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Revolutionizing pain management: How AmacaThera is helping combat the opioid crisis

This article was originally published by RBCx on June 14, 2024. Read the original article here.

Every 65 minutes and 22 seconds.

That’s how often someone dies from an opioid overdose in Canada. On average, it works out to about 22 people per day. By comparison, at the height of Covid-19, the death toll in 2020 was about 11 per day. All told, opioids—a class of prescription pain-relieving medications that include heroin, fentanyl, morphine, oxycontin, among others—have killed more than 42,000 Canadians since tracking began in 2016.

According to the OECD (Organization for Economic Cooperation and Development), Canada holds the dubious distinction of having the second highest rate of opioid–related deaths, just behind the U.S. In the face of such brutal numbers, it’s clear that combatting the opioid epidemic requires an all-hands-on-deck approach, integrating everything from health care providers and emergency services to all levels of government. A pair of scientists-turned-startup-entrepreneurs, however, believe that the private sector, specifically their emerging biotech company, can play a critical part in solving this widespread and devastating issue.

AmacaThera’s Co-Founders: Molly Shoichet, CSO and Mike Cooke, CEO

Mike Cooke and Molly Shoichet are the co-founders of AmacaThera, a Toronto-based venture offering a novel way to provide pain relief without the use of opioids. Their breakthrough product, which is currently in clinical trials, was spun out of research led by Shoichet from her lab at the University of Toronto, where she’s a professor in the Department of Chemical Engineering and Applied Chemistry. Cooke, who hails from the U.K., worked in the lab studying stem cells while pursuing his PhD. In 2016, the two joined forces (she as chief science officer; he as CEO) with a vision, Cooke says, of “translating their academic research into real-world products” that have the potential to herald a promising avenue for long-term opioid reduction strategies.

The FedEx of therapeutic delivery

At the core of the company’s technology is its proprietary hydrogel platform. The AmacaGel, as it’s known, is a blend of hyaluronic acid (the same ingredient commonly used in anti-aging cosmetics), and methyl cellulose which, when combined with the hyaluronic acid, gives the material its gel consistency. When injected by syringe into a patient’s soft tissue, the gel acts as a kind of carrier system for existing drugs like an anesthetic, or other therapeutics that have been mixed with it, allowing their gradual release into the body.

Without changing the way surgeons operate, a concoction of the AmacaGel and a therapeutic is injected at the surgical site via syringe. It’s designed to offer long-lasting pain relief after surgery, with the intent to aid patients in their recovery journey.

Shoichet likens AmacaThera to FedEx, whereby it provides the protective packaging (the gel) for what’s inside (the drugs) and then determines where and when they need to be deployed. “We’re not changing the drugs, we’re changing the delivery method,” adds Cooke. “That’s why we call it a platform.”

How it works: a game-changer in pain management

To understand what sets AmacaThera’s technology apart as it relates to the opioid epidemic, is to understand why opioids are often prescribed in the first place. Anyone that’s undergone surgery—from major dental work to having a hip replaced—knows that the recovery period can be painful. During the procedure, an analgesic is typically administered to the area, but tends to wear off within hours, leaving most patients to rely on a prescription narcotic for relief. Studies have shown that this leads to millions of cases of opioid addiction each year.

In contrast, the AmacaGel platform’s controlled release mechanism would ensure a steady supply of opioid-free pain medication over three days, effectively numbing the surgical site for an extended duration, far beyond the 12 to 18 hour window of conventional local anesthetics. Cooke and Shoichet theorize this prolonged-release formulation not only obviates the need for frequent opioid administration, but also alleviates the intensity of postoperative pain, thereby safeguarding individuals from the perils of addiction and overdose. It’s against this backdrop that the company offers a lifeline in the battle against opioid misuse.

“It’s been so exciting to see our research invention of AmacaGel be the basis of AmacaThera and now to see it applied in people,” Shoichet says. “Our goal is to make products that will make a difference in people’s lives. With our first product, we aim to both alleviate pain and put a dent in the opioid crisis, thereby filling unmet medical and societal needs.”

