Attenua Treats First Patient in Phase 2 Study for Chronic Cough

Edward Kim  |

A chronic cough is defined as a cough that lasts for more than eight weeks in adults and more than four weeks in children. Estimates we've seen of prevalence vary widely from 2.5% to as high as 20% of the general population. While an occasional cough is a normal function of the body as it helps prevent infection by clearing irritants and secretions from your lungs, a chronic cough is usually the result of a medical problem, according to the Mayo Clinic. In many cases a chronic cough may involve multiple causes including: postnasal drip, asthma, gastroesophageal reflux disease (GERD), infections, blood pressure medication, chronic bronchitis and chronic obstructive pulmonary disorder (COPD). Most seriously, chronic cough may remain a significant problem for many patients even when the underlying causes are treated. There are no approved therapies for chronic cough.

San Mateo, California, based Attenua is developing therapies for patients who suffer from chronic respiratory disorders such as chronic cough. The company announced today that it has treated its first patient with its lead compound, bradanicline, in a Phase 2 clinical trial in chronic cough. Bradanicline, formerly known as ATA-101, is a highly selective agonist of the alpha 7 (α7) subtype of neuronal nicotinic receptors (NNRs)—also known as neuronal acetylcholine nicotinic receptors (nAChRs)—which modulate the flow of neurotransmitters throughout the brain and central nervous system. Bradanicline is in development as a centrally acting cough therapy that is free of the significant liabilities and abuse potential of traditionally prescribed opioid cough medicines.


Source: Attenua

In April 2018, Attenua announced that it raised $35 million in a Series A financing led by Omega Funds with participation from Abingworth, OrbiMed and Redmile Group. Michael Kitt, MD, joined as CEO concurrent with the financing. Dr. Kitt was previously Chief Medical Officer at Afferent Pharmaceuticals, where he led development of a chronic cough therapy candidate into Phase 2b clinical trials by 2016, when the company was acquired by Merck  (MRK) for $1.25 billion.

Within just six months of our initial Series A funding, Attenua has successfully filed an Investigational New Drug (IND) application, received Institutional Review Board (IRB) approval at 17 clinical trial sites, manufactured drug and launched a Phase 2 clinical trial with bradanicline in chronic cough. This is a testament to our experienced team and focused execution at top-tier clinical trial sites.

- Michael Kitt, MD, CEO, Attenua.

In September 2017, Attenua presented results from a preclinical study of bradanicline at the European Respiratory Society International Congress in Milan that demonstrated a dose-related cough suppression. The company acquired the candidate along with two other NNR agonists from Catalyst Biosciences  (CBIO) in 2016 which Catalyst had acquired through its acquisition of Targacept. Attenua plans to conduct additional clinical trials to test the safety and efficacy of bradanicline in 2019.

We look forward to testing bradanicline in this proof-of-concept study, which focuses on a new mechanism of action that is believed to play a key role in chronic cough.

- Jacky Smith, MD, Professor of Respiratory Medicine at the University of Manchester, and Principal Investigator in Attenua's Phase 2 trial.


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