March 24, 2025 • 43 mins
We love to hear from our listeners. Send us a message.
In this final installment of our episodes recorded and filmed on-site at the JP Morgan Healthcare Conference, Nima Farzan, CEO of Latigo Biotherapeutics, shares his company's mission to change the pain management paradigm by way of novel, non-opioid medications that target NAV 1.8 sodium channels involved in pain signal transmission. It's a timely and important conversation that explores how these selective inhibitors could provide effective pain relief without the addiction risks and side effects of traditional opioids. In addition to the social and medical implications of Latigo's work, we discuss investor perceptions about pain management as a commercial opportunity and how Latigo is differentiating from traditional approaches by focusing on safety and tolerability rather than just efficacy
The 2025 BoB@JPM series is supported by Alston & Bird, whose national health care and life sciences practice has more than 100 attorneys actively involved and integrated across the full spectrum of legal disciplines including regulatory, compliance, public policy, transactional, corporate governance, securities, FDA, biotechnology, intellectual property, government investigations, and litigation practice areas. Learn more at www.alston.com.
Access this and hundreds of episodes of the Business of Biotech videocast under the Business of Biotech tab at lifescienceleader.com.
Subscribe to our monthly Business of Biotech newsletter.
Get in touch with guest and topic suggestions: ben.comer@lifescienceleader.com
Find Ben Comer on LinkedIn: https://www.linkedin.com/in/bencomer/
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ben Comer (00:04):
Pain management has been overdue for an overhaul for
far too long.
Nima Farzan is keen to changethat paradigm.
I'm Ben Comer and I'm MattPillar, and this is the Business
of Biotech.
Jp Morgan 2025 Edition.
Matt Pillar (00:18):
We are here in San Francisco at the beautiful law
offices of Alston and Byrd, withNima, ceo at Latico
Biotherapeutics and one of themost enthusiastic CEOs.
I might add that we've known todiscuss his small biotech's
intent on taking a big primarycare problem in a biotech space
(00:41):
that's often focused on verysmall and expensive problems.
Thank you, nima, for joining us.
My pleasure, I'm excited to behere.
Nima Farzan (00:49):
We're excited to have you?
Matt Pillar (00:51):
You've spent five and a half years now leading
groups and marketing at Novartisbefore jumping into biotech and
venture capital.
So whenever you know, we oftenhave biotech execs on the show
who come from big pharma andjump into a biotech endeavor,
and I'm always curious about themotivation to do so.
So what was yours?
Nima Farzan (01:12):
Yeah, you know, I grew up in the Bay Area and so I
grew up at a time when you knowwho you looked up to were the
innovators in Silicon Valley andtech.
Both of my parents were in techand so I always wanted to be
actually on the more innovativesmall company side.
I actually did it beforebusiness school.
I was at a genomics company inthe early dot com boom time
(01:34):
frame.
I decided to go to businessschool and then realized, like
you know, for me to be trulysuccessful in this industry, I
need to learn.
It's a really complicated thing.
You've got to learn it, andwhat better place to learn it
than one of the biggest pharmacompanies that they know how to
do these things?
So I went to Novartis with theintention to learn the business,
learn drug development,Actually ended up loving it and
staying longer than I thought.
(01:55):
I thought it'd be a check thebox, couple of years come back,
and it was actually about sevenyears before I was like you know
I need to.
I want to get back to what I'vealways wanted to do, which is
something more entrepreneurial,something more innovative, and I
came out of the artist with,you know, I think, the
beginnings of understanding howto do drug development.
It's a lifelong process, but Igot the basics so that I could
(02:17):
go into biotech and apply that.
Matt Pillar (02:19):
Yeah.
Ben Comer (02:21):
How did your time at Foresight Capital prepare you
for the rigors of biotechbuilding?
Nima Farzan (02:29):
Yeah, I mean I spent a couple stints as an
executive resident at Foresightin between different CEO roles
and what I'll tell you is that.
It confirmed to me that I'm nota venture capitalist.
I like to build companies Right.
So it's funny when you, whenyou're sitting there and you're
seeing companies several a daycommon pitch and invariably your
(02:50):
reaction is like that's reallycool.
I'd love to like get in deep onthat and help build that,
figure that out and drive that.
But as a venture capitalist youknow onto the next and onto the
next.
So it was, it was great, youknow, to pull up and kind of see
the, the broader picture,what's going on in the industry,
see trends, but also justreconfirms that like what I want
to do is is build companies anddevelop drugs, um and and so uh
(03:12):
, you know it's a greatrelationship with foresight.
I've worked with them a coupletimes now.
They show me exciting things intheir portfolio.
Ben Comer (03:19):
When I get excited I jump in yeah, it probably helped
you improve your pitches too.
Nima Farzan (03:24):
Oh, for sure To see , you see how it's interpreted
on the back end, how it'sdiscussed on the back end what,
what resonates, what doesn'tthat it was very helpful.
Matt Pillar (03:33):
If any of your stints at Foresight overlapped
with Vic Bajaj's time there.
Yes, he's.
He was on the podcast pre JPMand not too long ago, just a few
weeks before we came to JPM, hewas a guest on the podcast.
Ben Comer (03:44):
Fascinating.
Matt Pillar (03:45):
He's a great guy, man, incredibly smart,
Incredibly smart, intimidatinglysmart, yeah yeah.
Nima Farzan (03:51):
So the last.
Matt Pillar (03:52):
We had the luxury of a conversation with you a
couple of weeks ago and one ofthe things that you've said that
is, you know, not necessarilyclairvoyant, but it's proving
true in the conversations thatI'm having with plenty of
founders, biotech founders andbuilders here at the show in all
sorts of modalities you saidthat you believe that we as an
(04:15):
industry are on the cusp of arenewal of drugs for the masses.
Yes, which?
you know, I mean, in the lastseveral years, Ben, we've been
covering this space and there'sbeen a ton, especially in the
ATMP arena.
