April 30, 2025 • 14 mins
This week on BioTech Nation, Sameer Sabir, CEO of Brixton Biosciences, shares how their breakthrough injectable cold therapy, Neural Ice, could offer lasting relief for osteoarthritis pain. With a drug-free, nerve-targeting approach currently in clinical trials, this innovation may change how we treat joint pain without pills or repeated steroid injections.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Moira Gunn (00:11):
Ever had to ice your knee? Ever had pain in your
knee or knees? Has the pain beenpersistent, as in all the time?
Possibly diagnosed asosteoarthritis or just that darn
sports injury. You know that anice pack will help, but it can
only go so far.
(00:33):
Here is a straightforward butstill unusual approach which
scientists have been working onfor ten plus years. It's
currently in clinical trials.Sameer Sabir is the CEO of
Brixton Biosciences. Samir,welcome to Biotech Nation.
Sameer Sabir (00:51):
Thank you for having me, Moira. It's a
pleasure to be here.
Dr. Moira Gunn (00:54):
Now I wanna start by reminding everyone how
often we all use ice from ourvery own freezers to help us
deal with one problem oranother. You know, let's put
some ice on that. What are weputting ice on, and why are we
putting ice on it?
Sameer Sabir (01:10):
Well, we've, known for millennia really that ice
has therapeutic benefit, in manydifferent ways, but the most
common ways that we use it todayare if you have, you know,
exercise that's too vigorous,and want a little bit of a way
to calm some of the inflammationin your joints or really in any
(01:34):
situation where you have a minorsprain or bruise, ice can be
effective as a way to help calmdown inflammation. It's a
wonderful tool.
Dr. Moira Gunn (01:42):
In fact, this can also happen if you've just
had surgery.
Sameer Sabir (01:45):
Sure, yeah. Ice can also be used to help with
swelling from surgery, fromedema and other issues, incision
sites. It's not just somethingthat tamps down on inflammation.
It also is soothing. I mean, itactually, helps, helps these
sites feel better as well, whichis, you know, half the half the
(02:06):
battle.
Dr. Moira Gunn (02:07):
So when we put this ice on the outside, it just
it goes on the outside, but asit goes into the middle of,
we'll just say, the knee Sure.It's gotta be less cold in
there. Is that a problem?
Sameer Sabir (02:20):
Yeah. I think, you know, typically, the way ice is
used today, as, as an ice pack,you're You're treating things
that are relatively superficial,and the cold doesn't necessarily
penetrate, as deeply into theinto the joint or wherever you
may be putting it as one mightwant. So, it's definitely,
(02:46):
limited, in its current, in itscurrent, methodology of use, by
the fact that it it is somethingthat's applied topically, it's
applied from the outside.
Dr. Moira Gunn (02:55):
So it doesn't take a rocket scientist to say,
golly, it'd be sure good if wecould get that cold a little
deeper. Yeah. This and thiscomes to the technology you're
working on. Tell us, what is itthat Brixton Bio is working on?
Sameer Sabir (03:10):
Yeah. Well, Brixton Bio is working on a
product that's called NeuralIce, and it's in its most basic
form essentially an injectablean injectable version of ice. So
it's not quite the same as theice in is an ice pipe, but it is
a formulation of ice, aproprietary formulation. And the
(03:31):
idea is to be able to injectthis ice directly around nerves
because we know that when weapply ice to nerves, the nerve
then undergoes somewhat of atransformation that reduces
sensation for a long period oftime, which results, from the
patient's perspective in areduction in sensation, a
(03:51):
reduction in pain. So we'retrying to put ice in it and not
on it.
Dr. Moira Gunn (03:57):
Now let me ask you this. Those of us who have
had any kind of problem with ourfeet, our knees, even our hips,
We're used to having the doctorsay, well, we can give you an
injection of one drug oranother, and you could only have
so many per year or you can onlydo this so many times. If I'm
(04:18):
injecting this and it's ice,doesn't it just turn to sort of
water?
