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Data shows combination psilocybin therapy effective for TBI and PTSD

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Data shows combination psilocybin therapy effective for TBI and PTSD

Data from Lobe Sciences has demonstrated that combination therapy of psilocybin and N-Acetylcysteine is more effective than monotherapy for mTBI and PTSD.

Lobe Sciences has announced interim data from its preclinical research studies showing the effectiveness of its combination therapeutic candidates, demonstrating that psilocybin and N-Acetylcysteine is statistically significantly better than either agent alone or a placebo for mild traumatic brain injury/concussion (mTBI) and post-traumatic stress disorder (PTSD).

The research, being conducted in collaboration with the University of Miami Miller School of Medicine under the leadership of Michael Hoffer, M.D., professor of otolaryngology and neurological surgery, was carried out in established rodent models of mild traumatic brain injury/concussion PTSD.

CEO of Lobe, Philip Young, commented: “I am thankful to Dr Hoffer and his team for their excellent work. This data is validation of our therapeutic hypothesis that the use of these two active therapeutics provides superior efficacy to either placebo or single-drug therapy in this model of TBI and PTSD. We believe that these data directly support our IP and will allow us to build on our leadership position in the rapidly evolving psychedelic therapeutics marketplace.

“Despite the significant shortage of psilocybin in North America the Miami team was able to deliver these data. However, the shortage has impacted the timing of the next planned studies. We have responded to this supply shortage by working to identify a manufacturing company who will supply high purity cGMP psilocybin to the University of Miami so that the remaining studies can be completed.”

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Dr Hoffer added: “These are promising results that suggest that a combination of psilocybin and NAC can work better than either drug administered as a single agent after traumatic brain injury. We look forward to future work that will help to reaffirm these outcomes and further clarify the role of medical countermeasures in combatting traumatic insults to the brain.”

“We are extremely pleased that the interim data from our preclinical studies validates our therapeutic hypothesis that NAC plus psilocybin would provide superior efficacy over either agent used alone. NAC remains the only compound that has successfully completed a human phase 1 equivalent trial in a population of individuals who had acute mTBI.

“Dr Hoffer’s team has made significant in-roads studying psychedelic medicine and NAC specifically as it relates to mTBI and PTSD. Given there are currently no approved medicinal treatments for mTBI and PTSD, we feel this data is supportive of our plans to advance into future human clinical trials which we hope will eventually lead to approved therapeutics for these unmet needs,” commented Maghsoud Dariani, CSO of Lobe.

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Markets & Industry

Shortwave Life Sciences hits major milestone with positive patent claim

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Shortwave Life Sciences, previously Psych Capital, has received a positive patent report from the PCT confirming its mucoadhesive buccal film as a novel and inventive drug delivery platform for psychedelic-based drugs.

Shortwave Life Sciences (PSY:Aquis AQSE) is working to transform Anorexia nervosa care through innovative approaches and treatments, including psychedelics.

Anorexia nervosa is a complex mental health condition as well as a metabolic disease, with one of the highest fatality rates. However, there is currently no FDA-approved pharmacological treatment for the condition, underlining an urgent need for innovation in this area.

To tackle this challenge, Shortwave Life Sciences has developed a novel drug based on psilocybin and another API, which Shortwave says provides an expanded mechanism of action and a therapeutic effect superior to psilocybin alone, impacting more than one group of receptors in the brain.

See also  Psych Capital completes acquisition of Short Wave Pharma

The company has developed its novel delivery method in the form of a buccal film. This method of administration is designed to be sensitive to patient needs, who may not want to swallow the medicine, and also provides higher bioavailability.

Positive patent report

Shortwave recently received its positive report from the PCT examining authority acknowledging all of its claims regarding its buccal film as novel, non-obvious and industrially applicable, marking a major milestone for the company.

Rivki Stern Youdkevich, CEO of Shortwave Life Sciences, commented: “This acknowledgement by the PCT committee is very important for us as we progress in our drug development path.

“The PCT’s examining committee’s report acknowledging all our claims as free of prior art confirms our belief in our patient-focused IP and drug development strategy. As we move to the national phase, we are reaffirmed in our mission of pioneering breakthrough therapies that transform the landscape of mental health care, especially psychedelics-based.”

With this IP confirmation, Shortwave has confirmed it can now begin to utilise its buccal film delivery platform, which is currently in clinical testing, in administering additional drug combinations including under licensing agreements with future potential partners.

Stern Youdkevich continued: “Our Buccal film, which is a topical route of administration applied in the cheek, allows our psilocybin-based drug combination to diffuse through the oral mucosa and enter directly into the bloodstream, providing better bioavailability and more rapid onset of action compared to oral administration because the medication does not pass through the digestive system and thereby avoids first-pass metabolism.

“We believe this can be extremely beneficial for anorexia nervosa patients who experience severe metabolism-related challenges. We are very excited to study this further in our upcoming clinical trials coming up.”

The company has stated that it is aiming for a rapid approval process through the FDA pathway for approval.

