S-1226

Last updated

S-1226, or S1226, is a mixture of carbon dioxide-enriched air and nebulized perflubron being developed as a novel bronchodilator for use in respiratory diseases such as asthma, [1] cystic fibrosis, [2] and COVID-19 [3] by SolAeroMed.

Contents

Unlike typical bronchodilators such as β2-adrenergic agonists and antimuscarinics, S-1226 does not act on receptors in the airways. Instead, it combines the bronchodilator activity of gaseous carbon dioxide with the mucolytic properties of the synthetic surfactant perflubron to relax the smooth musculature of the airways, clear excess mucus, and reduce inflammation. Thus, S-1226 represents a novel class of bronchodilators that could alleviate certain problems of existing therapeutics, such as the buildup of tolerance to their effects and their inefficient penetration of airway mucus. [1] [4]

Clinical studies

Asthma

S-1226 has completed phase I and II clinical trials for the treatment of acute asthma exacerbations caused by exposure to allergens.

Phase I

The phase I randomized double-blind placebo-controlled trial designed to assess the safety of S-1226 compared 3 different formulations of S-1226 containing varying concentrations of carbon dioxide (4%, 8%, and 12%) to a placebo. No serious adverse events were reported, though S-1226 caused a greater number of related adverse events than did the placebo. These events were attributed by the investigators to the carbon dioxide constituent of S-1226. [1]

Phase II

The phase II randomized double-blind placebo-controlled cross-over trial was designed to further assess the safety and to provide preliminary evidence of efficacy of S-1226 in treating acute asthma exacerbations caused by exposure to allergens. The 8% carbon dioxide formulation of S-1226 was used in this study due to its favourable efficacy in animal studies and favourable safety in the phase I trial. The trial enrolled 12 patients with mild allergic asthma who were randomised to either receive S-1226 (8% carbon dioxide) or placebo. After the first treatment period and a washout period of 14 days, the group initially randomised to S-1226 received placebo, and vice versa in the second treatment period. [4]

No serious adverse events were reported. The placebo group experienced a gradual lowering of peripheral blood oxygenation levels, while the S-1226 intervention group did not. The S-1226 intervention group regained their initial FEV1 (the volume of air a person can forcibly exhale in 1 second) more rapidly than the placebo group following allergen exposure. [4]

Cystic fibrosis

As of December 2023, SolAeroMed were recruiting patients with cystic fibrosis for a phase II trial of S-1226. [5]

Related Research Articles

A bronchodilator or broncholytic is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lungs. Bronchodilators may be originating naturally within the body, or they may be medications administered for the treatment of breathing difficulties, usually in the form of inhalers. They are most useful in obstructive lung diseases, of which asthma and chronic obstructive pulmonary disease are the most common conditions. Although this remains somewhat controversial, they might be useful in bronchiolitis and bronchiectasis. They are often prescribed but of unproven significance in restrictive lung diseases.

<span class="mw-page-title-main">Nebulizer</span> Drug delivery device

In medicine, a nebulizer or nebuliser is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs. Nebulizers are commonly used for the treatment of asthma, cystic fibrosis, COPD and other respiratory diseases or disorders. They use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into small aerosol droplets that are inhaled from the mouthpiece of the device. An aerosol is a mixture of gas and solid or liquid particles.

Beta<sub>2</sub>-adrenergic agonist Compounds that bind to and activate adrenergic beta-2 receptors

Beta2-adrenergic agonists, also known as adrenergic β2 receptor agonists, are a class of drugs that act on the β2 adrenergic receptor. Like other β adrenergic agonists, they cause smooth muscle relaxation. β2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle, and release of insulin. They are primarily used to treat asthma and other pulmonary disorders. Bronchodilators are considered an important treatment regime for Chronic obstructive pulmonary disease (COPD) and are usually used in combination with short acting medications and long acting medications in a combined inhaler.

<span class="mw-page-title-main">Renzapride</span> Chemical compound

Renzapride is a prokinetic agent and antiemetic which acts as a full 5-HT4 agonist and partial 5-HT3 antagonist. It also functions as a 5-HT2B antagonist and has some affinity for the 5-HT2A and 5-HT2C receptors.