Sameer Sabir (04:22):
It essentially turns to water and some other
components that are alsobiocompatible and is excreted
out of the body. That's correct,Myra. It's a very benign
formulation. We actuallydeliberately formulated the
product with, ingredients thatwere all on what's known as the
FDA's generally regarded as safelist, the excipients, the inert
(04:44):
components. And so the product'sactually considered to be a
medical device because of thefact that, the composition is
inert and the mechanism ofaction, is purely physical.
The product works by virtue ofthe ice melting. That's what
drives the changes to the nerve.And so, it's drug free, which we
(05:05):
think is really exciting,because, as you mentioned, many
of the treatments that are usedtoday in, for example, treating
osteoarthritis can be, quitedamaging, if used, chronically.
And so, we still need todemonstrate and and prove this
out in clinical studies goingforward. But our sincere hope is
(05:25):
that this is something that notonly will provide months of
relief from a single injection,but it can also be used,
multiple times, in patients.
Dr. Moira Gunn (05:33):
Now why is it called neural ice as opposed to
it's a lot of cold ice or iceice or the ice?
Sameer Sabir (05:41):
Well, that's a that's a great question. And,
you know, what what we're tryingto do, and this is underpinned
by, almost a decade of researchin an academic lab before we
spun it out into Brixton, is totarget the nerve that's causing
the pain that the patient isdealing with. So if we take the
(06:02):
knee, for example, which is thefirst indication that we're
targeting, we're interested inhelping patients who have
osteoarthritis of the knee, andtherefore have pain because of
osteoarthritis. Now that paingets transmitted through, a
network of nerves that are knownas the genicular nerves, and,
(06:22):
we're going to target thosegenicular nerves, so nerves,
neural neural ice. And the waythat, neural ice works is that
you essentially inject theneural ice around the nerve, you
surround the nerve with the ice,and then as the ice melts, it
extracts a significant amount ofenergy from the surrounding
(06:43):
tissue.
And that rapid extraction ofenergy from the surrounding
tissue, which includes the nerveand specifically the myelin
sheath, which is the sort offatty layer of insulation around
the nerve, that's disrupted. Andwhen that's disrupted, that
triggers this process wherebythe nerve essentially is tamped
down or desensitized for aperiod of time. And that's what
(07:06):
causes the reduction in pain.
Dr. Moira Gunn (07:08):
Now Neural Ice has received what's called a
breakthrough device designationfrom the FDA. No surprise from
my end given how many knees arelistening to this interview
right now saying, I hurt.
Sameer Sabir (07:22):
Yeah. Yeah.
Dr. Moira Gunn (07:23):
Get get this to me fast. But you're now doing
clinical trial, and you arerecruiting.
Sameer Sabir (07:30):
That's right.
Dr. Moira Gunn (07:31):
Who are you studying? What are you looking
for? How long is Tell us thedetails here.
Sameer Sabir (07:36):
Sure. So we've already done a series of, pilot
studies, in patients, to, ensurethat the product is safe and so
on and so forth. And thosestudies were done in patients
who, had chronic osteoarthritisof the knee, and pain as a
result of that. And so ourcurrent, pivotal regulatory
(07:57):
study, is that same patientpopulation as patients who have
chronic osteoarthritis of theknee. They need to have a
minimum threshold of pain, to beenrolled in the study.
And it's a large study. It's,around two hundred and seventy
patients, and the study has anactive control. So we're
comparing Neural ICE to steroidor a single steroid shot, which
(08:20):
is a very common treatmentthat's used today to treat knee
pain and all kinds of other painwhen it comes to joints. And in
this study, we're going to bemeasuring both pain scores to
see how patients fare when itcomes to pain after the
treatment, but also somefunctional outcomes as well,
because I think pain iscertainly an important component
(08:41):
of this. But what's probablymore important and more relevant
to the patient from a day to daystandpoint is does that
reduction in pain improve their,functional abilities so they can
live their lives in a more,wholesome way?
Dr. Moira Gunn (08:57):
Now these are osteoarthritis patients, so we
know that there's pain.
Sameer Sabir (09:01):
Correct.
Dr. Moira Gunn (09:01):
Are you looking for people with two knees so you
can compare each knee?
