Latest / The BioHub - by Avetix / Episode 178 - Kevin Finney - Chairman, President and CEO at Autobahn Therapeutics
Transcript
- 0:06Welcome back to the Bio Hub podcast by Avetics.
- 0:10Today, I'm joined by Kevin Finney, President, Chief
- 0:13Executive Officer and Chairman of Autobahn Therapeutics.
- 0:17Kevin has built an impressive career across biotech and pharma
- 0:21with leadership experience spanning commercial strategy,
- 0:24company building, corporate development and M and A Prior to
- 0:27Autobahn, he was President and COO of Abide Therapeutics, where
- 0:32he led the company through its acquisition by Lundbeck in 2019.
- 0:36Before that, he was founder and COO of Zavante Therapeutics
- 0:41helping build the business from inception through to it's sale
- 0:45and earlier held senior leadership roles at Allegan
- 0:48where he was involved in some of the industry's most significant
- 0:51transactions during a period of major growth.
- 0:53Kevin, it's a pleasure to have you with me today.
- 0:56Ben, thank you for having me. It's going to be a lot of fun.
- 0:59Yeah, looking forward to it. I mean, let's start from the
- 1:02beginning. You've taken a rather unusual
- 1:05route to the CEOC. You started in sales in pharma.
- 1:10You spent years in the field. You moved through large pharma,
- 1:13through many launches, M&A deals and through multiple biotech
- 1:18companies. What were really the key
- 1:20inflection points in that journey, and how did they shape
- 1:23the way that you lead Autobahn today?
- 1:25That's, that's true. Those are good questions.
- 1:27And I have had the privilege of being with seven different
- 1:31companies I believe as an operator.
- 1:34Each one of those companies I was hoping would be my last
- 1:37company and it's been my career there because they're just
- 1:39terrific organizations. But it seems like great
- 1:42companies tend to come together and merge.
- 1:45If I think back about those companies and really starting my
- 1:49career in the field, which is a little non traditional as you
- 1:52mentioned for ACEO in sales, carrying a bag, calling on the
- 1:56customers, which are the doctors.
- 1:58I've learned that science alone doesn't get a drug into the
- 2:02hands of doctors treating patients and more importantly
- 2:05the patients themselves. And at Autobahn we built a
- 2:10patient customer focus model and that's the lens I think I bring
- 2:17to the company thinking about each of those interactions and
- 2:20how to focus on the people that count most, which is the doctors
- 2:24and the patients. Yeah.
- 2:26I mean unique perspectives and unique experiences is often what
- 2:30leads to to great leaders. So I guess you know coming from
- 2:34that that side of things and having that angle of different
- 2:37experience will certainly be able to provide you with some
- 2:41sort of leg up in different circumstances when it does come
- 2:43to leadership. In sales and pharmaceuticals,
- 2:46when you're calling on the doctor all day, getting to
- 2:49understand the office and how they treat patients, things that
- 2:53go right and wrong on an individual patient basis enables
- 2:56you to think about how do you really design programs in a way
- 3:00that are going to meet the needs not only of the patient, but the
- 3:04doctor caregiver, because they are the keepers of the patient's
- 3:08health. And something that came out of
- 3:10that, that we use every day at Autobahn it's not a new term,
- 3:14but it's true for us. And I hope others, the patient
- 3:17comes first and profits will follow.
- 3:20So we tried to bring that thematically into how we make
- 3:23decisions for the company, how we design our drugs.
- 3:26And I will point out that we carry that really that customer
- 3:30centric perspective into the customer comes first and that
- 3:34everyone is your customer. So at work across the company,
- 3:38if you're in manufacturing or quality or research or being a
- 3:43chemist, thinking about your customers is everybody you work
- 3:47with enables you to build a better team and allows you to
- 3:51advance programs more rapidly. So all of our interactions with
- 3:56each other, our board members, our key opinion leaders who we
- 4:00spend a lot of time listening to, the doctors that are leading
- 4:04the charge in psychiatry. We tried to take all them, their
- 4:07design inputs into how we thoughtfully develop our
- 4:11clinical programs, think about what kinds of things are going
- 4:15to be important for patients. And you know, we're in the month
- 4:18of May, it's Mental Health Awareness Month and which is an
- 4:22important platform for patient advocacy.
