Wednesday 23 October 2013

Interview with Optogenetics pioneer Dr Ofer Yizhar from Stanford Karl Deisseroth lab

DR OFER YIZHAR | Synaptic Organization in Neural Circuits, Department of Neurobiology, Weizmann Institute of Science 

Dr. Ofer Yizhar is one of Israel’s pioneers in the field of optogenetics – a breakthrough neuroscientific method based on light-specific activation (or suppression) of neurons in the brain. Dr. Yizhar has recently returned to Israel from Stanford University, where his expertise in optogenetics gathered traction during his postdoctoral work. He now heads the optogenetics lab at Weizmann Institute, which is currently being set up to accommodate the revolutionary research likely to make Israel one of the world’s leading optogenetic hubs in the near future. 

Utilizing optogenetic methods, Dr. Yizhar’s lab is studying a specific part of the brain – the prefrontal cortex, where processes such as memory generation and goal-directed behavior take place, and which is home to an array of widely studied psychiatric disorders, such as schizophrenia and autism.

OPTOGENETICS

Several brain exploration methods are currently in use in labs throughout the world, and perhaps to best grasp the beauty of optogenetics as a brain research tool it is necessary to introduce other techniques in the field. Below is a brief recap of some of the most common neuronal mapping approaches used in the lab.

One rather straight-forward technique used to visualize individual neurons and synapses in the cortical column is, literally, brain carving. A team of researchers at Harvard, led by prominent brain explorer Dr. Lichtman, have been working towards creating the most efficient contraption for slicing off pastrami-thin slices of mouse brain and observing them under a powerful electron microscope. Theoretically, this process may yield a complete 3D cellular reconstruction of a brain, but it would require creating and aligning thousands, if not millions, of brain slices.

Amongst other, less brute-force neuronal visualization technique is the Clarity Project, which helps visualize neurons in brains of live mice. The Clarity project revolves around scientists' ability to chemically produce completely transparent brains (or other organs) in mice--a technique which was recently developed by Prof. Karl Deisseroth and his team at Stanford, where, incidentally, Dr. Yizhar carried out his post-doctoral work. The chemical treatment strips away lipids which normally block the passage of light using the detergent SDS.

To help them through the treacherous cranial terrain scientists at Dr. Lichtman's and Dr. Diesseroth's labs utilize fluorescent staining of neurons, which helps isolate single cells spanning a number of brain areas. The staining produces colorful images, termed BrainBows.

But certainly the most compelling technique developed at Deisseroth's lab is optogenetics - a research tool which revolves around a gene discovered in 2002, encoding light-gated ion channels, or Channelrhodopsins, found in unicellular green algae. Upon activation with a specific-frequency light, the channels open, causing an ion influx into the cell much akin to the mechanism which causes our neurons to fire. Using a different color of light can also activate a different set of channels—the Halorhodopsins which will cause a negative ion influx into the cell and thus inhibition of the neuron. For algae, this mechanism’s function is to orient the cells towards or away from light. But this mechanism can also be applied to mammalian cells.


Channelrhodopsin activation using 470 nm light frequency will cause a positive ion influx into the cell, whilst Halorhodopsin activation using 580 nm light frequency will initiate a negative ion influx



Image source: John Carnett /Popular Science

In recent years scientists succeeded in engineering rhodopsins from algae into nerve cells of lab animals, either grown externally or, in fact, in perfectly alive animals. In essence, genes encoding these channels can be “injected” into very specific areas of the brain, which will render those areas light-sensitive. By shining a light with the use of optic cables into those areas, scientists can trigger very specific neurons, and examine the animal’s behavior, thereby demonstrating the role of the specific neurons they are studying. 

A WORD WITH DR. OFER YIZHAR

What was your inspiration to become involved in the field of neuroscience?

