4DMT Receives FDA Regenerative Medicine Advanced Therapy Designation for 4D-150 Genetic Medicine for Intravitreal Treatment of Wet AMD, the First RMAT Designation in Wet AMD

4D Molecular Therapeutics recently announced the US FDA has granted the RMAT designation for the investigational genetic medicine candidate 4D-150 for intravitreal treatment of wet age-related macular degeneration (wet AMD). The FDA granted RMAT designation based on the potential of 4D-150 to address the unmet medical need within this population.

RMAT designation is part of the 21st Century Cures Act. The program was created to expedite the development and review of regenerative medicine therapies intended to treat, modify, reverse, or cure a serious condition. Receiving RMAT designation offers sponsor companies all the benefits of the fast track and breakthrough therapy designation programs, allowing for early, close and frequent interactions with the FDA with the goal of expediting drug development. The designation follows interim Phase 1 PRISM clinical data for 4D-150 that demonstrated an encouraging safety, tolerability and clinical activity profile. 4D-150 has the potential to address an unmet medical need to safely maintain long-term visual acuity outcomes while avoiding the need for repeated intravitreal injections. 4DMT is currently working with the FDA and EMA on preliminary Phase 3 clinical trial plans and expects to provide an update in February 2024 along with 4D-150 interim randomized Phase 2 PRISM trial data.

“We are honored to receive the first ever RMAT designation for an investigational treatment for wet AMD with our intravitreal 4D-150 genetic medicine,” said David Kirn, MD, Co-founder and Chief Executive Officer of 4DMT. “This designation validates our belief in 4D-150’s potential to address the high unmet need of wet AMD patients, to maintain their visual acuity outcomes, and to reduce their treatment burden. We continue to work closely with the FDA and EMA on efficiently advancing 4D-150 development for both wet AMD and diabetic macular edema, and having both RMAT and PRIME designations enables us to further collaborate expeditiously in our efforts to advance development in both geographies.”

“Wet AMD patients are waiting for a durable therapy with the potential to significantly reduce treatment burden and preserve vision long term,” said Robert Kim, MD, Chief Medical Officer of 4DMT. “We are grateful that the two largest pharmaceutical regulatory agencies in the world recognize 4D-150’s potential by awarding the unprecedented combination of both RMAT and PRIME designations in wet AMD. I am incredibly proud of the team at 4DMT for this accomplishment and we look forward to sharing initial interim data from our randomized Phase 2 Dose Expansion clinical trial in the highest anti-VEGF need patients in February at the 2024 Angiogenesis Conference.”

In July 2023, 4DMT announced that a dose response was demonstrated in favor of the highest tested dose of 3E10 vg/eye, including a promising reduction in supplemental anti-VEGF injections (4 of 4 evaluable patients injection-free) and a clinically meaningful reduction in mean central subfield thickness (CST) at 36 weeks in a patient population with high anti-VEGF need. As of July 2023, intravitreal 4D-150 remained well tolerated at all doses in all patients, with no Grade ≥1 inflammatory cells, hypotony, dose-limiting toxicities or treatment-related serious adverse events (SAE) during follow-up through 36 weeks in all 15 patients. Additionally, 4DMT announced that the 3E10 vg/eye dose cohort showed a durable reduction in supplemental anti-VEGF injections beyond 36 weeks, with 3 of 4 evaluable participants remaining injection-free beyond one year and one patient remaining injection-free during a maximum follow-up of 80 weeks with no change in safety profile observed.

4D-150 is composed of our customized and evolved intravitreal vector, R100, and a transgene cassette that expresses both aflibercept and a VEGF-C inhibitory RNAi. This dual-transgene payload inhibits four members of the VEGF angiogenic family of factors that drive wet AMD and DME: VEGF A, B, C and PlGF. R100 was invented at 4DMT through our proprietary Therapeutic Vector Evolution platform; we developed this platform utilizing principles of directed evolution, a Nobel Prize-winning technology. 4D-150 is designed for single, low-dose intravitreal delivery for transgene expression from the retina without significant inflammation.

Wet AMD is a highly prevalent disease with estimated incidence rate of 200,000 new patients per year in the United States. It is estimated that the total prevalence of wet AMD in the major markets, including the US, EU (major markets), and Japan, will be greater than 4 million individuals in the next five years. Wet AMD is a type of macular degeneration where abnormal blood vessels (choroidal neovascularization or CNV) grow into the macula, the central area of the retina. As a consequence, CNV causes swelling and edema of the retina, bleeding and scarring, and causes visual distortion and reduced visual acuity. The proliferation and leakage of abnormal blood vessels is stimulated by VEGF. This process distorts and can potentially destroy central vision and may progress to blindness without treatment.

4DMT is a leading clinical-stage genetic medicines company focused on unlocking the full potential of genetic medicines to treat large market diseases in ophthalmology and pulmonology. 4DMT’s proprietary invention platform, Therapeutic Vector Evolution, combines the power of the Nobel Prize-winning technology, directed evolution, with approximately 1 billion synthetic AAV capsid-derived sequences to invent customized and evolved vectors for use in our wholly owned and partnered product candidates. Our product design, development, and manufacturing engine helps us efficiently create and advance our diverse product pipeline with the goal of revolutionizing medicine with potential curative therapies for millions of patients. Currently, 4DMT is advancing five clinical-stage and two preclinical product candidates, each tailored to address rare and large market diseases in ophthalmology, pulmonology, and cardiology. 4D Molecular Therapeutics, 4DMT, Therapeutic Vector Evolution™, and the 4DMT logo are trademarks of 4DMT.

All of our product candidates are in clinical or preclinical development and have not yet been approved for marketing by the FDA or any other regulatory authority. No representation is made as to the safety or effectiveness of our product candidates for the therapeutic uses for which they are being studied. For more information, visit www.4DMT.com.