Delving into the Latest Updates on Emricasan with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Emricasan (USAN/INN), IDN-6556, PF-03491390

+ [4]

Target

CASP family

Mechanism

caspase inhibitors(Caspase inhibitors), Apoptosis inhibitors

Therapeutic Areas

Infectious DiseasesSkin and Musculoskeletal Diseases

Active Indication

Skin and skin structure infections

Inactive Indication

Acute-On-Chronic Liver FailureCholestasisCOVID-19+ [11]

Originator Organization

Conatus Pharmaceuticals, Inc.

Active Organization

Histogen, Inc.

Inactive Organization

Conatus Pharmaceuticals, Inc.

Drug Highest PhaseIND Approval

First Approval Date-

RegulationOrphan Drug (US)

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Structure/Sequence

Molecular FormulaC26H27F4N3O7

InChIKeySCVHJVCATBPIHN-SJCJKPOMSA-N

CAS Registry254750-02-2

Treatments for COVID-19 are urgently needed. Emricasan (EMR) is a pan caspase inhibitor. Caspase-1 plays a role in a form of cell death called pyroptosis. EMR inhibits pyroptosis. The Investigators have shown that peripheral blood lymphocytes of COVID-19 patients overexpress caspase-1, providing evidence for pyroptosis. A recent European study corroborate the Investigators finding as they have shown evidence for the activation of the inflammasome in COVID-19.

Start Date11 Mar 2021

Sponsor / Collaborator

Histogen, Inc.

NCT03462576

/ TerminatedNot Applicable

Companion Protocol for the ¹³C-Methacetin Breath Test Using the BreathID® MCS System for Conatus Phase 2 Study of Emricasan, an Oral Caspase Inhibitor, Under Protocol IDN-6556-17

This study is a companion protocol that will use the data generated by Conatus' study of emricasan under protocol IDN-6556-17.The IDN-6556-17 study is a Phase 2, multicenter, double-blind, placebo-controlled trial of Emricasan in subjects with decompensated non-alcoholic steatohepatitis (NASH) cirrhosis.

Start Date28 Jun 2017

Sponsor / Collaborator

Meridian Bioscience, Inc.

[+1]

NCT03205345

/ Unknown statusPhase 2

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Emricasan, an Oral Caspase Inhibitor, in Subjects With Decompensated Non-Alcoholic Steatohepatitis (NASH) Cirrhosis

This is a multicenter, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy of emricasan in improving event-free survival based on a composite clinical endpoint (where all-cause mortality, new decompensation events, and MELD score progression are events) in subjects with decompensated NASH cirrhosis.

Start Date28 Jun 2017

Sponsor / Collaborator

Conatus Pharmaceuticals, Inc.

100 Clinical Results associated with Emricasan

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100 Translational Medicine associated with Emricasan

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100 Patents (Medical) associated with Emricasan

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81

Literatures (Medical) associated with Emricasan

01 Sep 2024·JOURNAL OF MOLECULAR MEDICINE-JMM

The caspase-inhibitor Emricasan efficiently counteracts cisplatin- and neomycin-induced cytotoxicity in cochlear cells

Article

Author: Galla, Melanie ; Schott, Juliane W ; Warnecke, Athanasia ; Morgan, Michael ; Harre, Jennifer ; Nassauer, Larissa ; Schambach, Axel

Abstract:

Cisplatin is a chemotherapeutic agent widely used to treat solid tumors. However, it can also be highly ototoxic, resulting in high-frequency hearing loss. Cisplatin causes degeneration of hair cells (HCs) and spiral ganglion neurons (SGNs) in the inner ear, which are essential components of the hearing process and cannot be regenerated in mammals. As the affected cells primarily die by apoptosis, we tested several anti-apoptotic small molecules to protect these cells from drug-induced toxicity. We found that the general caspase inhibitor Emricasan could significantly counteract the toxic effects of cisplatin in House Ear Institute-Organ of Corti 1 (HEI-OC1) cells, phoenix auditory cells, and primary SGNs. Importantly, the anti-cytotoxic effect in neuronal cells was even more pronounced than the effect of sodium thiosulfate (STS), which is currently the only approved prevention option for cisplatin-induced ototoxicity. Finally, we tested the protective effect of Emricasan treatment in the context of another ototoxic drug, i.e., the aminoglycoside antibiotic neomycin, and again found a significant increase in cell viability when the cultures were co-treated with Emricasan. These results suggest a promising strategy to prevent ototoxicity in patients by temporarily blocking the apoptotic pathway when applying cisplatin or aminoglycoside antibiotics.

