Retinopathy (damage to blood vessels in the retina at the back of the eye) is a serious and common complication of diabetes that can lead to blindness. One of the main problems is that the blood vessels become leaky which allows fluid to escape and accumulate in the retina. There are a limited number of treatment options; laser therapy is commonly used, or alternatively injections into the eye of drugs known to prevent leakiness, although this doesn’t work for every patient. Recently KalVista scientists showed that large amounts of a protein called plasma kallikrein causes the blood vessel leakiness and that a drug which can block plasma kallikrein effectively could become a breakthrough treatment for retinopathy. KalVista is a pharmaceutical company that has extensively studied plasma kallikrein and is proposing to use this experience to develop an oral drug that will block the action of plasma kallikrein which could lead to a brand new treatment for this debilitating and devastating disease.

Diabetes poses the most important threat to public health in the 21st Century. By 2025, it is estimated that 5M people in the UK alone will have diabetes. Diabetic retinopathy (DR) is the most frequent vascular complication of diabetes, when manifested as diabetic macular edema (DME), it is the leading cause of working age blindness, affecting 20-25% of all patients. Once detected, effective treatment options are limited. Pharmacological therapies such as intravitreal (IVT) VEGF inhibitors are expensive & studies have shown that <50% of patients fully respond to this treatment. Plasma Kallikrein (PKal) is an enzyme recently shown to be strongly associated with the pathophysiology of DR & KalVista Pharmaceuticals are developing a novel IVT PKal inhibitor that will soon enter clinical trials. However, identifying patients with DR who will respond either to VEGF inhibitors or the emerging pharmacological treatment, PKal inhibitors, will be an enormous clinical challenge in the future. To address this, KalVista seek to develop an innovative companion diagnostic, building on recent studies that have investigated unique biomarkers in the aqueous humour of patients. By measuring & comparing levels of these with known response, KalVista believe that defining a unique proteome fingerprint is important in determining which patients are most likely to respond to a particular pharmacological treatment. This diagnostic will be used in the first instance for patient enrichment in clinical trials for KalVista’s PKal inhibitor, a drug which could become a breakthrough treatment for DR. The use of a companion diagnostic will help identify those patients who will benefit most from, or suffer fewer side effects from targeted therapies, and thereby present a more compelling approval and prescribing case to regulators & clinicians. Ultimately, this will then be used as a diagnostic to better direct future treatment, saving valuable resource whilst improving patient quality of life.

Retinopathy (damage to blood vessels in the retina at the back of the eye) is a serious and common complication of diabetes that can lead to blindness. One of the main problems is that the blood vessels become leaky which allows fluid to escape and accumulate in the retina. There are a limited number of treatment options; laser therapy is commonly used, or alternatively injections into the eye of drugs known to prevent leakiness, although this doesn’t work for every patient. Recently KalVista scientists showed that large amounts of a protein called plasma kallikrein causes the blood vessel leakiness and that a drug which can block plasma kallikrein effectively could become a breakthrough treatment for retinopathy. KalVista is a pharmaceutical company that has extensively studied plasma kallikrein and is proposing to use this experience to develop an oral drug that will block the action of plasma kallikrein which could lead to a brand new treatment for this debilitating and devastating disease.