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Start-up announces clinical trial to evaluate treatment for endometriosis
The study will evaluate cannabinoids-based formulations intravaginally, raising hopes for millions of women with endometriosis
The biotech start-up Gynica has announced the submission of a first-in-human clinical trial to evaluate its “novel” endometriosis treatment.
The study will take place at Careggi University Hospital in Florence, Italy and will evaluate the safety, tolerability, and pharmacokinetics of the IntraVag intra-vaginal drug delivery platform and two proprietary drug candidates, S-301 and S-302.
Endometriosis is a debilitating disease characterised by abnormal growth of uterine-like tissue outside the uterus.
The condition, which affects one in 10 women and girls of reproductive age, has a devastating impact on the lives of over 190 million women globally, disrupting careers, relationships and overall quality of life.
Despite its widespread prevalence representing an estimated US$180bn annual market, according to the World Economic Forum and Mckinsey’s Health Institute, the disease continues to be an underserved and underfunded area, lacking effective treatment solutions.
Gynica’s clinical study aims to assess the company’s cannabinoids-based formulations intravaginally, raising hopes for millions of women with endometriosis.
“After four years of rigorous pre-clinical research and development efforts, we are thrilled to announce this upcoming milestone during Endometriosis Awareness Month,” said Yotam Hod, CEO of Gynica.
“This trial represents a significant step forward in our mission to revolutionise care and provide a better quality of life for the millions of women worldwide suffering from endometriosis. In this enormous unmet need, patients urgently seek efficient solutions.”
The trial will be led by endometriosis expert Professor Felice Petraglia, former president and founding member of the Society for Endometriosis and Uterine Disorders (SEUD) and will evaluate the safety, tolerability, and pharmacokinetics of the IntraVag platform and drug candidates.
According to Gynica, the team will examine the potential of cannabinoids as they engage with the endocannabinoid system (ECS), which is extensively distributed in women’s reproductive organs, such as the uterus and ovaries.
This positioning, the start-up said, makes the ECS a crucial target for addressing conditions like endometriosis. In this context, cannabinoids may possess the capability to alleviate various types of endometriosis-associated pain.
Further, it could mitigate the inflammatory microenvironment associated with endometriosis, the company added.
Professor Petraglia said: “Endometriosis is now recognised as a chronic disease.
“To have a non-hormonal treatment for endometriosis-associated pain is an absolute priority for many patients who require long-term management and for gynaecologists who need new therapeutic options with multiple mechanisms of action.”
Gynica aims to pursue registration of its solutions with the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). Pending positive Phase 1 results, the company plans to soon advance into Phase 2 efficacy trials.
Insight
Topical HRT protects bone density in women with period loss – study
Transdermal HRT best protects bone density in women with functional hypothalamic amenorrhoea, a condition that stops periods, a review of trials has found.
The meta-analysis pooled randomised clinical trials involving 692 participants and found transdermal hormone replacement therapy and teriparatide increased bone mineral density by between 2 and 13 per cent.
Functional hypothalamic amenorrhoea can follow anorexia or intense exercise. Bone mineral density measures bone strength and the amount of mineral in bone.
Around half of women with the condition have low bone mineral density, compared with about 1 per cent of healthy women, and their fracture risk is up to seven times higher.
The research was conducted by scientists at Imperial College London and Imperial College Healthcare NHS Trust.
Professor Alexander Comninos, senior author of the study and consultant endocrinologist at the trust, said: “Bone density is lost very rapidly in FHA and so addressing bone health early is very important to reduce the lifelong risk of fractures.
“Our study provides much needed comparisons of all the available treatments from all available studies.
“Clearly the best treatment is to restore normal menstrual cycles and therefore oestrogen levels through various psychological, nutritional or exercise interventions – but that is not always possible.
“The foundation for bone health is good calcium and vitamin D intake (through diet and/or supplements) but we have additional treatments that are more effective.”
When FHA is diagnosed, clinicians first try to restore periods through lifestyle measures, including psychological and dietary support, but these can fail. Guidelines then recommend giving oestrogen, though the best form was unclear.
The team reviewed all prior randomised trials comparing therapies, including oral and transdermal oestrogen, and also assessed teriparatide, a prescription bone-building drug used for severe osteoporosis.
They found no significant benefit for oral contraceptive pills or oral hormone therapy.
A recent UK audit reported that about a quarter of women with anorexia-related FHA are prescribed the oral contraceptive pill for bone loss; the study suggests using transdermal therapy instead.
Comninos said: “Our goal is simple: to help women receive the right treatment sooner and to protect their bone health in the long-term.
“We hope this study provides clinicians with better evidence to choose transdermal oestrogen when prescribing oestrogen and so inform future practice guidelines.
“Right now, millions of women with FHA may not be receiving the best treatments for their bone health.”
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