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JDRF is the world’s leading non-profit organization with the mission to accelerate life-changing breakthroughs to cure, prevent and treat type 1 diabetes (T1D) and its complications. To this end, JDRF is soliciting letters of intent for innovative therapeutic strategies to prevent or delay progression of diabetic retinopathy (DR) at the earliest possible stages.
Diabetic retinopathy is a sight-threatening complication of diabetes and the largest cause of blindness in the US. Almost all individuals with T1D experience progressive vision loss over a 15- to 20-year period, and approximately 20–30% advance to the blinding stage of the disease. Tight glycemic control reduces the risk of complications, but only about one-fifth with T1D are achieving recommended targets. Furthermore, some may develop DR despite having good glycemic control.
The past decade has seen significant progress in therapeutic options for DR with the advent of drugs that block the actions of vascular endothelial growth factor (VEGF). However, frequent intravitreal injections are required and up to 50% of individuals do not achieve a satisfactory response. Although additional molecular targets have been identified, including the plasma kallikrein pathway, lipoprotein-associated phospholipase A2 (Lp-PLA2) and Tie-2, with some are under clinical evaluation, there remains a critical gap in effective treatments.
Recent data from Joslin T1D Medalists, individuals who have lived with T1D for over 50 years without major complications, suggests the presence of endogenous mechanisms that can protect against DR. Therapeutic strategies to enhance these protective effects may lead to novel treatments that prevent onset and progression of DR.
As such, there remains an urgent need for alternative therapeutic options. Ideally, these would be administered orally or topically to reduce the burden of invasive treatment, frequent clinical visits and improve patient adherence – especially when targeting the earliest stages of disease before permanent damage has been realized, such as mild to moderate NPDR.