Key messages:

Anti-apoptotic small molecules can reduce cisplatin-induced toxicity.Emricasan can effectively exert its anti-apoptotic effect on cochlear cells.Strong protection from cisplatin- and neomycin-induced cytotoxicity with Emricasan.Sodium thiosulfate and Emricasan provide similar protective effects to cisplatin-treated cells.Emricasan is more potent than sodium thiosulfate in reducing neomycin-induced cytotoxicity.

01 Sep 2024·CRYOBIOLOGY

Polyethylene glycol and caspase inhibitor emricasan alleviate cold injury in primary rat hepatocytes

Article

Author: Ellis, Bradley W ; Uygun, Korkut ; Tessier, Shannon N ; Mojoudi, Mohammadreza ; Dinicu, Antonia T ; Chen, Huyun ; Uygun, Basak E ; Wilks, Benjamin T ; Toner, Mehmet

Current methods of storing explanted donor livers at 4 °C in University of Wisconsin (UW) solution result in loss of graft function and ultimately lead to less-than-ideal outcomes post transplantation. Our lab has previously shown that supplementing UW solution with 35-kilodalton polyethylene glycol (PEG) has membrane stabilizing effects for cold stored primary rat hepatocytes in suspension. Expanding on past studies, we here investigate if PEG has the same beneficial effects in an adherent primary rat hepatocyte cold storage model. In addition, we investigated the extent of cold-induced apoptosis through treating cold-stored hepatocytes with pan caspase inhibitor emricasan. In parallel to storage at the current cold storage standard of 4 °C, we investigated the effects of lowering the storage temperature to -4 °C, at which the storage solution remains ice-free due to the supercooling phenomenon. We show the addition of 5 % PEG to the storage medium significantly reduced the release of lactate dehydrogenase (LDH) in plated rat hepatocytes and a combinatorial treatment with emricasan maintains hepatocyte viability and morphology following recovery from cold storage. These results show that cold-stored hepatocytes undergo multiple mechanisms of cold-induced injury and that PEG and emricasan treatment in combination with supercooling may improve cell and organ preservation.

31 Jul 2024·Journal of Clinical and Translational Hepatology

Pipeline of New Drug Treatment for Non-alcoholic Fatty Liver Disease/Metabolic Dysfunction-associated Steatotic Liver Disease

Review

Author: Fan, Jian-Gao ; Hu, Ye ; Liu, Yu-Dong ; Sun, Chao ; Chen, Ying

Given the global prevalence and rising incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), the absence of licensed medications is striking. A deeper understanding of the heterogeneous nature of MASLD has recently contributed to the discovery of novel groups of agents and the potential repurposing of currently available medications. MASLD therapies center on four major pathways. Considering the close relationship between MASLD and type 2 diabetes, the first approach involves antidiabetic medications, including incretins, thiazolidinedione insulin sensitizers, and sodium-glucose cotransporter 2 inhibitors. The second approach targets hepatic lipid accumulation and the resultant metabolic stress. Agents in this group include peroxisome proliferator-activated receptor agonists (e.g., pioglitazone, elafibranor, saroglitazar), bile acid-farnesoid X receptor axis regulators (obeticholic acid), de novo lipogenesis inhibitors (aramchol, NDI-010976), and fibroblast growth factor 21/19 analogs. The third approach focuses on targeting oxidative stress, inflammation, and fibrosis. Agents in this group include antioxidants (vitamin E), tumor necrosis factor α pathway regulators (emricasan, pentoxifylline, ZSP1601), and immune modulators (cenicriviroc, belapectin). The final group targets the gut (IMM-124e, solithromycin). Combination therapies targeting different pathogenetic pathways may provide an alternative to MASLD treatment with higher efficacy and fewer side effects. This review aimed to provide an update on these medications.

