Agitation

Agitation

We are currently developing our second product candidate, INP105, as an upper nasal formulation of olanzapine administered using our proprietary POD technology for the treatment of agitation and aggression associated with autism spectrum disorder (ASD).

Impel INP105 – Acute Treatment of Agitation and Aggression in Autism Spectrum Disorder (ASD)

 

ASD is a neurodevelopmental disorder affecting approximately 3.5 million children and adults in the U.S. and characterized by persistent difficulties in social communication and social interaction, coupled with restricted, repetitive patterns of behavior and higher aggression rates.

 

Agitation and aggression are frequent and difficult to manage symptoms and associated with negative outcomes for patients with ASD and their caregivers, including decreased quality of life, increased stress levels, and reduced availability of educational and social support.

 

Based on a study of emergency room usage in Canada, which found that 18% of individuals with ASD aged 12 and up had visited the emergency room within the past year, and that approximately 34% of such visits were for mental health issues, we estimate that approximately 220,000 patients with ASD in the U.S. seek emergency room care due to mental health issues annually. Current treatment strategies include functional behavioral assessment, reinforcement strategies, functional communication training, and the use of second-generation antipsychotics.

 

With an increasing rate of ASD diagnosis, we believe that the development of effective therapeutic and pharmacologic methods for preventing and treating agitation and aggression are essential to improving outcomes in this disorder. Currently, there is no approved treatment for patients living with ASD once there is onset of agitation leading to aggression, and we believe that INP105 has the potential to be an on-demand therapy in this indication.

 

In a double-blind, placebo-controlled, single ascending dose Phase 1 clinical trial in 40 healthy adults conducted in Australia, we observed similar bioavailability for INP105 compared to equivalent doses of olanzapine delivered through Intra Muscular administration, as measured by the area under the plasma drug concentration-time curve, or AUC, which reflects the actual body exposure to the drug after administration of a drug dose, and the maximum drug concentration, or Cmax, and achieved time to maximum drug concentration, or Tmax, 25-22% faster than that of IM olanzapine.

 

Based on its pharmacokinetic profile and method of administration, we believe INP105, if approved, has the potential to treat acute agitation and aggression events in this under-served population and in patients’ homes, potentially reducing visits to the emergency department and limiting the need to call in reinforcements to help caregivers. We plan to initiate a double-blind, placebo-controlled Phase 2 proof-of-concept clinical trial of INP105 in adolescents with ASD in the U.S. by the end of 2021 and expect to report topline results in the second half of 2022.

SYMPTOMS OF AGITATION:

Feelings of unease

Excessive talking

Unintentional and purposeless motions

Poor impulse control

Tension

Disruptive behavior which can lead to aggression
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Impel Pharmaceuticals is currently developing INP105 with the goal to be a preferred choice for the safe and rapid treatment of acute agitation and, because it is designed to be non-invasive, it has the potential to expand the treatment setting beyond the emergency room, such as inpatient treatment or community care facilities and the patient’s home.

References

1 Roberts, J., Gracia Canales, A., Blanthorn-Hazell, S. et al. BMC Psychiatry 18, 104 (2018)
2 Impel Data on File.
3 Faden J. et al. Neuropsychiatric Disease and Treatment. 2019:15 2273–2283
4 Impel Data on File
5 Impel Data on File