Can CBD tem­per Parkin­son's-re­lat­ed psy­chosis? UK re­searchers will look for an­swers in PhII study

Cannabid­i­ol (CBD), the cannabi­noid com­pound found in the cannabis plant, has been tried and test­ed in pa­tients with rare forms of epilep­sy, in­spir­ing the ap­proval of GW Phar­ma’s $GW­PH land­mark plant-de­rived Epid­i­olex. Its resur­gence in re­search — and its ubiq­ui­tous pres­ence in oils, creams, and gum­my bears — is on the ba­sis that it is not ad­dic­tive, like its in­tox­i­cat­ing cousin THC, and re­tains the ther­a­peu­tic po­ten­tial for a plant that was once tout­ed as a cure-all in In­dia. Re­searchers at King’s Col­lege Lon­don have been study­ing the ef­fect of CBD on psy­chosis, and on Mon­day sig­naled they are prep­ping to be­gin a large-scale Phase II tri­al in pa­tients with Parkin­son’s-re­lat­ed psy­chosis, char­ac­ter­ized by hal­lu­ci­na­tions and delu­sions.

The re­search team, led by Pro­fes­sor Sag­nik Bhat­tacharyya from the In­sti­tute of Psy­chi­a­try, Psy­chol­o­gy & Neu­ro­science, will as­sess the safe­ty and ef­fec­tive­ness of CBD by track­ing psy­chot­ic, mo­tor and non-mo­tor symp­toms, along­side brain imag­ing.

The emer­gence of dopamine D2 re­cep­tor an­tag­o­nists in the 1950s trans­formed the treat­ment of psy­chot­ic dis­or­ders — and they per­sist as one of the main tools in the treat­ment ar­se­nal for psy­chosis. How­ev­er, tra­di­tion­al an­tipsy­chotics car­ry a litany of side ef­fects and a sig­nif­i­cant pro­por­tion of pa­tients do not de­rive ad­e­quate ben­e­fit from the class of drugs.

CBD casts a wide net be­cause it acts through en­do­cannabi­noid re­cep­tors; CB1 and CB2, as well as oth­er re­cep­tors, such as GPR18, GPR55, GPR 119, 5HT1A, and TR­PV2. This sug­gests ther­a­peu­tic val­ue in a pletho­ra of con­di­tions due to its neu­ro­pro­tec­tive and im­munomod­u­la­to­ry prop­er­ties.

Pre­clin­i­cal stud­ies sug­gest CBD may have an­tipsy­chot­ic prop­er­ties, al­though cannabis use, in gen­er­al, is as­so­ci­at­ed with an in­creased risk of de­vel­op­ing psy­chosis. Bhat­tacharyya, of King’s Col­lege Lon­don, has been un­pack­ing the ev­i­dence sup­port­ing CBD’s ben­e­fit in psy­chosis pa­tients.

In a study pub­lished last year, Bhat­tacharyya et al in­ves­ti­gat­ed the neu­rocog­ni­tive mech­a­nisms that un­der­lie the pur­port­ed ther­a­peu­tic ef­fects of CBD in psy­chosis in a small place­bo-con­trolled tri­al (n=16 par­tic­i­pants with a clin­i­cal high risk (CHR) of psy­chosis re­ceived a sin­gle oral dose of 600 mg of CBD; n=17 such par­tic­i­pants re­ceived a place­bo, and n=19 con­trol par­tic­i­pants were not giv­en any drug). Each par­tic­i­pant was then stud­ied us­ing func­tion­al mag­net­ic res­o­nance imag­ing while per­form­ing a ver­bal learn­ing task. The re­searchers found that CBD could par­tial­ly nor­mal­ize al­ter­ations in parahip­pocam­pal, stri­atal, and mid­brain func­tion as­so­ci­at­ed with the CHR state.

