Rarecast

Hereditary angioedema is a rare and potentially life-threatening genetic disease that causes sudden and prolonged swelling to various parts of the body. While there are therapies available today, they require either injection or infusions, carry inconvenient dosing regimens, and can cause undesirable side effects. Pharvaris is developing an oral therapy to treat HAE that it says could provide an effective and more convenient alternative to existing therapies. We spoke to Wim Souverijns, chief community engagement and commercial officer for Pharvaris, about hereditary angioedema, Pharvaris’ efforts to develop a convenient oral alternative to existing therapies, and why it believes it will be able to provide an effective alternative that is safe, tolerable, and convenient.

James Geraghty has had an up-close view of the rise of the rare disease drug industry as an entrepreneur, investor, and executive. Now he’s added the additional title of “author” with his new book “Inside the Orphan Drug Revolution.” Geraghty looks back through the past 40 years of his career starting with the passage of the Orphan Drug Act in 1983. We spoke to Geraghty about the catalysts that gave rise to the orphan drug industry, his concerns about the changing rare disease policy landscape, and why he believes it's essential for companies to take a patient-centric approach to drug development.

When Emily Rapp Black’s son Ronan was diagnosed with the rare and fatal condition Tay-Sachs disease, she turned to writing to make sense of her grief, what his short life would be, and what it meant to be his mother. Her memoir “The Still Point of the Turning World,” was written during Ronan’s life. Eight year’s later she wrote a companion memoir “Sanctuary” in which she explores learning to live after Ronan’s death, coming to terms with her loss, and learning that loss in not something that is overcome but rather absorbed into our beings. We spoke to Black about her two memoirs, her experience as a mother of a child with a rare and fatal disease, how she came to understand the meaning of resilience.   

Alok Tayi thinks the biggest obstacle to treating patients with rare diseases isn’t finding potential treatments but funding them. Vibe Bio, a decentralized autonomous organization, is building a community of patient advocates and investors where holders of a crypto currency token Vibe sells each get to vote on how to invest its pool of money in rare disease drug development efforts. Once a decision is made to invest in the development of a therapy, Vibe creates a traditional corporation and uses conventional financing mechanisms. We spoke to Tayi, co-founder and CEO of Vibe Bio, about its approach, why he believes it will lead to the development of therapies that would otherwise go unfunded, and how the company’s decision-making model works.

X-linked adrenoleukodystrophy is a rare, inherited, neurodegenerative disease. It is a debilitating and chronic condition that is characterized by progressive weakness, stiffness, and muscle spasms, as well as sensory dysfunction, and incontinence. There is currently no approved treatment. Minoryx raised $51.4 million in May to support the application for marketing approval of its X-ALD therapy in Europe and to support launch preparations. We spoke Marc Martinell, co-founder and CEO of Minoryx, about X-ALD, the company’s experimental therapy leriglitizone, and why it’s being viewed as a potential treatment for other rare CNS diseases.

Oligonucleotide therapies can target the root cause of many diseases through the modulation of RNA expression and processing. Despite the promise of these medicines, their development has been limited by delivery challenges because they are not able to adequately reach heart and skeletal muscle, the critical affected tissues in neuromuscular diseases. PepGen is advancing next-generation oligonucleotide therapeutics that leverage its delivery platform technology to produce cell-penetrating peptide conjugates that improve the activity and tolerability of oligonucleotide therapies. We spoke to James McArthur, president and CEO of PepGen, about the company’s platform technology for conjugating peptides with oligonucleotides, how this allows it to target hard to reach tissue, and why it opens the potential for new therapies to treat neuromuscular and other diseases.

While biologics and gene therapies have altered what it means to have a rare disease for many people, one problem with these treatments is that they can trigger an immune response that can make a patient ineligible for gene therapies or render a medicine ineffective. Selecta Biosciences is developing a platform technology called ImmTOR that trains the immune system with precision not to react to specific antigens and can restore balance to the immune system. We spoke to Carsten Brunn, president and CEO of Selecta Biosciences, about the problem of immunogenicity to biologics, the company’s ImmTOR platform, and how its leveraging that platform with a growing pipeline of biologics and gene therapies. 

Jenn McNary is a mother of children with rare conditions, as well as an outspoken advocate who has sought to elevate the patient voice in rare disease drug development. She was responsible for the organization of the largest FDA advisory committee hearing in history, with more than 1,000 Duchenne Muscular Dystrophy advocates, families, clinicians, and researchers in attendance. Now, as executive director and head of patient advocacy and engagement for Fulcrum Therapeutics, she’s working to inform company’s clinical trial designs through bringing in patients’ perspectives. We spoke to McNary about her journey as a patient advocate, her role as an advocate within industry, and how her views on the patient voice have evolved. 

Clinical trials can get derailed for a variety of reasons that may have nothing to do with whether a drug works or not. Lokavant has developed an artificial intelligence platform that tracks disparate sources of clinical trials data in real time and through its predicative abilities alert companies to potential problems as they begin to emerge. The company said the system not only saves clinical trial sponsors time and money, but also improves the quality of outcomes. We spoke to Rohit Nambisan, CEO of Lokavant, about the company’s clinical trial data platform, how it works, and the role its system is playing in Ergomed’s Rare Disease Innovation Center.

Last year, the Retinal Degeneration Fund, a venture philanthropy established by the patient advocacy organization Foundation for Fighting Blindness, spun out Opus Genetics to develop gene therapies to treat rare, inherited, retinal diseases. The patient organization’s then CEO Ben Yerxa, who also headed the RD Fund, recently became the full-time CEO of Opus. We spoke to Yerxa about the genesis of Opus, its gene therapy pipeline, and what other patient organizations looking to take a more hands-on approach to therapeutic development can learn from its example.