Sameer Sabir (09:07):
Yeah. No. Great question. We we in this study,
it's unilateral, so it's onlyone knee. We're only allowed to
enroll one knee at a time as perthe protocol that we agreed with
FDA.
I can tell you that in our pilotstudy, there were several
patients who wanted both kneesdone at the same time, but, you
know, we believe in, going onestep at a time and making sure
(09:29):
that everything is shaping upthe way we want it to before we,
before we, jump to that.
Dr. Moira Gunn (09:34):
Welcome to science.
Sameer Sabir (09:36):
Yeah. Yeah. Absolutely.
Dr. Moira Gunn (09:38):
It's a journey. It's a journey. It's a journey.
Sometimes not everyone doesn'tget exactly what they wanted out
of it. Exactly.
But but at the end, if it allworks, they can get their other
knee done. So that's that is agood thing. Yeah. That is a very
good thing. How long is thistrial gonna take if you're for
an individual?
I mean, you've gotta get theseover 200 patients in and and all
(09:58):
of this. How long would a personparticipate?
Sameer Sabir (10:01):
Well, we have, we have 11 now, I think, wonderful
sites, across The US, who arestudy centers for us, and
enrollment is going quite well.We started the study at the end
of last year, we're hoping it'llbe fully enrolled actually by
the end of this year, whichmeans that we would then there's
a six month follow-up period, sowe follow the patients for six
months after the injections. Soour hope is that we can actually
(10:25):
go to the FDA for approval, bythe middle, or or a little bit
later next year in '26.
Dr. Moira Gunn (10:32):
So, there's a good chance there's gonna be
some place near you if there's11 sites across The US. Yes. How
does someone find out about thetrial and where they might be
able to participate?
Sameer Sabir (10:45):
Sure. The the trial, information is on
Brixton's website,BrixtonBio.com. It's called ICE
trial. And you can go to thewebsite and take a look at the
details and see if you may, beeligible. And if you are, please
reach out to one of the sitesthat are participating.
Dr. Moira Gunn (11:05):
Now will this only help knees?
Sameer Sabir (11:09):
No. So, we actually, founded the company
after we spun out from the labreally as a platform technology.
We can target nerves whereverthey may be in the body. I think
the way to think about NeuralICE, which is why it's so
interesting actually, is that,if you can identify the nerve
that's causing the pain, thenyou can target that pain using
(11:32):
Neural ICE. And so when westarted to look at really where
the need existed, where thebiggest burden on the system
exists, it really tends to be,within the musculoskeletal
system, and specifically theknee is a big contributor to
sort of the global health, theglobal burden when it comes to
pain.
And so we we settled on the kneefirst, but there are also other
(11:55):
joints that we're, interested inand starting to look at. So our
second indication that we'relooking at is lateral hip pain,
and we just very recentlystarted a pilot study in the hip
indication as well. And then thethird indication that we're
interested in is probably thethumb joint. So the thumb joint
is a very prevalent, problem,when it comes to osteoarthritis.
(12:19):
It affects women about twice asmuch as it affects men, and is
again, you think about usingyour hand and and and your thumb
if that's in severe pain, andthat really inhibits your
quality of life.
So We're trying to pickindications where there's a real
need, there's a lack of realsolutions, and also we can we
can demonstrate functionalimprovements in the patient.
Dr. Moira Gunn (12:39):
Well, Sameer, this has been terrific. I hope
you come back and and, see usagain and and bring us some some
new outcomes. What else we mighthave learned from all this? And
and good luck to you.
Sameer Sabir (12:50):
Thank you very much for having me, Moira. This
has been very cool. No punintended.
Dr. Moira Gunn (12:56):
Sameer Sabir is the CEO of Brixton Biosciences
in Cambridge, Massachusetts.More information about
BrixtonBio and about their ICEtrial is available on the web at
brixtonbio.com. At the time ofthis recording, US sites
conducting the ICE trialstudying injectable cold energy
(13:19):
therapy for the management ofchronic pain associated with
osteoarthritis of the knee arelocated in or near the San
Francisco Bay Area, Houston,Texas, Gainesville, Florida,
Atlanta, Georgia, Flint,Michigan, Pittsburgh,
Pennsylvania, Boston,Massachusetts, Washington, DC,
(13:41):
and several sites in Oklahoma.Recruitment is underway and
eligibility criteria for the ICEtrial can be found at
BrixtonBio.com.