Now, with a $1.2 mil­lion grant from Parkin­son’s UK, Bhat­tacharyya will lead the Parkin­son’s study, sched­uled to start in ear­ly 2020. There are cur­rent­ly 145,000 peo­ple liv­ing with Parkin­son’s in the Unit­ed King­dom, and da­ta sug­gest more than half will suf­fer from psy­chosis at some point.

The tri­al will be­gin with a six-week pi­lot to as­sess the safe­ty, tol­er­a­bil­i­ty, and ef­fec­tive­ness of phar­ma­ceu­ti­cal-grade CBD in pa­tients with Parkin­son’s-re­lat­ed psy­chosis.

CBD will be de­liv­ered oral­ly in cap­sules at a dose of up to 1,000 mg/day — in a bid to find an op­ti­mum dose. In the sec­ond tranche of the study, 120 pa­tients will be re­cruit­ed to a 12-week dou­ble-blind, place­bo-con­trolled study.

Re­cent­ly, there was one an­tipsy­chot­ic ap­proved for Parkin­son’s dis­ease psy­chosis, which is de­signed to work by in­ter­act­ing with 5HT2A re­cep­tors and to a less­er ex­tent 5HT2C re­cep­tors — in­stead of tar­get­ing the over­pro­duc­tion of dopamine.

Aca­dia’s $ACAD Nu­plazid was ap­proved in 2016, al­though an in­de­pen­dent pan­el to the FDA sug­gest­ed its ef­fi­ca­cy was not as ro­bust as it would have liked. It was al­so ap­proved with a black box warn­ing — which most an­tipsy­chotics car­ry — high­light­ing the high­er risk of death as­so­ci­at­ed with its use in the el­der­ly.

Nu­plazid, which gen­er­at­ed sales of about $146 mil­lion in the first half of this year, gained no­to­ri­ety af­ter a se­ries of re­ports sug­gest­ed its mak­er had mis­rep­re­sent­ed the dan­gers of us­ing the drug and em­ployed ques­tion­able tac­tics to mar­ket it, prompt­ing an FDA re­view, which even­tu­al­ly reaf­firmed the drug’s safe­ty pro­file.

Ven­ture Cap­i­tal as a Strate­gic Part­ner: Fu­el­ing In­no­va­tion be­yond Fi­nance

The average level of investment required for a biotech start-up to succeed is increasing every year, elevating the pressure even further on venture capital to make smart financial investments. Financial investment alone, however, does not always guarantee that exciting innovations can be transformed into real businesses that make a meaningful difference to patients.

Beyond just capital

At Astellas Venture Management (AVM) – a wholly-owned venture capital organization within Astellas, headquartered in the San Francisco Bay Area – capital is just one of the ingredients we offer to add value to our biotechnology investments and partnerships. We generally take a strategic investor approach for companies in our invested portfolio, providing access to expertise, technology and/or resources in addition to the injection of finance. An equity investment from AVM can include access to Astellas’ research and development (R&D) capabilities and expertise, and a global network of partner academic institutions and biotechnology companies, to help advance and accelerate the start-up’s innovation.

UP­DAT­ED: Ver­tex joins Mer­ck, Pfiz­er — re­vamp­ing multi­bil­lion-dol­lar tri­al strat­e­gy as biotech R&D crum­bles

You can add Pfizer, Merck and — as we found out Friday morning — Vertex to the growing list of pharma giants hitting the pause button on a range of clinical trials. But not everyone in R&D is getting a red light.

Vertex says that it’s doing its best to keep working its pipeline strategy, coming up with a plan “to enable virtual clinic visits and home delivery of study drug to ensure study continuity and medical monitoring, and to facilitate study procedures.”

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Covid-19 roundup: In­ter­cept, blue­bird and a grow­ing list of biotechs feel the pain as pan­dem­ic man­gles FDA, R&D sched­ules

Around 100 staffers at Boston area hospitals have now tested positive for Covid-19, spotlighting the growing risk that the pandemic will sideline many of the most essential workers in healthcare as caseloads peak in the US and around the globe. With more than 3,400 deaths, Spain has become the latest country to surpass the official death count attributed to the new coronavirus in China, where the outbreak originated. As of Thursday morning, confirmed global cases had crossed 470,000 and the death count eclipsed 21,000.

