Neurogenic Detrusor Overactivity (NDO)
Neurogenic Detrusor Overactivity (NDO)
The company’s primary focus is to treat a common urinary bladder dysfunction caused by spinal cord injury (SCI) and other neurodegenerative diseases such as multiple sclerosis (MS). This is the neurological disease known as neurogenic detrusor overactivity (NDO), responsible for various degrees of incontinence, as well as urinary tract infections and renal (kidney) damage than can lead to death in 5-10% of SCI population. NDO affects almost all (85-90%) of patients with SCI1 , half of those with MS2 , and a third of those with Parkinson’s disease, and impacts on an individual’s independence and dignity.
1 Hamid, R., Averbeck, M.A., Chiang, H. et al. Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury. World J Urol 36, 1517–1527 (2018). https://doi.org/10.1007/s00345-018-2301-z
2 Phé V et al., nrurol.2016.53 doi:10.1038, Management of neurogenic bladder in patients with MS
Medical need
Over time, most patients do not respond to the standard pharmacological approaches to treatment, such as oral antimuscarinics and beta-3 agonists that have systemic off-target effects and are thus poorly tolerated by many patients. Local injections of botulinum toxins basically paralyse the bladder muscle, thus requiring patients, in 15% of cases, to initiate catheterization 4 to 6 times a day to empty their bladder, with an associated higher risk of urinary infections.
EG110A could bring the expected long-term and truly local efficacy, to multiple hundred thousand of patients across this indication across all patient groups. It thus represents a major market opportunity of multi-billion-dollar revenues, in an innovation poor environment.
Our solution
Using the characteristics of our nrHSV-1, our vector EG110A selectively silences the sensory nerves of the bladder responsible for conveying pathogenic signal in this indication. Preserving the ability of the bladder to contract, we want to offer patient suffering from NDO a long-lasting treatment that restores continence and preserves volitional voiding either naturally or stimulated, and potentially reduce urinary infections that represent a real threat in the long run. Suppressing the bladder overactivity is also a key feature to protect the kidneys in the long run.
Expanded access: please note that EG110A is in the early stages of development. Therefore, EG 427 is not in a position to provide expanded access to EG110A outside of clinical trials at this time. The information on where clinical trials are being conducted is posted on ClinicalTrials.gov or study-specific websites.
What Key Opinion Leaders think
"Neurogenic bladder overactivity in spinal cord injury patients is a severe condition leading to urinary incontinence and may have a significant impact on their kidneys – a new treatment is needed which offers new alternatives.
EG427 with its novel approach using targeted gene therapy potentially provides a unique and long-lasting new therapy which is being developed to treat this group of patients and is currently under evaluation."
Prof. Christopher Chapple, BSc, MBBS, MD, FRCS (Urol), FEBU, FCSHK (Hon)
Emeritus Consultant Urological Surgeon, Sheffield Teaching Hospitals NHS Foundation Trust
Honorary Professor, University of Sheffield
Visiting Professor, Sheffield Hallam University
“There is a pressing need for efficacious treatment options for people suffering from neurologic bladder conditions. A targeted and long -lasting therapy, such as what EG110A could offer would meet these needs. Its focus on bladder sensory neurons offers the potential for long lasting effect without impacting the voiding function.”
Prof. Roger Dmochowski
Professor of Urology and Surgery at Vanderbilt University Medical Center