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Research

Study identifies MDMA variants that could make therapy safer

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Study identifies MDMA variants that could make therapy safer

A new study from MedUni Vienna has identified three new variants of MDMA as promising alternatives for safer use in a controlled psychotherapeutic setting.

The recent blow to MDMA therapy from the FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) has put a dampener on many people’s hopes that the treatment would be approved this August.

While that still may happen, one of the major concerns of the advisory body was the compound’s safety data, and the PDAC has advised that Lykos has not collected enough safety data on the molecule in its trials so far.

See also  FDA MDMA therapy advice may be a setback, but it is not the end of the road

Despite this setback in the US, countries such as Canada and Australia have increased legal access to MDMA-assisted psychotherapy for PTSD in recent years.

However, there are concerns about the safety profile of the drug due to its side effects such as tachycardia, high blood pressure, and liver and nerve damage despite promising studies.

Safer alternatives

Now, published in the Journal of Neurochemistry, an international research team led by Harald Sitte at MedUni Vienna’s Center for Physiology and Pharmacology has identified three new variants of MDMA as promising alternatives for safer use.

According to the team, the variants – ODMA, TDMA and SeDMA – have been developed to retain the positive effects of MDMA while reducing negative effects.

The studies suggest that the variants impact structures in the brain such as serotonin and dopamine in a similar way to MDMA, but unlike MDMA, they have lower activity at certain serotonin receptors.

Study lead Harald Sitte stated: “This allows the conclusion that both the acute and long-term side effects of ODMA, TDMA and SeDMA may be lower than those of the conventional substance.”

“Since the MDMA analogues also have a weaker interaction with certain transport proteins in the body that are responsible for the absorption and excretion of drugs, the risk of interactions with other drugs could also be reduced,” added first author, Ana Sofia Alberto-Silva.

Sitte continued: “Our experimental results showed that the new variants can retain the therapeutic potential of the conventional substance, but are likely to cause fewer side effects.

“This could advance the controlled use of psychoactive substances in neuropsychiatric illness.”

The authors wrote: “Our findings suggest that these new MDMA bioisosteres might constitute appealing therapeutic alternatives to MDMA, sparing the primary pharmacological activity at hSERT, hDAT, and hNET, but displaying a reduced activity at 5-HT2A/2B/2C receptors and alternative hepatic metabolism. Whether these MDMA bioisosteres may pose lower risk alternatives to the clinically re-emerging MDMA warrants further studies.”

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Policy

FDA MDMA therapy advice may be a setback, but it is not the end of the road

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FDA MDMA therapy advice may be a setback, but it is not the end of the road

An advisory body to the U.S Food and Drug Administration (FDA) has recommended against the approval of Lykos Therapeutics’ MDMA-assisted therapy – but the development is not deterring the industry.

Four months ago the psychedelics industry was abuzz when Lykos Therapeutics (formerly MAPS Public Benefit Corporation) announced it had received FDA acceptance and priority review for a New Drug Application (NDA) concerning its MDMA-assisted therapy for PTSD.

While the final decision on the matter is not expected until 11 August 2024, the FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) has delivered a major blow to the development.

The committee voted “no” on the question of whether the data shows the treatment’s effecitveness as well as on the question of whether the benefits outweigh the risks, with concerns raised over trial design, data gaps, and the potential for abuse and unethical practice.

As highlighted by Lykos, the FDA is not bound by PDAC’s guidance but it does take its advice into consideration – meaning the outcome is not looking good for the FDA’s final decision later this year.

Lykos has expressed its disappointment on the vote outcome given “the urgent unmet need in PTSD”, however, the organisation has acknowledged that the committee “faced a challenging and atypical assignment, which was to evaluate a therapeutic approach that combines drug therapy (MDMA) and psychological intervention.”

Amy Emerson, Chief Executive Officer of Lykos Therapeutics, stated: “We remain committed to working with the FDA to address outstanding questions so that we may find a path forward to ensure the responsible and careful introduction of MDMA-assisted therapy into the healthcare system, if approved.”

Not the end of the road

While the advisory vote may not bode well, industry stakeholders believe this is not the end of the road for MDMA-assisted psychotherapy.

With the advice concerning only the Lykos trial, there may be scope for concerns raised by the committee to be addressed in further trials, as well as other MDMA analogues or therapy designs to make it to approval.

Christian Angermayer, Founder of atai Life Sciences, believes that there is still a strong chance that, with a properly conducted Phase 3 trial, MDMA-assisted therapy will get approved.

“I (still) believe MDMA is a promising drug with tremendous therapeutic potential for patients with severe mental health issues,” wrote Angermayer.

“It isn’t MDMA itself that was rejected per se, but the specific, poor data set provided by Lykos; the committee particularly cited discrepancies in clinical trial design and conduct, inadequate collection of safety and other relevant data, bias in the evaluation of patients, and cases of patient abuse during the trials.”