36

News (Medical) associated with Emricasan

20 Sep 2023

·www.biospace.com

Fresh Tracks, Histogen to Shutter Businesses in Absence of Viable Options

Pictured: Closed sign being flipped over/iStock, StockSeller_ukr Colorado-based pharma Fresh Tracks announced Tuesday that its board of directors had unanimously agreed to dissolve the company and liquidate its assets, while California biotech Histogen on Monday also announced that it was dissolving and liquidating its business. Fresh Tracks will discontinue all its clinical and preclinical development programs as well as lay off “most employees,” which is set to happen by early October 2023, according to the company’s announcement. The news comes after the company’s search for potential strategic alternatives to save its business had turned up empty. However, Fresh Tracks will retain consultants, advisors and certain employees who are involved in the company’s dissolution. The company’s liquidation is still pending final approval from its shareholders. A day before Fresh Tracks announced its closure plans, San Diego-based Histogen said that it was dissolving and liquidating its business. Like its Colorado counterpart, Histogen has opted to discontinue all clinical development programs and has drastically slimmed down its workforce as part of its dissolution plan. Most employees will be laid off by the end of September 2023, according to the company’s announcement. Fresh Tracks was launched in September 2022 from a sweeping rebranding of Brickell Biotech. At the time, former CEO Robert Brown said that the company’s new name reflects the company’s mission “to develop groundbreaking, novel therapies that have the potential to restore immune balance.” Brown retired in January 2023 and was succeeded by Andew Sklawer. The company has since advanced a pipeline of immunology assets, including the DYRK1A inhibitor FRTX-02, which was in Phase I assessments for atopic dermatitis and was also being proposed for rheumatoid arthritis and type 1 diabetes. The company also owned an oral STING inhibitor, dubbed FRTX-10, which was in preclinical development for systemic lupus erythematosus, dermatomyositis and non-alcoholic steatohepatitis. In its most recent earnings report, posted August 2023, Fresh Tracks announced that it had “paused substantially all of its research and development activities in order to conserve capital resources.” In a previous earnings call soon after its rebrand, the company indicated that it was looking at strategic options including financing, merger or reverse merger, business combination or the sale of part of the company. Under its plan of dissolution, Histogen is considering selling off its pipeline assets—the proceeds from which would be distributed to stockholders along with its remaining cash. The proposed dissolution is still pending approval from the company’s stockholders, for which it expects to convene a special meeting in the fourth quarter of this year. Prior to the announcement, Histogen was advancing its experimental bacterial skin infection treatment emricasan. It had received the FDA’s go-ahead in March 2023 to conduct clinical trials for the candidate. Tristan Manalac is an independent science writer based in Metro Manila, Philippines. He can be reached at tristan@tristanmanalac.com or tristan.manalac@biospace.com.

Phase 1Executive Change

19 Sep 2023

·www.biopharmadive.com

Histogen plans to wind down operations after failing to find a partner

Dive Brief:Histogen intends to close down after an investment bank found no viable options to provide the regenerative medicine company with the money needed to stay operational.Directors of the San Diego-based drugmaker approved a liquidation plan that will be up for a shareholder vote in the fourth quarter. In the meantime, Histogen has stopped all clinical work and laid off almost all of its staff. By Sept. 30, only two employees will remain, including Chief Financial Officer Susan Knudson, who will also become CEO, president and principal executive officer.As part of the plan announced Monday, Histogen will delist its shares on the Nasdaq stock exchange, seek to sell assets, and distribute any remaining cash to stockholders after paying debts and obligations. The company will also continue looking for buyers for pipeline assets, which may produce more cash for investors.Dive Insight:Histogen reaches the end of its road after hiring Roth Capital Partnersin July to explore strategic alternatives. In the end, no possibility existed that would enhance stockholder value, Steven Mento, the companys current CEO, said in a statement.Mento will lose his position effective Sept. 30, as will the rest of Histogens suite of executives, aside from Knudson.Histogen needed cash to develop an experimental drug called emricasan, for treatment of bacterial skin infections. The company received approval from the Food and Drug Administration in March to start human testing, and had plans to begin to begin the research in the second half of this year if it could raise the required capital. But that didnt happen.Though a total dissolution is unusual in the biotechnology industry, its not unheard of. Genocea Biosciences, for example, found itself in a similar position last year.Histogen was also working in infectious disease a field of research thats proven difficult to succeed in for many drug developers.Histogen started out as a private company focused on regenerating tissue in the body. In 2020, its lead drug was meant to be a potential treatment for male pattern baldness. But Histogen would eventually enter a reverse merger with Conatus Pharmaceuticals, which had developed emricasan and was reeling from the failure from the failure of a medicine for non-alcoholic steatohepatitis, or NASH.The new combined company eventually gave up on the baldness drug, researched emricasan as a treatment for COVID-19 and tried at various times to refocus on a more promising path forward. It also undertook small private placements to raise cash and, in 2022, executed a 1-for-20 reverse stock split.Histogen has been operating with limited resources for a while; at the end of December, it had only seven full-time employees. Mento, who had cofounded and led Conatus, became president and CEO of the new company in March. He left the board of directors on Monday. '

