Innovation in neuropsychiatry, dormant for nearly forty years, is experiencing a resurgence, marked by recent approvals like Bristol Myers Squibb’s Cobenfy for schizophrenia and Sage Therapeutics’ Zurzuave for post-partum depression. This shift is driven by large Phase III studies investigating psychedelics like psilocybin, aiming to establish evidence-based treatments. However, the neuroscience field faces significant hurdles, including costly Phase III trials and the poor translation of animal models for CNS disorders, making patient selection crucial.
Targeting the Right Patient Population
Seth Ettenburg, President and CEO of BlueRock Therapeutics, noted that investment in neuroscience is cyclical, driven by excitement for emerging treatments but hampered by a lack of clear causality and biomarkers. Kylie Bromley, Vice President and Managing Director, UK & Ireland, Biogen, highlighted the challenges of introducing new treatments for conditions like Alzheimer’s Disease, requiring massive infrastructure. Biogen's Aduhelm, an amyloid-targeting drug for Alzheimer’s, was pulled from the market earlier this year, underscoring these difficulties.
Identifying suitable patients is critical, as only a small fraction (around 2%) of diagnosed Alzheimer’s patients are appropriate for current treatments, with early-stage patients showing the best response. Improving diagnosis through less intrusive methods, such as blood-based biomarkers, is essential. Bromley emphasized that infrastructure implementation is key to enabling access to treatments.
Innovation in Neurodegenerative Diseases
Bromley highlighted the importance of biomarkers and technology, such as blood-based diagnostics and AI, in offering new diagnostic tools. Companies like Novoic use AI to identify patients earlier for clinical trials, streamlining the process. Technology is increasingly critical in early patient identification and trial recruitment, especially in identifying pre-symptomatic patients as research looks earlier in the disease. AI and analytics advancements could improve diagnostic efficiency and foster a more targeted approach, crucial for treatments with narrow patient applicability.
Investment and Challenges in Neuropsychiatry
Kabir Nath, CEO of Compass Pathways, stated that while the neuropsychiatry space is a small community, there is growing interest in the therapeutic potential of psychedelics for PTSD, depression, and anxiety, despite regulatory hurdles and mixed public perception. Large-scale robust trials are essential, especially in a field that lacks robust biological markers. The neuropsychiatry field faces persistent challenges due to the lack of biological biomarkers for conditions like depression, relying instead on broad diagnostic labels. Nath noted the difficulty companies face in transitioning from Phase II to Phase III clinical trials, citing Alto Neuroscience’s recent setback in a Phase IIb trial. Despite these challenges, the potential for functional improvements and quality-of-life gains fuels optimism and investment.
With one in nine people having a CNS disorder, there is an unmet need and untapped opportunity, driving investment in the space.