Rivki Stern Youdkevich, Co-founder and CEO at Shortwave Life Sciences (SWLS), which is developing psychedelic medicines for the treatment of anorexia nervosa, has said the decision is not deterring their developments.

Youdkevich commented: “We were disappointed to learn of the panel’s recommendation but we are not discouraged.

“Mental ill health is growing at an alarming rate with an increasing number of conditions affecting more people in every age group worldwide. This necessitates novel approaches to medication and treatment, as existing therapies do not suffice. So our enthusiasm for development of psychedelics-based treatments and medicine remains undiminished.

“In fact, we are doubling down on it. Shortwave Life Sciences’ goal is to become a leader in the origination, development and operation of innovative solutions in the field of mental health. Like other psychedelics drug makers, we remain unwavering in our commitment to overcome the expected challenges on the way to approval and wide acceptance of this new field as safe, effective and viable.”

Youdkevich emphasised that the FDA’s advice will not affect Shortwave’s chances of approving its drug product for anorexia nervosa.

“Specifically at Shortwave we have several strengths in our clinical and development approach which would lead us, I believe and hope, to a positive reception,” explained Youdkevich.

“Our team of experienced clinical experts led by Dr. Nadya Lisovoder designed our clinical strategy to anticipate and meet the most stringent requirements from the regulator. We are undergoing a full set of pre-clinical studies to create a robust base of evidence and research which will illuminate our clinical trials design.

“Furthermore, our by-the-book clinical trial design will be further wisened by real-time data and learnings from our partners at the Sheba Medical Center Department of Eating disorders’ Phase 1 psilocybin-assisted therapy trial for anorexia patients.

“Our anorexia programme is based on a combination of psilocybin and additional APIs. We initially designed this combination to extend the mechanism of action of the drug, giving us flexibility in dosing of the scheduled component, psilocybin. Our drug delivery method allows for efficient administration and absorption which is currently being tested, thus maximising the effect even in a potentially lower dose of psilocybin.

“Anorexia nervosa is a life-threatening disease, with the highest mortality rate of mental health conditions and with no FDA-approved medication.

“Today, treatment for anorexia nervosa is psychotherapy based, with no standardised protocol. Our novel drug product and delivery method would naturally fit into this mode of care with the aim of achieving remission in a relatively short period, and reducing the need for years of therapy and treatment. So, although psychotherapy adds complexity to the process of regulatory approval, in our case, it is the incumbent standard of care.

“We applaud and look up to the pioneers in psychedelics drug development who are the avant-garde in creating this “new field of medicine”. They are facing head on the challenges and hurdles of evaluation and acceptance into mainstream medicine.

“Our strategy at SWLS has always been to follow in the regulatory path created by the first-comers and implement their learnings vis-a-vis the regulators. Such learning may include special attention to communication at all stages and on all aspects of trial methodology design and implementation with the regulators, to the degree trial participants are novice to the drug, as well as consideration of all aspects and the possibility of conducting blind studies with psychedelic compounds.”

MDMA is gaining global traction

While it remains to be seen if MDMA-assisted therapy will gain approval in the United States in August, the compound is gaining traction as a treatment for mental health conditions including PTSD elsewhere across the world.

Canada added MDMA-assisted therapy to its Special Access Programme in 2022 for the treatment of PTSD, and in 2023 Australia rescheduled the compound to allow authorised access to the therapy for select patients living with PTSD.

In fact, just days following the FDA’s advice, a Dutch advisory committee, which conducted a multidisciplinary analysis of the health risks of MDMA to advise the Dutch Cabinet, recommended the Government should allow access to MDMA-assisted therapy for people living with PTSD.

The independent State Commission was established by the Dutch Parliament to research the legal status of MDMA and provide advice on its medical use.

The report produced by the committee specifically advises on the pros and cons of the medicinal use of MDMA for the treatment of PTSD, advising that there appears to be sufficient scientific evidence for the effectiveness and safety of this form of therapy.

The committee has now recommended developing the medical use of MDMA for PTSD as quickly as possible, advising that regulatory frameworks are established.

In a statement, Minister Pia Dijkstra, Minister for Medical Care of the Netherlands, commented: “I am pleased that the report is now available, because it provides tools to further develop the therapeutic application of MDMA.

“Research into the therapeutic use of MDMA is promising. It is possible that MDMA as a therapy-supporting medication can help, especially for mental health patients who have been dealing with their problems for years and have not been helped by the current range of therapies.

“However, more scientific, clinical research needs to be done. With regard to the recreational use of MDMA, the report emphasises the principle of Dutch drug policy, which primarily emphasises health, prevention and reducing the harmful consequences of use, for example through monitoring and testing.

“It is therefore good that this report is now available and supports the need for substantiated policy and further scientific research.”

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Psychedelic Health is a journalist-led news site. Any views expressed by interviewees or commentators do not reflect our own. We do not provide medical advice or promote the personal use of psychedelic compounds. Please seek professional medical advice if you are concerned about any of the issues raised.

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