PANDEMICS: FINDING A NEW PURPOSE FOR OLD DRUGS

Helperby Therapeutics aims to produce affordable, rapid and effective combination solutions to treat infectious disease.

COVID-19 has drawn attention to how unprepared we are to find treatments quickly for pandemics. With the speed at which a crisis can unfold, developing an entirely new treatment from scratch is clearly too slow to be available for the first peak of the pandemic. There has been recognition that combining repurposed existing drugs could provide a quick and effective solution to this problem; the first solid progress on discovering a treatment for COVID-19 has come from an old drug, Dexamethasone, which was approved in 1961 and has now been intelligently repurposed. Further work developing new combinations of repurposed old drugs will build on this success and will be vital to our efforts to cope with the COVID-19 pandemic. This work is necessary for us to be better equipped to handle recurrent waves of this virus and any future pandemics that we may face in the years to come.

The recognition of using combinations of repurposed old drugs (like Dexamethasone) has sparked widespread interest in the topic. Combining old drugs started many decades ago and are the only effective treatments for infections such as tuberculosis and HIV, but using combinations for most other types of infections has not been well researched to date. Many old drugs can be repurposed outside of their primary designated use because they have other useful effects that can be identified. Well designed combinations take advantage of overlapping useful effects while minimising potentially harmful ones. Helperby has a long history in developing patented, new combinations of old drugs.

Helperby has been using this approach to tackle the crisis of failing antibiotics. Every class of antibiotics has met infections that they cannot treat and in these cases, doctors are unable to carry out routine procedures such as transplants, hip/knee implants and cancer treatments. There is a trend of new bugs emerging which can’t be treated by our existing inventory of antibiotics and that currently kill an estimated 1m people each year. This is progressively rendering the inventory of existing antibiotics ineffective and extrapolating this trend suggests that in 30 years, bugs that can’t be treated properly will kill more people than currently die of cancer today.

Doctors are demanding more effective drugs. Developing new drugs from scratch has shown to be prohibitively expensive given the sizeable development costs and unknown market size. Helperby’s approach is around 10x cheaper and develops optimally matched combinations of repurposed old drugs that are exceptionally effective against even the most challenging infections. This cost advantage has been key to its survival as most new antibiotic companies have gone bankrupt in the last few years trying to develop new drugs from scratch. Similarly, large pharmaceutical companies have generally left the field because developing a new drug from scratch is not commercially attractive for them. Interest in combinations has the potential to allow smaller companies like Helperby to develop cheaper and quicker permanent or interim solutions to manage the crisis of failing antibiotics.

Helperby’s lead product, Zidistin®, is in phase II clinical trials. As well as addressing the WHO’s Critical Priority pathogens that have few other treatments, Zidistin® is expected to be profitable independent of government incentives. Zidistin®’s initial authorisation is planned to be for treating complicated urinary tract infections of which there are 6.6m cases per year (projected revenue of $164m on a 25% market share) in the EU and USA markets.

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