Precision imaging can finally match the precision of modern drug design
Systemic sclerosis is a disease that leaves little room for optimism — it scars the lungs, hardens the body, and offers few paths of escape. Now, a partnership between Mediar Therapeutics and Qureight brings together a novel monoclonal antibody targeting the protein EphrinB2 and an AI imaging platform capable of reading the lungs with a granularity no human eye can match. The question being asked in the EncompaSSc trial is not only whether MTX-474 can slow the scarring, but whether medicine has finally built instruments sensitive enough to know when it has succeeded.
- Systemic sclerosis kills without a cure, and the urgency of the EncompaSSc trial reflects how little time patients and researchers can afford to waste.
- Traditional imaging methods — slow, subjective, dependent on a radiologist's eye — have long been a bottleneck in proving whether fibrosis drugs actually work.
- Qureight's five-model AI suite dissects the lung into distinct compartments, tracking inflammation, scarring, vascular change, and airway structure simultaneously and automatically.
- The 24-week trial window is narrow, making the platform's sensitivity to subtle, early change not a luxury but a clinical necessity.
- If the combination of MTX-474 and AI-driven imaging succeeds, it could redefine how fibrotic diseases across the board are measured and treated.
Systemic sclerosis scars the lungs, hardens the skin, and claims lives. There is no cure. The options for slowing it are few. This week, Mediar Therapeutics and Qureight announced a partnership built on the premise that better measurement might be as important as better medicine.
Mediar's drug, MTX-474, is a monoclonal antibody designed to block EphrinB2, a protein believed to drive the fibrosis at the heart of the disease. It is now in Phase 2 testing through the EncompaSSc trial, enrolling patients with diffuse cutaneous systemic sclerosis — the most severe form — in a randomized, placebo-controlled study running 24 weeks, with an interim look at 12.
What distinguishes this trial is not the drug alone but the imaging infrastructure around it. Qureight will deploy five specialized AI models to analyze high-resolution CT scans at enrollment and again at 24 weeks. Each model targets a different dimension of lung disease: inflammatory signals, fibrotic scarring, vascular changes, airway structure, and overall architecture. Together they produce a compartment-by-compartment map of what is happening inside the lungs — something no radiologist reviewing scans by eye can replicate with the same speed or consistency.
That granularity matters because systemic sclerosis attacks on multiple fronts at once. A drug that halts fibrosis may leave inflammation untouched, or vice versa. The five-model approach lets researchers see not just whether the lungs are improving overall, but exactly which compartments are responding — and which are not. That distinction could reveal how MTX-474 works, or illuminate why it falls short.
If the trial succeeds — if the drug slows fibrosis and the imaging platform reliably captures that change — the combination could set a new standard for evaluating fibrotic diseases well beyond systemic sclerosis. Measurement has long been the bottleneck. The next few months will show whether precision imaging has finally caught up to precision medicine.
Systemic sclerosis is a disease that hardens and scars the lungs, skin, and other vital organs. It kills. There is no cure, and the options for slowing it down are limited. This week, two companies announced a partnership that might change that calculus—not through a new drug alone, but through a smarter way of watching whether the drug is working.
Mediar Therapeutics is testing MTX-474, a monoclonal antibody designed to block a protein called EphrinB2, which appears to drive the fibrosis—the scarring—that defines systemic sclerosis. The drug is in Phase 2 trials now, in a study called EncompaSSc. Patients with diffuse cutaneous systemic sclerosis, the most severe form of the disease, will be randomly assigned to receive either MTX-474 or a placebo, given intravenously every four weeks. The trial will run for 24 weeks, with an interim look at the 12-week mark.
What makes this announcement notable is not the drug itself, but the imaging technology that will measure whether it's working. Qureight, a clinical research organization that specializes in lung and heart imaging, will deploy an artificial intelligence platform to analyze high-resolution CT scans of patients' lungs at the start of the trial and again at 24 weeks. The platform is not a single tool but a suite of five specialized AI models, each trained to detect a different aspect of lung disease. Glass8 identifies inflammatory signals. Fibr8 quantifies fibrotic scarring. Vascul8 evaluates changes in blood vessels. Air8 analyzes airways. Lung8 provides a comprehensive structural assessment. Together, they create a compartment-by-compartment map of what is happening inside the lungs.