When I was about to hand in my PhD thesis, I was looking for my next step and I came across the 2005 paper where Ed Boyden and Karl Deisseroth showed how channelrhodopsin can be expressed in neurons and used for light-based activation of these cells. I was immediately fascinated with this technique and decided to try to learn more about it. During my time as a postdoc at Stanford, the field virtually exploded and more and more labs were adopting the technique, which made our work very exciting. 

Regarding neuroscience in general, I was fascinated with the brain, I felt that neuroscience is a huge challenge and I had some amazing teachers during my undergraduate studies (such as Idan Segev and Micha Spira), who conveyed the passion for neuroscience. I guess it caught on.

Personally, what are your most profound interests in the sphere of neuroscience?

I was always fascinated by synaptic connections, the places where neurons communicate with each other. These connections provide the brain with the stability at which it can continuously represent lasting memories, but are also remarkably plastic, allowing us to rapidly generate new memories and recover from trauma. Recent genetic studies of mental disorders show that these disorders are often associated with mutations that change the molecules of synaptic connections. My goal is to understand how these genetic changes lead to altered structure and function in neural circuits. The optogenetic tools provide us with a whole new experimental ground in which we can address these questions.

What is the focus of your current research?

Our goal is to uncover some of the basic properties of the prefrontal cortex, and elucidate the mechanisms that lead to impaired function in this part of the brain associated with neuropsychiatric disorders. The tools I developed at Stanford are in use in the lab, but we are also working on expanding the optogenetic toolkit to allow new types of light-based modulation of neural circuits.

What recent noteworthy discoveries in optogenetics have there been?
The field is constantly changing, being only several years old. Developments in optics that allow exquisite single-cell resolution at which we can probe the function of neural circuits, techniques for wireless optical stimulation and recording of neural activity, and continuous molecular engineering of new tools with unique properties, are all pushing the technology forward at a really fast pace. I think these are all things that make optogenetics so exciting at the moment.

Which neuro-research tools that you are aware of are in most direct competition with optogenetics?

I don’t really see it as a competition. All of these tools are out in the open and scientists are just picking and choosing among the different techniques to answer the scientific questions they are working on. There have been excellent papers recently combining optogenetics, calcium imaging and pharmacogenetic tools (“designer receptors” that can be expressed genetically and respond only to synthetic ligands, allowing pharmacological activation or inactivation of specifically defined cells). 

You recently returned from Stanford and began work at Weizmann Institute. How would you say the two environments compare or differ?

Weizmann is an amazing place to work in. It’s not the same scale at Stanford, but it’s a first grade research institute and I can see many parallels between the two places. The emphasis on scientific excellence, the collaborative spirit and the vibrant scientific atmosphere are all part of that. Another thing that I think makes Weizmann similar is its ability to draw excellent students who are excited about science. In neuroscience we have a unique challenge of bringing together people with very diverse specialties. We are trying to recruit students with engineering, computer science, biology and psychology backgrounds – this is just because of the multidisciplinary nature of the work. At Stanford we had a program called “Bio-X” which tries to do exactly that and I think that the brain sciences program at Weizmann is very successful in attracting this type of diversity of students.

As optogenetics gathers momentum many people are beginning to wonder whether this tool can ever be applied on humans. Can you comment on that?

I think it might be possible at some point, but several things need to happen before that – the first is that we have a strong indication of a therapeutic target for modulation using optogenetics with good pre-clinical results. The second is extensive safety testing of the method of gene delivery and of the outcome of expression of opsins in mammalian or primate neurons for years. Since viral vectors are currently being used in numerous clinical trials (for example using AAV-based vectors), I think this is not such a far-fetched goal. 

Do you intend to have any commercial projects underway in your field of research? Do you believe there is a commercial aspect to optogenetics? 

At the moment my research is purely basic in nature. I think that one of the crucial steps in the potential translation of optogenetic techniques to the clinic is the discovery of good therapeutic targets (neural circuits that when modulated with optogenetics might lead improvement in symptoms). This type of discovery can only arise from a detailed understanding of pathophysiological mechanisms.