<span class="mw-page-title-main">NS-2359</span> Chemical compound

NS-2359 (GSK-372,475) is a serotonin-norepinephrine-dopamine reuptake inhibitor. It was under development by GlaxoSmithKline (GSK) as an antidepressant, but was discontinued in 2009 when phase II clinical trials showed the drug was not effective and not well tolerated. The results did not support further effort by the company. NS-2359 was also in clinical trials for the treatment of ADHD, phase II having been completed in 2007. A phase I clinical trial exploring the effect of NS-2359 on cocaine-dependent individuals was completed in 2002.

<span class="mw-page-title-main">Riociguat</span> Chemical compound

Riociguat, sold under the brand name Adempas, is a medication by Bayer that is a stimulator of soluble guanylate cyclase (sGC). It is used to treat two forms of pulmonary hypertension (PH): chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension (PAH). Riociguat constitutes the first drug of the class of sGC stimulators. The drug has a half-life of 12 hours and will decrease dyspnea associated with pulmonary arterial hypertension.

<span class="mw-page-title-main">PBT2</span> Chemical compound

PBT2 is a safe-for-human-use Zinc ionophore and an experimental drug candidate. It is a second-generation 8-hydroxyquinoline analog intended to be a successor to clioquinol and a potential treatment of Alzheimer's disease and Huntington's disease.

<span class="mw-page-title-main">Ivacaftor</span> Pharmaceutical medication used to treat cystic fibrosis

Ivacaftor is a medication used to treat cystic fibrosis in people with certain mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, who account for 4–5% cases of cystic fibrosis. It is also included in combination medications, lumacaftor/ivacaftor, tezacaftor/ivacaftor, and elexacaftor/tezacaftor/ivacaftor which are used to treat people with cystic fibrosis.

<span class="mw-page-title-main">Gemigliptin</span> Chemical compound

Gemigliptin (rINN), sold under the brand name Zemiglo, is an oral anti-hyperglycemic agent of the dipeptidyl peptidase-4 inhibitor class of drugs. Glucose lowering effects of DPP-4 inhibitors are mainly mediated by GLP-1 and gastric inhibitory polypeptide (GIP) incretin hormones which are inactivated by DPP-4.

Dupilumab, sold under the brand name Dupixent, is a monoclonal antibody blocking interleukin 4 and interleukin 13, used for allergic diseases such as eczema, asthma and nasal polyps which result in chronic sinusitis. It is also used for the treatment of eosinophilic esophagitis and prurigo nodularis.

<span class="mw-page-title-main">Brilaroxazine</span> Experimental atypical antipsycotic

Brilaroxazine, also known as oxaripiprazole, is an investigational atypical antipsychotic which is under development by Reviva Pharmaceuticals for the treatment of neuropsychiatric and inflammatory disorders. It has currently completed the first of two phase III clinical trials for schizophrenia. Reviva Pharmaceuticals also intends to investigate brilaroxazine for the treatment of bipolar disorder, major depressive disorder, attention deficit hyperactivity disorder (ADD/ADHD), psychosis/agitation associated with Alzheimer's disease, Parkinson's disease psychosis, as well as the inflammatory disorders pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis (IPF), and psoriasis. The FDA granted brilaroxazine orphan drug designation for the treatment of PAH and IPF.

<span class="mw-page-title-main">Setipiprant</span> Chemical compound

Setipiprant (INN; developmental code names ACT-129968, KYTH-105) is an investigational drug developed for the treatment of asthma and scalp hair loss. It was originally developed by Actelion and acts as a selective, orally available antagonist of the prostaglandin D2 receptor 2 (DP2). The drug is being developed as a novel treatment for male pattern baldness by Allergan.

<span class="mw-page-title-main">Centanafadine</span> Serotonin-norepinephrine-dopamine reuptake inhibitor

Centanafadine (INN) is a serotonin-norepinephrine-dopamine reuptake inhibitor (SNDRI) that began its development with Euthymics Bioscience after they acquired DOV Pharmaceutical. It was developed as a treatment for attention-deficit hyperactivity disorder (ADHD) and inhibits the reuptake of norepinephrine, dopamine, and serotonin with a ratio of 1:6:14, respectively. In 2011, Euthymics Bioscience spun off its development of centanafadine to a new company called Neurovance. In March 2017, Otsuka Pharmaceutical acquired Neurovance and the rights to centanafadine. As of January 2018, Otsuka's pipeline indicates it is in Phase II and III clinical trials for a number of different applications to medical conditions.

Risankizumab, sold under the brand name Skyrizi, is a humanized monoclonal antibody used for the treatment of plaque psoriasis, psoriatic arthritis, and Crohn's disease. It is designed to target interleukin 23A (IL-23A). It is given by subcutaneous injection.