- 4:25I mean, put, put on your, your sales Rep hat for a minute and
- 4:28pretend that you're back in the field speaking with
- 4:30psychiatrists. What what are you hearing about
- 4:32the primary unmet needs and residual symptoms for patients
- 4:36who are suffering from MDD and bipolar depression?
- 4:41That's probably the most important question that I can
- 4:43answer today and I can do you one better there besides just
- 4:46putting my head hat on and what things might have looked like 30
- 4:49years ago. I, I have had a couple of recent
- 4:51doctor interactions and lunches where I've had really had a
- 4:55chance to dig in again. But I think kind of the big
- 4:57picture of the space is we, we recognize that in the US alone
- 5:02and of course we can expand this globally, including for the UK.
- 5:07In the US, 21 million patients suffer from major depressive
- 5:11disorder and 7 million patients suffer from a very significant
- 5:15problem called bipolar depression.
- 5:18Combined, that's 30 million patients.
- 5:20And we all recognize that more than 50% of those patients are
- 5:25getting inadequate care. Their drugs aren't working and
- 5:28helping them, so they're going back and back into the office.
- 5:31Often it's that the groups don't have just the right efficacy for
- 5:34the patient so they feel better, but often it's actually the side
- 5:39effects associated with these drugs.
- 5:41So it's kind of sad if you're a patient going into a doctor's
- 5:44office to be treated, the symptom and the adverse effects
- 5:49you get feel worse than the primary symptom.
- 5:53You're being treated for things like weight gain, metabolic
- 5:57complications, fatigue. And so that is more of the big
- 6:02issue. There's a toolbox that doctors
- 6:03have and they're limited to what's in those toolboxes. 1
- 6:07practical story. Just recently I was speaking to
- 6:11a psychiatrist that is well recognized by name nationally
- 6:15and he just plainly stated that as a psychiatrist he's been
- 6:19treating his patients the same way for two decades, targeting
- 6:24neurotransmitters, serotonin, norepinephrine, dopamine, and
- 6:28that's the tools in his toolbox and that we need newer
- 6:32medications that are designed to tackle disease burden
- 6:35differently. Another example would be another
- 6:42example would be a lunch I had recently with a physician that's
- 6:45full time seeing patients. But it's also recognized as a
- 6:48national key opinion leader. And as a backdrop, you said if
- 6:53you're an orthopedic doctor and a patient's having a joint
- 6:56problem, you could treat them and you want to treat them and
- 7:00address both their symptoms in the underlying condition.
- 7:03And so you can give them a little NSAID pill for pain.
- 7:06If they need more, you can give them a disease modifying drug a
- 7:09little bit more. You can inject their knee a
- 7:11little bit more. You can do different degrees of
- 7:14invasive procedures. Because as a psychiatrist, a
- 7:18patient will come to me and they'll say they're having
- 7:20anxiety, they're feeling anxiety symptoms, maybe they have
- 7:26depression, or maybe they have depression and mania called
- 7:30bipolar. In each case, he wants to help
- 7:33them so he can give them a pill that makes them feel better for
- 7:36a few hours. Then everything just comes back
- 7:39again. And it's perspective was
- 7:41psychiatrists have very many tools in their toolbox that can
- 7:46help maybe tackle the underlying condition differently in a more
- 7:50substantial way and provide a different solution for these
- 7:55patients. So I think if you went in the
- 7:57field today and talked to psychiatrists, that's likely
- 8:00what you would hear or hear. Do you think that lack of sort
- 8:05of varying options then is one of the main reasons that
- 8:09patients with depression really struggle to find treatments that
- 8:13that work for them specifically? So far science is, is limiting
- 8:17us to a, a little pill that can adjust neurotransmitters.
