MSD has reported that remigromig, a high-affinity trispecific antibody (TsAb) against LRP5 and FZD4 derived from EyeBiotech's Norrin-mimetic design, met the primary endpoint in the Phase II/III BRUNELLO study in treatment-naive diabetic macular oedema (DME), with both 0.5 mg and 0.8 mg doses non-inferior to 0.5 mg ranibizumab on best-corrected visual acuity (BCVA) at week 52.

By activating Wnt signalling without TSPAN12, remigromig restores paracellular tight junctions and vascular-barrier proteins while suppressing permeability-controlling proteins, making it the first novel-mechanism asset in two decades to match anti-VEGF vision gains in a Phase III setting, across a 960-patient, randomised, double-blind, three-arm, active-controlled trial.

The commercial opening is a retina market locked around aflibercept, ranibizumab and faricimab, where prescribers want durability, barrier restoration and reduced injection burden rather than another VEGF blocker. Remigromig's BRUNELLO design starts monthly in year one and shifts to personalised treat-and-extend in year two, hinting at differentiated dosing, but the safety sheet tempers enthusiasm: proliferative diabetic retinopathy, vitreous haemorrhage and treatment discontinuation due to adverse events were higher in the remigromig arm.