Lanadelumab, sold under the brand name Takhzyro, is a human monoclonal antibody that targets plasma kallikrein (pKal) in order to promote prevention of angioedema in people with hereditary angioedema. Lanadelumab, was approved in the United States as the first monoclonal antibody indicated for prophylactic treatment to prevent hereditary angioedema attacks. Lanadelumab is the first treatment for hereditary angioedema prevention made by using cells within a lab, not human plasma.

<span class="mw-page-title-main">Fevipiprant</span> Chemical compound

Fevipiprant (INN; code name QAW039) is a drug of the piprant class that was being developed by Novartis. It is a selective, orally available antagonist of the prostaglandin D2 receptor 2 (DP2 or CRTh2).

Peanut Allergen Powder, sold under the brand name Palforzia, is an oral medication for the treatment of allergic reactions, including anaphylaxis, in children typically aged between four and 17 years of age who have confirmed cases of peanut allergy. It is taken by mouth.

<span class="mw-page-title-main">Sinopharm WIBP COVID-19 vaccine</span> Vaccine against COVID-19

The Sinopharm WIBP COVID-19 vaccine, also known as WIBP-CorV, is one of two inactivated virus COVID-19 vaccines developed by Sinopharm. Peer-reviewed results show that the vaccine is 72.8% effective against symptomatic cases and 100% against severe cases. The other inactivated virus COVID-19 vaccine developed by Sinopharm is the BIBP vaccine (BBIBP-CorV) which is comparably more successful. 1 billion doses are expected to be produced per year.

<span class="mw-page-title-main">COVAX-19</span> Vaccine candidate against COVID-19

COVAX-19 is a recombinant protein-based COVID-19 vaccine developed by South Australian-based biotech company Vaxine, in collaboration with CinnaGen, a private company with operations in the Middle East. It is under clinical trial in collaboration with the Iranian company CinnaGen.

<span class="mw-page-title-main">S-268019</span> Vaccine candidate against COVID-19

S-268019-b is a protein subunit COVID-19 vaccine candidate developed by Shionogi.

References

  1. 1 2 3 Green, Francis H. Y.; Leigh, Richard; Fadayomi, Morenike; Lalli, Gurkeet; Chiu, Andrea; Shrestha, Grishma; ElShahat, Sharif G.; Nelson, David Evan; El Mays, Tamer Y.; Pieron, Cora A.; Dennis, John H. (2016-07-28). "A phase I, placebo-controlled, randomized, double-blind, single ascending dose-ranging study to evaluate the safety and tolerability of a novel biophysical bronchodilator (S-1226) administered by nebulization in healthy volunteers". Trials. 17: 361. doi: 10.1186/s13063-016-1489-8 . ISSN   1745-6215. PMC   4964056 . PMID   27464582.
  2. Shrestha, Grishma; Githumbi, Racheal; Oslanski, Bryce; Lachman, Nadia; Venkova, Daria; Montgomery, Ben; Pieron, Cora; Dennis, John; Bjornson, Candice L. (2021-12-13), A Phase IIa Open Label Study to Evaluate the Safety, Tolerability and Efficacy of S-1226 Administered by Nebulization in Subjects with Cystic Fibrosis Lung Disease, doi:10.1101/2021.12.10.21266937, S2CID   245123442 , retrieved 2023-12-15
  3. "Safety, Tolerability and Efficacy Of S-1226 in Moderate Severity Covid-19 Bronchiolitis/Pneumonia | Reagan-Udall Foundation". reaganudall.org. Retrieved 2023-12-15.
  4. 1 2 3 Swystun, Veronica; Green, Francis H. Y.; Dennis, John H.; Rampakakis, Emmanouil; Lalli, Gurkeet; Fadayomi, Morenike; Chiu, Andrea; Shrestha, Grishma; El Shahat, Sharif Galal; Nelson, David Evan; El Mays, Tamer Y.; Pieron, Cora A.; Leigh, Richard (2018-06-18). "A phase IIa proof-of-concept, placebo-controlled, randomized, double-blind, crossover, single-dose clinical trial of a new class of bronchodilator for acute asthma". Trials. 19 (1): 321. doi: 10.1186/s13063-018-2720-6 . ISSN   1745-6215. PMC   6006836 . PMID   29914544.
  5. "S1226 Lead Product | SolAeroMed I Leader in Biophysical Respiratory Drugs and Delivery Devices" . Retrieved 2023-12-15.