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Sustained Drug Delivery for Ophthalmology Bob Butchofsky, CEO, Mati Therapeutics Inc. Punctal Plug Delivery System [email protected] [email protected]

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Sustained Drug Delivery for Ophthalmology

Bob Butchofsky, CEO, Mati Therapeutics Inc.

Punctal Plug Delivery System

[email protected]

[email protected]

Evolute® Punctal Plug Delivery System

Consistent efficacy and

therapy control delivered

easily and comfortably

Considerations For Sustained Ocular Drug Delivery

Ocular Therapeutix Allergan / ForSight Ring

Keys To Success

1. Easy to place and remove

2. Cosmetically invisible – easy to identify

3. Tolerable

4. Consistent, sustained efficacy

5. Use in multiple disease states

Evolute® Punctal Plug Delivery System

StableFit™ Design

Successful By Design

1. Easy to place and remove

2. Cosmetically invisible – easy to identify

3. Tolerable

4. Consistent, sustained efficacy

5. Use in multiple disease states

Targeted Delivery

Drug Core

Polymer Sleeve

Cyanoacrylate Film

Proven Sustained Elution

Easy Delivery & High Tolerability

Stable, Familiar Placement

Tolerable Position

Invisible

Excellent Plug Retention Rates Over 12 Weeks

Study Week 4 Week 8 Week 12

Glau 12 (n = 92) 98% 97% 96%

Glau 13 (n = 87) 98% 96% 92%

U.S. Phase II Multi-center Trials

Evolute®: Familiar, Precise Insertion

Evolute® Tearing & Comfort Scores

18.923 21 19.6

18.9 20.7 20 19.3

0

10

20

30

40

50

60

70

80

90

100

Baseline Week 4 Week 8 Week 12

Tearing Comfort

VA

S s

co

rin

g, 0

= n

o r

es

po

ns

e, 10

0 =

in

tole

rab

le

Multiple Disease State Treatment Applications

Glaucoma

Prostaglandins

• Latanoprost

• Travoprost

• Bimatoprost

Beta-Blockers

• Timolol

• Betaxolol

• Levobunolol

Alpha Agonists

• Brimonidine

NCEs

• Rho Kinase Inhibitors

• Adenosine agonists

Allergy

Antihistamines / Mast Cell Stabilizers

• Olopatadine

• Levocabastine

• alcaftadine

Mast Cell Stabilizers

• Cromolyn

• Nedocromil

Anti-Inflammatory

Steroids

• Difluprednate

• Loteprednol

• Fluorometholone

Dexamethasone

• NSAIDs

• Nepafenac

• Bromfenac

Dry Eye

Immunosuppressants

• Cyclosporine

Integrin antagonist

• Lifitegrast

OTC Demulcents / Oils / Emulsions

Multiple compounds can be formulated with

Evolute® Punctal Plug Delivery System

Strong Intellectual Property Position

U.S. Patent, De Juan

“Use of ocular implants to deliver a therapeutic agent to the

eye, either placed through the punctum or between the sclera

and conjunctiva tissue layer.”

82 issued patents

91 pending applications

15 patent families

NSAID – Nepafenac Elution Rate

Initial burst is tunable to extend duration of action or power of initial dose

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

2 3 4 7 8 9 10 11 15

Deli

very

g/d

ay)

Day

NSAID Minimum Target μg for Delivery

NSAID: Aqueous Humor Concentrations of Amfenac*

0

5

10

15

20

25

2 3 4 7 8 9 10 11 15

Aq

ueo

us

C

on

ce

ntr

ati

on

(n

M)

Day

NSAID Targeted IC50

*Approximation

Evolute® Steroid Elution Rate for Difluprednate

0

2

4

6

8

10

12

2 3 4 8 9 11 14

Elu

tio

n R

ate

g/d

ay)

Day

Evolute Targeted Elution

Travoprost - Accelerated Screening Model for Elution Rates

0

2

4

6

8

10

12

14

1 2 4 7

µg

Day

T-Evolute L-Evolute

0

1

2

3

4

5

6

µg/day

T-Evolute L-Evolute

T-Evolute® over one week can elute

much higher concentration of drug

when compared to L-Evolute®

At two weeks, the T-Evolute® can

elute at 5 times the rate of the

L-Evolute®

µg

Animal IOP Model (Mean Time Points) -Travoprost

-8

-7

-6

-5

-4

-3

-2

-1

0

1 2 3 4 5 6 7

T-Evolute L-Evolute

Ch

an

ge i

n I

OP

(m

mH

g)

Day

Animal model confirms greater efficacy of T-Evolute®

Ph II U.S. Multi-center 12 Week Results:L-Evolute® with Previously Shown Elution Profile

-6.09

-5.35 -5.44

-5.07

-5.56

-4.88

-5.3

-5.06

-7

-6

-5

-4

-3

-2

-1

0

1 2 3 4 6 8 10 12

Ch

an

ge

in

IO

P (

mm

Hg

)

Week

*95% CI excludes 0, indicating a p-value of <.05

All IOP included, regardless of plug loss/removal

Development data to date shows the T-Evolute® should out perform

the L-Evolute® shown above in humans

L-Evolute®

Evolute® Punctal Plug Delivery System

Summary Of Benefits

• Wide range of compounds

• Flexible drug delivery profile

• Non-invasive approach

• Steady elution – unlike eye drops

• Comfortable + excellent retention

o 92% and 96% in last two clinical trials at 12 weeks

• Cosmetically invisible / easily identifiable

• Preservative free

• “Passive” system for patients / physician controls compliance

• Favorable reimbursement opportunity for MDs and ODs

• Strong IP protection

• Favorable COGs

Evolute® Punctal Plug Delivery System

Consistent efficacy and

therapy control delivered

easily and comfortably