- 8:20That's, that's all that's out there, right?
- 8:22I mean, you can go for more invasive procedures and there's
- 8:25interventional psychiatrists that do more and I think some of
- 8:28that helps. But in your garden variety 90%
- 8:32of psychiatry offices, they're limited to counseling, patient
- 8:38interactions and one of those bespoke medications, which as I
- 8:42mentioned have been for the last two decades narrowly working on
- 8:47adjusting neurotransmitters and maybe not dealing with new
- 8:51thinking on underlying the Physiology of disease.
- 8:56I will also point out that there's an, a, a sub patient
- 8:59type that I'm sure we'll talk about a little bit later when we
- 9:02get into our regulatory strategy.
- 9:04This is very interesting and it's a patient called ateical
- 9:07depression and realizing that people are diagnosed by going
- 9:11through a series of questions and getting ADSM 5
- 9:14categorization of OK, you have depression, but there are sub
- 9:18patient types. One patient's subtype is called
- 9:22atypical depression, and there's actually no medications approved
- 9:26for this patient and this patient, part of the symptoms
- 9:30that they look at besides the depression symptoms is these
- 9:33patients tend to be overeaters, maybe a little overweight,
- 9:38they're hypersomnolent, so they sleep too much and they're
- 9:41effectively called, in modern terms, couch potato.
- 9:46So you can visualize that versus another patient that comes in
- 9:50and maybe she can't sleep, she's skinny, has anxiety, and she
- 9:55also gets a, a categorization of depression.
- 9:58But there's two different patients that walk in the
- 10:00office, 1 after another. They look very different.
- 10:03And so obviously there's probably a different path of
- 10:05Physiology for their disease. And modern psychiatrists
- 10:09commonly call that patient their sleeper eater.
- 10:13They walk into the office and they know right there, you know,
- 10:16I need to find a unique treatment approach to address
- 10:18your form of depression. Nothing's approved.
- 10:21And that's a patient type that we are doing at, at, at
- 10:24Autobahn. Yeah.
- 10:27I mean, let's jump over to Autobahn for a minute.
- 10:29I mean, before joining, your career spanned major commercial
- 10:34organisations, entrepreneurial biotech and multiple successful
- 10:38acquisitions. I mean, you've really seen it
- 10:39all. What was it in particular about
- 10:42Autobahn science and the opportunity that you guys have
- 10:45here that made you want to step in and help to build this
- 10:47company? That's a great question.
- 10:49And I think maybe to approach the answer, we'll start with,
- 10:53well, it's in CNS and CNS over the last 20 years has had
- 10:59periods where there's inflows, people are very interested in
- 11:02investing in doing research and there's other areas where people
- 11:05really backed out because it's so tough.
- 11:08It, it's the brain, it's the CNS.
- 11:10You can't go take a tissue sample in a patient, right, like
- 11:13you can with cancer or some other diseases.
- 11:16It's very difficult. So the strategic answer for what
- 11:19you just said is that Autobahn is pursuing A validated target,
- 11:23which is thyroid hormone in depression, which has been used
- 11:27off label for over 50 years by psychiatrists.
- 11:30I'll say spontaneously realizing that activating hormone might
- 11:37help with the depression episodes and pairing the
- 11:40validated target with a proprietary chemistry platform
- 11:44that solves the historical problem of peripheral side
- 11:48effects. That has been the limitation
- 11:50there. So it's a rare combination of
- 11:53starting with a validated target and having a specific technology
- 11:57that can be paired to overcome the specific liability of that
- 12:01technology. And I mean that that is so
- 12:04different from the rest of the field.
- 12:06I mean, the novel chemistry platform combined with known
- 12:09thyroid hormone biology as opposed to following the more
- 12:12traditional neurotransmitter driven path, which is seen in
- 12:16depression. I mean, what what is really the
- 12:18core scientific insight behind that strategy?
