RetinUp Podcast

About RetinUp Podcast

RetinUp is a podcast exploring the latest in retina science and ophthalmology. Hosted by John Kitchens, MD, and Scott Krzywonos, each episode features expert insights, research breakthroughs, and practical discussions designed for ophthalmologists, retina specialists, and vision science researchers.

Publisher

RetinUp Podcast, LLC

Category

health & fitness · science · technology

Language

en

Explicit

No

First episode

28 Oct 2025

Latest episode

29 Oct 2026

Latest episodes

39 episodes in the feed.

1. 

   29 Oct 2026

   Big Pharma’s Retina Bets | Don D’Amico, MD, on BRUNELLO | RetinUp Turns One

   RetinUp turns one year old. Before the birthday reflections, John Kitchens, MD, and Scott Krzywonos take stock of what the past eighteen months of retina acquisitions actually mean: Merck’s purchase of EyeBio for up to $3 billion, Eli Lilly’s acquisition of Adverum Biotechnologies for up to $262 million, Biogen’s acquisition of Apellis for $5.6 billion, and AbbVie’s licensing partnership with RegenxBio worth up to $1.75 billion. Companies with no prior retina footprint are placing major bets. The conversation covers why, and what comes next. Donald J. D’Amico, MD, then joins to go beyond the press release on the BRUNELLO Phase 2b/3 results for remigromig (Merck) in DME. He explains the Wnt pathway, why the PDR signal is permissive rather than causative, why ranibizumab 0.5mg was the only valid active comparator, how AI accelerated antibody development, and why he sees remigromig as the beginning of a new era in retinal pharmacology, not a one-time event. The episode closes with RetinUp producers Laura Brown and Liz Hogan joining John and Scott to reflect on year one, what surprised them, and where RetinUp goes from here. Hosts: John Kitchens, MD, Scott Krzywonos Topics Covered Big Pharma Comes to Retina Four major deals in eighteen months: Merck/EyeBio (up to $3B, 2024), Eli Lilly/Adverum Biotechnologies (up to 262M, 2025), Biogen/Apellis (5.6B, 2026), AbbVie/RegenxBio licensing partnership (up to $1.75B). Of these, only Apellis had an approved drug at time of acquisition. Why retina: aging patient population, novel biology, a proven track record of drug development (anti-VEGF), and a compressed window between Phase 2 and approval for diseases with clear endpoints. Retina is also a specialty where institutional relationships and a surgical infrastructure matter — the same reasons Alcon’s Neurotech acquisition makes sense. What it signals: the gold rush is not over. Kodiak Sciences, with a multi-indication BLA in Q4 2026, is a prime acquisition target. Earlier-stage companies like Ollin BIo (noted for strong science and team) represent a lower-price entry point. The human infrastructure point: talent migration has accelerated. People from established companies are moving to acquirees or to smaller companies that may themselves be acquired. Keeping the original team intact post-acquisition — as Biogen did with Apellis leadership — matters. EyeBio founders David R. Guyer, MD, and Tony Adamis, MD: John reflects on their track record — co-founders of Eyetech Pharmaceuticals (pegaptanib, the first approved anti-VEGF), now at Merck with remigromig and tiespectus in the pipeline. BRUNELLO Deep Dive with Donald J. D’Amico, MD Study recap: remigromig 0.5 mg and 0.8 mg monthly vs. ranibizumab 0.5 mg monthly in DME with BCVA 24–75 letters and CST 325 µm or greater; 25% previously treated; primary endpoint BCVA change at week 52; both doses met non-inferiority. The Wnt pathway: an evolutionarily conserved pathway with tissue-specific roles in blood-retinal barrier maintenance via the FZD4 receptor in retinal and brain vasculature. The natural agonist, norrin, has been notoriously difficult to mimic pharmacologically because it must simultaneously