There's been a ton of interestin, you know, ultra rare and
rare disease.
But even in those ATMP spaces,like at this show, I've had so
many conversations with folkswho are doing genetic therapies,
(04:37):
for instance, who want topursue big, big, giant
indications, which is awesome.
The indication you're workingin has a super big opportunity.
But getting back to the pointabout this being on the cusp of
an era of drug for the masses,what are the indicators for you?
What's indicating that for you?
Why do you say that?
Nima Farzan (04:58):
Why do I say that?
Well, I think a couple ofthings.
So I mean, things are a signalright, and for a long time rare
diseases were ignored becausepeople didn't think there was a
business model until a lot of it.
And then that became anopportunity.
People started investing theirsuccesses and there was more and
more in rare disease.
And at some point, the pendulumhas to swing back right.
We've now ignored R&Dinvestment in some of the larger
opportunities and you know,frankly, the obesity space and
(05:22):
some of the GOP ones havesuccesses in obesity that have
opened people's eyes to.
(05:46):
There really is still a lot ofunmet need in some of these
primary care segments.
Ben Comer (05:52):
Are there any incentives changing?
Because obviously part of thereason that there has been this
enormous focus on rare disease,aside from the unmet need which
we're acknowledging, is fastertime to market smaller trials,
sometimes better IP protectionFor the larger indication, more
expensive trials, primary caredrugs Are there any kind of the
(06:17):
dynamics that are shifting tohelp To help the group.
Nima Farzan (06:22):
I wish that were more true.
On the r&d side.
I think in pain there are somespecific things that are helpful
, um, but in general I don'tnecessarily can think of
something.
But what I will say is that someof the commercial incentives
are changing.
So if you think about what um,you know I I, as we talked about
when I was at novartis and Iwas looking primary care we had
(06:42):
thousands of reps sellinghypotensive drugs and now we've
gotten, you know, frankly, awayfrom those rep wars and you know
parallel lines and gottenbetter at using technology and
different ways to accessphysicians so that you can
actually commercialize primarycare drugs with.
You know a more reasonable,rational footprint, so that
(07:02):
helps in terms of the NPDanalysis, if you will.
On drug development side, youknow a more reasonable, rational
footprint, so that helps interms of the NPD analysis, if
you will.
On drug development side, youknow there's a lot of exciting
technologies.
I mean we can obviously talkabout AI and you know regulatory
innovation is important, butthose are still fairly nascent.
I mean it's still.
Ben Comer (07:19):
You're still having to do the safety studies and the
larger scale studies that youneed to do to access the primary
share market One strategy thatcompanies have used for years is
to go after a really raredisease first and get on the
market and then, of course,expand the indication later, go
for a larger population.
(07:40):
Is that something that couldhappen in pain?
Have you seen that kind ofstrategy?
Nima Farzan (07:49):
sure in in one very clear way.
It's exactly how it's playingout.
So it's not quite a super nicheindication of pain.
But acute pain versus chronic.
Okay, right, so acute painlet's talk about is primarily
post-surgical.
I've had a procedure, that's,my wisdom teeth taken out or
knee repair or something larger,uh, or it's some sort of severe
non-surgical pain.
I've sprained an ankle badly,I've thrown on my back or
(08:11):
something that doesn't.
It's not a niche indication butit is a much smaller indication
than chronic pain.
Osteoarthritis, like neuropathy, uh, you know, headache, muscle
, lower back pain, etc.
Um, but the big advantage ofacute pain relative to chronic
pain and the reason why it's afaster to market, it's a more
tenable development plan forsmall companies as well as large
(08:34):
companies is the duration oftreatment.
It's limited.
You know, typically when theFDA talks about acute pain it's
under 30 days and often actuallyyou're getting prescriptions
that maybe last two weeks and sowhen you're treating someone
for that duration of time, thereare a couple of things that
make the development that mucheasier, right?
So one clearly you don't have tohave long studies.
(08:56):
You can determine your endpointin a couple of days.
You know that's nice and infact our first endpoint that
you're going to look at is 15minutes.
You know like we want to seeonset of pain relief starting.
You know, ideally maybe not at15 minutes, but soon thereafter.
So you start looking at 15minutes.
So you know you're gettingimmediate help and because the
duration of treatment isn't thatlong.
(09:18):
the safety database you have tobuild for regulatory approval is
less Right.
You don't have to have long.
You don't have to haveyear-long studies with patients,
because treating them for thatkind of duration, so acute pain,
is where you would start as anoptician.
If you have a broad actinganalgesic, like we believe we do
, acute pain is where you startbecause that pathways faster
(09:40):
there and it is a more limitedmarket because these
prescriptions are two weeks,they're not lifelong
prescriptions because they havechronic pain right.
Matt Pillar (09:47):
So, uh, why?
Why pain?
That's a fundamental question.
We just kind of glossed rightover right.
Why did you want pain?
Yeah, why, why this company andwhy?
Nima Farzan (09:56):
pain.
Yeah, I mean, do you knowanyone who hasn't had pain?
Matt Pillar (10:01):
I'm in pain as we speak.
Exactly right, it touches allof us, right?
I mean we all.
It's almost, you know, notbecause of this.
Nima Farzan (10:06):
I'm in pain as we speak.
Exactly Right it touches all ofus right.
Matt Pillar (10:08):
I mean, it's almost , you know, Not because of this
conversation.
No, not physically.
It was here before we gottogether.
Nima Farzan (10:14):
That's good to know .
I mean, pain touches all of usand all been in pain at some
point of our lives or will be inpain at some point of our lives
, and we look at patients whoare dealing with chronic pain in
particular.
It is debilitating.
It's very hard to focus, tofunction and to operate in life.
(10:35):
So you know, I look back on mycareer and I've worked.
You know the biotechs that I'verun since my time in the bar.
