Ocular Biodistribution Study for Topically Applied ESBA105

Evaluation of Tolerability, Safety and Ocular Pharmacokinetics of Topically Applied ESBA105 in Patients Undergoing Cataract Surgery or Combined Cataract Surgery and Vitrectomy

The purpose of this study is to determine whether ESBA105, a single-chain (scFv) antibody against TNF-alpha, efficiently penetrates into the anterior chamber and the vitreous body upon topical administration to the eye.

ESBA105 is a topically administered tumour necrosis factor alpha (TNF-alpha) inhibitor that has significant therapeutic potential in various inflammatory intraocular diseases. In animal experiments, ESBA105 was shown to efficiently penetrate into the inner of the eye upon topical administration, associated with very low systemic exposure. A recently completed Phase I trial with topical ESBA105 has confirmed the safety of topical administration to the human eye and the low systemic exposure using this route of administration.

This study is designed to determine the intraocular levels and the specific intraocular distribution pattern of ESBA105 following topical administration to the human eye. In addition it shall be explored whether topical administration of ESBA105 reduces intraocular inflammation following cataract surgery.

Three different dose regimens will be applied to four different patient cohorts. Three patient cohorts will be conducted in an open label design and one in a double-masked, placebo controlled design.

Inclusion Criteria:

• Male or female Caucasian patients ≥18 years.
• Written informed consent prior to any study procedures including screening tests for eligibility.
• Patients should be in good health as determined by past medical history, physical examination, vital signs, electrocardiogram (ECG), and laboratory tests at screening.
• Ability to administer eye drops (personally or administered by another person).

Cataract patients:

• Eligible for routine, uncomplicated senile cataract surgery.

Vitrectomy patients:

• Diagnosis of epiretinal fibroplasia requiring vitrectomy and cataract surgery.

Exclusion Criteria:

• Treated glaucoma / elevated intraocular pressure (IOP) requiring therapy.
• History of chronic or recurrent intraocular inflammatory disease.
• Uncontrolled diabetes mellitus (fasting blood glucose >15 mmol/L).
• Diabetic retinopathy with history of laser photocoagulation.
• Patients with a single eye or a pinholed visual acuity (VA) 20/200 or worse measured on Snellen chart in the non-study eye.
• Iris atrophy in the eye to undergo surgery.
• Pregnant or breast-feeding women or women of childbearing potential, who with their partners refuse to use 2 reliable methods of contraception
• History of collagenosis or systemic vasculitis.
• Patients who have had ocular surgery (including laser surgery) in the study eye within 3 months or in the contralateral eye within 2 weeks prior to screening.
• Patients who have an active systemic or local (anywhere in the body) bacterial and/or viral infection.
• Positive or unclear QuantiFERON-TB Gold assay result.
• Participation in a clinical study with investigational drugs within 3 months prior to screening.
• Inability to comply with the study requirements.
• Patients with known, severely impaired hepatic function, or laboratory values reflecting inadequate hepatic function.
• Patients with pre-existing chronic renal failure defined by a calculated creatinine clearance (CrCl) of < 40 mL/min, using the Cockcroft-Gault estimate for glomerular filtration rate