Executive ChangeDrug ApprovalIPOAcquisition

06 Jul 2023

·www.fiercebiotech.com

Histogen could be history as biotech halts all programs to conserve remaining cash

Histogen has been slowly shrinking its portfolio to survive over recent years. Could Histogen soon join the growing list of biotechs shutting up shop for good in 2023? That’s certainly the mood music of the company’s announcement that its last remaining programs are being placed on pause to explore “strategic alternatives.” The immune-focused biotech made the call to extend its cash runway of $9.7 million, which as of the end of March was only expected to last to January 2024. The company had been hoping to launch a trial for its lead candidate emricasan for acute bacterial skin infections in the second half of 2023, but that ambition had been reliant on raising sufficient capital. Histogen has been slowly shrinking its portfolio to survive over recent years, with 2021 seeing the company drop a phase 1 alopecia treatment to focus on its orthopedic candidates. In March 2023, the company then dropped both of those candidates as well, leaving just emricasan to sit alone on the clinical-stage pipeline. Emricasan is a pan-caspase inhibitor designed to reduce the activities of human caspases, which are enzymes that mediate inflammation and cell death. As well as the hoped-for study in bacterial skin infections, the drug has already undergone various phase 1 trials, including for COVID-19 patients where it was shown to shorten symptoms and was well tolerated. “We remain excited about emricasan given its broad potential to treat both viral and bacterial infections as a more generalized host-based immunotherapeutic treatment without the risk of generating resistance,” CEO Steven Mento, Ph.D., said in a postmarket release Wednesday. “However, we have paused our development activities in order to preserve our remaining resources and extend our cash runway to explore strategic alternatives that have the potential to benefit shareholders.” Mento only took up the permanent CEO role in March. The former Idun Pharmaceuticals chief had been interim CEO of Histogen since November 2021. Histogen isn’t the only company facing the end of the road this year. Already we’ve seen Sorrento Therapeutics and Athenex file for bankruptcy, Talaris Therapeutics and Oncorus let go of nearly all of their employees, and Vedere Bio II and Vyant Bio begin winding down operations.

Phase 1Executive ChangePhase 2Immunotherapy

100 Deals associated with Emricasan

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External Link

KEGG	Wiki	ATC	Drug Bank
D10004	Emricasan	-	DB05408

R&D Status

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Decompensated cirrhosis of liver	Phase 2	US	Conatus Pharmaceuticals, Inc.	28 Jun 2017
Fibrosis	Phase 2	US	Histogen, Inc.	17 Oct 2016
Fibrosis	Phase 2	DE	Histogen, Inc.	17 Oct 2016
Fibrosis	Phase 2	ES	Histogen, Inc.	17 Oct 2016
Hypertension, Portal	Phase 2	US	Histogen, Inc.	17 Oct 2016
Hypertension, Portal	Phase 2	DE	Histogen, Inc.	17 Oct 2016
Hypertension, Portal	Phase 2	ES	Histogen, Inc.	17 Oct 2016
Nonalcoholic Steatohepatitis	Phase 2	US	Histogen, Inc.	17 Oct 2016
Nonalcoholic Steatohepatitis	Phase 2	DE	Histogen, Inc.	17 Oct 2016
Nonalcoholic Steatohepatitis	Phase 2	ES	Histogen, Inc.	17 Oct 2016

