do you have any insights on how payers think about reimbursement for a potential three- to six-month flexible dosing label for CLSAX compared to competitors? Thank you.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

So I go to second question first. It might be a little bit easier question, but I think the first question is probably quite technical. And the second part is, like, we have did some payer research, and the payer – have given the peer research support our assessment, you know, how that we can potentially put a commercial value to it. And I think that the simplest way to think about it is that some of our competitors would do something different to us potentially. So on the other hand, from our point of view, if we have the flexible dosing, So we believe that we're quite likely to model from the flexible dosing drugs, such as idea high dose and Robismo. And then, you know, one way to think about it is that because we have a small molecule and the device is made by our own, it's our own device. And so a cause of good will be very low and it will be actually lower than the biologic. So again, that we can be potentially pricing it very competitively. So I think that is something that for further down the road that we have explored on the peer research and what would be the best way to get into the market. And then the first question is really a standard phase three, you know, the kind of the assumption that we took some of the assumptions that are very similar to BISMO. you know, we were changing to potentially around a 14-letter variability. And we believe that our variability is probably a little bit lower. However, that, you know, we were looking at a very similar to abysmal type of number. And we used a 4.5-letter margin as suggested by the agency. And then to get to the 90%, as you would expect on a phase three study.

speaker
Paul
Questioner (Affiliation Unknown)

Thank you. Thank you.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Our next question is coming from Daniel Gatua with Sharda. Your line is live.

speaker
Daniel Gatua
Questioner, Sharda

Hey, guys. Thank you for taking my question. Victor, I have one for you. Can you please elaborate on redosing criteria, which, as I understand, relies on OCT biomarkers and how these interplay with the rescue criteria of the BCVA loss and the fluid gain? And also, where does the physician's discretion come in in redosing decision? Because I think that's always a big variability factor. Thank you.

speaker
Dr. Victor Chong
Chief Medical Officer and Head of Research and Development

Yeah, thank you for that question, and allow me to spend time to explain that. So, redosing and rescue is two different things in our position. So, redosing is similar to what we have seen with idea high dose and with BISMO, they have a certain criteria and the two companies have different criteria. And I'm not going to go into detail of their criteria, but again, neither of those are really used in clinical practice. And we have spent quite a lot of time talking to a lot of KOL and including myself that we consider that just the thickness is not really that reliable. And in fact, that's something what we call intra-retinal fluid, means the fluid is actually inside the retina, to sub-retinal fluid, which is the fluid just underneath the retina, so not in the retina. And again, over the years that we learned that intra-retinal fluid, you know, the fluid is actually inside the retina, they cause more damage, and as one would expect it, and also cause more visual loss. And so, but sub-retinal fluid, in fact, is actually not as much harm and some debate that even some sub-retinal fluid is good for you. So what we have decided is that because now that we can really map out not just the thickness, but we can actually map out the inter-retinal fluid and sub-retinal fluid. And the exact criteria we have not openly shared yet, but we can share if that is If we have interretinal fluid returning, that would be used to redosing the patient earlier. And the subretinal fluid, we will allow a little bit more. So, but that is similar to, as I mentioned, ileohydros and vavismo, they, you know, have vision criteria and they have so-called CST increased criteria. But we're just doing it a little bit more scientific, a little more technical. So I think that is what we would plan to do, and that's what we're referring to. And luckily that we now have AI tools that can do that. The second part about rescue is, again, just like earlier, high-dose and revisible, they were very, very rare that they have rescue. And in fact that, you know, we have agreed with the agency, the criteria for rescue. And that is different. That is something that, you know, the patients are losing vision, and as well as anatomy is getting worse. And again, this is something that we have to agree with the agency. That is very different and even different probably in some of our competitive trials. So obviously, as you said, a physician can always so-called rescue a patient when they wanted to. We can't control that. And on the other hand, what we believe is similar to ILEA-Hydro and Webismo. And in fact, if anything, our redosing criteria are tighter, in other words, easier. And so we believe that, you know, because of that, we will have no rescue, very similar to Webismo and ILEA-Hydro. And again, obviously, that is what we believe. And we believe that that design are particularly useful It's because that you've been proven by other drugs already. And so by doing that and by eliminating rescue, we believe that we can also reduce our regulatory risk and improve our possibility of success.

speaker
Paul
Questioner (Affiliation Unknown)

Thank you.

speaker
Mr. Leszczyk
Conference Operator/Moderator

As we have no further questions in the queue at this time, I would like to hand the call back over to Mr. Leszczyk for any closing remarks.

speaker
George Ledeske
Chief Executive Officer

I want to thank everyone for joining us on the call this afternoon. We greatly appreciate your continued interest in our company, Clearside, and we look forward to updating you on our progress. Operator, you may now disconnect the call.

speaker
Mr. Leszczyk
Conference Operator/Moderator

Thank you, sir. Ladies and gentlemen, this does conclude today's call. You may disconnect your lines at this time and have a wonderful day. We thank you for your participation.

Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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