African Americans are four times more likely than Whites to suffer from end-stage kidney disease. In part, that’s because of genetic causes underlying kidney-disease being more common in people of African descent. A recent study suggests that genetic testing and genetic counseling to patients of African ancestry changed behaviors and lowered their risk of developing kidney disease. We spoke to Maggie Westemeyer, a genetic counselor with the clinical genetic testing company Natera, about the genetic risks of kidney disease, racial health disparities, and how genetic testing can be used to address that and improve outcomes for patients. 

The U.S. Food and Drug Administration’s Accelerated Approval pathway allows for the use of surrogate endpoints to make therapies more quickly available for unmet medical needs. About 82 percent of the drugs approved under the designation have been for orphan indications. But controversy around its use to win approval for Biogen’s Alzheimer’s disease drug Aduhelm last year set lawmakers off on an effort to reform how the pathway is used and to place new requirements on drugmakers. The healthcare consulting firm Vital Transformation recently did an analysis on the effects potential changes to the Accelerated Approval pathway could have and found that as many as two-thirds of treatments approved this way would no longer reach patients. We spoke to Duane Schulthess, CEO of Vital Transformation, about proposed reforms to the Accelerated Approval pathway, the findings of his firms’ analysis, and why these changes could have dire consequences for rare disease drug development. 

In February, ProJenX launched to develop novel, brain-penetrant therapies that target defined pathways for the treatment of the rare neurodegenerative condition amyotrophic lateral sclerosis and other brain diseases. ProJenX lead candidate is prosetin, an experimental therapy developed through a collaboration between Project ALS and researchers at Columbia University. We spoke to Stan Abel, CEO of ProJenX, about ALS, the company’s lead therapeutic candidate prosetin, and the company’s ongoing relationship with Project ALS and Columbia University.

Dravet Syndrome is a severe genetic epilepsy characterized by lifelong seizures and neurodevelopmental impairment that starts in infancy. Camp4 is developing an RNA therapy that it believes can reduce the frequency and severity of seizures, or eliminate them, by upregulating a gene that underlies the condition. We spoke to Ann Barbier, chief medical officer of Camp4 Therapeutics, about Dravet syndrome, the company’s platform technology to develop therapies that can upregulate gene expression, and the potential to apply its approach to a broad range of conditions.

Plasmacytoid dendritic cells or pDCs are immune cells that help the body fight infections but in certain chronic autoimmune condition these cells can become continuously activated and cause the body to attack itself. Horizon Therapeutics is developing an experimental monoclonal antibody known as daxdilimab that can get certain immune cells to deplete the pDC and shut down chronic inflammation in these conditions. We spoke to Jodi Karnell, senior director of Research at Horizon Therapeutics, about the role of pDCs in certain autoimmune conditions, how daxdilimab works, and why it may offer a way to address a range of rare autoimmune condition for which there are no approved therapies or that are poorly addressed by existing treatment options.

As a scientist seeking funding to do rare disease research, Olivier Menzel confronted the lack of interest from funding sources. He eventually created the Blackswan Foundation to support research on any type of rare disease. Since then, the foundation has held scientific conferences, raised awareness about rare disease, and been involved in a large number of projects and collaborations around the world. The foundation also created the RE(ACT) Community, a crowdfunding and knowledge-sharing digital platform that connects researchers, patients, and other rare disease stakeholders. We spoke to Menzel, chairman and founder of the Blackswan Foundation, about the challenges of rare disease research, how it has worked to address common obstacles, and how it is serving as an accelerator to bridge the gap between basic scientific and commercial research.

Stoke Therapeutics platform technology allows it to target genetic diseases where people have one functional copy of a gene and one mutated copy. As a result, they can only produce half as much protein as they need to maintain health. Stoke seeks to restore missing proteins by increasing the protein output from healthy genes to compensate for the non-functioning copy of the gene. The company’s lead experimental therapy is an antisense oligonucleotide to treat the rare and progressive genetic epilepsy Dravet syndrome. We spoke to Ed Kaye, CEO of Stoke, about the company’s platform technology, how it works, and its lead program in Dravet syndrome.

After Alon Ben-Noon had a chance meeting with patient advocate Shay Rishoni, who suffered from the neurodegenerative condition ALS, he was so inspired by the experience that it led to his founding of NeuroSense Therapeutics to find a treatment for the condition. The company is pursuing synergistic combinations of existing therapies to go after biologic targets underlying the core pathologies of the disease. We spoke to Ben-Noon, CEO of NeuroSense, about the company’s approach to developing therapies, its current lead therapeutic candidate, and its efforts to target other neurodegenerative conditions beyond ALS.

The Russian invasion of Ukraine that began at the end of February has caused more than 5 million people to flee the country as the brutal assault has not spared civilian populations, schools, or hospitals. For people with rare diseases, the war has sent families in search of needed medications and care as they have crossed the border in search of help. Healthcare Education Institute, a Poland-base rare disease advocacy group, has been working to help Ukrainians with rare diseases get across the border, find accommodations, and connect them to medical care. We spoke to Adrian Goretzki, founder and president of the foundation, about the needs of Ukrainians with rare diseases, what his organization has been able to do to help, and why the humanitarian crisis for these rare disease patients will last beyond the current hostilities. 

Genomics England is working to embed genomics into healthcare, enable research, and improve the diagnosis and treatment of patients. In 2018, it completed enrollment of its first initiative—the 100,000 Genomes Project—and is working on a new initiatives to explore the benefits and challenges of sequencing and analyzing the genomes of newborns. We spoke to Ellen Thomas, clinical director and director of quality for Genomics England, about the outcomes from the 100,000 Genomes Project, its Newborn Genomes Programme, and the potential for genome sequencing to alter the diagnostic odyssey for people with rare disease