- 12:22And why do you think that it could matter in a field that's
- 12:24been so hard to crack over the past, you know, 5 or so decades?
- 12:29Yeah, I will say that you know, maybe it's a summary statement
- 12:32to that. The last comments that I made is
- 12:34that after watching the field cycle through different versions
- 12:37of the same neurotransmitter story for 20 years and have a
- 12:42chance to build a new company, we can do better.
- 12:45I guess to answer your question about the science behind this,
- 12:50we take a very clear two pillar framing approach.
- 12:54The medication that we chose to advance is our medication into
- 12:57the clinic which is Eleneteron has a two pillar frame.
- 13:02The drug boosts brain energy by mitochondrial activation and is
- 13:10driving neuroplasticity and for the audience that's maybe not
- 13:14quite familiar with that term, strengthening the neuro neuronal
- 13:19connections, and we're doing both of those at once, boosting
- 13:22brain energy through activating mitochondria and driving
- 13:25neuroplasticity. It tackles the underlying cause
- 13:30of what we think is many types of CNS disorders in that besides
- 13:35just monkeying with neurotransmitters, patients with
- 13:38depression, especially serious depression and bipolar
- 13:41depression have underlying deficiencies with brain atrophy,
- 13:46synaptic junctions that are operating inefficiently.
- 13:50And the idea of a boosting agent in a drug that directly
- 13:54intervenes and drives synaptic growth together combined can
- 13:59address, as we said at the beginning, the psychiatrist that
- 14:03has few options for the patient in a different way.
- 14:07It might make sense right now just to mention our, our
- 14:09technology platform and what it is.
- 14:12And I'll, I'll tap that with a short story.
- 14:16Our thyromimetics, which are starting compounds are unique
- 14:19compounds. They're similar, but they're
- 14:21different than thyroid hormone. They're not generic versions of
- 14:25thyroid hormone. They're engineered to be
- 14:27receptor selective and to be tissue selective.
- 14:31And so if you take the oral version of our drug in its plain
- 14:36form, it can't cross the blood brain barrier.
- 14:38It gets blocked because it's a charged molecule.
- 14:41We've all heard a lot about the blood brain barrier.
- 14:44Our enabling technology, it enables making a pro drug and
- 14:48that pro drug is orally delivered and then it just makes
- 14:52its way to the CNS. It passively diffuses into the
- 14:56brain. Still it's a it's a pro drug and
- 14:59it's inactive and interesting enough, there's a naturally
- 15:03occurring enzyme in my brain. Your brain, patient's brain is
- 15:06called fo fatty acid amid hydrolase and fog cleaves and
- 15:11liberates the pro drug and enables a large amount of drug
- 15:15to deposit and target receptors only in the CNS.
- 15:21In that way you're getting high concentrations of drug into CNS
- 15:26with low concentrations of drug in the periphery and you can
- 15:29optimize that thyroid hormone signal which was just a signal
- 15:33with thyroid hormone because that's a blunt instrument.
- 15:36It can't do it the same way. It enables us to get really high
- 15:39concentrations, activating your thyroid hormone receptors in the
- 15:42CNS, reducing the peripheral liabilities of heart rate that
- 15:46you would see with thyroid hormone.
- 15:49And in a way, it's sort of like a Trojan horse.
- 15:52I mean, if we move forward, I, I guess a few years from your
- 15:56scientific foundations that, that are backing Autobahn to
- 15:59where you guys are now in terms of being in the clinic.
- 16:02I mean, you've made some pretty deliberate decisions around
- 16:05study design Fuel league programme in MDD, which includes
- 16:09avoiding a small exploratory path and instead aiming for a
- 16:12more highly powered study in CNS where endpoints can be soft and
- 16:18placebo effects can be a major issue.
