Cachexia development enters new phase

The development of espindolol for the treatment of cancer cachexia entered a new phase this month, with the formation of a new spin out company Actimed Therapeutics. Actimed was founded by Profs Andrew Coats and Stefan Anker, two leading cardiologists and inventors of the background intellectual property for the use of beta adrenergic blockers in the treatment of cachexia. Numedicus improved on this technology in the identification of a single isomer of pindolol, and the filing of a patent (now granted worldwide) for the treatment of cachexia. Espindolol is an improvement on the general utility of beta blockade, since it combines three mechanisms of action in one molecule: beta-1 adrenergic inhibition for the prevention of excess catabolism, partial beta-2 adrenergic agonism to promote anabolism and interaction with 5-HT1A receptors to combat fatigue. In in vivo testing, espindolol outperformed all other beta blockers in various measures of cachexia; and in a Phase IIb clinical trial, espindolol was shown to significantly reverse weight loss, improve fat free mass, and maintain fat mass in advanced colorectal cancer and non-small cell lung cancer-related cachexia over 4 months. A Coats et al Espindolol for treatment and prevention of cachexia: the ACT-ONE trial. J Cachexia Sarcopenia Muscle 2016; 7: 355–365.