New biotech Exalys, seeking to prevent postoperative delirium, launches with $15 million in Series A
An old group of former colleagues will be reuniting to lead a new biotech venture aimed at cultivating a portfolio to treat neuroinflammatory disorders.
Led by Rick Orr, who ran the biotech Adynxx, the group is launching the startup Exalys on Thursday with $15 million in Series A funding from venture firms Catalys Pacific and Domain Associates. The nascent company’s first project will focus on preventing postoperative delirium, licensing a platform of EP4 receptors from Japanese pharma Eisai.
“We’re working with a team that has done this multiple times, particularly with assets that were sourced out of Japan,” Orr told Endpoints News. “All the pieces are in place — you’ve got the technology and you’ve got the team.”
In addition to Orr, who will serve as president and CEO, Exalys’ board will be headed by Dennis Podlesak and joined by Eckard Weber. The three have previously collaborated with Domain on Peninsula Pharmaceuticals, Cerexa, Calixa and Corthera.
EP4s essentially drive the immune system’s response coming out of surgery, Orr said. Immune cells release cytokines that disrupt the brain barrier in surgery, which can lead to postoperative delirium afterwards. EP4 is pivotal in the secretion of those cytokines, and blocking the immune response during surgical procedures can prevent patients from contracting the condition.
There is nothing on the market that can currently prevent postoperative delirium, and though there are limited medicines that can treat the condition, few are both safe and effective, Orr said. By researching and ultimately developing EP4 antagonists, Exalys hopes this initial target indication can provide a foundation for the company moving forward.
“It’s not the only response,” Orr said of postoperative delirium, “but certainly there are other neuroinflammatory diseases that can be targeted through EP4 antagonists. So we’re starting with postoperative delirium given that it’s such an unmet medical need, but with the portfolio we currently have we’ll be looking to address other neuroinflammatory disorders.”
Orr envisions an eventual procedure looking something like this: A patient at high risk for postoperative delirium — generally individuals older than 65 — is prepped for surgery and is administered anesthesia. In addition to the typical pre-op drugs, the patient is also given the hypothetical Exalys drug, preemptively inhibiting the body’s EP4 response. During the surgery, the EP4 antagonists do their work, and once the surgery has ended, the at-risk individuals will be safe from the disorder.
Not only would such candidates diminish negative impacts on the patients, but they also have the potential to ease the burden on the healthcare system. Those who suffer from postoperative delirium often require extended hospital stays, adding up to an estimated $150 billion in costs per year, Orr said.
“It’s pretty marked in the impact it has on the patient as well as the family,” Orr said. “Truly the patient almost becomes unrecognizable, just in terms of change in behavior and change in cognition. That does lead to prolonged hospitalizations, but there are other aspects that, probably from the patient’s perspective, are even more dramatic than just the longer time in the hospital.”
Those already suffering from other neurological diseases, such as Alzheimer’s or dementia, may have their conditions exacerbated by postoperative delirium, Orr added.
The current plan, Orr said, is to start clinical development using the Series A funding, and if everything stays on track, Exalys will apply for an IND for the postoperative delirium candidate in the second half of 2021. Exalys is looking at two other EP4 antagonist candidates, but those are farther down the road.
What other potential candidates end up treating, Orr doesn’t know yet, but the biotech will continue focusing on neuroinflammation. Exalys doesn’t aim to start with a problem it wants to fix and work toward that, but rather continue testing the EP4 antagonists and go in the direction of the most promising data.
It’s part of the company’s philosophy of “following where the science leads you,” Orr said.