Home Intervjuer Fusion öppnar upp nya möjligheter för Coegin Pharma

Fusion öppnar upp nya möjligheter för Coegin Pharma

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Fusion öppnar upp nya möjligheter för Coegin Pharma

1 mars, 2022

Coegin Pharma har framgångsrikt slutfört fusionsförvärvet av Lundabaserade Follicum. Bolaget genomför just nu en fas I/II-studie med huvudkandidaten AVX001 inom aktinisk keratos samt preklinisk utveckling av AVX420 inom leukemi och kronisk njursjukdom. Dessutom tar de tillvara på möjligheten att utöka utvecklingsportföljen till diabeteskomplikationer genom förvärvet av Follicum. BioStock kontaktade professorerna Anna Hultgårdh och Jan Nilsson, två internationellt erkända experter inom diabeteskomplikationer, för att få veta mer om vad förvärvet innebär för Coegin.

Coegin Pharma är ett biofarmabolag som utvecklar nya behandlingar mot cancer, inklusive den precancerösa hudförändringen aktinisk keratos (AK). Förra året initierade bolaget fas I/II-studien Copenhagen Actinic Keratosis Study (COAKS) för att utvärdera säkerhet och effekt för bolagets ledande läkemedelskandidat AVX001 på AK-patienter. Läs mer om AVX001 och Coegins vision här. År 2021 inleddes även den prekliniska utvecklingen av AVX420 för behandling av leukemi och kronisk njursjukdom.

Coegins läkemedelskandidater baseras på årtionden av forskning inriktad på att motverka de inflammatoriska processer som är associerade med kroniska inflammatoriska sjukdomar och inflammationsdrivna cancerformer. Faktum är att bolaget tidigare har erhållit proof-of-concept med AVX001 inom psoriasis, en kronisk inflammatorisk sjukdom i huden.

Diabeteskomplikationer i fokus

En annan sjukdom som leder till kroniska inflammatoriska komplikationer är diabetes. Vid diabetes kan en inflammation uppstå i njurarna på grund av skador på små blodkärl. Faktum är att njurfibros är en vanlig komplikation av sjukdomen, och antalet drabbade ökar i takt med den ökade förekomsten av diabetes (från 4,7 procent av världens befolkning 1980 till 8,5 procent 2014). Denna ökning medför ett antal utmaningar och utgör en enorm börda för patienter, sjukvårdssystem och samhället.

»New research from Lund University has shown that a disturbed balance between tissue injury and repair of this injury may be an important explanation for the development of diabetes complications. […] Our research has shown that some of the Follicum drug candidates can protect cells against the injury caused by high glucose and fatty acids and to activate tissue repair responses.« — Professor Jan Nilsson

Diabetes leder till en ökad blodsockernivå som kan behandlas med flera effektiva läkemedel, men som dock har en mycket begränsad effekt när det gäller att minska risken för komplikationer. Detta betyder att cellskador hos diabetespatienter orsakas av andra faktorer än ökningen av blodsockernivån.

Att identifiera dessa faktorer skulle skapa förutsättningar för att bättre förhindra utvecklingen av kronisk njursjukdom, leversjukdomar, hjärt-kärlsjukdom, synnedsättning och andra komplikationer hos diabetespatienter. Den höga efterfrågan på nya och bättre läkemedel för att behandla diabeteskomplikationer öppnar möjligheten för Coegin att använda sin expertis inom kroniska inflammatoriska tillstånd även inom området för diabeteskomplikationer och därmed utöka sin pipeline.

Fusion med Follicum slutförd

Det verkar som om Coegin siktar på att ta vara på denna möjlighet. I september offentliggjorde bolaget att de avser att genomföra en fusion med Lundabaserade Follicum, ett bioteknikbolag som har utvecklat peptider med potential att behandla alopeci (håravfall) och diabeteskomplikationer. Follicums peptidbaserade läkemedelskandidater har inte bara potential att sänka blodsockret genom att stimulera frisättningen av insulin från betaceller, utan också potential att minska risken för organskador.

»This merger provides an excellent opportunity to bring the candidate drugs developed by Follicum into clinical testing based on the combined expertise of the Follicum and Coegin teams.« — professor Anna Hultgårdh

I februari meddelade Coegin att fusionsförvärvet har slutförts framgångsrikt. Detta innebär att arbetet med att utveckla behandlingar inom diabeteskomplikationer nu intensifieras. Arbetet utförs i nära samarbete med de internationellt erkända forskarna, professor Anna Hultgårdh och professor Jan Nilsson vid Lunds universitet, som båda har haft nyckelroller på Follicum.

Q&A med två professorer från Follicum

BioStock kontaktade båda professorerna för att få veta mer om fusionen och Coegin Pharmas satsning inom diabeteskomplikationer.

Professor Anna Hultgårdh, as an original founder at Follicum, could you speak to the overall significance of this merger and what Follicum can bring to Coegin?