Upcoming FDA PDUFA: Auxilium Pharmaceuticals + Biospecifics Technologies - Xiaflex (collagenase clostridium histolyticum) - Peyronie's Disease

Auxilium Pharmaceuticals and Biospecifics Technologies announced a three-month FDA PDUFA date delay since the initial scheduled date of Sept 6, 2013. The next PDUFA date for Xiaflex's supplemental biologics license application (sBLA) for the treatment of Peyronie's disease is December 6, 2013. 

The delay was caused by the company, rather than by the FDA, and is related to changes made by Auxilium in relation to proposed Risk Evaluation and Mitigation Strategy (REMS) program and other aspects related to the proposed label. The changes were classified as a major amendment by the FDA, causing the delay in the scheduled PDUFA date. The FDA has not requested any additional clinical trials or information at this time. 




Date of FDA Decision (PDUFA): December 6, 2013
Company name: Auxilium Pharmaceuticals & Biospecifics Technologies
Stock tickerAUXL and BSTC
LocationMalvern, Pennsylvania
Type of applicationSupplemental BLA – novel indication
Name of drug: Xiaflex (Collagenase clostridium histolyticum)
Indication: Peyronie's Disease

23rd October 2013:
Auxilium Pharma:
Market Cap
$851.28 Mln
52-week range
13.87 – 21.60
Avg. volume
851,374

Q2 2013:
Net Income
$0.22 per share
Cash
$74.6 mln


Biospecifics Technologies:
Market Cap
$116.95 Mln
52-week range
12.52 - 19.99
Avg. volume
24,868

Q1 2013:
Net Income
$0.15 per share
Cash
$12.0 mln


Auxilium is an unmet niche specialist addressing rare and orphan diseases, mainly through biopharmaceuticals.  Auxilium has two products on the market and three currently in clinical development; all products in the Auxilium’s pipeline are for different indications of the same product – Xiaflex (collagenase clostridium histolyticum).

Auxilium Pharmaceuticals: Clinical Pipeline
Note: The Xiaflex Cellulite Study has recently entered phase 2a

Collagenase clostridium histolyticum is an enzyme produced by the bacterium Clostridium histolyticum that dismantles collagen. It is marketed and is being developed as a local injection into areas with overly high collagen accumulation, such as in the case of Dupuytren’s disease (severely clenched fingers) and Peyronie’s disease (penile curvature)—a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting up to 10% of men. According to Auxilium, 65,000 to 120,000 new patients are diagnosed with Peyronie’s disease each year. Peyronie’s disease causes pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening, with no effective treatment to date. Xiaflex has already demonstrated efficacy in treating Peyronie’s disease in clinical trials, and, if approved, will be the first non-surgical treatment for the indication.

In two 400-patient trials Xiaflex was injected into the penile plaque over a period of several months. The company reported in a press release that the treatment yielded a 37.6 reduction in penile curvature in one trial and a 30.5% reduction in the second. The average deformity of the penis at the beginning of the study was 48.8 degrees in men receiving the drug and 49 degrees in those receiving placebo. After 52 weeks, the deformity was only 31 degrees in men receiving Xiaflex and 39 degrees in those receiving placebo. Although the results are not overwhelming, Xiaflex is the only available treatment currently in the pipeline, thus an automatic improvement over what is currently available.

According to the Auxilium company website, "During the course of recent product label discussions, Auxilium submitted revisions regarding the Company's proposed Risk Evaluation and Mitigation Strategy (REMS) program and other aspects related to the proposed label. The FDA determined that this submission qualified as a major amendment filed during the final three months of the review and extended the PDUFA goal date to December 6, 2013. The FDA has not requested that any additional clinical studies be performed prior to the revised PDUFA action date."

Xiaflex was developed by BioSpecifics Technologies, but its clinical trials were carried out by Auxilium. Along with Pfizer Auxilium is also responsible for Xiaflex’s marketing.

