An Exclusive Interview with Estibaliz Arce Cirauqui
VP of Translational Science and Clinical Development, Engrail Therapeutics, Inc
How has the psychiatry treatment landscape evolved over the last 12 months and where do you see it heading in the next few years?
Over the past several years, there has been an increase in the recognition of common psychiatric conditions as well as greater interest from patients to seek treatment. The negative stigma associated with many psychiatric conditions continues to decrease over time. We are also observing an increase in routine screening for psychiatric conditions. In June 2023, the United States Preventative Services Task Force (USPSTF) recommended annual screening for anxiety disorders in adults <65 years old. This is an important step forward as it will boost diagnosis rates, particularly in the primary care setting. We belief a greater diagnosis rate will also increase the rate of treatment, improving overall patient outcomes.
Following recent approvals, with more anticipated this year, where is the field looking next to develop more effective, differentiated and transformative therapies for mental health disorders?
Given the surge in prevalence in anxiety disorders in recent years in addition to the USPSTF recommendations for screening for anxiety disorders, we are seeing more interest from pharmaceutical companies in pursuing novel approaches to the treatment of anxiety disorders. At Engrail Therapeutics, our lead program, currently in Phase 2 clinical development, is a precision targeted GABA-A positive allosteric modulator selective for alpha 2-, 3-, or 5-containing channels for the treatment of generalized anxiety disorder.
What would you say are the most promising new targets in development to tackle specific mood or behavioural symptoms?
GABA-A positive allosteric modulators or PAMs have been used for decades for the treatment of anxiety disorders. Benzodiazepines, for example, activate GABA-A channels containing alpha 1-, 2-, 3- or 5-containing subunits, and, although are highly effective anxiolytics, are associated with safety issues largely attributed to alpha1 activation.
By avoiding alpha1, selective alpha2,3,5 PAMs may offer anxiolytic efficacy with a favorable tolerability and safety profile. Proof-of-concept has already been established with the alpha2,3,5 preferring PAM darigabat in a CO2 model of panic disorder and it is currently in development for panic disorder and epilepsy. ENX-102 is a highly selective alpha2,3,5 PAM currently in development for the treatment of generalized anxiety disorder and may have utility for treating other anxiety and mood disorders.
Which specific challenges are you looking forward to addressing with colleagues at the Neuropsychiatric Drug Development Summit in order to collaboratively propel advancements?
Advancements in identification of target biomarkers for psychiatric disorders and precompetitive initiatives to collaborate toward a common goal, i.e., bringing safe and effective medicines to patients.
Which sessions in the agenda are you most looking forward to at the 7th Neuropsychiatric Drug Development Summit?
Many, if not all, sessions look interesting but “Applying CircuitBased Approaches in Neuropsychiatric Drug Discovery” caught my eye.
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