- 16:21What have you learnt about designing trials that gives you
- 16:24the best chance of generating meaningful and interpretable
- 16:27data? That's another really good
- 16:30question. I would say it's a company
- 16:32formation and the company was started in Arch Venture's
- 16:36office, which is, you know, a prominent recognised healthcare
- 16:39venture investor. And we licensed technology from
- 16:43Oregon Health Science University out of Oregon, US, and then out
- 16:47of the Scripps Research Clinic in San Diego.
- 16:51We have the right molecule. We are forming the right
- 16:53company. And how do you design the right
- 16:56studies? And so our investors have been
- 17:01around for a while and they have invested in some major
- 17:04blockbusters and CNS and some complete failures.
- 17:10And so if I understand your question right, how are we
- 17:12designing our clinical program in order to enable success?
- 17:17We're very deliberate. We decided to do a round of
- 17:23financing and to design our phase two study to actually have
- 17:29the look and feel of a phase three study and to highly power
- 17:34it on the order of plus 90% to detect a drug treatment effect
- 17:39with our drug versus placebo. And to answer the question that
- 17:43we use in industry sometimes, do you have a drug?
- 17:46So we've designed our lead program Amplify, which is
- 17:50studying Elinetarom as an adjunctive agent, which means
- 17:56for the common person a drug that you're giving on top of
- 17:58something else that you're already taking for depression.
- 18:01So adjunctively adding it to this regimen you're already on.
- 18:04And we have to prove that we're better against placebo and not
- 18:07just our drug, but the drugs that you're already on together
- 18:10versus placebo, which would be the baseline, whatever therapy
- 18:13you're on. And we want to powerfully detect
- 18:17a 90 point, at least a 90% chance of showing a change.
- 18:21At the conclusion of that, we go to end of Phase 2 with the FDA.
- 18:26And the way we think about it is unlike other CNS companies,
- 18:31maybe they have exploratory new Moas and they hit on Phase 2 and
- 18:35they'll put 100 million into phase three and then you get a
- 18:38data card flip that doesn't work.
- 18:40Our confidence level lies in the fact that we're starting with
- 18:43validated biology that we know that off label thyroid hormone
- 18:47is a blunt instrument, but it's proven it has a signal.
- 18:50So we're more confident that upon successful Phase 2 success,
- 18:55we'll be able to repeat that in phase three.
- 18:58We also made a decision to do an exploratory second indication in
- 19:02a very important disease area with very limited options and
- 19:07that's bipolar depression. These patients have substantial
- 19:11impacts to their lifestyles. Some of these patients end up
- 19:15missing three days a week of school or work.
- 19:18And so we wanted to do an exploratory Phase 2A on top of
- 19:22that that would have an earlier read and enable us to see how
- 19:26this drug works in the bipolar patient population.
- 19:30Yeah. I mean, can you can you touch a
- 19:32little bit on how that broader sort of portfolio strategy
- 19:37across both MDD and bipolar gives you know gives you a sort
- 19:42of regulatory optionality moving forward?
- 19:45That's a very strategic, insightful question, Ben.
- 19:47And I would say we have 3 indications shot on goal with
- 19:55one molecule with our first interactions with the FTAI think
- 20:02our drugs mechanism of action, which we discussed previously
- 20:06could work for several other indications.
- 20:09But as it relates to how we approach our clinical trial
- 20:12design and our future regulatory interactions for elineteron, we
- 20:18started with a highly powered, as I mentioned, amplified study.
- 20:23And we're intending to show that our drug works on top of an
- 20:27adjunctive therapy, on top of baseline therapy in the total
- 20:31population, 21 million patients. In addition to that, since we
- 20:36have this atypical depression patient that we mentioned
- 20:38previously, which represents about a third of all MDD
- 20:43patients, we pre specified in the phase two protocol that we
- 20:48want to track these patients in particular.
- 20:51And I think our study is showing that we're tracking that again
- 20:53about actually in fact with the real world EPI, about 1/3 of
- 20:57patients are atypical. We're tracking those patients
- 21:01independently as a subgroup. So this would not be a scenario
- 21:05where somebody runs a study, they miss their intent to treat
- 21:09population. We hope to blow that out of the
- 21:12water by the way, but they miss it and then they say, oh, in a
- 21:15sub analysis, look about that. Look at this.