activate FZD4 and two epitopes of LRP5. Remigromig achieves this with a tetravalent, trispecific antibody — two arms to FZD4, one each to the LRP5 epitopes. A genuine pharmacological achievement. The PDR signal: 6.1–6.7% PDR in remigromig arms vs. 0.9% with ranibizumab. Dr. D’Amico’s view: permissive, not causative. Remigromig is not anti-neovascular; it simply does not suppress PDR the way anti-VEGF does. Comparing to true sham controls in RISE/RIDE (16.3% PDR at one year) and VIVID/VISTA (11.1% at two years), remigromig’s PDR rate appears superior to natural history. Additionally, blood-retinal barrier restoration may itself have some anti-neovascular effect. Nothing in the current data suggests remigromig causes or accelerates PDR. Why ranibizumab 0.5 mg as comparator: a non-inferiority trial requires an active comparator with an established non-inferiority margin and a primarily monthly dosing label. Ranibizumab is the only drug that meets this criterion. The 0.5 mg dose reflects international standard (US uses 0.3 mg); the trial will be hopefully used for global approval. Combination and duration questions: remigromig was dosed monthly in BRUNELLO, but duration of effect is unknown. Dr. D’Amico raises the possibility that three monthly doses could produce six-to-eight months of efficacy. Combination with anti-VEGF is the logical next step; the mechanism is orthogonal, not competitive. BAROLO companion study expected Q1–Q2 2027. Looking ahead: AI (specifically AlphaFold) played a meaningful role in remigromig’s antibody development by enabling prediction of three-dimensional polypeptide structure — one reason novel antibody development is accelerating. Other potential indications include RVO, wet AMD, uveitic macular edema, and postoperative CME. RetinUp Year One: Reflections from the Team Laura Brown, producer: came in knowing nothing about retina; learned by osmosis; continues to find eyeballs mildly distressing. Hopes for live recording at future meetings (specifically, Hawaii). Liz Hogan, producer: surprised by how welcoming industry partners were from day one; credits John and Scott’s standing in the field with making early conversations easier. Notes that breaking news episodes — sometimes turned around in under 12 hours — are an industry best, and calls out Laura specifically for being reachable at all hours. John Kitchens, MD: proud of the editorial independence, the quality of guests as educators, and the speed of breaking news coverage. Wants to move to weekly episodes and expand into human interest stories — not just data, but the people behind the field. Scott Krzywonos: credits Liz for herding the cats on breaking news days; credits John for cultivating industry relationships built on genuine win-win thinking and unpaid goodwill over many years. Year two outlook: more frequent episodes, possibly additional content channels, continued breaking news coverage, and more human interest storytelling. Key Takeaways The retina acquisition wave is not over. Merck, Lilly, Biogen, and AbbVie have all placed bets; Kodiak and others remain attractive targets. EyeBio’s founders — David Guyer, MD, and Tony Adamis, MD — have now brought two transformative retina drug classes to the field. Remigromig represents a credible second act. Remigromig’s PDR signal is permissive, not causative; cross-trial comparisons suggest remigromig patients fare better than natural history controls. The mechanism is orthogonal to anti-VEGF and is likely to be additive in combination. Year one of RetinUp: 4,786+ downloads, a year of breaking news episodes, and a field that happened to produce more clinical data in twelve months than most specialties see in a decade. Credits Production & Marketing: Laura Brown | Business Operations: Liz Hogan 🎧 Listen at RetinUp.com | Apple Podcasts | Spotify | YouTube

2. 