One was in infectious diseaseand vaccines, one was in
precision oncology and what Iliked about vaccines was this
ability to impact a lot ofpeople.
Vaccines are something thatmany people can take but the
tangible benefit of that vaccineis not obvious to the patient.
I mean, if it works, they neverget the disease and never think
(10:57):
about it again.
You didn't actually.
You don't get that directimpact.
It's a theoretical impact.
You've made and you kind ofhave to calculate it on many
thousands of people taking yourvaccine, on many thousands of
people taking your vaccine.
Ben Comer (11:07):
So when I transitioned to the oncology
side.
Nima Farzan (11:10):
We're talking about patients with stage four
terminal cancer that have runout of all other options.
Many of them have diagnosedweak slant and if your drug can
reverse that, tumor growth haveregression and you can add
months or years to thatpatient's life, I mean that's an
amazing, amazing impact thatyou can have immediately on
years to that patient's life.
I mean that's an amazing,amazing impact that you can have
immediately on someone who hasno other options.
(11:31):
But the fundamentals of thatbusiness are very rare types of
cancer that we were doing andthe whole concept precision is
very genetically specificpatient populations that might
occur in 1% of the tumor typeand if that patient had that
mutation we have a drug for them.
So it's really small numbers ofpatients you're impacting.
Pain gave me the opportunity todo both, to have something that
(11:54):
impacts everyone but it alsohas a meaningful, tangible
benefit to their livesimmediately.
And I say that but we talkedabout within 15 minutes, 30
minutes or one hour that you canhelp alleviate pain.
And you know it doesn't takeliving in San Francisco to know
(12:14):
that the opioid crisis has beena huge societal challenge and
the problem in pain is not alack of efficacy from the drugs
we have.
Ben Comer (12:28):
We can completely eliminate your pain if you're
willing to take enough morphine.
Nima Farzan (12:30):
That's not the problem.
The problem is, can you developdrugs to have that pain relief
that are safe and tolerant?
And what Labigo is working onhas that opportunity and really
can create.
Not just have a health impact,like we've been talking about,
but a positive socioeconomic,sociopolitical impact by helping
eliminate, most likely reduce,the use of opioids.
Matt Pillar (12:55):
How is that proposition being received by an
investment community that hasbeen enamored of late with ATMPs
and super sexy fancy stuff?
Ben Comer (13:08):
Not that yours isn't right, but it's definitely a
world away from you.
Matt Pillar (13:14):
Know gene therapies , it is, and for some.
Nima Farzan (13:17):
I will say you know we've had success and there's
definitely been investors whoare, you know, very strong, bold
, lucid supporters of this, andyou know you can just you
understand intuitively andimmediately the patient need
here and the rationale, butthat's.
But there are definitelyinvestors who are used to saying
well, you know they're genericdrugs.
(13:37):
I need generic opioids anddon't you have to have I see
substantially better than thegeneric to get used.
You don't, because people don'twant to take an opioid.
Patients don't want to takeopioids.
Physicians don't want to takean opioid.
Patients don't want to takeopioids.
Physicians don't want toprescribe opioids.
There's a lot of bureaucracyassociated with tracking how
many opioid prescriptions youhave relative to the number of
patients you're seeing, andreporting that you have to do
state by state level.
(13:57):
Governments don't wantprescribers prescribing opioids.
They want to limit it.
They're creating incentives tomove away from it and
restrictions from going to it.
So it is a little bit of adifferent mindset.
This thing I talked about,which is, you know, the efficacy
in pain, is not the unmet need,it's the safety and
tolerability.
It's not how investors are usedto thinking.
(14:18):
They're used to thinking aboutlike how are we more efficacious
than the generic so that you'llget reimbursed?
And this is a differentsocietal issue.
Matt Pillar (14:25):
I'd say most get it but definitely some need some
discussions around that.
Does that societal impact, thatmore global, broad societal
impact, open up for you perhapsa new pocket or a different
pocket of potential investmentthan traditional biotech pharma
(14:45):
investors?
Nima Farzan (14:45):
Yeah, I mean it has .
Here's what I would say we havestuck to the more traditional
investors.
Now, there are certainlynon-traditional investors that
we can go to, but within thetraditional investors there are
some that are a little moremachine-driven and we have found
that those do correlate in thatrespect, and I do think that
there are some of our investorsthat look at that and say there
(15:11):
are benefits here that we wantto get part of.
Matt Pillar (15:13):
Yeah, pain is, you know, famously hard to uh
measure objectively.
Yes, you know you, if you're inpain you know, and you're you
know often.
Ben Comer (15:18):
You know how much pain you're in is, you know
which face you point to.
You know, on the pain chart, doyou feel that there's a need
for, or maybe there are already,some new kinds of scales or
other types of objectivemeasures to assess different
types of pain.
Have you worked on that at all?
Nima Farzan (15:37):
Yeah, so there are a couple of things a couple of
ways I'd answer that there arestudies that you can run that
are going to be a little moreobjective or functional, so I'll
mention studies that are calledcompressor studies, right?
And so what this type of studyis is, you ask in this case it
would be a volunteer.
Put their hand in a bucket ofice water that's one degree
(15:59):
Celsius, see how long they cankeep it in there.
Measure that as a baselinescore.
Give them a randomized eitherplacebo or drug and ask them to
do it again and see how muchlonger they can keep their hand
in that water.
That's the same level of painstimulus.
Bucket of water at one degree.
Same person how much differencedoes the drug versus placebo
make on their ability totolerate that?
(16:20):
You can measure that in secondsor percentage increase.
That's more quantitative thanthan a scale, right?
That's really a valuable toolfor us.
It's not a pivotal study.
The FDA is not going to let youget your label based on that,
you're still going to have to gointo post-surgical pain or
others, but it's a very valuableway to objectively test your
drugs early on, and those arestudies that we've done.
