DelveInsight’s, “Persistent corneal epithelial defects (PCEDs) – Pipeline Insight, 2020,” report provides comprehensive insights about 5+ companies and 5+ pipeline drugs in Persistent corneal epithelial defects pipeline landscape. It covers the pipeline drug profiles, including clinical and nonclinical stage products. It also covers the therapeutics assessment by product type, stage, route of administration, and molecule type. It further highlights the inactive pipeline products in this space.
Geography Covered
• Global coverage
Persistent corneal epithelial defects Understanding
Persistent corneal epithelial defects (PCEDs): Overview
The cornea is the transparent, outermost layer of the eye that uniformly refracts the majority of light that enters the eye onto the lens and is essential for ideal vision. The multi-layered corneal epithelium acts as a protective barrier to infectious agents via tight junctions between neighboring cells, and it maintains its smooth optical surface by constantly regenerating cells in the basal cell layer. Persistent corneal epithelial defects (PEDs or PCEDs) result from the failure of rapid re-epithelialization and closure within 10-14 days after a corneal injury, even with standard supportive treatment. Disruptions in the protective epithelial and stromal layers of the cornea can render the eye susceptible to infection, stromal ulceration, perforation, scarring, and significant vision loss.
Epithelial Wound Healing
In the Case of Injury to the Cornea, Interleukin 1 (IL-1) is secreted by the Damaged Epithelial Cells, Causing some Keratocytes to Undergo Apoptosis and some to Proliferate into Activated Keratocytes. Epithelial Cells will also Secrete Transforming Growth Factor-beta (TGF-β) in Response to Destruction of the Basement Membrane and Results in Myofibroblast transformation. Growth Factors Insulin-like Growth Factor (IGF), Insulin, Epidermal Growth Factor (EGF), platelet-Derived Growth Factor (PDGF), Keratinocyte Growth Factor (KGF), and Hepatocyte Growth Factor (HGF) Play Important Roles in Corneal Wound Healing. EGF, IGF and Insulin Regulate Epithelial Growth and Stromal Keratocyte Activation. KGF and HGF are produced by Keratocytes to influence Migration and Proliferation of Epithelial Cells. PDGF Regulates Epithelial Proliferation and Keratocyte Function.
Etiology
The normal corneal wound healing process can be disrupted from defective epithelial adhesion, limbal stem cell deficiency, surface trauma, medications, infections, and several other etiologies discussed below. The pathophysiology of PED involves proliferation of myofibroblasts and a resulting disordered extracellular matrix, producing an opacity in the cornea.
Diagnosis
Evaluating a Persistent corneal epithelial defects involves fluorescein instillation to monitor the size, location, and depth of the defect. In deeper Persistent corneal epithelial defects, it takes a longer time for the fluorescein to absorb into the epithelium and stroma. A thorough physical exam should reveal findings such as inflammation in the anterior chamber, eyelid abnormalities, or decreased sensation of the cornea, such as in the case of a neurotrophic Persistent corneal epithelial defects.
Treatment
The current standard management of Persistent corneal epithelial defects includes a stepwise strategy, starting with conservative management and progressing to medical or surgical treatments if refractory. This includes lubrication, bandage soft contact lenses, punctal plugs, debridement, and tarsorrhaphy. Initially, aggressive lubrication every 1-2 hours with preservative-free artificial tears and ocular ointments are applied to the eye.
Bandage soft contact lenses (BCL) along with preservative-free artificial tears and antibiotics are beneficial in protecting the damaged epithelium from mechanical erosion from eyelid blinking, thus aiding the re-epithelialization process.
Surgical interventions, such as debridement and tarsorrhaphy, are effective in most cases of Persistent corneal epithelial defects refractory to medical management.
Tetracyclines, prophylactic topical antibiotics, and steroids are also used as standard therapy for Persistent corneal epithelial defects. Oral tetracyclines exhibit anticollagenolytic activity, inhibiting MMPs produced by inflammation mediators, and have been shown to be effective in healing Persistent corneal epithelial defects within weeks.
Persistent corneal epithelial defects Emerging Drugs Chapters
This segment of the Persistent corneal epithelial defects report encloses its detailed analysis of various drugs in different stages of clinical development, including phase II, I, preclinical and Discovery. It also helps to understand clinical trial details, expressive pharmacological action, agreements and collaborations, and the latest news and press releases.
Persistent corneal epithelial defects Emerging Drugs
• Nexagon: OcuNexus Therapeutics / Eyevance Pharmaceuticals
The active ingredient in OcuNexus lead drug product candidate Nexagon is a natural, unmodified oligonucleotide (30-mer) that downregulates expression of the key gap junction protein Cx43. Cx43 is upregulated and overexpressed in pathological conditions such as chemical or thermal injuries to the eye, resulting in non-healing of the crucial epithelial layer of the cornea. Without an epithelium which is a major protective layer of the eye to external stimuli, as well as maintaining a moist and clear surface enabling good vision, the cornea would fibrose or perforate, resulting in loss of vision.
Several patients experiencing the devastation of sight threatening chemical or thermal injury to the eye resulting in a persistent defect of the crucial first layer of the cornea, the epithelium, and that were non responsive to current standard of care (SOC) treatment, have been treated compassionately with Nexagon. Nexagon is formulated in a thermoreversible gel placed under a contact lens or amniotic membrane to ensure contact with the corneal/conjunctival surface for sufficient time to get the active drug into the cell.
Further product details are provided in the report……..
Persistent corneal epithelial defects: Therapeutic Assessment
This segment of the report provides insights about the different Persistent corneal epithelial defects drugs segregated based on following parameters that define the scope of the report, such as:
• Major Players in Persistent corneal epithelial defects
There are approx. 5+ key companies which are developing the therapies for Persistent corneal epithelial defects. The companies which have their Persistent corneal epithelial defects drug candidates in the advanced stage, i.e. phase III include, OcuNexus Therapeutics etc.
Phases
DelveInsight’s report covers around 5+ products under different phases of clinical development like
• Mid-stage products (Phase II and Phase I/II)
• Early-stage products (Phase I/II and Phase I) along with the details of
• Pre-clinical and Discovery stage candidates
• Discontinued & Inactive candidates

