BioStock’s article series on autoimmune disease has so far focused on two of the most common autoimmune disorders: rheumatoid arthritis and multiple sclerosis. However, there are more than 80 other autoimmune disorders that cause immense suffering to patients all over the world. In this fourth and final segment of this article series, we dig into some of the Swedish companies developing drugs for less common autoimmune diseases and/or candidates with potential for a broad autoimmune indication.

If you missed parts I, II, and III of this series, you can find them here:

Part I

Part II

Part III

Autoimmune diseases affect between 10 and 20 per cent of the population in Europe and North America. The numbers vary depending on the source, probably due to the number of autoimmune disorders and the difficulty to diagnose the wide range of symptoms that often overlap with other diseases. These unknows make for a huge obstacle in autoimmune disease drug development.

Pressure is rising to find better treatments

Given the obvious need for more efficient treatments, R&D facilities and drug companies are under a lot of pressure to discover new molecular targets and develop treatments that give better results, improve the long-term outcomes and reduce the debilitating complications caused by suppressing the immune system.

Also, given the fact that many autoimmune indications share some of the same pathogenic mechanisms and similar symptoms, drug companies also feel the pressure to find a common denominator for all autoimmune diseases that could become a potential therapeutic target. This would help decrease the economic burden on health care systems as well as the burden physicians carry when deciding on the best treatment to prescribe.

Less common autoimmune diseases need more attention

With so many autoimmune diseases affecting millions of people world-wide, many companies decide to focus on the most common disorders, since they account for the majority of the research done so far and thus provide the most resources to scientist. Nevertheless, some companies are tackling more rare indications and others are trying to discover treatments that could work for more than one specific autoimmune disease.

Companies in Sweden and Denmark have promising innovative pipelines

In Sweden, Hansa Biopharma has candidate treatments targeting biological pathways that could be linked to most, if not all, autoimmune diseases. In Denmark, Saniona, which is listed on Nasdaq Stockholm Small Cap, also has a stake in the field.

Hansa Biopharma’s antibody-degrading enzyme

Hansa Biopharma are focusing on the immune system and develop immunomodulatory enzymes for organ transplantation and acute autoimmune diseases such as Guillain-Barré syndrome (GBS). Their flagship candidate is imlifidase, an antibody-degrading enzyme with the ability to search and destroy pathogenic antibodies. For now, the candidate is in late stage clinical trials for enabling kidney transplantation and Phase 2 studies are also ongoing in the rare and acute autoimmune diseases anti-GBM antibody disease and GBS as well as treatment of antibody mediated kidney transplant rejection. In addition, imlifidase has shown great potential for targeting and deactivating rogue antibodies that typically develop in additional autoimmune diseases in pre-clinical studies.

Saniona’s ion channel expertise could be crucial for treating autoimmune disease

Danish Saniona are experts in ion channels, key proteins needed for proper signal messaging within the body. The company has identified molecules able to inhibit specific ion channels called IK channels, which are essential for activation of immune cells. By inhibiting such channels, Saniona believe they can develop treatments for autoimmune diseases including inflammatory bowel diseases (IBD), Crohn`s disease and ulcerative colitis.

Finding treatments that could treat all autoimmune diseases is tricky business

In this final piece of the autoimmune diseases article series puzzle, BioStock reached out to said biotech companies listed on the Swedish stock market who put a lot of focus on autoimmune diseases in general and not strictly on RA and MS. The conversation features the CEOs of Hansa Biopharma and Saniona.

Hansa Biopharma

Søren Tulstrup, CEO of Hansa Biopharma

Søren Tulstrup, CEO of Hansa Biopharma, imlifidase has promising characteristics, but how can you be sure that such an enzyme will not affect non-pathogenic antibodies?

– Enzymes are molecules that by nature are designed to do specific tasks. In our case, imlifidase acts by specifically and effectively eliminating pathogenic Immunoglobulin G (IgG) antibodies and nothing else. It is this specificity for IgG antibodies that makes imlifidase so interesting and promising to develop as a drug for fast and effective IgG antibody inactivation.

For now, you are focusing on enabling more transplantations and treat acute autoimmune diseases like GBS. Why is that?

– Imlifidase’s mode-of-action is highly relevant in a number of acute autoimmune diseases and in several transplant-related indications.  Today, plasma exchange and high doses of intravenous gammaglobulin are applied to acutely mitigate the harmful damage autoantibodies are causing in acute autoimmune diseases. Imlifidase can help eliminate systemic IgG levels in 2-4 hours and can potentially make a significant difference in the acute autoimmune kidney disease, anti-GBM, also known as Goodpasture syndrome, as well as in the acute autoimmune neurological condition, Guillain-Barré syndrome (GBS).

How likely is it that imlifidase could work as a therapy for other, if not all, autoimmune diseases?

– We believe our technology platform can be used across a range of acute autoimmune diseases and transplant related indication in which pathogenic IgG antibodies have an important role for disease progression. Also, imlifidase and other similar IgG-eliminating enzymes from our NiceR-program have potential in gene therapy and oncology.

Saniona

Jørgen Drejer, CEO of Saniona

Jørgen Drejer, CEO of Saniona, could you briefly tell us more about the link between IK ion channels and the immune system?

– The IK potassium channel is present in many cells of the immune system and it regulates the electrical voltage difference between the cells’ interior and their surroundings – a key determinant of activation of immune cells. The relative impact IK channels have on cell division, migration/homing, and production of pro-inflammatory agents, depends on the  production levels of IK channel protein and the regulation of its sensitivity to intracellular calcium in certain subsets of immune cells. High levels of activity sustained by IK channels for too long may lead to exaggerated immunological reactions and IK channel inhibitors will effectively dampen these immune responses.

Do you believe that ion channel modulators could be used to treat most, if not all, autoimmune disorders?

– Our most progressed small molecule compounds, now in preclinical development, have shown very convincing effects in models of inflammatory bowel disease, which is currently our focus indication. However, we have also demonstrated that IK inhibitors are effective in models of RA and MS. We have no scientific basis for saying that this principle will work in any autoimmune disorder, but we will obviously aim at expanding the possible therapeutic areas, as we progress the development. An obvious example would be systemic lupus erythematosus (SLE).

– In general, however, I am skeptical about the idea of a “master target” driving all autoimmune diseases. That is also exactly the reason why we focus on specific modulation of a quite general physiological mechanism and not a single cytokine.

This concludes BioStock’s article series on autoimmune disease. We would like to thank the CEOs of Hansa Biopharma and Saniona for sharing their insights with us in this last segment and thank once again all those who contributed to this series.

The content of BioStock’s news and analyses is independent but the work of BioStock is to a certain degree financed by life science companies. The above article concerns a company from which BioStock has received financing.