RE:RE:RE:RE:Thank youIPF cough is VERY different than cough with underlying disease (acute/chronic, which is where Merck Gefapixant is focusing) ) or no underlying pathogenesis (refracotry cough, which is where Bellus is focusing).
Cough is divided in mainly 4 categories -
1) Acute cough (due to UTRI/COPD/Asthma) may last for 1-3 weeks
2) Sub acute cough (due to postinfection) may last for 3-5 weeks
3) Chronic cough (due to GERD, UACS) may last for less than a year, affects 24 million is US
4) Refracotory cough (unknown reason) beyond 1 year; affects 12.5 milion in US
And then there is IPF related cough for which the underlying reason is Fibrosis but its idiopathic in nature (i.e. nobody knows why lung injury is happening)
Chornic cough competitors -
- Gefapixant (Merck, Ph3 completed) P2X3 target - for chonic cough
- Bradaaniclinc (Attenua, Ph2 ongoing) nAChR modulator - for refractory cough
- BLU 5937 (Bellus, Ph2b ongoing) P2X3 target - for refractory cough
- S 600918 (Shionogi, Ph2b ongoing) P2X3 target - for refracotory cough
- BAY 1817080 (Bayer, Ph2b ongoing) P2X3 target - for refracotyr cough
IPF cough competitors -
- ST 015 (Cornig, Ph2a, planned) Undisclosed target - for IPF cough
- Cromolyn Sodium (Respivant, Ph2b, terminated) GRP35 - for IPF cough
- NP 120 (AGN, Ph2a ongoing) NMDA modulator - for IPF cough
Failed IPF cough competitors -
- VRP 700 (Verona, Ph2 failed 2014) Adelta fiber inhibitor - IPF cough
- (Amarillio Bio, Ph2 failed 2012) Interferon alpha modulator - IPF cough
- Gefapixant (Merck, Ph1/2 failed 2017) P2X3 antagonist - IPF cough
NMDA modulator/antagonit (similar to NP 120) failure in the past in cough space -
- FP 01 (Cerecor, Ph2 inconslusive results) NMDA antagonit - for refratory cough
- V3381 (Vernalis, Ph2, no efficacy) NMDA modulator - for chronic cough
Now I believe AGN focused in IPF cough instead of broader Chronic/refractory cough mainly becuase,
- as you can see above, chornic/refractory cough pipeline is very crowded
- After Respivant termination (one of Vivek_Ramaswamy "Vants") the IPF cough space is completely open. and
- in the past other NMDA modulators failed to show efficacy in chronic/refractory cough
I know AGN has guinea pig data for chronic cough and if IPF cough shows positive outcome, AGN wont take a minute to jump on broader chornic/refractory cough space.