(16:42):
The other thing I would say,which is less about endpoints
but protocol design to managethis issue, and there are things
you can do, and you would dothis more in chronic pain
studies than you would in acute.
But you can decide whichpatients you want to enroll in
your study based on you did do asort of rolling screening
(17:05):
period with patient diaries thatthey record their pain prior to
entering your study and youlook for patients that are good
pain responders, meaning theyactually do understand.
It's not everyone can maybeconceptualize that pain and
report it out.
So do I consistently reportscores?
Is there some variability?
Because if I say my pain is a 5, 5, 5, 5 every day, that's
(17:27):
probably not.
I'm probably not a good painreporter.
Matt Pillar (17:30):
If I say 1, 10,.
Ben Comer (17:31):
1, 10,.
Nima Farzan (17:32):
I'm probably not a good pain reporter.
So you want a little bit ofvariability, not too much, and
we consider those patients goodpain responders and those are
ones that maybe will give you alittle bit better answer in your
studies.
Ben Comer (17:42):
And you are doing those kinds of studies as well.
Nima Farzan (17:44):
Yeah.
Matt Pillar (17:50):
While you're on the studies subject, where are give
us an update on on where thestudies are right now.
Nima Farzan (17:52):
Yeah, we have a couple compounds that are in the
clinic right now.
Uh, our first program is inphase two for acute pain, you're
not.
So this is the development wetalked about.
We're in post-surgical pain, uh, we're currently running that
study.
Uh, and we're doing that in awisdom teeth extraction
post-surgical pain patientpopulation.
Our second drug that we intendto develop for chronic pain is
(18:14):
currently in phase one.
Matt Pillar (18:17):
My dentist growing up had a sign on the office door
that said modern dentistry ispainless.
So I'm not sure you know.
I mean when I had the wisdomteeth taken out.
I proved that theory wrong, ofcourse, so yeah, yeah, yeah, so
yeah.
Yeah, yeah.
So what are?
Nima Farzan (18:30):
the next steps then .
So the next steps after that onthe acute side, you move into
pivotal studies and pivotalstudies from a regulatory
pathway.
The agency would like to seeone post-surgical study in
patients who have had softtissue surgery and one efficacy
study in patients who've hadsoft tissue surgery and one
efficacy study in patientswho've had hard tissue surgery
(18:52):
or bony tissue.
So, typically, where we'veevolved to you know, different
models have been used over time,but today most people will do
abdominoplasty and bunionectomyas the soft tissue and hard
tissue studies.
So you go to patients havingthose surgeons and need to run
the studies in that and that isthe efficacy studies you need to
run for an acute indication,chronic, you have a lot more
(19:12):
options.
There's a lot of differenttypes of chronic pain and you
know roughly I bucket it asneuropathic pain or
musculoskeletal pain and ourfocus is going to be in the
musculoskeletal side inparticular where we started with
osteoarthritis.
Ben Comer (19:27):
I think everyone recognizes the unmet need for
new pain medications,non-opioids, Even regulators.
Matt Pillar (19:35):
I think would recognize that.
Ben Comer (19:38):
Do you anticipate any sort of accelerated regulatory
pathway breakthrough designation, anything like that?
Nima Farzan (19:47):
I would hope that and believe that the agency will
work with us in a number ofparameters, given the unmet need
.
I think it's too soon tospeculate on whether he would
have breakthrough designationsspecifically, but you know I
will say that to date in ourinteractions with the FDA
they've been very forthcoming inproviding good guidance for us
(20:09):
with the FDA.
They've been very forthcomingin providing good guidance for
us.
I do think the FDA wants to seehypnotic and fluid pain drugs
developed and so they've beenvery forthcoming.
Matt Pillar (20:17):
Our friends at Alston and Byrd set us up with
some amazing space to recordduring JPM week.
The firm's national healthcareand life sciences practice has
more than 100 attorneys activelyinvolved in the healthcare
(20:41):
industry across the fullspectrum of legal disciplines
compliance, public policy,transactional corporate
governance, securities, fda,biotech, ip, government
investigations and litigationpractice areas.
Alston Byrd represents lifesciences companies and their
(21:04):
partners in corporate stagesranging from private to newly
public to well-estab, and in avariety of stages of product
development, from preclinical topost-approval commercial launch
.
Learn more at alstoncom andtell them you learned about them
.
On the Business of Biotech,give us a sense for Latigo's, I
(21:26):
guess growth and I use the termlike like shape shifting as a as
a biotech moves from R&D into aclinical stage, into a
potentially manufacturingenvironment.
You know where are you now?
Yeah, on that.
And sort of what have you?
(21:47):
What have you had to growthrough in your time?
Nima Farzan (21:51):
there.
No, I mean, this is what I lovetalking about, because this is
what I've done the last fewtimes and this is where I I
think I can bring expertise tobears.
How do you transition from adiscovery company to a discovery
and development company andeven to a late stage chivalric
company, early stage commercialcompany?
I think that's kind of my sweetspot in you know who had been
in my career.
Matt Pillar (22:10):
I'm glad I asked.
Nima Farzan (22:14):
So I think you know , when I came in about six
months ago, the company hadprimarily a discovery team in
place, very strong discoveryteam that developed multiple
compounds that we're now takinginto the clinic.
But we're literally in the veryinitial stages of building
development capabilities.
So my focus has been primarilyon scaling development.
(22:35):
So when we say development,obviously that's clinical
development, it's clinicaloperations, it's biometrics,
it's regulatory, it is DMPK,clinpharm, these kind of
functions and capabilities,especially as you go beyond a
phase one study and you need tostart thinking about full
development program.
So that's been the people,growth on the organization that
(22:56):
always has this interestingtension in biotech, because, you
know, discovery will have beenfront and center for this case.
