Ex­as­per­at­ed with the of­ten-in­ef­fec­tive ex­ist­ing slate of an­ti­de­pres­sants, COM­PASS Path­ways set up shop in Lon­don 2016 — and made a bee­line for psilo­cy­bin, the psy­choac­tive in­gre­di­ent in mag­ic mush­rooms.

On Wednes­day, the start­up said its man-made ver­sion of the chem­i­cal — which is il­le­gal across ge­o­gra­phies in its nat­ur­al fun­gi form — had been well-tol­er­at­ed in an ear­ly-stage, place­bo-con­trolled tri­al in 89 healthy vol­un­teers.

Al­though pre­vi­ous re­search sup­ports the use of psilo­cy­bin in re­liev­ing symp­toms of de­pres­sion, small­er stud­ies are not al­ways place­bo-con­trolled. The tri­al test­ing the COM­PASS com­pound is the largest con­trolled study of psilo­cy­bin to date, said the study’s lead in­ves­ti­ga­tor, James Ruck­er of King’s Col­lege Lon­don’s In­sti­tute of Psy­chi­a­try, Psy­chol­o­gy & Neu­ro­science, in a state­ment.

Ex­ist­ing an­ti­de­pres­sants typ­i­cal­ly come in a pill form, and take weeks to kick in. J&J’s phar­ma­ceu­ti­cal con­coc­tion of ke­t­a­mine — the no­to­ri­ous par­ty drug that is al­so a horse and cat tran­quil­iz­er — was ap­proved ear­li­er this year, comes in the form of a nasal spray.

Tra­cy Che­ung

In the COM­PASS tri­al, vol­un­teers were ran­dom­ized to re­ceive a 10 mg or 25 mg dose of the syn­the­sized chem­i­cal (en­cap­su­lat­ed in a pill) or giv­en place­bo. Once dosed, vol­un­teers were giv­en in­di­vid­ual sup­port from ther­a­pists in groups of six in ses­sions that last­ed up to six hours.

The pa­tients who got the drug will most like­ly have ex­pe­ri­enced some psy­che­del­ic ef­fect, which is why the ther­a­pists were avail­able on hand, COM­PASS’ chief com­mu­ni­ca­tions of­fi­cer Tra­cy Che­ung not­ed in an in­ter­view with End­points News.

“Some­times that can be a lit­tle bit fright­en­ing or a lit­tle bit in­tense and the ther­a­pist is just there to hold your hand if that’s what’s re­quired and just pro­vide some sup­port or just to kind of say it’s all right, I’m here.”

No se­ri­ous ad­verse events emerged, and the most com­mon side ef­fects — as ex­pect­ed — were in the psy­che­del­ic realm, in­clud­ing changes in sen­so­ry per­cep­tion. The com­pound, dubbed COMP360, al­so had no im­pact on cog­ni­tive and emo­tion­al func­tion­ing, the com­pa­ny said.

COM­PASS is al­so con­duct­ing a Phase II tri­al test­ing its psilo­cy­bin com­pound in 216 pa­tients with treat­ment-re­sis­tant de­pres­sion across sites in North Amer­i­ca and Eu­rope. The com­pa­ny ex­pects to re­port da­ta from this study, which does not in­clude a place­bo arm, by ear­ly 2021.

Psilo­cy­bin is a sub­stance that in most re­gions is clas­si­fied as hav­ing no med­i­c­i­nal val­ue, falling in the same cat­e­go­ry as chem­i­cals such as LSD.

“At the mo­ment…we can use it but there’s an aw­ful lot of pa­per­work and we have to get li­cens­es for each of the coun­tries that we’re work­ing on do­ing the clin­i­cal tri­al,” Che­ung said, not­ing that the com­pa­ny has raised £28 mil­lion so far to in­ves­ti­gate the drug.

Psy­choac­tive in­gre­di­ents, whether de­rived from cannabis, LSD or mag­ic mush­rooms, have long cap­ti­vat­ed men­tal health re­searchers. Nav­i­gat­ing the com­plex le­gal hur­dles to ac­cess these com­pounds has thawed the pace of re­search but with mo­ti­vat­ed sci­en­tists and a grow­ing bur­den of poor­ly treat­ed men­tal health con­di­tions, the ecosys­tem of psy­che­del­ic re­search has ex­plod­ed. In Sep­tem­ber, John Hop­kin’s un­veiled it had scored $17 mil­lion to open its very own cen­ter of psy­che­del­ic re­search to ex­plore the im­pact of psy­che­del­ic com­pounds on cre­ativ­i­ty and well-be­ing.

But the brim­ming en­thu­si­asm comes with a healthy dose of skep­ti­cism. Crit­ics wor­ry that the bur­geon­ing re­search could in­cen­tivize un­bri­dled use of non-phar­ma­ceu­ti­cal ver­sions of these drugs and that clin­i­cal tri­al da­ta could be cloud­ed by the fact that place­bo-con­trolled stud­ies are not nec­es­sar­i­ly dou­ble-blind­ed, be­cause it is far too easy to de­ter­mine which group of pa­tients have been giv­en a place­bo.

Novartis is calling off a UK-based trial for Leqvio in the primary prevention of cardiovascular events in patients with high cholesterol, the company confirmed on Wednesday.

The Swiss pharma giant made the decision after “careful evaluation,” a spokesperson told Endpoints News via email. The trial, dubbed ORION-17, was planned in partnership with England’s National Health Service (NHS) and was part of the company’s strategy to establish Leqvio as a standard of care in cardiovascular disease management.

89bio said its drug was better than placebo at lessening fibrosis without worsening nonalcoholic steatohepatitis, or NASH, in two of three dose groups.

The San Francisco biotech said it thinks the Phase IIb data pave the way for a potential Phase III, following in the footsteps of another biotech in its drug class, Akero Therapeutics. To fund a late-stage study, CEO Rohan Palekar told Endpoints News 89bio “would need to raise additional capital,” with the company having about $188 million at the end of last year.