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Our Focus

Ophthalmic Disease

At Santen, our single focus in ophthalmology helps us investigate various disease states and develop therapies that challenge unmet needs in the field.

All compounds/drugs mentioned are currently in development, with some undergoing clinical trial investigations. The content provided is for informational purposes only. Santen does not make any claims of safety or efficacy, and Santen does not promote compounds/drugs that the US Food and Drug Administration (FDA) has not approved.

Retinal Disorders

Uveitis is a group of conditions characterized by sight-threatening intraocular inflammation of infectious, autoimmune, or unknown etiology. It is classified by disease location:

  • Anterior uveitis is the most common type, and can involve the iris and/or anterior ciliary body
  • Intermediate uveitis affects the middle portion of the eye, such as the anterior ciliary body, anterior vitreous, and peripheral retina
  • Posterior uveitis can involve the posterior vitreous, choroid, and/or retina
  • Panuveitis, also referred to as diffuse uveitis, can encompass the anterior, intermediate, and posterior segments of the eye

Corticosteroids are currently the only drugs in the United States approved for treating non-infectious uveitis, though the side effects associated with their long-term use are well known. When delivered locally to the eye—either topically or via implantation—corticosteroids are associated with cataract formation and increased intraocular pressure (IOP). When systemically administered, they can cause Cushing syndrome, diabetes, osteoporosis, or metabolic disturbances.

With uveitis accounting for approximately 10% of the visual handicaps in Western countries, and recognized as a leading cause of blindness worldwide, there is an unmet need for an effective therapy that can treat the condition, while also minimizing the side effects seen with steroid therapy.1 The development of DE-109 (sirolimus) represents a unique approach to the treatment of non-infectious posterior uveitis.

Age-related macular degeneration (AMD) is the most common cause of blindness, particularly irreversible blindness, in elderly people worldwide. AMD is a complex disease with multiple risk factors. In addition to smoking, hypertension and obesity, a growing body of evidence indicates that inflammation and the immune system play a key role in the development of the disease. Early AMD is generally asymptomatic while the two subtypes of late AMD, dry (atrophic) AMD and wet (neovascular) AMD can both impact on vision. The primary clinical characteristic of dry AMD is the change in appearance of retinal pigment epithelium atrophy, usually known as geographic atrophy (GA). Wet AMD causes more vision loss and is characterized by new vessels which grow from below the retina (choroidal neovascularization) and fibrous tissue. The new vessels invade the subretinal space, with leakage and hemorrhage resulting in scarring of the central retina and loss of vision. Vascular endothelial growth factor (VEGF) is a key molecule in promoting new vessel growth and vascular leakage. Although targeting VEGF for the treatment of wet AMD has marked an important advancement in the field of ophthalmology, retina specialists acknowledge the need for other targets in the treatment of wet AMD. In fact, growing clinical and laboratory evidence suggest that dual inhibition of VEGF and platelet-derived growth factor (PDGF) may be more effective than targeting VEGF alone. Angiogenesis requires coordinated activity of VEGF and PDGF, but PDGF may also contribute to distinct aspects of wet AMD pathology, such as fibrosis.

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Dry eye and corneal disorders

Dry eye—also known as keratoconjunctivitis sicca (KCS), keratitis sicca, or dry eye syndrome (DES)—is a condition in which the eye doesn’t produce enough tears (aqueous-deficient dry eye) or the tears evaporate from the eye too quickly (evaporative dry eye) to keep the ocular surface lubricated. In either case, patients may experience irritation, redness, burning, stinging, aching, soreness, photophobia, or, in severe cases, decreased vision.

Treatments for dry eye syndrome include artificial tears, gels, or ointments; corticosteroid drops; cyclosporine A drops; and punctal plugs. Supportive therapies to treat underlying causes of dry eye, such as meibomian gland dysfunction, include hot compresses, lid scrubs, and omega-3 supplements. Increasing water consumption/humidity and limiting known exacerbants of dry eye may also prove beneficial. Hypotonic ointment, bandage contact lenses, and nighttime protection may be recommended for severe cases arising from recurrent corneal erosions.

Dry eye is one of the most common disorders affecting the anterior segment of the eye, affecting approximately 5 million Americans over the age of 50. An additional tens of millions suffer from less severe symptoms.2

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Glaucoma

Although much about glaucoma remains unknown, increased intraocular pressure (IOP) may result in progressive damage of the optic nerve, a known hallmark of the disease. The cause of IOP seen in cases of glaucoma may be variable, but often results from obstruction of the eyes’ aqueous drainage mechanisms, such as the trabecular meshwork (TM) or the iris.

Although there is no cure for glaucoma, IOP-lowering eye drops are the current treatment strategy for most types of the disease. For patients with certain types of glaucoma, or those who no longer respond to eye drops, laser surgery or operative surgery may be needed. If left untreated, glaucoma may lead to progressive and irreversible vision loss, so early detection and treatment are key. Santen’s DE-117 is currently in development as a potential treatment option for the reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension.

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Santen has investigational compounds at various stages in clinical trial.
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References: 1. Uveitis/infectious eye diseases. Research to Prevent Blindness website. http://www.rpbusa.org/rpb/eye_info/page_2/. Accessed May 21, 2012. 2. Facts about dry eye. National Eye Institute website. http://www.nei.nih.gov/health/dryeye/dryeye.asp#6. Accessed May 17, 2012.

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