Friday 4 October 2013

Ligand and Pfizer's Aprela (Duavee) approved despite government shutdown, Ligand stock up 10% intraday

The FDA kept its promise on delivering a verdict for Ligand (LGND) and Pfizer's (PFE) Aprela on Oct 3, 2013. The drug was approved despite low expectations. 

Aprela (now known as Duavee) is a novel combination drug of Bazedoxifene and Conjugated estrogens (Premarin) for the treatment of moderate-to-severe vasomotor symptoms (VMS) and vulvar and vaginal atrophy (VVA) associated with menopause, as well as the prevention of postmenopausal osteoporosis in non-hysterectomized women.

The drug was approved amidst low hops and safety speculations. Pfizer has previously struggled with gaining approval of bazedoxifene on its own, having had the drug previously rejected by the FDA. The new combination, however, includes conjugated estrogens isolated from pregnant mares' urine, sold under the name Premarin since 1942 indicated for hormone replacement therapy. 

The drug may have a hard time appealing to physicians, particularly as non-hormonal competitors indicated for hot flushes have recently reached the market - OKed Hisamitsu Pharmaceutical's Brisdelle was approved by the FDA in June.

Ligand's stock gained nearly 10% on the news on Oct 3rd. 


Thursday 3 October 2013

Government Shutdown May Delay FDA AdCom, PDUFA dates and Stock Catalysts

Advisory committee (Adcom) and Prescription Drug User Fee Act (PDUFA) drug approval dates may face unpredictable delays due to government shortages affecting the FDA. Several drugs are/were scheduled to receive FDA decisions in October 2013 but have so far not heard from the agency on whether their applications are being processed and whether their decision dates have been affected.

On Oct 3, 2013, Ligand Pharma and Pfizer did not hear from the FDA concerning the agency's decision on Aprela/ Duavive (bazedoxifene) for the treatment of moderate-to-severe vasomotor symptoms (VMS) and vulvar and vaginal atrophy (VVA) associated with menopause, as well as the prevention of postmenopausal osteoporosis in non-hysterectomized women. Several more drugs are in the queue for October's PDUFA decisions:

Oct 3
Ligand Pharmaceuticals (LGND); Pfizer (PFE)
Duavive (EU); Aprela
Bazedoxifene/Conjugated estrogens (BZA/CE)

Moderate-to-severe vasomotor symptoms (VMS) and vulvar and vaginal atrophy (VVA) associated with menopause, as well as the prevention of postmenopausal osteoporosis in non-hysterectomized women
Oct 14
Antares Pharma (ATRS)
Otrexup
Methotrexate (combination product for use with Medi-Jet™ technology)
Rheumatoid arthritis (RA), poly-articular-course juvenile RA and moderate to severe psoriasis
Oct 17
Alimera Sciences (ALIM),
pSivida Corp (PSVD)
Iluvien
Fluocinolone acetonide intravitreal insert
Diabetic Macular Edema (DME)
Oct 21
Amag Pharmaceuticals (AMAG)
Feraheme (supplemental NDA – new formulation)
Ferumoxytol
Intravenous administration for Iron Deficiency Anemia Patients Who Cannot Take Oral Iron
Dec 18
Theravance (THRX), GlaxoSmithKline (GSK)
Anoro Ellipta
Umeclidinium bromide and vilanterol
Chronic Obstructive Pulmonary Disorder (COPD)
Dec 20
Amarin Corp (AMRN)
Vascepa (supplemental NDA)
Icosapent ethyl
Cardiovascular disease – triglyceride reducer during diet for adult patients with high triglycerides (TG ≥200 mg/dL and < 500 mg/dL) with mixed dyslipidemia

Until the FDA makes specific announcements, the investors are likely to be kept in the dark about October's PDUFA decisions. Delays are also likely to cause bottlenecks in the approval process and may delay the rest of the PDUFA calendar. 