Five years, five years,bradwell and we've been around
and now they start to see thegrowth and development elsewhere
and what you have to do is makesure you're spending time
letting discovery team know thatthat's still a huge source of
value today and in the futureand maintaining excitement and
(23:19):
motivation there while most ofthe growth is happening on the
development side, yeah, and asfar as that development side,
growth, is concerned, what's itbeen like in your experience
gearing up, staffing up Like?
Matt Pillar (23:35):
have there been particular challenges to that?
Nima Farzan (23:38):
I, you know, I've been really lucky in the sense
that I think Lattigo is verywell positioned for everything
we've talked about and theexcitement around this class,
that we've been able to attractgreat talent.
I know that's not always thecase and I will say that you
know we're trying to bring in amix of people with pain
experience and not Right, andthere isn't the depth of um, you
(24:02):
know, companies working in painto have a whole sort of people,
you know a whole set of talentthat have experience in pain not
many companies to snipe from.
Matt Pillar (24:10):
Is that what?
Nima Farzan (24:10):
you're saying exactly right, there's not as
many um, but it's also lesscompetition.
You know, because, like I meanfrom oncology, for example, like
you know, if you're an mdclinical oncology experience,
you know you're gonna have 10offers um and uh.
So we've been, I think, lucky inbeing able to attract people
who have pain expertise acrossdifferent functions, even
(24:34):
bioethics and the like.
But then I've also beencognizant about mixing in some
people with capabilities inother therapeutic areas to
augment this right.
Because, as we think about thedevelopment and what's been
interesting is a lot of peoplewill say, well, okay, you're in
pain, so you've got to go getCNS people.
That's, you know, like thetherapeutic area we kind of fall
(24:57):
under.
But the answer is we'reactually not a cns company we're
a science company, but.
Ben Comer (25:02):
But.
Nima Farzan (25:02):
But you know, it's a very different experience from
um if you've been working ondegenerative disease, spark
concerns, dementia etc.
Um, actually, what I kind ofwant are people who've had more
primary care.
You know drug developmentexperience right and really
understand the drug, druginteraction work, the clinical
(25:23):
pharmacology work.
You know the scale up on themanufacturing side et cetera
that we need for the kind ofbusiness.
Matt Pillar (25:30):
Yeah.
Ben Comer (25:33):
Tell us about LTG 101 , and you know it works.
Maybe at a high level, sure.
Nima Farzan (25:42):
So LTG-101 is a NAV 1.8 inhibitor.
It's a small molecule, oralcompound and it inhibits very
selectively and potently NAV 1.8.
So what is NAV 1.8?
Why is that matter of opinion?
Nav 1.8, in this case NAVsodium voltage channel 1.8.
There, that you know, matter ofpain.
Uh, now 1.8, in this case navsodium voltage channel 1.8.
There are uh, nine of thesechannels.
Um, we're targeting 1.8 veryselectively.
(26:02):
That's important because othernav channels play other
important roles in the body thatyou don't want to interfere.
But now 1.8 is exclusivelyreserved by the body for the use
of propagating the pain signalfrom the periphery back to the
world.
And so whatever that painsignal may be that could be an
inflammatory brain signal, likefrom prostaglandins or cytokines
, it could be nociceptive, frompressure, heat, cold, it could
(26:26):
be neuropathic, from glucosedamage to the nerves All those
signals, that action potential,that electrical firing, is
carried through thissodium-molded channel that helps
propagate that signal back tothe brain.
So inhibiting that channel canreduce the perception of pain
that's coming from the peripheryback to the brain.
(26:47):
And if you do that selectively,without hitting other sodium
channels that play importantroles in the body, like 1-1, 1-5
, 1-7, then you can have a verysafe and fast danger.
Ben Comer (26:59):
Is there a danger, then, of the old hand on the
stove and not feeling it?
Matt Pillar (27:05):
There's the frog in the boiling pot.
No.
Nima Farzan (27:11):
For a couple reasons.
Matt Pillar (27:12):
One is you thought maybe you caught Neiman on that
that like wait a minute I'll betyou didn't think about that?
No, I know we thought aboutyeah, no, I'm curious about why,
right like I would have askedthe same question.
Yeah, yeah, you first of allthis is more.
Nima Farzan (27:32):
I'm gonna blunt the pain, that you're going to
completely not feel pain, um,and you still have senses.
You still can feel heat, youcan feel cold, um, and so it
does block pain effectively,does not eliminate all pain.
You're not going to walk around, you know, grab your hand on
that.
So there are no.
You got your hands on um and,frankly, if we ever got to a
(27:55):
level of analgesia that was thatmuch of it Probably pretty
stiff, you know, and not providethat.
Matt Pillar (28:02):
So good, yeah.
Yeah.
I remarked the first time wetalked a couple weeks ago that
your disposition is likeuncommonly cheery and pleasant,
I mean this is a tough businessthat we're in.
I mean, you're working in amarket that has, as you
mentioned, big socialimplications.
That, can you know, if youthink about it long and hard,
(28:23):
could bring you down right, likethinking about the opioid
epidemic, for instance.
I'm just curious a totallypersonal question but how do you
maintain this disposition?
Nima Farzan (28:36):
I mean, I think I have it naturally.
I think I I'm surprised thatanyone can be a biotech ceo and
not be naively optimistic allthe time, because we enter a
business where things fail 90 ofthe time.
Ben Comer (28:46):
Well, I know you don't think that this one's
gonna work.
Matt Pillar (28:48):
I believe like you gotta be optimistic right yeah,
yeah, but I mean that could becausing, I mean that stress.
Right, the acceptance of thatrisk could be cause for, you
know, for concern enough tobring a guy down.
Nima Farzan (29:01):
Well, it is the hardest part of the job.
I had this conversation with acolleague last night who's
thinking about transitioning toa senior role and you know,
obviously you have to have somelevel of technical capabilities
and you know intelligence andbackground in joint development.
So let's check the box things,um.
And then we talked a lot aboutthe energy you need to be a ceo,
(29:23):
right, that's?
