Isabelle Racamier, CEO and Board Director
Modern medicine began to emerge in the post-industrial revolution era of the 18th century. Since those early days, medicine has advanced by leaps and bounds, with many scientific discoveries being made and breakthroughs achieved. Today, technology’s fingerprints can be found all over the healthcare domain—from new ways of teaching medical students to taking care of patients in hospitals with the most sophisticated equipment. So much so that technology now helps in accurate diagnosis and treatment of many of the previously unknown diseases, including eosinophilic esophagitis (EoE).
Earlier, if someone had EoE, the chances of a doctor misdiagnosing it as gastro-esophageal reflux disease (GERD) were particularly high. It was not so long ago that doctors realised that even though EoE showed symptoms similar to GERD, it was a different, rare disease. In EoE, eosinophils (a type of white blood cell) build up in the lining of the esophagus. This buildup, often caused by a person’s reaction to allergens, inflames the esophageal tissue and leads to difficulty in swallowing and extremely painful food impaction. While the current treatment options are limited to strict dietary measures and out of label administration of steroids, there is no single globally accepted therapy for the condition. Moreover, even though steroids for EoE are generally effective, these medications are minimally absorbed by the esophageal segment of the gastrointestinal tract. The short transit time of the drug from mouth to the stomach hinders the expected effect of the drug. Thus, the pharmaceutical industry had been on the lookout for a tool that can administer the medications directly to the esophagus for treating EoE.
At this juncture, the group of Prof. Dr. Werner Weitschies, from the Center of Drug Absorption and Transport at the University of Greifswald, came up with a breakthrough that the healthcare industry has been waiting for so long. They developed a novel drug delivery platform for the treatment of upper gastrointestinal diseases. And to bring this smart drug application technology into clinical testing and to EoE patients, Prof. Dr. Weitschies collaborated with Dr. Werner Tschollar. The result of their partnership led to the foundation of EsoCap, an emerging biotech startup based in Basel, Switzerland. Today, the company is building upon the work of the Greifswald Center of Drug Absorption and Transport to develop a unique topical drug delivery platform designed to assist in the treatment of the upper gastrointestinal tract.
We have already reached a point of achieving technical development and technical proof of concept of our underlying technology
Currently entering the phase two clinical stage, the smart drug application technology will allow targeted delivery of a broad range of pharmaceutical drugs to the affected areas with maximum accuracy.
The Paradigm Shift in EoE Treatment
EsoCap’s smart drug delivery platform uses a thin film loaded with the drug substance. The film is rolled up into a capsule, which, when swallowed, unrolls the film in the esophagus and delivers the drug slowly over time. To ensure the film stays in the intended area of application, it is designed such that one end of the film is attached to a mouthpiece through a slit in the capsule and a connecting thread. The mouthpiece is further placed onto a specially-designed drinking cup, which allows the patients to swallow the capsule easily. When patients consume the capsule, the film sticks to the esophageal mucosa, ensuring local delivery and prolonged mucosal contact time as the film dissolves slowly over time. Further, with an approximate length of 25 cm, the thin film stretches throughout the length of the esophagus. Isabelle Racamier, the CEO and board member of EsoCap, believes that their topical drug delivery platform comes at a time when drug discovery and development are witnessing the next stage of evolution. She says, “We have already reached a point of achieving technical development and technical proof of concept of our underlying technology.” Markedly, the University of Greifswald, EsoCap’s collaborator in the development of the product, has already corroborated the feasibility of the drug delivery concept. An imaging study showed sustained placement of a polymer film on the esophageal mucosa. Such a highly localised approach reduces the risk of side effects since doctors do not have to administer any systemic drug. Therefore, the smart drug application technology opens the door for new treatment options that were not possible up until now because of the limitations around local delivery and subsequent side effects of drugs.
Applications beyond EoE
EsoCap’s innovative technology is not only meant to benefit thousands of patients with EoE but also be a major advancement in the treatment of several diseases of the upper gastrointestinal tract. In a recent multidisciplinary scientific advisory meeting held by EsoCap, the role of its novel technology for the topical treatment of eosinophilic esophagitis was discussed. In the conference, the experts also explored the broader applications of EsoCap’s drug delivery platform in the treatment of other esophageal diseases. Executive teams of many large pharmaceutical companies and other accomplished experts in the field have already started noticing this innovative drug delivery platform.
“EsoCap’s new platform has given pharmaceutical community a reason to be excited,” comments Isabelle.
Incentivised by such positive reception, EsoCap initiated a cooperation with Lohmann Therapie- Systeme (LTS), a leader in the production of oral thin films, to begin the industrial development of the drug delivery technology. The collaboration is paving the way for clinical trials for patients suffering from EoE. The potential of the drug delivery platform has also been recognised by the U.S. Food & Drug Administration (FDA), which has granted EsoCap the Orphan Drug Designation status in the treatment of EoE.
However, Isabelle notes, “We are currently starting a phase two clinical trial for only one indication of EoE, and there are five additional indications of gastroenterology and oncology disorders covering approximately 370 million patients.” EsoCap’s drug delivery technology can easily be combined with other drugs to treat each of the gastroenterology and oncology disorders’ indications. Besides, considering the flexibility of the smart drug application technology, it can be used with both clinically proven and innovative new classes of drugs that are still in development.
The Art of Running a Startup
The successful journey of EsoCap, so far, would not have been possible without the harmonious blend of the expertise of each management and board member. “When the team plays together; we need to be in full harmony with a high quality of execution to reach the business goals of EsoCap,” underlines Isabelle. The management team of EsoCap has educational backgrounds and past experiences in the fields of science, management, and finance. And each individual in the team brings their subject matter expertise in general management, strategic planning, finance, project management, and development in the pharmaceutical space. In addition to its internal team, EsoCap also collaborates with a number of external partners for reaching out to a large scope of functions. These external contributors include companies covering industrial development, production of different pieces of the drug delivery platform, along with scientific and regulatory advisors. Moreover, both internal and external members are encouraged to bring in their personal initiative and contribute to strategy development, and at the same time have an actionoriented mindset for the execution of the company’s business strategy. According to Isabelle, the beauty of being a startup is in the fact that their internal functioning resembles that of an orchestra. Isabelle adds, “Everyone needs to come in and out at the right time with the right component based on their expertise and talent.”
Such expertise and interoperability have helped EsoCap in finalising the development of its product and the company is currently starting a phase two clinical trial. “The next step for EsoCap in the upcoming months will be to enter into a transaction with a major biopharmaceutical company,” concludes Isabelle.