To re-cap: 

Oct 3, 2013: Ligard Pharmaceuticals and Pfizer - Aprela (bazedoxifene and conjugated equine estrogens (Premarin)) - moderate-to-severe vasomotor symptoms (VMS) and vulvar and vaginal atrophy (VVA) associated with menopause, as well as the prevention of postmenopausal osteoporosis in non-hysterectomized women

Ligand is a biopharmaceutical company that develops and acquires assets it believes will generate royalty revenues and produce sustainable profitability. Ligand has a diverse asset portfolio addressing the unmet medical needs of patients for a broad spectrum of diseases including thrombocytopenia, multiple myeloma, diabetes, hepatitis, muscle wasting, dyslipidemia, anemia, and osteoporosis. Ligand has established multiple alliances with the world's leading pharmaceutical companies including GlaxoSmithKline, Merck, Pfizer, Eli Lilly & Company, Baxter International, Bristol-Myers Squibb, Celgene, Onyx Pharmaceuticals, Lundbeck Inc., and The Medicines Company, among others.

As a result of a series of successful licensing agreements, Ligand’s total revenue more than doubled in recent years, with royalties up 90% on higher sales of GlaxoSmithKline’s Promacta® and a contribution from Onyx Pharmaceuticals’ Kyprolis™, plus increases of 131% and 125% in sales and licensing revenues of Ligand’s proprietary patented drug delivery technology Captisol.

Aprela is a drug which combines Pfizer’s as-of-yet-unapproved drug Viviant (bazedoxifene), initially developed by Ligand and Wyeth (now Pfizer) in 1994 and Premarin, Pfizer’s conjugated estrogen compound. Bazedoxifene is a selective estrogen receptor modulator, which is a compound able to selectively act on estrogen receptors throughout the body. Aprela belongs to the novel class of tissue-selective estrogen complexes (TSECs), which pair SERM with conjugated estrogen (Premarin). So far, the combination drug has demonstrated positive efficacy and safety results in a series of Phase III clinical trials involving approximately 7,500 women.

The FDA accepted an NDA from Pfizer and Ligand in December 2012. The agency will deliver its verdict on Oct 3, 2013, but complications are expected, in light of the fact that bazedoxifene has been encountering obstacles with FDA approval since 2007.
  

Oct 14, 2013: – Antares pharma Otrexup (Methotrexate - combination product for use with Medi-Jet™ self-injection technology)- Rheumatoid arthritis (RA), poly-articular-course juvenile RA and moderate to severe psoriasis

Antares Pharma is a developer of parenteral technologies, specializing in self-injectable drug delivery. Among the company’s proprietary products are Jet-injectors, Auto-injectors and Pen injectors which can be used with a wide array of oral and injectable medications. Among the companies to which Antares has licensed its technologies are Pfizer, Teva and Jazz Pharmaceuticals. Teva is Antares’s largest source of revenue, having licensed three technologies from the company.

Although Antares normally engages in risk-diluting partnerships with Big Pharma, it is developing Otrexup (methotrexate) on its own. Methotrexate is a rheumatoid arthritis (RA) drug used in 70% of 1.3 million RA cases in the US. Commonly, the drug is taken orally, but complications exist with this mode of delivery, namely poor absorption and gastrointestinal side effects.  A self-injectable formulation of methotrexate would lower the necessary dosage of the drug, and reduce side effects. In clinical studies, Antares found that 98% of patients found the self-injectable system easy to use. In addition to RA, the company intends to market Otrexup for moderate to severe psoriasis, an autoimmune skin pigmentation disorder, for which methotrexane is also commonly prescribed. The global psoriasis market was worth US$ 3.9 billion in 2010.

Oct 17, 2013: Alimera Sciences (ALIM) + Psivida Corp (PSVD) Iluvien (Fluocinolone acetonide intravitreal insert) - Diabetic Macular Edema (DME)

Alimera Sciences specializes in the research, development and commercialization of prescription ophthalmic pharmaceuticals. The company’s main focus is on diseases affecting the retina. pSivida corp specializes in developing sustained-release drug delivery systems and licensing them out. Iluvien is currently licensed out by pSivida to Alimera.