- 21:18We wanted to approach this with the agency offensively in MDD
- 21:21given that there is no drugs that are currently approved for
- 21:24atypical depression. It's a defined DSM 5 patient
- 21:29subtype. So we get to go talk about the
- 21:31total population and the atypical population in the same
- 21:35meeting as we approach phase three.
- 21:39In addition to that, we have our Phase 2A bipolar data with which
- 21:45is called amplified BD and that's another patient group
- 21:49that is suffering from depression, but they suffer from
- 21:52bipolar depression and that's another more immediate shot on
- 21:56goal as well. We'll be trying to approach the
- 21:59agency and ask how we might pursue both indications for a
- 22:03submission at the same time. So you have in a way patients
- 22:07one molecule shot on goal and. Yeah, you've got two of these
- 22:11data readouts coming up fairly shortly on the horizon.
- 22:15Without getting ahead of the data, could can you walk us
- 22:17through a little bit about what these studies are designed to
- 22:20show and also why the endpoints matter?
- 22:23How we design these studies and and what we're hoping to show as
- 22:29it relates to the amplify MDD study.
- 22:32Again, we're proud of the fact that we designed the molecules,
- 22:36we did the we didn't license them in.
- 22:38We've taken them through non clan phase one powered phase
- 22:42two. We expect a readout for that one
- 22:45in Q3 of this year. And I would say as of today,
- 22:50we've actually stopped screening patients.
- 22:52We're advancing now to finishing randomization and and dosing.
- 22:57And so we're on track for a powered readout, which is the
- 23:01data card flip. Do we have a drug in Q3 of this
- 23:06year. On top of that, we also have a
- 23:11bipolar readout, which is imminent and we'd expect that
- 23:14bipolar readout to take place within Q2 of this year, which
- 23:20we're currently in. And so we look at this staggered
- 23:23data read bipolar patients, very important patient population,
- 23:29coincidentally, less than 5 drugs approved to treat the
- 23:34depressive episodes of bipolar. And they're all within the same
- 23:38class of drugs. And they all have class labeling
- 23:41that I've mentioned earlier that makes these drugs very onerous
- 23:44for that patient group. That data card flip will be
- 23:47within this quarter. And then we'll rally the team
- 23:51and move forward after publishing that data work on a
- 23:57preparation for an end of phase two meeting with the agency.
- 24:01And the fun part of the job is we get to discuss with them
- 24:05what's the last third of the pathway look like.
- 24:09We've completed for people in pharma, all of our Clint Farm
- 24:13studies, all of our talk studies.
- 24:16I think everything in addition to the clinical studies will be
- 24:20completed and so we can have a clear line of sight conversation
- 24:22with the agency about their expectations for submitting an
- 24:26NDAI mean. Yeah, it's, it's exciting times.
- 24:30I think the next, the next couple of months are going to be
- 24:32going to be pretty hectic on your end.
- 24:34But I'm, I'm excited to keep up with, keep up with what the data
- 24:37shows. I mean, you know, sort of going
- 24:41back, you, you've worked across seven companies now that have
- 24:44ended up either being acquired or, or or merging.
- 24:47You've seen both large organisations and small biotechs
- 24:51up close and in the flesh. From an operational standpoint,
- 24:54when you're building a company around a novel CNS platform,
- 24:58what are the key decisions that really determine whether it
- 25:02becomes strategically valuable or not?
- 25:05Ben, that's a good question. And you know, I, I, I will say
- 25:07again that all of us in this in the pharma, in the biotechnology
- 25:11industry, we're really privileged.
- 25:13It's a lot of fun to advance science and move drugs through
- 25:18all the way to commercial and watch those drug being drugs
- 25:20being picked up at the pharmacy with, with for patients.
- 25:25And the important point of your question is CNS, this is really
- 25:28different. I've worked across disease
- 25:30categories and five or six of them, and in this particular
- 25:35case, CNS is a unique place to be.