– Follicum has developed several peptide-based drug candidates with the potential to protect against the long-term complications of diabetes. They work by protecting cells against the metabolic stress and inflammation caused by elevated blood glucose and fatty acids in diabetes. Coegin has a long experience in inflammation and to develop drugs that can protect against the negative consequences of inflammation in chronic disorders. This merger provides an excellent opportunity to bring the candidate drugs developed by Follicum into clinical testing based on the combined expertise of the Follicum and Coegin teams.

Prof Anna hultgaardh
Professor Anna Hultgaardh

How well do Coegin’s company values and vision match those of Follicum, and, based on that, do you expect a smooth integration within Coegin?

– Yes, I believe that this merger makes a lot of sense and I see numerous opportunities in the field of diabetes complications. Both companies have a strong background and expertise in diseases associated with inflammation. Coegin has a very interesting programme in skin cancer and a well-established academic network in dermatology, cancer and kidney diseases.

– Follicum has developed a drug candidate against alopecia and conducted two clinical trials where the results turned out ambiguous. However, Coegin is now doing an in-depth analysis of the clinical data in order to identify potential opportunities for further development or out-licensing. There is an enormous unmet need for better treatment for alopecia, and I would not be surprised if the new team identifies a new avenue for this project. 

– It Is important to add that Follicum, in connection with the alopecia project, developed novel technologies for microparticle based delivery of peptide drugs. There are several possible applications for this including stimulation of wound healing. Chronic leg ulcers represent one of the most common and feared complications of diabetes. It is well known that cells present in hair follicles play an important role in wound healing and we have in collaboration with a leading dermatology group in Germany demonstrated promising effects on wound healing in experimental models by drug candidates developed by Follicum. The Follicum drug candidates may have the potential to help these patients. So, to answer your question, yes the values, expertise and vision of Coegin and Follicum are well aligned and the two companies bring matching assets and expertise that holds promise to the development of important new treatments. The integration process is well on the way, and I have been excited to meet and work with the professional Coegin staff and their academic partners.

What will be your role in this new endeavour?

– I will act as a scientific advisor to Coegin and take an active part in several of the ongoing projects. Society interactions including collaboration with industry is one of key priorities for us and for Lund University and I look forward to working as a link between Coegin and the university.

Professor Jan Nilsson, generally speaking, how are diabetes and chronic inflammation linked?

– This is a question that is the focus of intense research. The exposure of the cells in the body to high levels of blood glucose has stressful effects but it is becoming increasingly clear that the high level of free fatty acids in the blood is even more harmful. These factors act jointly to increase the oxidative stress inside cells. The reactive oxygen radicals that are generated by this process are very potent activators of inflammation.

Prof Jan Nilsson
Professor Jan Nilsson

What are the most important complications to diabetes?

– Diabetes is associated with a more aggressive development of atherosclerosis, a chronic disease of major arteries resulting in lipid deposition, chronic inflammation and scarring. Rupture of atherosclerotic plaques is the main cause of myocardial infarction and stroke. Subjects that have diabetes have a doubled risk of suffering from myocardial infarction and stroke. Diabetes is also one of the most common causes for kidney failure and blindness.

How are patients with diabetes treated today in order to decrease the risk of these complications?

– The most effective way to lower the risk of myocardial infarction and stroke is treatment with cholesterol-lowering statins. The discovery of this was rather unexpected because subjects with diabetes generally do not have elevated levels of the dangerous LDL cholesterol. We know now that statins decrease cardiovascular risk equally well in subjects with diabetes as in non-diabetics. However, it does not remove the increased risk associated with having diabetes.

– It has been generally assumed by the medical community that the best approach to lower the risk of diabetic complications is to lower blood glucose levels to as close to normal as possible. However, while we now have many drugs that effectively lowers blood glucose most of these have very limited effect on the risk of complications. It has thus become clear that we still do not really understand how diabetes give rise to long term complications. A better understanding of this is necessary for the development of new and more effective preventive treatments.

What potential do you see for the drug candidate in the Follicum pipeline to prevent diabetic complications?

– New research from Lund University has shown that a disturbed balance between tissue injury and repair of this injury may be an important explanation for the development of diabetes complications. It is well known that high levels of glucose and certain lipids (particularly fatty acids) are stressful for many types of cells and may cause injury to many organs including blood vessels, the kidneys, the liver and the eyes. However, we are now able to show that subjects with diabetes have an impaired ability to protect against and repair such injuries. Our research has shown that some of the Follicum drug candidates can protect cells against the injury caused by high glucose and fatty acids and to activate tissue repair responses. Other studies that we have done in large populations show that subjects with high levels of natural factors with similar effects have a lower risk of suffering from myocardial infarction and stroke. These findings suggest that the Follicum drug candidates could represent an entirely new and very promising approach for prevention of diabetic complications. I am very much looking forward to exploring this together with Coegin.

Finally, how will you contribute to Coegin’s vision of developing new treatments for diabetes complications?

– Coegin will continue the collaboration, initiated by Follicum, with Lund University Diabetes Center and I will be an active part of this collaboration. I will also act as a scientific advisor for Coegin.

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