That's, I think, clear.
I think most people would saylike you just gotta have energy,
you gotta have passion, and andthe thing that I raise is like
here's the last part.
That is hard is the emotionalroller coaster component.
And this is a business likemany businesses, but we have
this binary outcomes where thedata is revealed or you know,
and there's going to be ups andthere's going to be downs, and
(29:45):
you know I will tell you,whatever what it's been almost
10 years as a CEO in differenttimes you don't get better at
riding that rollercoaster.
It's still euphoric when it'shigh and crushing when it's low.
And I think I've gotten betterat all the other aspects of the
job over time as you learnexperience, but I haven't been
(30:07):
able to get better at that andyou just have to ride the
rollercoaster and then you knowto manage this on home.
Sometimes it is.
Ben Comer (30:19):
We talked about LTG 101.
What could you tell us about, Iguess, your pipeline beyond?
That, such as it is, and anysort of plans to add additional
campaigns.
Nima Farzan (30:29):
Yeah, so we have a second compound in the clinic
305.
That's the one we're developingfor chronic.
The characteristics of the drugthe first compound is twice
daily.
The second compound is oncedaily.
That makes more sense for ahuman patient Actually acute
pain sometimes twice dailydosing is actually an advantage.
(30:50):
Patients will tend to take thedrug whenever they want.
So you want to have quick onsetor offset, so that they're not
taking a one-stage drug multipletimes.
But in chronic pain you reallywould rather have one day a day
dosing.
So that's the second compoundthat's in the clinic, that's the
one that's in phase one, thatwill start arthritis studies
later this year.
We have a third NAV18 inhibitorthat we're intending to bring
(31:13):
into the clinic.
What's exciting about that onefor us is that it has the
potential to have a really lowdose, which gives you the
opportunity to develop differentformulations.
And if you think about paindrugs that you would get in OTC
the opportunity to have a patchor a spray or something like
that could be really interesting.
To do that you have to have avery low-matter drug, and so
(31:35):
that's the opportunity of thethird.
The third time we are continuingto work on other pain targets.
I think we're very excitedabout that.
One is your.
We've doubled down triple downif in it, as you will.
But we are also working onother pain targets.
We're looking at one calledasic, which is acid sensing ion
channel, which is triggered whenyou have acid driven pain, and
there are obviously certaintypes of pain, like ischemic
(31:57):
pain, that is, cancer pain, thatis specifically often
acid-driven but also can be acidand now in hatred.
So you got combinations as wellto better block pain.
Ben Comer (32:10):
For those different delivery mechanisms that you
mentioned.
Would you, is that somethingyou would work on in-house?
Would you partner for thosekinds of yeah?
Nima Farzan (32:19):
that's a great question.
I mean, I think those arethings that we're still thinking
through.
I think you could probablythink about some early proof of
concept work that you could do,demonstrating bioavailability or
the like, or technicalfeasibility.
But yes, ultimately those areprobably benefit from having
partners.
Matt Pillar (32:38):
What have you been doing here at JPM during JPM
week, like what's been theagenda?
Nima Farzan (32:44):
Getting steps in.
Well, I mean, yeah, that'shappening regardless.
Matt Pillar (32:48):
right, it just comes yeah.
Nima Farzan (32:50):
Yeah, you know our focus.
This is a great conference.
I live in San Francisco so it'salways fun for me.
I can pop over and go home whenI need to.
Can I sleep in your own bed?
Ben Comer (33:01):
I have a hypothesis that JP Morgan Week is the week
that there are the most peoplein suits in San Francisco on the
street, is that?
Accurate.
Can you verify?
Nima Farzan (33:11):
that I can verify that in three days here you will
see more people in suits andyou will see in 362 days, put
together over 10 years, the restof it.
Ben Comer (33:20):
Okay, 10 years, wow, yeah, I mean 100%, I mean.
Nima Farzan (33:27):
I will also say that over the years I've been
coming to JP Morgan it's gottenmore casual.
Ben Comer (33:33):
So I've noticed that too.
Nima Farzan (33:34):
Student tie right and now we moved a few years
back to, like we didn't want tohave to wear ties, and now a lot
of people wear sneakers, andthis year I saw a lot of people
not even wearing suits, you know, jacket, blazers and sneakers.
So that's definitely the trend,yeah.
Matt Pillar (33:49):
But I, like, actually felt guilty about not
wearing a tie today.
I wore a tie the last two daysand I today we're tied the last
two days and I noticed to yourpoint that I was one of the few
guys who ties off Ben's holdingout.
Ben Comer (34:01):
I've been going back and forth a little bit.
I'm not really sure which oneis the right view.
I cut you off on JP Morgan.
Nima Farzan (34:10):
Great conference for a couple reasons.
One clearly the world'sinvestment community is here.
It's a good conference formeeting for investors, but
honestly, there are otherconferences where you have
access to investors and prettyregular cadence of those.
This is one of the fewconferences where you can access
strategics and not justbusiness development teams but
(34:32):
senior executives, and so that'sreally unique about this, and
so the opportunity certainly tohave conversations with
strategic is a focus and needfor this week.
Matt Pillar (34:44):
Are those senior executives generally?
I mean, that's the expectationof them while they're here, and
how do you access them?
Nima Farzan (34:53):
You know it is.
Certainly the thing with thesenior executives here in pharma
is that they kind of have amillion options to pick from and
they'll kind of go with whatstrikes their fancy right.
And you can try to work withyour colleagues in the business
development team and see ifthere's enough excitement to get
a C-suite executive to pop intoyour meeting.
Sometimes they do come,sometimes they don't come.
Um, you know, I think it'd befun to be a pharmacist.
(35:15):
I can just be like looking at acalorie every day Like I want to
get that one, that one, thatone half of this one, you know,
but that's that's kind of how itworks.
It is still speed dating, butit's it's still a unique kind of
access.