Ever had to ice your knee? Ever had pain in your
knee or knees? Has the pain beenpersistent, as in all the time?
Possibly diagnosed asosteoarthritis or just that darn
sports injury. You know that anice pack will help, but it can
only go so far.
(00:33):
Here is a straightforward butstill unusual approach which
scientists have been working onfor ten plus years. It's
currently in clinical trials.Sameer Sabir is the CEO of
Brixton Biosciences. Samir,welcome to Biotech Nation.
Sameer Sabir (00:51):
Thank you for having me, Moira. It's a
pleasure to be here.
Dr. Moira Gunn (00:54):
Now I wanna start by reminding everyone how
often we all use ice from ourvery own freezers to help us
deal with one problem oranother. You know, let's put
some ice on that. What are weputting ice on, and why are we
putting ice on it?
Sameer Sabir (01:10):
Well, we've, known for millennia really that ice
has therapeutic benefit, in manydifferent ways, but the most
common ways that we use it todayare if you have, you know,
exercise that's too vigorous,and want a little bit of a way
to calm some of the inflammationin your joints or really in any
(01:34):
situation where you have a minorsprain or bruise, ice can be
effective as a way to help calmdown inflammation. It's a
wonderful tool.
Dr. Moira Gunn (01:42):
In fact, this can also happen if you've just
had surgery.
Sameer Sabir (01:45):
Sure, yeah. Ice can also be used to help with
swelling from surgery, fromedema and other issues, incision
sites. It's not just somethingthat tamps down on inflammation.
It also is soothing. I mean, itactually, helps, helps these
sites feel better as well, whichis, you know, half the half the
(02:06):
battle.
Dr. Moira Gunn (02:07):
So when we put this ice on the outside, it just
it goes on the outside, but asit goes into the middle of,
we'll just say, the knee Sure.It's gotta be less cold in
there. Is that a problem?
Sameer Sabir (02:20):
Yeah. I think, you know, typically, the way ice is
used today, as, as an ice pack,you're You're treating things
that are relatively superficial,and the cold doesn't necessarily
penetrate, as deeply into theinto the joint or wherever you
may be putting it as one mightwant. So, it's definitely,
(02:46):
limited, in its current, in itscurrent, methodology of use, by
the fact that it it is somethingthat's applied topically, it's
applied from the outside.
Dr. Moira Gunn (02:55):
So it doesn't take a rocket scientist to say,
golly, it'd be sure good if wecould get that cold a little
deeper. Yeah. This and thiscomes to the technology you're
working on. Tell us, what is itthat Brixton Bio is working on?
Sameer Sabir (03:10):
Yeah. Well, Brixton Bio is working on a
product that's called NeuralIce, and it's in its most basic
form essentially an injectablean injectable version of ice. So
it's not quite the same as theice in is an ice pipe, but it is
a formulation of ice, aproprietary formulation. And the
(03:31):
idea is to be able to injectthis ice directly around nerves
because we know that when weapply ice to nerves, the nerve
then undergoes somewhat of atransformation that reduces
sensation for a long period oftime, which results, from the
patient's perspective in areduction in sensation, a
(03:51):
reduction in pain. So we'retrying to put ice in it and not
on it.
Dr. Moira Gunn (03:57):
Now let me ask you this. Those of us who have
had any kind of problem with ourfeet, our knees, even our hips,
We're used to having the doctorsay, well, we can give you an
injection of one drug oranother, and you could only have
so many per year or you can onlydo this so many times. If I'm
(04:18):
injecting this and it's ice,doesn't it just turn to sort of
water?
Sameer Sabir (04:22):
It essentially turns to water and some other
components that are alsobiocompatible and is excreted
out of the body. That's correct,Myra. It's a very benign
formulation. We actuallydeliberately formulated the
product with, ingredients thatwere all on what's known as the
FDA's generally regarded as safelist, the excipients, the inert
(04:44):
components. And so the product'sactually considered to be a
medical device because of thefact that, the composition is
inert and the mechanism ofaction, is purely physical.