Traditional imaging analysis relies on radiologists reviewing scans by eye, a process that is slow, subjective, and often misses subtle changes. Qureight's platform generates results automatically and immediately, with precision that human reviewers cannot match. The company claims this approach is more sensitive to disease progression or stabilization than conventional methods—meaning it can detect smaller changes, faster, which matters enormously in a 24-week trial where the window to show efficacy is narrow.
Systemic sclerosis affects multiple organ systems at once, and the lungs are often where the disease does its worst damage. Patients develop pulmonary fibrosis, inflammation, and vascular problems, sometimes all three simultaneously. A drug that halts fibrosis might not touch inflammation, or vice versa. The five-model approach allows Mediar and Qureight to see not just whether the lungs are getting better or worse overall, but exactly which compartments are responding to treatment and which are not. That level of granularity could reveal how MTX-474 actually works—or why it fails.
Jeff Bornstein, Mediar's chief medical officer, framed the partnership as a way to "understand disease mechanisms and effectively evaluate participants' response to MTX-474 treatment." Jessica Payne, Qureight's chief commercial officer, emphasized that the AI-driven approach offers "precise, compartment-specific insights" beyond what traditional metrics provide. Both statements point to the same underlying logic: in a disease as complex as systemic sclerosis, you need measurement tools that match the complexity.
The trial will enroll patients with diffuse cutaneous systemic sclerosis in a 3-to-2 ratio favoring the drug over placebo. Results from the 12-week interim analysis will come first; the full dataset at 24 weeks will follow. If MTX-474 shows efficacy in slowing or halting fibrosis—and if Qureight's imaging platform can reliably detect that change—the combination could establish a new standard for how fibrotic diseases are evaluated in clinical trials. That matters not just for systemic sclerosis, but for the entire landscape of fibrotic conditions, where measurement has long been a bottleneck. The next few months will tell whether precision imaging can finally match the precision of modern drug design.
Notable Quotes
Our AI-powered imaging platform delivers analysis beyond traditional metrics, providing precise, compartment-specific insights into lung disease.— Jessica Payne, Chief Commercial Officer, Qureight
Qureight's AI-driven imaging endpoints provide deeper insights into lung fibrosis in complex diseases, such as Systemic Sclerosis.— Jeff Bornstein, Chief Medical Officer, Mediar Therapeutics
The Hearth Conversation Another angle on the story
Why does the imaging matter so much here? Isn't the drug either working or it isn't?
The drug might be working in one part of the lung and not another. Systemic sclerosis doesn't attack uniformly. You can have fibrosis in one compartment, inflammation in another, vascular damage in a third. A traditional scan might show the lungs look stable overall, but miss that fibrosis is actually spreading in one region while inflammation recedes in another. The five AI models let you see that granularity.
So Qureight's platform is really about resolution—seeing smaller changes, faster.
Exactly. And speed matters in a 24-week trial. You have a narrow window to show the drug is doing something. If your measurement tool is slow or imprecise, you might miss a real effect, or worse, think there's no effect when there is one.
What happens if the interim analysis at 12 weeks shows nothing?
Then Mediar will have to decide whether to continue or stop. But they'll have detailed compartment-specific data to guide that decision, not just a vague sense that the lungs look the same. That's more honest, and it's more useful for the next trial.
Is this the first time Qureight's platform has been used in a systemic sclerosis trial?
The announcement doesn't say. But the fact that Mediar chose them suggests they've proven themselves in other fibrotic lung diseases. Systemic sclerosis is complex, but it's not unique in that way.
What's at stake for patients?
Everything. Systemic sclerosis has high morbidity and mortality. There are no good treatments. If MTX-474 works, and if Qureight's imaging can prove it works, then you've got a new option for a disease that desperately needs one. And you've got a template for how to measure efficacy in other fibrotic diseases.