- 25:38And so for us, we think about in CNS for our company, we want to
- 25:46focus on real targets, biological targets, validated
- 25:51targets #1 it helps deal with the ambiguity of clinical
- 25:57studies that have soft endpoints, not I'm going to take
- 26:02your blood pressure and yes, you're up or you're down.
- 26:04So the number one would be really focusing on the hard
- 26:09endpoint that we get to anchor against this biological proof of
- 26:14principle with thyroid hormone. So that's really important if
- 26:18you can do that, and if you can couple that with the technology
- 26:21that overcomes the actual problem with that therapy, which
- 26:25in this case is we want really high CNS levels of drug and
- 26:29really low peripheral levels. So that's important for the CNS
- 26:35platform play #2 I'd say that drug development is the long
- 26:39game. So for me, being a people person
- 26:42and being with customers and growing up talking to people,
- 26:46interacting with them, you have to build the right team.
- 26:50To the second point, our team is designed to listen to each
- 26:56other, understand the company, understand the customer, and
- 26:59overcome challenges that inevitably will emerge.
- 27:03And then #3 this is super important.
- 27:06I think we kind of touched on this a little bit.
- 27:08Even though you might have a great drug, you very well, in
- 27:12fact I would argue probably you're still going to fail if
- 27:15you don't design your clinical programs the right kind of way.
- 27:20These clinical trial executions and psychiatry are different.
- 27:23You're not testing blood pressure, putting on a cuff and
- 27:26then measuring if the patient's blood pressure is up or down.
- 27:30These are psychiatry studies with soft endpoints.
- 27:33Many different components in that value chain can be
- 27:36disrupted and so you have to design your clinical programs
- 27:40with belt and suspender to ensure that you can reduce
- 27:43unnecessary risk. That that's where so many,
- 27:47especially within psychiatry, even as a subtext or of CNS,
- 27:50that's where so many companies fall down.
- 27:52I think you know you, you speak with anyone within the industry,
- 27:56be that C-Suite leaders, be that VC leaders who take a look back
- 28:00on psychiatry companies and psychiatry programmes that have
- 28:03failed and that that's often the deciding factor.
- 28:07Without getting into too much of like shop talk, we did a lot of
- 28:11design considerations before we started our study.
- 28:14We're we're humble enough that we want to talk to everybody and
- 28:18design the right program and we hope everyone wins and gets
- 28:21drugs through approval. So we spent a lot of time
- 28:26speaking to CM OS and CE OS of other companies in depression
- 28:31and many of them, their studies failed.
- 28:33And it's not uncommon when you see a press release with a
- 28:37company that didn't meet their statistical endpoints, they'll
- 28:39do a sub analysis and they'll find out that one or two sites
- 28:43data corrupted the whole study. It's not uncommon for patients
- 28:48in psychiatry if if you hear this, it's kind of shocking to
- 28:52actually sign up for two or three studies at the same time.
- 28:57There's actually Reddit sites that let you go into and figure
- 29:01out how to get enrolled in a depression study because they
- 29:05want the income. And so we have mature AI
- 29:10databases. We have different systems where
- 29:14we flag and can find a patient who would maybe sign up for our
- 29:18study. And they also signed up for a
- 29:20competitor study at the same time.
- 29:24Or even more interesting, they signed up for our same study at
- 29:27two different sites. It's this kind of work,
- 29:30detective work, you have to do upfront to find the real patient
- 29:35suffering from disease and only and only enroll those patients
- 29:40into the study. Yeah.
- 29:41And and I guess you know, with with the rise of AI and, and
- 29:44other forms of artificial intelligence that that all of a
- 29:48sudden becomes easier and easier as things go on.
- 29:50I'd imagine if you look back 1520 years ago, doing that
- 29:55manually was was a hell of a task.
- 29:58To your point about the use of AI and enabling clinical
- 30:01studies, I think the Internet age goes two ways.