   21 Oct 2026

   Breaking News: Alcon Acquires Neurotech

   Two pieces of news today, October 21, 2026. Alcon announced the acquisition of Neurotech Pharmaceuticals for $550 million upfront, with additional milestone payments possible. John Kitchens, MD, and Scott Krzywonos break down why the pairing makes sense, what Alcon’s OR infrastructure could mean for Encelto’s adoption, and where the reimbursement path goes from here. Priovant Therapeutics (Roivant Sciences) also announced positive Phase 3 CLARITY results for brepocitinib in non-infectious uveitis. Both trials met their primary endpoints. Scott and John review what this means alongside vamikibart, and why the two drugs are more complementary than competitive. Hosts: John Kitchens, MD, Scott Krzywonos Topics Covered Alcon Acquires Neurotech for $550 Million Encelto (revakinagene taroretcel-lwey) is the only approved treatment for MacTel 2 — an estimated 25,000 US patients, 2,000–3,000 newly diagnosed annually. It’s an OR-delivered encapsulated cell therapy implant requiring surgical expertise, OR relationships, and reimbursement infrastructure. Alcon has all three. Adoption to date: more than 100 surgeries and 700+ patients in the patient portal as of March 2026. Alcon’s network is expected to expand the number of centers offering Encelto significantly. Reimbursement: buy-and-bill at approximately $200,000+ is a meaningful risk for surgery centers. Neurotech’s specialty pharmacy model removed that risk but limited center economics. Alcon’s infrastructure may help centers navigate both pathways. Centers of excellence: neither academic nor private practice dominates. John cites Drew Somerville, MD, a private practice retina specialist in Evansville, Indiana, who built out an Encelto program independently. Alcon can replicate that at scale. Alcon’s broader strategy: Lumithera (photobiomodulation), Aurion Biotech (corneal cell therapy), RxSight partnership (light adjustable lens), and now Neurotech — a consistent pattern of investing in disease-specific technology with a procedural delivery component. Brepocitinib / CLARITY (Priovant Therapeutics / Roivant Sciences) Brepocitinib is an oral TYK2/JAK1 inhibitor, 45mg once daily, already approved for psoriatic arthritis. CLARITY is the sNDA program for non-infectious uveitis (NIU). Study design: CLARITY-1 (N=166) and CLARITY-2 (N=204); 48-week double-masked; mandatory steroid taper to zero — more aggressive than prior NIU trials. Results: cumulative treatment failure at week 48 was 35.4% vs. 78.7% in CLARITY-1 and 32.4% vs. 77.8% in CLARITY-2. Pooled steroid-free quiescence: 62% vs. 20%. Macular edema resolution among patients with baseline ME: 42% vs. 4.8%. Median time to treatment failure not reached in the brepocitinib arm vs. approximately 12 weeks on placebo. Regulatory path: sNDA planned 1H 2027. How it fits with vamikibart: brepocitinib is systemic — whole-eye disease control; vamikibart is intravitreal — macular edema specifically. Complementary, not competitive. Patients with refractory macular edema despite systemic control are the logical combination candidates. Key Takeaways Alcon’s acquisition of Neurotech gives Encelto the OR infrastructure, relationships, and reimbursement support it needs to scale. Good for patients, and for the long-term viability of a therapy with no real comparator. MacTel 2 is likely underdiagnosed. With Alcon behind the treatment, earlier detection and expanded identification are reasonable expectations. Brepocitinib delivers the strongest uveitis Phase 3 data seen to date — 62% steroid-free quiescence vs. 20% placebo under an aggressive steroid taper. sNDA in 1H 2027. Brepocitinib and vamikibart address different aspects of uveitis and are likely to be used together in difficult patients. Credits Production & Marketing: Laura Brown | Business Operations: Liz Hogan 🎧 Listen at RetinUp.com | Apple Podcasts | Spotify | YouTube

3. 