The product works by virtue ofthe ice melting. That's what
drives the changes to the nerve.And so, it's drug free, which we
(05:05):
think is really exciting,because, as you mentioned, many
of the treatments that are usedtoday in, for example, treating
osteoarthritis can be, quitedamaging, if used, chronically.
And so, we still need todemonstrate and and prove this
out in clinical studies goingforward. But our sincere hope is
(05:25):
that this is something that notonly will provide months of
relief from a single injection,but it can also be used,
multiple times, in patients.
Dr. Moira Gunn (05:33):
Now why is it called neural ice as opposed to
it's a lot of cold ice or iceice or the ice?
Sameer Sabir (05:41):
Well, that's a that's a great question. And,
you know, what what we're tryingto do, and this is underpinned
by, almost a decade of researchin an academic lab before we
spun it out into Brixton, is totarget the nerve that's causing
the pain that the patient isdealing with. So if we take the
(06:02):
knee, for example, which is thefirst indication that we're
targeting, we're interested inhelping patients who have
osteoarthritis of the knee, andtherefore have pain because of
osteoarthritis. Now that paingets transmitted through, a
network of nerves that are knownas the genicular nerves, and,
(06:22):
we're going to target thosegenicular nerves, so nerves,
neural neural ice. And the waythat, neural ice works is that
you essentially inject theneural ice around the nerve, you
surround the nerve with the ice,and then as the ice melts, it
extracts a significant amount ofenergy from the surrounding
(06:43):
tissue.
And that rapid extraction ofenergy from the surrounding
tissue, which includes the nerveand specifically the myelin
sheath, which is the sort offatty layer of insulation around
the nerve, that's disrupted. Andwhen that's disrupted, that
triggers this process wherebythe nerve essentially is tamped
down or desensitized for aperiod of time. And that's what
(07:06):
causes the reduction in pain.
Dr. Moira Gunn (07:08):
Now Neural Ice has received what's called a
breakthrough device designationfrom the FDA. No surprise from
my end given how many knees arelistening to this interview
right now saying, I hurt.
Sameer Sabir (07:22):
Yeah. Yeah.
Dr. Moira Gunn (07:23):
Get get this to me fast. But you're now doing
clinical trial, and you arerecruiting.
Sameer Sabir (07:30):
That's right.
Dr. Moira Gunn (07:31):
Who are you studying? What are you looking
for? How long is Tell us thedetails here.
Sameer Sabir (07:36):
Sure. So we've already done a series of, pilot
studies, in patients, to, ensurethat the product is safe and so
on and so forth. And thosestudies were done in patients
who, had chronic osteoarthritisof the knee, and pain as a
result of that. And so ourcurrent, pivotal regulatory
(07:57):
study, is that same patientpopulation as patients who have
chronic osteoarthritis of theknee. They need to have a
minimum threshold of pain, to beenrolled in the study.
And it's a large study. It's,around two hundred and seventy
patients, and the study has anactive control. So we're
comparing Neural ICE to steroidor a single steroid shot, which
(08:20):
is a very common treatmentthat's used today to treat knee
pain and all kinds of other painwhen it comes to joints. And in
this study, we're going to bemeasuring both pain scores to
see how patients fare when itcomes to pain after the
treatment, but also somefunctional outcomes as well,
because I think pain iscertainly an important component
(08:41):
of this. But what's probablymore important and more relevant
to the patient from a day to daystandpoint is does that
reduction in pain improve their,functional abilities so they can
live their lives in a more,wholesome way?
Dr. Moira Gunn (08:57):
Now these are osteoarthritis patients, so we
know that there's pain.
Sameer Sabir (09:01):
Correct.
Dr. Moira Gunn (09:01):
Are you looking for people with two knees so you
can compare each knee?
Sameer Sabir (09:07):
Yeah. No. Great question. We we in this study,
it's unilateral, so it's onlyone knee. We're only allowed to
enroll one knee at a time as perthe protocol that we agreed with
FDA.
