Transcend Therapeutics’ PTSD treatment succeeded in a mid-stage study, propelling the scrappy company of less than 20 people toward a Phase 3 trial that could begin at the start of next year.
The placebo-controlled results are the first for the company’s non-hallucinogenic psychostimulant treatment, methylone, or TSND-201. Though not a psychedelic, the drug fits within the broader and emerging class of neuroplastogen companies trying to turn therapies out of the brain’s ability to reorganize and build new neural connections.
Transcend showed that TSND-201 beat placebo in improving patients’ PTSD symptoms, as measured by a clinical scale. The treatment showed both a short- and long-term impact, with statistically significant improvements in CAPS-5 scores at both day 10 and day 64. Patients receiving treatment had an 8-point placebo-adjusted improvement in symptoms at day 10 and a 9.64 improvement at day 64. Almost 61% of patients treated with TSND-201 shed their PTSD diagnosis, twice the rate of placebo.
The data made CEO Blake Mandell feel hopeful and encouraged, reflecting on the dearth of treatments for patients.
“The average duration of PTSD symptoms for patients in the study was like 20 years,” he said in an exclusive interview with
Endpoints News
. “And by 10 days, there was a clear separation from placebo.”
The study recruited 65 patients with severe PTSD across the US, UK and Ireland who had previously been treated for the condition. Participants were given four oral doses of either treatment or placebo, each separated by a week. The data at day 10 followed the patients’ second treatment course.
The majority of adverse events occurred on the day of dosing and resolved that day. One patient in the treatment arm who had a history of seizures experienced one seven days after the last dose, but the event was deemed unrelated to the study drug.
Transcend is among the crop of biotechs that are trying to harness the power of psychedelics without patients tripping or hallucinating. Other companies, like Delix Therapeutics and Gilgamesh, are working on similar therapies.
Patients in Transcend’s trial still had to be monitored for at least eight hours in the study, and Mandell described a range of experiences. Some were more chatty, others were introspective; a number of patients had a positive adverse reaction described as “non-sedated relaxation.”
“I imagine it’s important for the agency to be able to understand what is happening to these patients in the study. And the more data we can collect, the more helpful it is for them,” he said.
The level of detail on side effects is not just a show of good faith. Mandell and Transcend are looking to learn from Lykos Therapeutics, which stumbled last year on the path to treating PTSD. That company, developing MDMA as central to psychedelic-assisted therapy, faced an FDA rejection despite two successful Phase 3 studies. The agency ultimately didn’t trust the data, and issues about integrity and adverse event monitoring plagued the company.
“Everything different from baseline was tracked,” Mandell said.
Patient monitors were instructed to be non-directive with patients and to only assist if patients needed it. One monitor was removed for continuously directing patients contrary to the agreed-upon approach, Mandell said. Unlike Lykos, TSND-201 is not being tested as assisting psychotherapy, hence the nondirective guidance.
Transcend, like Lykos, used central raters to assess patients’ CAPS-5 scores to try to limit bias from trial investigators, meaning people who didn’t work with the patients during the dosing session were assessing their PTSD symptoms afterward.
The biotech has raised $50 million to date, enough to get it to the end of the year when it plans to be ready to launch a Phase 3 study. Between now and then, Transcend will meet with the FDA to align on that study, which will include discussing a potential tweak to the monitoring time, according to Mandell. And it will need to raise more money.
“Our path is to tell the story and try to raise the capital to begin a pivotal program,” he said.
Editor’s note: This story was updated to correct that the case of seizure occurred after the last dose of TSND-201, not the second dose.