I appeared on the Narratives podcast to discuss drug development!
Here’s a link to the podcast. In the podcast, I speak to my friend Will Jarvis about drug development, autoimmune diseases, and cats. Some (lightly edited for clarity) highlighted bits below:
Will Jarvis: How did you first come up with the drug cyclosporine as the drug to repurpose?
Trevor Klee: When I first got interested in autoimmune and neurodegenerative diseases, I was looking for out-of-the-box ways to tackle them. I came across this drugs cyclosporine, which used to be a really widely used immunosuppressant for humans and animals. For humans, it had since fallen out of fashion, but it was still widely used in animals.
What I thought was interesting about it is that it’s this really powerful drug. It has great effects in a ton of different diseases, everything from psoriasis, to IBD, to even some early studies done on ALS and other neurodegenerative where it showed some promise. But it had been largely looked over in recent years because it has a bunch of bad side effects and it's a very tricky drug to dose. So, I focused a lot on how we can make this drug easier to use, safer, and better. Eventually I came up with this idea that if we combine it with a certain other drug, which is a metabolic inhibitor, we could solve a lot of the issues while keeping the potency.
Will Jarvis: Why cats for the drug trial? You always hear about mice, or rhesus monkeys, perhaps dogs, beagles or something, but like, you don't often hear cats.
Trevor Klee: There's a good reason why you don't often hear cats.
It's actually funny. I have a friend who was thinking of testing drugs for an antiviral treatment, and he was like, “Do you think I should test my drug in cats? Seems to be working really well for you.” And I was like, “Almost certainly not.”
The reason why is that cats in general are harder to deal with than dogs, which is the standard big animal option. Anyone who’s ever owned a cat can tell you that they’re tricky animals. They don’t take direction well. They’re smaller than dogs, which makes blood draws hard. And, cat owners might not know this, but cats can have some surprisingly bad reactions to certain drugs like Tylenol because of differences in their metabolism.
But, for us, what we found when we were looking at really good uses for this safer version of cyclosporine is that cats get this nasty autoimmune disease called feline stomatitis. It affects about 1% of all cats. And like right now, it really doesn't have a good treatment. And so we thought we’d ask some vets about using our modified version of cyclosporine for feline stomatitis when we were exploring possible uses for our drug. So we were talking to vets, and of all the diseases that we talked about, feline stomatitis was by far the one they were most excited about. They were like, “Oh, my God, yes, any treatment you can create for feline stomatitis would be great”. Because the only option right now is surgery. So that's really where we started our exploration of using cats as our first animal here.
Will Jarvis: What is the cost delta between your cat study and doing an equivalent trial in humans?
Trevor Klee: Well, as you know, we started off thinking about this as a human drug. And so the cost for that would have been around 1.4 million to 1.6 million for doing a high quality trial in healthy humans. And, meanwhile, we're going to be spending about 300,000 for a good high quality trial on healthy cats. So it's a big difference. For cats, there's less regulation and you can pay cats in cat food, rather than money. Cats are very happy to stay overnight in the facility, because, they don't have a home that they're waiting to get back to. So yeah, it's much cheaper.