I can tell you that in our pilotstudy, there were several
patients who wanted both kneesdone at the same time, but, you
know, we believe in, going onestep at a time and making sure
(09:29):
that everything is shaping upthe way we want it to before we,
before we, jump to that.
Dr. Moira Gunn (09:34):
Welcome to science.
Sameer Sabir (09:36):
Yeah. Yeah. Absolutely.
Dr. Moira Gunn (09:38):
It's a journey. It's a journey. It's a journey.
Sometimes not everyone doesn'tget exactly what they wanted out
of it. Exactly.
But but at the end, if it allworks, they can get their other
knee done. So that's that is agood thing. Yeah. That is a very
good thing. How long is thistrial gonna take if you're for
an individual?
I mean, you've gotta get theseover 200 patients in and and all
(09:58):
of this. How long would a personparticipate?
Sameer Sabir (10:01):
Well, we have, we have 11 now, I think, wonderful
sites, across The US, who arestudy centers for us, and
enrollment is going quite well.We started the study at the end
of last year, we're hoping it'llbe fully enrolled actually by
the end of this year, whichmeans that we would then there's
a six month follow-up period, sowe follow the patients for six
months after the injections. Soour hope is that we can actually
(10:25):
go to the FDA for approval, bythe middle, or or a little bit
later next year in '26.
Dr. Moira Gunn (10:32):
So, there's a good chance there's gonna be
some place near you if there's11 sites across The US. Yes. How
does someone find out about thetrial and where they might be
able to participate?
Sameer Sabir (10:45):
Sure. The the trial, information is on
Brixton's website,BrixtonBio.com. It's called ICE
trial. And you can go to thewebsite and take a look at the
details and see if you may, beeligible. And if you are, please
reach out to one of the sitesthat are participating.
Dr. Moira Gunn (11:05):
Now will this only help knees?
Sameer Sabir (11:09):
No. So, we actually, founded the company
after we spun out from the labreally as a platform technology.
We can target nerves whereverthey may be in the body. I think
the way to think about NeuralICE, which is why it's so
interesting actually, is that,if you can identify the nerve
that's causing the pain, thenyou can target that pain using
(11:32):
Neural ICE. And so when westarted to look at really where
the need existed, where thebiggest burden on the system
exists, it really tends to be,within the musculoskeletal
system, and specifically theknee is a big contributor to
sort of the global health, theglobal burden when it comes to
pain.
And so we we settled on the kneefirst, but there are also other
(11:55):
joints that we're, interested inand starting to look at. So our
second indication that we'relooking at is lateral hip pain,
and we just very recentlystarted a pilot study in the hip
indication as well. And then thethird indication that we're
interested in is probably thethumb joint. So the thumb joint
is a very prevalent, problem,when it comes to osteoarthritis.
(12:19):
It affects women about twice asmuch as it affects men, and is
again, you think about usingyour hand and and and your thumb
if that's in severe pain, andthat really inhibits your
quality of life.
So We're trying to pickindications where there's a real
need, there's a lack of realsolutions, and also we can we
can demonstrate functionalimprovements in the patient.
Dr. Moira Gunn (12:39):
Well, Sameer, this has been terrific. I hope
you come back and and, see usagain and and bring us some some
new outcomes. What else we mighthave learned from all this? And
and good luck to you.
Sameer Sabir (12:50):
Thank you very much for having me, Moira. This
has been very cool. No punintended.
Dr. Moira Gunn (12:56):
Sameer Sabir is the CEO of Brixton Biosciences
in Cambridge, Massachusetts.More information about
BrixtonBio and about their ICEtrial is available on the web at
brixtonbio.com. At the time ofthis recording, US sites
conducting the ICE trialstudying injectable cold energy
(13:19):
therapy for the management ofchronic pain associated with
osteoarthritis of the knee arelocated in or near the San
Francisco Bay Area, Houston,Texas, Gainesville, Florida,
Atlanta, Georgia, Flint,Michigan, Pittsburgh,
Pennsylvania, Boston,Massachusetts, Washington, DC,
(13:41):
and several sites in Oklahoma.Recruitment is underway and
eligibility criteria for the ICEtrial can be found at
BrixtonBio.com.
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