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT02960204 (ENCORE-PH, CTgov)	Phase 2	Nonalcoholic Steatohepatitis \| Fibrosis \| Hypertension, Portal	263	Emricasan (Emricasan (5 mg))	ylzexrsjzh(yulidjleux) = gbkuxullpi rfggvinqop (ezkubdjfge, ljyhmwemob - rysfpbxvwi) View more	-	14 Jan 2022
				Emricasan (Emricasan (25 mg))	ylzexrsjzh(yulidjleux) = zyzgubwafc rfggvinqop (ezkubdjfge, rrgrdpvoen - yonerjionm) View more
NCT04803227 (GlobeNewswire) Manual	Phase 1	COVID-19	13	emricasan	rxjkqbaouh(tfebpgzngn) = No Serious Adverse Events wtsjxvneqb (wqrujciefc ) View more	Positive	22 Jun 2021
				Placebo
NCT03462576 (CTgov)	Not Applicable	Decompensated cirrhosis of liver	199	Emricasan (Number of Subjects Experiencing a High Risk Event in 25 mg Treatment Arm)	vysjmjxtfh(hmlrkywael) = qsxftcsjlv gtmpisaffh (dmwljndlgz, mfqmloocvb - tgyvwhwhpo) View more	-	16 Dec 2020
				Emricasan (Number of Subjects Experiencing a High Risk Event in 5 mg Treatment Arm)	vysjmjxtfh(hmlrkywael) = awlterccoo gtmpisaffh (dmwljndlgz, junihzyvpz - vhgstfmvoo) View more
NCT02960204 (Pubmed \| J Hepatol)	Phase 2	Nonalcoholic Steatohepatitis \| Fibrosis \| Hypertension, Portal	263	Emricasan 5 mg	aztwbvpwxm(jlcbhtzscb) = saophfsvak dbpkbkayrb (qhuxwyuwiy )	Negative	01 May 2020
				Emricasan 25 mg	aztwbvpwxm(jlcbhtzscb) = kbrnczzagf dbpkbkayrb (qhuxwyuwiy )
NCT02686762 (Pubmed \| J Hepatol)	Phase 2	Nonalcoholic Steatohepatitis	318	Emricasan 5 mg	hlsgrruhec(hwvglwxkun) = hzusiipdxz sgrxaxkdcr (jdkwmupmxl ) View more	Negative	01 May 2020
				Emricasan 50 mg	hlsgrruhec(hwvglwxkun) = mnlrxhzbps sgrxaxkdcr (jdkwmupmxl ) View more
NCT02138253 (POLT-HCV-SVR, CTgov)	Phase 2	Fibrosis, Liver \| Hepatitis C, Chronic	64	IDN-6556 (IDN-6556)	krtcoonbgl(vftlujubuc) = bfqerqwlio aetgwlgsbx (gkefvdcjyf, opnswagrjb - grsritjrma) View more	-	11 Dec 2019
				Placebo (Placebo)	krtcoonbgl(vftlujubuc) = pmgfcmpjer aetgwlgsbx (gkefvdcjyf, pihazsbndu - cbneqoqmld) View more
NCT02686762 (ENCORE-NF, PipelineReview) Manual	Phase 2	Nonalcoholic Steatohepatitis	318	Emricasan	vzlmaadedv(saydiwzhdw) = fibrosis by at least 1 stage with no worsening of NASH smtatjbpis (kwdymqctfw ) View more	Negative	22 Mar 2019
				Placebo
NCT02230683 (Pubmed \| Hepatology) Manual	Phase 2	Hypertension, Portal \| Compensated cirrhosis	23	Emricasan	khqhmuadzg(rphshoikgn) = mzhwdhezaz sklwvrhngd (omxzufxwbk ) View more	Positive	01 Feb 2019
NCT02230670 (LC, CTgov)	Phase 2	Liver Cirrhosis	87	IDN-6556 (IDN-6556)	htylyxywae(kbsgwphvdy) = cgctwcjccz qhisgxnydl (snlwmavvju, srptlcmvth - agkgqoqqrb) View more	-	05 Jul 2017
				Placebo (Placebo)	htylyxywae(kbsgwphvdy) = fusccnsfcn qhisgxnydl (snlwmavvju, xaygnmffrm - foysochtde) View more
NCT02230683 (PH, CTgov)	Phase 2	Hypertension, Portal \| Liver Cirrhosis	23	IDN-6556	pbabynwlhp(mfebbsemny) = zupdgcfuar zoftcqdmvq (ogycmxxwmz, lrittqgyod - lguhciqaqc) View more	-	21 Dec 2016