Ben Comer (35:27):
Yeah, yeah, I mean, interest in certain therapeutic
areas swings back and forth.
You know, different thingsbecome hot, different things
aren't.
Or you know, when there was alot of reporting on opioid
deaths and the CDC changed itsguidance there, I think there
was a huge focus on non-opioidpain medications and a
(35:49):
recognition of the need for them.
Do you have a sense that thatsentiment still exists and is
still just as strong?
Has it decreased?
Has it increased?
Nima Farzan (36:01):
Yeah it's a great point because I mean we're
seeing a national decrease inthe number of opioid deaths,
right, certainly locally andnationally, and a lot of people
are, you know asserting thatit's related to these efforts to
reduce opioid prescriptions,and so we can look at it one of
two ways.
One is like you know, phew, it'sgetting better, we don't have
(36:22):
to focus on it, or no, whatwe've been doing has actually
worked, and we should keepdoubling down and pushing up,
because it's not like opioiddeaths have gone.
I mean, they're down maybe 20%from last year.
Yeah, they haven't disappeared,but they haven't disappeared,
it's still many, but theyhaven't disappeared so many X,
what they were 10 or 15, 20years ago.
So I think, that the latter iswhere I'm hopeful and I believe
it is which is theseinterventions that we've been
(36:43):
putting in place are starting towork.
Let's continue and continue todouble down, and we're seeing
that snowballing in.
You know, dependency, opioiddependency, translating to you
know a lot of the society levelsthat we see related to that.
(37:04):
as other non-opioid painmedicines become available, I
think they'll become evengreater incentive to be like
look, it's been working already,now we have even more
therapeutic options.
We should be even stricterabout letting opioids be used.
Why should we have, why shouldit even be allowed to have
opioids be prescribed for lowrisk surgical procedure?
Why should we send an 18 to 20year old child, young adult,
(37:27):
back to their college dorm witha bunch of opioids after wisdom
teeth extraction?
We probably shouldn't let thathappen.
Ben Comer (37:34):
Yeah, and I would imagine payers that would think
about it the same way.
Right, and when more therapiesbecome available, I would think
you know that there would be apretty strong push to prevent
people from getting hooked to anopioid because it's costly.
It's costly.
Nima Farzan (37:50):
And you know it's really easy to focus on and we
should on the dependencecomponent of opioids.
But there are other issues withopioids, right.
So obviously there is thenausea and constipation that
they're well known for, but alsojust you know, intuitively, the
CNS, the somnolence, the, youknow, the being out of it, right
, and the impact that has.
So one of the anecdotes that Iwas hearing is how surgeons are
(38:14):
really, you know, lookingforward to a non-opioid, an
additional non-opioid to add tothe mix, to reduce opioid use.
Because if you think about howthey're measured, it's often
30-day mortality, morbidity,post-surgery, and if the surgery
goes great but you give someonean opioid, especially someone
more elderly, and they're out ofit and they have a fall, that's
(38:34):
actually one of the things thatbrings people back into the
hospital and that counts againstyour mortality, morbidity, on
that operation.
Ben Comer (38:40):
So there are a lot of concerns with opioids.
Nima Farzan (38:44):
The dependence is the obvious one, but even if you
don't become dependent, you'renot very functional yeah.
Matt Pillar (38:54):
Yeah, and are you finding that that sort of the
nuance of that story is beingwell received as well?
Nima Farzan (39:00):
Yeah.
Matt Pillar (39:01):
Is it just a big story that resonates?
Nima Farzan (39:03):
It's that, yeah, you know that.
I'd say that we're findinggreater traction on the nuance
of the story as people start tobe like, no, actually, maybe
this is a real opportunity.
But there are still a lot ofpeople who will say, like, it's
not about opioid replacement,they're generic.
The acute market's small.
Who cares about these things?
It'll be whether you develop a,you know, a big neuropathic or
(39:24):
musculoskeletal problem.
But I think this opportunity toreplace opioids for all these
scenarios you're talking aboutis yeah.
Ben Comer (39:33):
Yeah, well, I mean, the cost of generic opioids, I
think has been one of thechallenges to overcome for for
alternatives, right, I mean, howdo you?
You have to develop a medicinethat is not so so much more
expensive that you know aninsurance company, for example,
is you know may end up choosingan opioid over over your new
(39:54):
drug.
Nima Farzan (39:55):
It's not going to potentially get someone addicted
and put them into a fog andcause them to fall and all sorts
of other things.
That's right.
I mean, look, you can make allthose arguments that we just
made about that.
You can have regulatory andgovernment policy pressures to
not let people just take theeasy way out with the cheaper
drug that has all these effects.
And you can also think aboutthe big picture.
(40:16):
If I walked, walked in, youknow for most procedures the
range of cost.
You know it's a $10,000,$15,000, $20,000, maybe $30,000
procedure and then for the costof a $30 to $40 a day drug for a
week you're going to put themon an opioid.
Matt Pillar (40:37):
You know, in the context of the surgery.
It's a very small percentage ofwhat they expect you know, uh,
we got a pretty good lay of theclinical land for.
Let it go.
Uh, let's go post show nextweek.
You're back in the office, nextsteps, big thing you're working
on like what's on your agenda.
Yeah, sleep Same yes.
Nima Farzan (41:03):
Same.
Matt Pillar (41:06):
But no, but seriously Take a few non-opioid
analgesics, that's right, right,I think a couple of things.
Nima Farzan (41:11):
So one is you know, the engagement you have with
investors and strategics at ameeting like this is a two-way
street.
So one obviously we're tellingour story, but we're hearing
feedback about like here's howwe would do things.
Here's how we think about things.
So I can just debrief with myteam at London today and we have
four or five things we want toexplore in some detail about.
How should we look at thatpotential indication?
(41:34):
What would a proof of conceptlook like in that idea?
What kind of study can we run?
How do we want to think aboutthis timing of the study?