   19 Oct 2026

   Breaking News: LUCIA Misses in Wet AMD — EyePoint Shifts to DME

   Breaking news: EyePoint Pharmaceuticals announced this morning that LUCIA, the second pivotal Phase 3 trial of Duravyu (vorolanib, EYP-1901) for wet AMD, did not achieve the primary endpoint of statistical non-inferiority in mean change in BCVA versus on-label aflibercept. EyePoint is shifting resources away from its wet AMD program and re-focusing efforts on its DME program. John Kitchens, MD, and Scott Krzywonos break down the data — what the secondary endpoints showed, what the safety profile looked like across both trials, and what LUCIA means for TKIs as a class. The conversation closes with a look at why EyePoint still believes Duravyu has a future in DME, and what the COMO and CAPRI trials will need to show. Hosts: John Kitchens, MD, Scott Krzywonos Topics Covered LUCIA Topline Results Primary endpoint: not met. LUCIA did not achieve statistical non-inferiority in mean change in BCVA vs. aflibercept 2mg every eight weeks in 475 patients with wet AMD. Secondary endpoints met: 38% reduction in treatment burden vs. aflibercept (nominal p less than 0.0001); 52% of Duravyu eyes supplement-free through week 56; 71% received zero or one supplement through week 56. Visual improvement was demonstrated — the drug works biologically — but not to the margin required for non-inferiority. Both LUGANO and LUCIA showed the same pattern: durability and anatomic control with treatment burden reduction, but not the vision bar that a regulatory submission requires. Pooled safety: retinal hemorrhage 4.7% (Duravyu) vs. 1.5% (aflibercept); vitreous hemorrhage 2.3% vs. 0.0%; cataract rate comparable between arms. No increase in inflammation with redosing. What the LUGANO Pattern Means In LUGANO, nine patients in the treatment arm drove the primary endpoint miss — six with GA progression, one with a repaired retinal detachment, two with glaucoma. Whether LUCIA showed a similar subgroup pattern or a broader, more global finding was not addressed on the investor call. EyePoint says additional analyses of pooled LUGANO and LUCIA data are ongoing. John’s read: the hemorrhage signal is worth watching for TKIs broadly. Extended dosing intervals without close monitoring may allow lapse of disease control in patients prone to hemorrhage. Identifying those patients earlier — and either monitoring them more closely or switching agents — will be important as TKIs move toward approval. What It Means for TKIs Duravyu’s wet AMD failure does not close the book on TKIs. Axpaxli (Ocular Therapeutix) had a positive superiority study in SOL-1, albeit with an unusual study design that selected for highly responsive patients. What the EyePoint data add is real-world texture: TKIs produce durability and anatomic control, but the vision bar in wet AMD may be harder to clear than expected. The extended interval also raises monitoring questions that approval studies don’t fully answer. Understanding which patients tolerate 6-month dosing — and which don’t — may be essential before widespread clinical adoption. The DME Pivot EyePoint is refocusing resources on Duravyu in DME. The rationale: DME is a multifactorial, inflammatory disease where Duravyu’s mechanism may be more relevant than in wet AMD. The Phase 2 VERONA trial met its primary endpoint in DME with extended time to first supplemental injection. Two pivotal Phase 3 DME trials — COMO and CAPRI — are ongoing. Topline data expected Q4 2027. John’s observation: treatment burden reduction in working-age DME patients carries a different weight than in wet AMD — fewer injections means less time off work, which matters to patients and their employers. DME is also a more forgiving disease for subretinal hemorrhage and does not carry the same atrophy risk that complicated both wet AMD trials. Key Takeaways LUCIA missed its primary endpoint. EyePoint is winding down the wet AMD program and pivoting to DME. The wet AMD TKI chapter for Duravyu is all but closed. The secondary data confirm Duravyu’s biological activity — 52% supplement-free at week 56 — but biological activity and regulatory approval are not the same thing. TKIs as a class still have a future, but the hemorrhage and monitoring data from LUGANO and LUCIA may inform how Axpaxli is positioned if it reaches approval. COMO and CAPRI in DME read out Q4 2027. DME may be where the TKI mechanism ultimately finds its clinical home. Credits Production & Marketing: Laura Brown | Business Operations: Liz Hogan 🎧 Listen at RetinUp.com | Apple Podcasts | Spotify | YouTube

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Apple Podcasts (US)

4.6 / 5

7 ratings

Spotify

5.0 / 5

7 ratings

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