REPRINT FROM AUGUST 2, 2010 BioCentury Arcion’s improved (noci)reception By Michael Flanagan
Opioids are associated with nausea, drowsiness and the risk
Senior Writer Arcion Therapeutics Inc. is hoping to improve on both
Arcion’s ARC-4558 is a 0.1% gel formulation of clonidine, a
the efficacy and safety of systemic therapies for diabetic neuropa-
direct-acting adrenergic receptor alpha 2 (ADRA2) agonist. The
thy by combining a topical approach with a screening test to
gel is designed to deliver the agent directly through the skin,
identify patients with increased nociceptor expression. The
“where it acts on the terminal end of irritable nociceptors or
hyperactive pain fibers” to provide pain
“What has begun to emerge in the neuropathic pain field is the concept that the disease involves
Campbell said. Topically targeting abnor-
that patients often have problems with the
two phenotypes.”
mally sensitive pain fibers “provides a
side effects on top of the fact that efficacy
is highly uneven,” said President and CEO
James Campbell,
should allow for a better safety and toler-
James Campbell. “A lot of patients who are
Acrion Therapeutics
ability profile with efficacy that is at least
on par with the marketed agents,” he said.
Oral drugs commonly prescribed for diabetic neuropathy
betic neuropathy, said COO Kerrie Brady, ARC-4558 has
include Lyrica pregabalin, a GABA receptor agonist from Pfizer
potential for “use as a standalone first-line agent or as an add-
Inc., and Cymbalta duloxetine, a selective serotonin and nore-
on for patients who are currently stabilized on oral medication
pinephrine reuptake inhibitor (SSNRI) from Eli Lilly and Co.,
but not getting sufficient pain relief.”
The initial clinical work with ARC-4558 was conducted by
Side effects on Lyrica’s label include dizziness, somnolence,
Curatek Pharmaceuticals L.P., which moved it into a Phase
dry mouth and peripheral edema, as well as more serious risks
III trial in patients with post-herpetic neuralgia and diabetic
such as angioedema, hypersensitivity reactions, seizures and
neuropathy in 2000. The compound did not meet the primary
suicidality. Cymbalta carries warnings about nausea, somno-
endpoint of pain relief from baseline and Curatek later shifted its
lence, insomnia and dizziness, as well as a possible risk of
focus to the dermatology space. Arcion purchased the assets in
hepatotoxicity, orthostatic hypotension, abnormal bleeding,
DAVID FLORES KAREN BERNSTEIN, Ph.D. BioCentury®
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The contents of this publication are gathered from sources believed to be reliable, but in any case arenot warranted by the publisher for a particular use or purpose. Also, the content and opinions hereinmay change without notice and do not constitute investment advice. BioCentury, THE BERNSTEIN REPORT ON BIOBUSINESS REPRINT FROM AUGUST 2, 2010 Product Discovery & Development,
involve other receptors in addition to the
both validate the screening tool and test
cotic withdrawal, attention deficit hyper-
more effective in patients with preserved
activity disorder (ADHD), hot flashes as-
interpret the results, but after I went back
sion. It is also approved as an oral tablet
clear positive signal there,” said Campbell.
efficacy signal by focusing on a subset of
patients with moderate to severe diabetic
the neuropathic pain field is the concept
that the disease involves two phenotypes.
correlation” between a patient’s ratings
or below the detection limit, and are far
pain originating in the nociceptors or pain
nociceptor expression. The results showed
hypertension,” which is supported by re-
fibers that are expressed in the skin, in
which case a topical therapy makes sense,”
sponse to the capsaicin stimulus test, he
Regarding efficacy, the study’s statisti-
proximal levels of the peripheral nervous
system, such as the spinal cord, or in some
relationship between pain relief and skin
cases even the central nervous system,” in
company will look to raise an undisclosed
which case a systemic therapy is likely to
patients with nociceptor expression.
Arcion’s hypothesis is that ARC-4558’s
success hinges on identifying patients with
Phase III testing, which is slated for 4Q10
higher levels of nociceptor expression in
the 180-patient intent to treat population
(p=0.069), the compound was significantly
more effective in patients with nociceptor
500 patients with increased levels of noci-
pany devised a test that involves putting a
expression (p<0.05). In addition, the level
ceptor expression identified using the same
of pain relief increased in patients with
on a distal part of the leg, covering it for
Arcion Therapeutics Inc., Baltimore, Md.
“The key thing about the capsaicin test
Curatek Pharmaceuticals L.P., Buffalo
is that it stimulates the same type of pain
fibers in the skin that we are looking for
Pfizer Inc. (NYSE:PFE), New York, N.Y.
clonidine to act on. Other tests involving
Eli Lilly and Co. (NYSE:LLY), Indianapolis,
skin pricks, vibrations or reflex stimuli
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