• Route of Administration
Persistent corneal epithelial defects pipeline report provides the therapeutic assessment of the pipeline drugs by the Route of Administration. Products have been categorized under various ROAs such as
• Intraocular
• Molecule Type
Products have been categorized under various Molecule types such as
• Antisense oligonucleotides

• Product Type
Drugs have been categorized under various product types like Mono, Combination and Mono/Combination.

Persistent corneal epithelial defects: Pipeline Development Activities
The report provides insights into different therapeutic candidates in phase II, I, preclinical and discovery stage. It also analyses Persistent corneal epithelial defects therapeutic drugs key players involved in developing key drugs.
Pipeline Development Activities
The report covers the detailed information of collaborations, acquisition and merger, licensing along with a thorough therapeutic assessment of emerging Persistent corneal epithelial defects drugs.

Report Highlights
• The companies and academics are working to assess challenges and seek opportunities that could influence Persistent corneal epithelial defects R&D. The therapies under development are focused on novel approaches to treat/improve Persistent corneal epithelial defects.
• Nexagon has orphan designation from the FDA.
Persistent corneal epithelial defects Report Insights
• Persistent corneal epithelial defects Pipeline Analysis
• Therapeutic Assessment
• Unmet Needs
• Impact of Drugs
Persistent corneal epithelial defects Report Assessment
• Pipeline Product Profiles
• Therapeutic Assessment
• Pipeline Assessment
• Inactive drugs assessment
• Unmet Needs

Key Questions
Current Treatment Scenario and Emerging Therapies:
• How many companies are developing Persistent corneal epithelial defects drugs?
• How many Persistent corneal epithelial defects drugs are developed by each company?
• How many emerging drugs are in mid-stage, and late-stage of development for the treatment of Persistent corneal epithelial defects?
• What are the key collaborations (Industry–Industry, Industry–Academia), Mergers and acquisitions, licensing activities related to the Persistent corneal epithelial defects therapeutics?
• What are the recent trends, drug types and novel technologies developed to overcome the limitation of existing therapies?
• What are the clinical studies going on for Persistent corneal epithelial defects and their status?
• What are the key designations that have been granted to the emerging drugs?
Key Players
• CoDa Therapeutics Inc
• Eyevance Pharmaceuticals
• OcuNexus Therapeutics
Key Products
• CODA001 (Nexagon)