Scilex Bio, a Controlling Interest of Joint Venture by Scilex Holding Company, Reports Phase 2 Trial for Obesity Currently Enrolling with U.S. Patient Cohort to be Added in 2025. Scilex Bio Reports Positive Results from the Recently Completed Phase 1 Trials Conducted by NeuroBiogen for KDS2010, a Novel Oral Tablet Recently Synthesized Potent, Selective, and Reversible Monoamine Oxidase B inhibitor
- The ongoing obesity Phase 2 trial is a randomized, double-blind, placebo-controlled, dose finding, clinical trial to evaluate the safety and efficacy of KDS2010 in approximately 75 overweight or obese patients currently enrolling in
South Korea with a cohort inU.S. to be added in 2025. - KDS2010 has shown promising preclinical results with a novel mechanism of blocking MAO-B-dependent aberrant GABA (gamma-aminobutyric acid) production in reactive astrocytes and eliminates neuronal inhibition in Lateral Hypothalamic Area, stimulating metabolism and energy expenditure without affecting appetite.
- MAO-B controls tonic levels of GABA, a chief inhibitory neurotransmitter in the central nervous system. Selective inhibition of astrocytic GABA is a new molecular target for treating obesity.
- KDS2010 pharmacokinetics, lack of food effect, safety and dose selection have been characterized in Single Ascending Dose and Multiple Ascending Dose Phase 1 clinical trials with 88 healthy young adults and elderly subjects, demonstrating favorable safety and tolerability and adequate pharmacokinetics for once-daily dosing.
- Several important pharmacological attributes distinguish KDS2010 from molecules of this class.
- Firstly, reversibility of the MAO-B inhibition is critical for long-lasting efficacy. Irreversible inhibitors such as selegiline covalently modify the MAO-B enzyme and destroy the enzyme itself to turn on the compensatory expression of enzyme diamine oxidase, which continues to produce GABA, whereas reversible inhibitor occupies the active site of MAO-B competitively, resulting in an intact MAO-B enzyme with no compensatory mechanism.
- Secondly, only the selective inhibition of MAO-B shown to have selective inhibition of astrocytic GABA, important for anti-obesity effect.
- Lastly, easy penetration of Blood-
Brain Barrier by KDS2010 is very important for targeting astrocytes in Lateral Hypothalamic Area.
KDS2010 (Tisolagiline) is a potent, selective, and reversible Monoamine oxidase B (MAO-B) inhibitor of new generation, which overcomes the drawbacks of existing irreversible and reversible MAO-B inhibitors. Recently, a new important mechanism of action was discovered for this class of drugs. In contrast to the traditional belief, MAO-A and MAO-B have profoundly different roles: MAO-A regulates dopamine levels, whereas MAO-B controls tonic levels of GABA, gamma-aminobutyric acid, a chief inhibitory neurotransmitter in the central nervous system. Selective inhibition of astrocytic GABA is a molecular target for treating obesity. This discovery was published in Nature (Hyun-U Cho, et al. 2021).
“It is exciting to see a new oral medication in development for treatment of obesity with the potential of overcoming current limitations of obesity medications. Reducing obesity and related comorbidities, such as heart disease, hypertension, diabetes, fatty liver disease, and dyslipidemia is of paramount importance for health maintenance. A new oral centrally acting once-a-day medication that is safe and effective would be an exciting development,” said
Individuals with obesity have an imbalance in food intake and energy expenditure, both of which are regulated by neural circuits that work inside the hypothalamus, in particular, in the lateral hypothalamic area (LHA). Astrocytes are glial cells known to be actively involved in the regulatory aspects of metabolic control, such as feeding and uptake of brain glucose. In addition to their physiological role, increasing lines of evidence point to the involvement of hypothalamic astrocytes in the pathogenesis of diet-induced obesity. Consumption of dietary fats induces metabolic damages in hypothalamic neurons. Genetic, pharmacological and electrophysiological evidence of existence of a distinct subpopulation of pacemaker-firing GABAergic neurons was recently discovered. It is a unique population of fat-burning neurons in LHA, regulating energy expenditure via astrocytic GABA without affecting food intake. Pharmacological inhibition of excessive astrocytic GABA synthesis may become a new effective therapeutic strategy for obesity. KDS2010 effectively and rapidly reduced obesity in mice, attenuated the elevated tonic inhibition in LHA, and reduced fats without suppressing appetite. These findings were published in Nature Metabolism (
Several important pharmacological attributes are distinguishing KDS2010 from other molecules of this class. Firstly, reversibility of the MAO-B inhibition is critical for long-lasting efficacy. Irreversible inhibitors such as selegiline covalently modify the MAO-B enzyme and destroy the enzyme itself to turn on the compensatory expression of enzyme diamine oxidase, which continues to produce GABA, whereas reversible inhibitor occupies the active site of MAO-B competitively, resulting in an intact MAO-B enzyme with no compensatory mechanism. Secondly, only the selective inhibition of MAO-B shown to have selective inhibition of astrocytic GABA, important for anti-obesity effect. And thirdly, easy penetration of Blood-
Several neuron-target obesity drugs were shown to be effective, but they suppress appetite and were withdrawn from the market or not used due serious safety risks, including cardiovascular and psychiatric complications. The current mainstay of obesity treatment, GLP-1 agonists, are associated with loss of appetite, gastrointestinal side effects, loss of muscle mass, depression, re-bound effect, and drug-resistance. KDS2010 has a potential to overcome these limitations and risks associated with GLP-1 agonists.
KDS2010 pharmacokinetics, lack of food effect, safety and dose selection has been characterized in Single Ascending Dose and Multiple Ascending Dose studies with approximately 90 patients, demonstrating favorable safety profile and tolerability. KDS2010 showed well tolerated and safe for single dose (30 to 960mg) and repeated dosing over 7 days (60 to 480mg) and has adequate pharmacokinetics for once-daily with dose-dependence in the range of 60 to 480mg for repeat dosing. KDS2010 also showed no significant differences in safety/tolerability and pharmacokinetics in healthy adults and the elderly, and between Korean and Western populations, with adequate pharmacokinetics for once-daily dosing.
A Randomized, Double-blind, Placebo-controlled, Dose Finding, Phase 2 Clinical Trial to Evaluate the Efficacy and Safety of KDS2010 in Overweight or Obese Patients is ongoing in
As millions seek access to weight loss drugs, IQVIA experts at
“We are very excited to acquire a New Chemical Entity molecule of known drug class, representing a new generation of MAO-B inhibitors, with a newly discovered central mechanism of action relevant for multiple neurological, analgesic and cardiometabolic indications. We are looking forward working with our partners to advance Tisolagiline development starting with adding a cohort of patients in the
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