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Af­ter crit­ics lam­bast­ed Gilead for grab­bing the FDA's spe­cial rare drug sta­tus on remde­sivir, they're giv­ing it back

Two days after Gilead won orphan drug status for remdesivir as a potential treatment for Covid-19, they’re handing it back.

The company was slammed from several sides after Gilead reported that the FDA had come through with the special status, which comes with 7 years of market exclusivity, the waiver of FDA fees and some tax credits as well. Typically, everyone who can get orphan status lands it without much of a fuss, but Democratic presidential candidate Bernie Sanders, Public Citizen and other consumer groups were outraged.

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Mod­er­na CEO Stéphane Ban­cel out­lines a short path for emer­gency use of a coro­n­avirus vac­cine

NIAID director Anthony Fauci has left no doubts that it takes 12 to 18 months to get a new vaccine tested and in commercial use, in the best of circumstances. But in times of a global emergency — like these — maybe there’s another, faster route to follow.

In an SEC filing on Tuesday, Moderna $MRNA staked out a record-setting pathway to getting their mRNA vaccine into the frontline of the healthcare response as early as this fall. The SEC filing notes that CEO Stéphane Bancel told Goldman Sachs that an emergency use approval could allow the vaccine to go to healthcare workers and certain individuals in a matter of months — presumably provided the NIH sees the safety and efficacy data they would need from the Phase I.

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Caught in a Covid-19 mael­strom, Eli Lil­ly locks down clin­i­cal tri­als as multi­bil­lion-dol­lar R&D ops de­rail

The Covid-19 pandemic has derailed Eli Lilly’s $6 billion R&D operations.

The pharma giant reported Monday morning that it has decided to hit the brakes on most new study starts and pause enrollment for most ongoing studies. Lilly adds that it is continuing dosing for ongoing studies, “but with study-by-study consideration.”

The pandemic has severely disrupted healthcare systems around the globe, says Lilly, making it difficult or impossible to conduct studies at many research sites. And there’s no timeline for when it expects to get back on track.

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As share buy­backs come un­der scruti­ny, what's in store for the bio­phar­ma in­dus­try?

Stock buybacks are not to be permitted for companies that will be bailed out in the coronavirus stimulus package, Congressional leaders have signaled. To what degree the biopharma industry has relied on buybacks for earnings growth in recent years, and if the trend continues, are the big questions as scrutiny into the practice heightens and balance sheets weaken with the coronavirus pandemic wreaking havoc on global economies.

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A Sin­ga­pore VC rais­es $200M for a new round, but will Covid-19 pre­vent it from rais­ing the rest?

A top Singaporean biotech venture fund is nearly halfway toward its largest ever fund, but in a sign of what could be in store for VCs amid a global economic freeze, said they could face headwinds raising the other half.

Vickers Venture Partners has secured $200 million out of a targeted $500 million for its 6th fund, first announced in early 2018. They’ve given themselves 13 months to complete the financing, Vickers founder Finian Tan told Deal Street Asia, but the financial frost settling amid the Covid-19 pandemic could slow efforts.

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Strug­gling Unum ex­ecs are ready to con­sid­er a sale, merg­er or any deal that comes its way

Unum $UMRX is working its way through a survival plan of sorts.

After getting hit with a trio of FDA holds in its brief public history and triggering its second pivot to a new lead drug program while laying off 60% of the staff, the troubled penny stock biotech Unum Therapeutics has hatched new plans to secure financial backing while lining up a go-forward strategy for the company.

First, Lincoln Park Capital Fund has agreed to buy up to $25 million of the long-suffering stock, as Unum directs. And the executive team — led by CEO Chuck Wilson — has put everything on the table for consideration: a sale, acquisition, merger, licensing deal, you name it. The ACTR707 program, meanwhile, is being formally wrapped up — their second failed lead program.