We have all had a case of the stomach cramps or runs after a bad meal. The feeling of discomfort and pain that lasts for a few hours is a constant endurance test for 1.6 million Americans living with inflammatory bowel disease(IBD). Classified as an autoimmune disease, IBD manifests in patients with stomach cramps, bloody diarrhea, weight loss and fatigue. With people across the world rapidly adopting a westernized lifestyle, IBD is set to become a global problem.
What is an autoimmune disease?
The human body is protected from infectious agents like bacteria and viruses by the immune system. Controlled by a set of genetic and environmental factors, the immune system is comprised of different types of cells which are equipped to handle threats to the body. Studies are still trying to understand the reasons why these cells turn rogue and start attacking the body and cause diseases such as IBD. Autoimmune diseases are treated with drugs that dampen this rogue immune response. The range of drugs for IBD are typically expensive and often need to be injected, a painful and cumbersome process that can be dangerous if not done right.
What if you could eliminate injections?
This is the exact question a biotech company in the Bay Area is asking. Protagonist Therapeutics is actively trying to make an orally ingestible pill version of injected drugs for IBD.
To achieve this, Protagonist will make “oral peptides” of commonly injectable drugs. This could potentially mean the complete elimination of the mad scramble to get to the closest expensive Mylan epi-pen in the event of severe allergies. We are envisioning a reality where patients could calmly take an “oral peptide” pill. For patients with chronic IBD, oral peptides signify a safe, painless way to manage the severe discomfort associated with the condition.
In May this year, the company negotiated with Johnson & Johnson’s pharmaceutical unit for $50 million deal which could result in $990 million in payouts as Protagonist’s drugs make it to clinical trials.
A quick look at oral peptides
Many injectable drugs such as the epinephrine in epi-pens or HUMIRA, a common injectable drug for IBD are purified peptides. Peptides are small proteins made up of amino acids. Proteins are a major part of the body as well as an important source of nutrition. However, peptides like epinephrine, HUMIRA and insulin are also notoriously unstable if not stored well and degrade quickly. In addition, when ingested orally, these delicate peptides are rapidly broken down by acidic stomach enzymes before they can reach the bowel.
Protagonist Therapeutics has pushed the limits of current “oral peptides” technology to create oral pill substitutes of drugs that are currently in use. Their PTG-100 and PTG-200, both in various phases of clinical trials are directed against the targets of existing drugs viz Takeda’s vedolizumab and J&J’s Stelara respectively. In the near future, Protagonist could potentially disrupt the $1 billion dollar sales markets of these drugs.