Ashvattha Therapeutics Announces First Patient Enrolled in a Phase 2 Study of D-4517.2 for the Treatment of Wet AMD and DME

– First patient was enrolled as part of a two-stage Phase 2 study evaluating Ashvattha’s subcutaneous (SC) anti-VEGF wet AMD and DME candidate, D-4517.2 – 

 – The first stage of the study will evaluate the safety and relative pharmacodynamic effect of different doses of subcutaneously (SC) administered D-4517.2 compared to intravitreal (IVT) injection of aflibercept, an approved therapy, in both wet AMD and DME patients up to 12 weeks – 

 – The second stage of the study will compare the relative efficacy of two dose regimens of D-4517.2 to IVT aflibercept in wet AMD patients up to 9 months –  

REDWOOD CITY, Calif., September 7, 2022 – Ashvattha Therapeutics (“Ashvattha”), a clinical-stage company developing novel hydroxyl dendrimer therapeutics (HDT), today announced that the first patient has been enrolled in a two-stage Phase 2 clinical study of D-4517.2, an HDT with potent anti-VEGF activity. This study aims to evaluate the safety and efficacy of a subcutaneous (SC) injection of D-4517.2 at different dose levels in comparison to intravitreal (IVT) injection of aflibercept, an approved therapy, in patients suffering from wet age-related macular degeneration (wet AMD) or diabetic macular edema (DME). 

“We are excited to initiate the first stage of our Phase 2 study evaluating our subcutaneous anti-VEGF wet AMD and DME candidate, D-4517.2. We believe in its potential to not only treat neovascular retinal diseases but also reduce the burden of treatment often associated with invasive IVT injections into the eye. A subcutaneously administered treatment offers an at-home option that patients can administer themselves,” said Jeffrey Cleland, Ph.D., Chairman, CEO and President of Ashvattha Therapeutics. “We are proceeding into Phase 2 based on positive results from our Phase 1 study in healthy subjects that we presented at ARVO demonstrating D-4517.2 has an exceptional safety and tolerability profile at varying dose levels and has been efficacious in animal models of choroidal neovascular disease.”  

Jeffrey Heier, MD, Director of Retina Research at Ophthalmic Consultants of Boston, added, The potential of HDT treatment for wet AMD and DME is in the systemic administration combined with the high degree of selectivity for inflammatory cells in the back of the eye, targeting diseased cells, potentially reducing the VEGF levels to normal while minimizing or eliminating entirely off-target effects. We look forward to further exploring D-4517.2’s potential to improve the current treatment paradigm for patients.” 

The first stage of the Phase 2 study (NCT05105607) will evaluate the safety of a single subcutaneous dose of D-4517.2 in approximately 30 patients with wet AMD or with DME randomized between three dosage cohorts (0.25 mg/kg, 0.50 mg/kg, an optional high dose). Patients will first undergo treatment with an IVT injection of aflibercept, then be given an SC dose of D-4517.2 up to 8 weeks later after the effects of aflibercept are no longer present (wash-out). Patients will be monitored for adverse events for up to 12 weeks following the SC administration of D-4517.2. Stage 1 of the study will also compare the reduction of subretinal fluid after a single IVT injection of aflibercept and a single SC dose of D-4517.2. Best-corrected visual acuity (BCVA) in the study eye will also be measured for each patient during the 12-week treatment period. Monitoring of the fellow eye will also be conducted.  

The second stage of the study will measure the relative efficacy of different dose regimens of SC administered D-4517.2 compared to IVT aflibercept as measured by the mean change from baseline in BCVA in the study eye up to 9 months post-administration in wet AMD patients.  The second stage is a double masked sham and placebo controlled non-inferiority study.  

About Wet AMD and DME
Wet age-related macular degeneration (wet AMD) is a retinal disease that develops when abnormal blood vessels grow into the macula – a part of the retina at the back of the eye which is responsible for sharp central vision. These vessels leak blood or fluid which can lead to rapid loss of central vision. Wet AMD can be treated if caught early with drugs to stop the growth of the abnormal vessels. According to the World Health Organization, 196 million people have AMD globally, including 10.4 million people with moderate to severe vision impairment or blindness. Diabetic macular edema (DME) is a retinal disease that develops when there is an accumulation of fluid in the macula due to leaking blood vessels. DME is a result of diabetic retinopathy, a disease that damages the blood vessels in the retina which if left untreated builds pressure in the eye and leaks fluid. A recent study estimated approximately 100 million individuals suffer from DME globally.1

About D-4517.2
D-4517.2 is a hydroxyl dendrimer therapeutic (HDT) with potent anti-angiogenic activity inhibiting VEGFR/PDGFR that crosses the blood-retinal barrier and selectively targets reactive inflammatory cells. Hydroxyl dendrimers (HDs) selectively target choroidal neovascular lesions that underlie wet AMD and DME pathology. HDs are selectively taken up by macrophages, microglia and hypertrophic retinal pigment epithelial (hRPE) cells and are retained in the lesion for at least 1 month after a single systemic dose. Current therapies have been shown to suppress neovascularization in animals and humans but have significant off-target toxicity when administered systemically. Covalently linking an anti-angiogenic small molecule to Ashvattha’s hydroxyl dendrimer creates a new chemical entity that could potentially solve the toxicity issues while retaining potency. In-vitro studies in hRPE cells with D-4517.2 demonstrated restoration of VEGF mRNA to normal, healthy levels. The lack of toxicity is the result of D-4517.2’s renal clearance with no significant exposure to the liver or detectable metabolism as observed with other clinical-stage HDTs.  

About Ashvattha Therapeutics 
Ashvattha Therapeutics is a clinical-stage biotech company developing novel hydroxyl dendrimer therapeutics (HDTs) targeting unmet medical needs in ophthalmology, neurology, inflammation and neuro-oncology. Hydroxyl dendrimers (HDs) are a targeted nanomedicine technology exclusively licensed from our founders, Kannan Rangaramanujam and Sujatha Kannan at Johns Hopkins University. HDs chemically conjugated to disease-modifying drugs create novel proprietary HDTs selectively targeting reactive inflammatory cells in disease tissue with localized sustained effects. Ashvattha has initiated multiple programs with HDTs focused on neurology, ocular neovascular disease including neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME), and hyperinflammation in diseases. For more information, visit:   

Media Contact
Sky Striar
LifeSci Communications


1 Duphare, C., Desai, K., Gupta, P., & Patel, B. C. (2021). Diabetic Macular Edema. In StatPearls. StatPearls Publishing.