Iluvien (fluocinolone acetodine (FAc)) is a sustained-release eye implant which delivers a corticosteroid (anti-inflammatory agent) to the eye for up to 36 months. Iluvien is indicated for Diabetic Macular Edema (DME) – a diabetes-related disorder characterized by fluid and protein deposits on or under the macula of the eye (a yellow central area of the retina), causing it to thicken and swell (edema). The swelling may distort a person's central vision. Alimera has conducted two Phase 3 pivotal clinical trials (collectively known as the FAME Study) for Iluvien involving 956 patients in sites across the United States, Canada, Europe and India to assess the efficacy and safety of Iluvien with two doses, a high and low dose, in the treatment of diabetic macular edema. 

Although Alimera already obtained marketing approval of Iluvien in Austria, France, Germany, Portugal, Spain and the United Kingdom, and is going through the national phase in the approval process in Italy, the FDA has so far refused to grant Iluvien marketing approval, stating that “the NDA did not provide sufficient data to support that Iluvien is safe and effective in the treatment of patients with DME. The FDA stated that the risks of adverse reactions shown for Iluvien in the FAME® Study were significant and were not offset by the benefits demonstrated by Iluvien in these clinical trials. The FDA stated that Alimera will need to conduct two additional clinical trials to demonstrate that the product is safe and effective for the proposed indication.”[i]
The third PDUFA date for Iluvien is anticipated on Oct. 17th, 2013.

Tuesday 1 October 2013

Upcoming FDA PDUFA: Oct 14 2013 - Antares Pharma - Otrexup for Rheumatoid arthritis (RA), poly-articular-course juvenile RA and moderate to severe psoriasis

Antares Pharma (ATRS) is awaiting an FDA approval decision on Oct 14 2013 for Otrexup (Methotrexate - combination product for use with Medi-Jet™ self-injection technology) for the treatment of Rheumatoid arthritis (RA), poly-articular-course juvenile RA and moderate to severe psoriasis. 


Date of FDA Decision (PDUFA): October 3, 2013

Company nameAntares Pharma

Stock ticker(ATRS)
LocationEwing, NJ
Type of application: First Submission; combination of previously approved drug with novel self-injection technology
Indication: Rheumatoid arthritis (RA), poly-articular-course juvenile RA and moderate to severe psoriasis



01 Oct 2013:
Market Cap
$516.26 Mln
52-week range
3.35 – 4.67
Avg. volume
926,105
Q2 2013:
Net loss
$0.02 per share
Cash
$75.0 mln



Antares Pharma is a developer of parenteral technologies, specializing in self-injectable drug delivery. Among the company’s proprietary products are Jet-injectors, Auto-injectors and Pen injectors which can be used with a wide array of oral and injectable medications. Among the companies to which Antares has licensed its technologies are Pfizer, Teva and Jazz Pharmaceuticals. Teva is Antares’s largest source of revenue, having licensed three technologies from the company.


Although Antares normally engages in risk-diluting partnerships with Big Pharma, it is developing Otrexup (methotrexate) on its own. Methotrexate is a rheumatoid arthritis (RA) drug used in 70% of 1.3 million RA cases in the US. Commonly, the drug is taken orally, but complications exist with this mode of delivery, namely poor absorption and gastrointestinal side effects.  A self-injectable formulation of methotrexate would lower the necessary dosage of the drug, and reduce side effects. In clinical studies, Antares found that 98% of patients found the self-injectable system easy to use. In addition to RA, the company intends to market Otrexup for moderate to severe psoriasis, an autoimmune skin pigmentation disorder, for which methotrexane is also commonly prescribed. The global psoriasis market was worth US$ 3.9 billion in 2010.