- 30:07Yes, we're using AI now to help us figure out the right patient.
- 30:12You can even on a site level match labs, blood work, patient
- 30:18history to really detect, you know, and that's not data that
- 30:21the sponsor sees, that's what the site sees.
- 30:24To really identify the right patient, avoid what we call the
- 30:28professional patient, which we just alluded to.
- 30:31On the other end, I've been told that 10 years ago that the
- 30:34number of patients that come into a study and stay in it, we
- 30:38call that the screen fail rate. At one point, screen fail rates
- 30:41were like 40%. Nowadays, screen fail rates in
- 30:46some studies go up to 80 to 90%. So the point is, is that as
- 30:52Internet's available, more patients can be aware of
- 30:55studies, they can sign up and they can try to kind of play the
- 30:59system. On the other hand, back in the
- 31:02old days, I think patients that were showing up for sites were
- 31:05more or less traditional patients that are finding their
- 31:08way through a referral, and they're the real patients.
- 31:10So in a way, it's just like security.
- 31:13We need to have our software AI systems to keep up with modern
- 31:17times. No, it, it, it makes sense, I
- 31:21guess just to sort of wrap things up as, as we typically
- 31:23do. If you could have dinner with
- 31:25any scientist or innovator, past or present, who would it be and
- 31:29why? That's a tough question.
- 31:33I was thinking along the lines of science and biology.
- 31:37But given that we started this conversation with me being in
- 31:40the field building relationships with doctors, I think the person
- 31:45that I would like to actually have lunch with or dinner would
- 31:49actually be Steve Jobs from from Apple.
- 31:53Don't know if you've ever heard of that before.
- 31:55And if you ask why, you know, I will say that I have a
- 32:00smartphone in my hand. I, I won't put it up in front of
- 32:02the camera, but almost every human being on the planet has a
- 32:06smartphone. And it was Apple's original idea
- 32:11and totally oriented towards the end user and what they want.
- 32:17And it was Steve who had the vision and the idea that we
- 32:21could take computers and phones and all these things and we can
- 32:25put them into a a handheld device.
- 32:28And he was completely designer patient user based.
- 32:32And I use that analogy as we translate to patients.
- 32:36But he was the first mover visionary with just exquisite
- 32:40focus on end user design to make a handheld that's portable, that
- 32:47is now useful around the world to just about everybody.
- 32:51And I feel like that is such a substantial invention.
- 32:54And now we know that, you know, intellectual property enables
- 32:58that company to keep a percent of the market on a worldwide
- 33:03level. The majority of the market is
- 33:04other companies. But who had the wild and crazy
- 33:07and audacious idea that you could actually have this device?
- 33:12And I think that that kind of visionary thinking and being
- 33:16relentlessly focused on the customer enables the best
- 33:21products in the world to come out.
- 33:22And to connect the analogy to what we're doing at Autobahn
- 33:27we're patient focused. So we're always thinking about
- 33:30the end user, thinking about the doctors that pick treatments,
- 33:33and designing our data and our programs with the end user in
- 33:39mind. Yeah, I mean, it's, it's one of
- 33:42the defining inventions of of the modern day.
- 33:45So I can I can completely understand wanting to to sit
- 33:48down with the man who was the was the genius behind it.
- 33:52And I mean, fingers crossed that that Autobahn follow in the
- 33:55footsteps of Apple and patient patients get access to to to
- 33:59your drugs and it's able to help them.
- 34:01Well. So, Kevin, look, it's been it's
- 34:03been an absolute pleasure. I really, really appreciate you
- 34:06joining me today. It's been a been a great
- 34:07conversation. Ben, thank you so much.
- 34:09It's been fun. Thank you for showing interest
- 34:11in our industry and I look forward to watching your future
- 34:16podcasts. Appreciate that and thank you to
- 34:18everyone for tuning in. Make sure you you drop a like
- 34:22and subscribe for any future episodes to come.
- 34:24Thank you and goodbye.