Moreover, Cooke explains, its efficacy in controlling pain not only fosters optimal healing, but the downstream effect may be a boon to our struggling health system. “If you have that rapid pain control, you’ll get better recovery. You can get people out of the hospital quicker and by reducing their length of stay, you can increase hospital capacity, and serve more patients. These are huge drivers and we’re building the company with that mentality of efficacy and efficiency.”

Beyond the operating room: Exploring diverse applications

AMT-143, AmacaThera’s first formulation, is a non-opioid anesthetic that, when approved, would be injected locally through a pre-filled syringe during a surgical procedure.

While the company’s first formulation, AMT-143, is focused on post-surgical pain management, Cooke and Shoichet are betting that AmacaThera’s utility could extend far beyond the confines of the operating room. Consider, for example, the ability to deliver cancer-fighting treatment to otherwise difficult-to-reach areas of the body, like the lungs or the brain. “With this technology, you could inject chemotherapy right into the tumour,” Cooke explains. “Because it’s localized, you could have greater efficacy because more of the drug would infiltrate the tumour directly, so that you’re decreasing the systemic toxicity overall.”

That AmacaThera’s platform is compatible with other materials—small molecules, antibodies, stem cells, proteins, and peptides, to name a few—effectively means patient outcomes could be improved across multiple therapeutic areas. A wide swath of rigorous scientific research has come out of Shoichet’s lab (underscored by over 325 peer-reviewed publications) shows how the technology could be used to treat not just certain cancers, but blindness, spinal cord injuries, and strokes.

Further still, when one considers the possibility of extending the product to patients of the non-human variety (think: dogs and cats, but also farm animals), its versatility could make it a cornerstone in various medical disciplines. “People pay a lot of money to care for their pets,” Cooke points out, “so there are active discussions with animal health pharma companies looking at licensing this technology.”

In this landscape, AmacaThera emerges as a revolutionary solution, offering a paradigm shift in the range of patient treatment options available, while holding the promise of mitigating some of society’s biggest challenges. “I believe in this technology because I’ve seen it work with my own eyes,” says Cooke. “As we learn more about the product itself, the manufacturing, the usages, how it performs as we advance to human trials, and the more positive aspects we’re uncovering, the more exciting it gets.”

Given the potential market opportunity (surgery alone is performed on over 51 million Americans every year, with opioids the primary means of pain control), AmacaThera has, unsurprisingly, created alot of excitement among investors as well. Last November, the company announced it secured a $4 million Series A extension from investors, including Lumira Ventures and StandUp Ventures, both of which RBCx proudly backs as a Limited Partner.

RBCx also supports the young startup with its day-to-day banking needs. “We’ve been with RBCx since the very start and it just makes life a lot simpler and more efficient. The fewer headaches I have, the more time we can devote to focusing on the science,” Cooke says, adding that the opportunity to network at RBCx-hosted client events with our thought leaders is a “big deal…I see that you’ve hired a few people from Silicon Valley Bank, so it will be exciting to see what RBCx does in the future.”

And yet, despite banking support, deep-pocketed investors, a best-in-class product, and Shoichet’s own prior experience launching two other startups, the co-founders acknowledge that entrepreneurship has been anything but easy. “When you start on this journey, you don’t know how hard this is going to be; it takes a certain type of crazy to want to do this because raising capital has been by far the toughest part,” says Cooke.

“The number one comment we’ve had from investors is congratulations on being so relentless. They’re amazed by the tenacity of this company and how it just keeps going,” says Cooke. “And that’s the key: we’re going to take this all the way to the finish line.”

To get there, AmacaThera is using the cash infusion to speed up testing and development of AMT-143, as well as advancing other formulations through their pipeline before going out to fundraise again later this year. And while they’re the first to acknowledge that Canada remains a tough economic environment for tech startups, the duo remain undaunted, driven by a profound commitment to their mission. “In 20 years, we envision a successful company with products that make lives better,” says Shoichet. “There’s nothing more exciting than working toward creating a better tomorrow with innovative ideas.”

“Getting the product in humans and moving it forward is such a huge privilege,” adds Cooke. “We’re privileged to have the investors, we’re privileged to have the team. I never want to lose sight of that. It would be great to have invented something going into potentially millions and millions of people. But, to be honest, I think if we’re able to improve even one person’s life, that would be a huge achievement.”

To learn more about AmacaThera, visit AmacaThera.ca.

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