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Algernon Pharmaceuticals, a clinical stage pharmaceutical development company, has recently engaged Maxim Group LLC to provide financial advisory and investment banking services towards the potential spin-off of the company's NP-120 or Ifenprodil chronic cough research program. Ifenprodil is a novel first-in-class potential treatment for chronic cough, targeting the NMDA-type subunit 2B (GluN2B) to prevent glutamate signaling in the brain, suppressing the urge to cough. This article aims to provide a comprehensive overview of Algernon Pharmaceuticals' Phase 2a study data, the chronic cough market, and the potential spin-off of Ifenprodil chronic cough research program. We will also explore the company's chronic cough advisors and the mechanism of action of Ifenprodil. Positive Phase 2a Study Data Algernon Pharmaceuticals' decision to advance to a Phase 2b cough study was based on positive data previously reported from the company's proof of concept Phase 2a study of idiopathic pulmonary fibrosis (IPF) and chronic cough on July 28, 2022. The study showed a significant reduction in cough count, wherein the geometric mean 24-hour cough counts were reduced by 32.0% at 4 weeks (p = 0.023) and 39.5% at 12 weeks (p = 0.001) compared to baseline. Furthermore, the geometric mean awake cough counts were reduced by 30.2% at 4 weeks (p = 0.038) and 37.4% at 12 weeks (p = 0.002) compared to baseline. It is noteworthy that patients with IPF are usually excluded from trials in refractory chronic cough (RCC), and cough in this population is regarded as extremely difficult to treat. The positive data from Algernon Pharmaceuticals' Phase 2a study represents a significant milestone in the development of a potential treatment for chronic cough. The Chronic Cough Market According to Data Bridge Market Research analyses, the global chronic cough market was valued at USD $6.15B in 2021 and is projected to grow up to USD $11.38B by 2029. The market is driven by the increasing prevalence of chronic cough, especially in the elderly population, and the lack of effective treatment options. There is an unmet need for better therapies for chronic cough, as seen in the acquisition of Afferent Pharmaceuticals by Merck & Co. in 2016, where Merck obtained the rights to gefapixant, a P2X3 receptor antagonist, as the lead asset in the deal worth up to USD $1.25 billion. Bellus Health, which is advancing camlipixant, its own novel P2X3 receptor antagonist, was acquired by GSK plc for USD $14.75 per share in cash with a total deal value estimated at USD $2 billion in April 2023. Algernon Pharmaceuticals' Ifenprodil chronic cough research program represents a potential first-in-class treatment for chronic cough, with promising Phase 2a study data. The potential spin-off of the program in collaboration with Maxim Group LLC could unlock significant value for the company's shareholders. Chronic Cough Advisors Algernon Pharmaceuticals' chronic cough advisors include Dr. Jacky Smith and Dr. Peter Dicpinigaitis. Dr. Jacky Smith is a Professor of Respiratory Medicine at the University of Manchester and an Honorary Consultant at Manchester University NHS Foundation Trust. She runs a multi-disciplinary research team whose focus is on understanding mechanisms underlying pathological cough and a regional clinical service seeing patients with refractory chronic cough. Dr. Smith is also the lead medical and scientific advisor to both Merck and Bellus Health for their RCC research programs. Dr. Peter Dicpinigaitis is board-certified in Internal Medicine, Pulmonary Diseases, and Critical Care Medicine. He is a faculty member of the Division of Critical Care Medicine at Montefiore Medical Center and is the founder and director of the Montefiore Cough Center, one of the few specialty centers in the world exclusively committed to the evaluation and management of patients with chronic cough. Algernon Pharmaceuticals' chronic cough advisors bring significant expertise and experience in the field of respiratory medicine and chronic cough, supporting the potential spin-off of the Ifenprodil chronic cough research program. Mechanism of Action of Ifenprodil Ifenprodil selectively inhibits N-methyl-D-aspartate (NMDA) receptors containing the NR2B subunit. These receptors are highly implicated in events such as neuronal plasticity and excitotoxicity. By inhibiting NMDA receptors, Ifenprodil can diminish the excitability of neurons and prevent the relaying of information along neuronal circuitry, including the cough reflex. Ifenprodil may also inhibit the neuroplastic enhancement of central and peripheral cough response neurons. Experimental antitussives often only engage a single receptor, while the overall cough response is governed by multiple receptors triggered by a large variety of stimuli. A compound acting centrally, like Ifenprodil, where all peripheral messages are sent and coordinated, may achieve a better outcome than what has been achieved in clinical trials. Conclusion Algernon Pharmaceuticals' Ifenprodil chronic cough research program represents a potential first-in-class treatment for chronic cough, with promising Phase 2a study data. The potential spin-off of the program in collaboration with Maxim Group LLC could unlock significant value for the company's shareholders, as seen in the acquisition of Afferent Pharmaceuticals by Merck & Co. and Bellus Health by GSK plc. The global chronic cough market is projected to grow, driven by the increasing prevalence of chronic cough and the lack of effective treatment options. Algernon Pharmaceuticals' chronic cough advisors bring significant expertise and experience in the field of respiratory medicine and chronic cough, supporting the potential spin-off of the Ifenprodil chronic cough research program. Ifenprodil selectively inhibits NMDA receptors containing the NR2B subunit, providing a novel mechanism of action in the treatment of chronic cough.
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