So there's some of theseconcrete things, and actually it
can be draining as a CEO to beconstantly doing the pitch, but
you can get feedback back.
That's useful and in an eventlike this you do.
(41:54):
So there are a few things thatwe want to explore.
So that's the kind of uniquething coming out of the
conference.
The other thing, of course, is,between the holidays and JP
Morgan, just getting back intogood operational planning,
tracking our objectives andbeing back in the flow of the
operations Also same.
Matt Pillar (42:14):
Yeah, yeah, yeah, we find ourselves just rolling
right out of the holidays.
Also same, yeah, yeah, yeah, wefind it.
We find ourselves just comerolling right out of the
holidays into jpm.
Then we get back and it's like,okay, let's let's get grounded.
Let's get grounded, yeah, yeah.
Well, that's uh, that's aboutall the time we have for today,
but there's so much more to talkabout.
We'd love to have you back onthe show at some point, um, to
talk about what's going on thereand clinical progress.
(42:36):
I appreciate you taking timeout of your super busy schedule
to spend with us.
This has been great.
I enjoyed it.
Yeah, so if we Thank you, thankyou.
So that's Latigo TherapeuticsCEO, nima Fawzan.
I'm Matt Piller, and I'm Dave.
Bummer and you just listened tothe business of biotech from JPM
2025.
Also from the beautiful lawoffices of Alston and Beard.
(42:58):
Thank you to Alston and Beardfor hosting us this week.
Listen and subscribe.
Wherever you listen to podcasts, Make sure you take in our
video casts under the Listen andWatch tab at Bioprocess Online
or under the Business of Biotechtab that is on
lifescienceleadercom.
We drop every Monday, so we'llsee you next week and thanks for
listening.
Pain management has been overdue for an overhaul for
far too long.
Nima Farzan is keen to changethat paradigm.
I'm Ben Comer and I'm MattPillar, and this is the Business
of Biotech.
Jp Morgan 2025 Edition.
Matt Pillar (00:18):
We are here in San Francisco at the beautiful law
offices of Alston and Byrd, withNima, ceo at Latico
Biotherapeutics and one of themost enthusiastic CEOs.
I might add that we've known todiscuss his small biotech's
intent on taking a big primarycare problem in a biotech space
(00:41):
that's often focused on verysmall and expensive problems.
Thank you, nima, for joining us.
My pleasure, I'm excited to behere.
Nima Farzan (00:49):
We're excited to have you?
Matt Pillar (00:51):
You've spent five and a half years now leading
groups and marketing at Novartisbefore jumping into biotech and
venture capital.
So whenever you know, we oftenhave biotech execs on the show
who come from big pharma andjump into a biotech endeavor,
and I'm always curious about themotivation to do so.
So what was yours?
Nima Farzan (01:12):
Yeah, you know, I grew up in the Bay Area and so I
grew up at a time when you knowwho you looked up to were the
innovators in Silicon Valley andtech.
Both of my parents were in techand so I always wanted to be
actually on the more innovativesmall company side.
I actually did it beforebusiness school.
I was at a genomics company inthe early dot com boom time
(01:34):
frame.
I decided to go to businessschool and then realized, like
you know, for me to be trulysuccessful in this industry, I
need to learn.
It's a really complicated thing.
You've got to learn it, andwhat better place to learn it
than one of the biggest pharmacompanies that they know how to
do these things?
So I went to Novartis with theintention to learn the business,
learn drug development,Actually ended up loving it and
staying longer than I thought.
(01:55):
I thought it'd be a check thebox, couple of years come back,
and it was actually about sevenyears before I was like you know
I need to.
I want to get back to what I'vealways wanted to do, which is
something more entrepreneurial,something more innovative, and I
came out of the artist with,you know, I think, the
beginnings of understanding howto do drug development.
It's a lifelong process, but Igot the basics so that I could
(02:17):
go into biotech and apply that.
Matt Pillar (02:19):
Yeah.
Ben Comer (02:21):
How did your time at Foresight Capital prepare you
for the rigors of biotechbuilding?
Nima Farzan (02:29):
Yeah, I mean I spent a couple stints as an
executive resident at Foresightin between different CEO roles
and what I'll tell you is that.
It confirmed to me that I'm nota venture capitalist.
I like to build companies Right.
So it's funny when you, whenyou're sitting there and you're
seeing companies several a daycommon pitch and invariably your
(02:50):
reaction is like that's reallycool.
I'd love to like get in deep onthat and help build that,
figure that out and drive that.
But as a venture capitalist youknow onto the next and onto the
next.
So it was, it was great, youknow, to pull up and kind of see
the, the broader picture,what's going on in the industry,
see trends, but also justreconfirms that like what I want
to do is is build companies anddevelop drugs, um and and so uh
(03:12):
, you know it's a greatrelationship with foresight.
I've worked with them a coupletimes now.
They show me exciting things intheir portfolio.
Ben Comer (03:19):
When I get excited I jump in yeah, it probably helped
you improve your pitches too.
Nima Farzan (03:24):
Oh, for sure To see , you see how it's interpreted
on the back end, how it'sdiscussed on the back end what,
what resonates, what doesn'tthat it was very helpful.
Matt Pillar (03:33):
If any of your stints at Foresight overlapped
with Vic Bajaj's time there.
Yes, he's.
He was on the podcast pre JPMand not too long ago, just a few
weeks before we came to JPM, hewas a guest on the podcast.
Ben Comer (03:44):
Fascinating.
Matt Pillar (03:45):
He's a great guy, man, incredibly smart,
Incredibly smart, intimidatinglysmart, yeah yeah.
Nima Farzan (03:51):
So the last.
Matt Pillar (03:52):
We had the luxury of a conversation with you a
couple of weeks ago and one ofthe things that you've said that
is, you know, not necessarilyclairvoyant, but it's proving
true in the conversations thatI'm having with plenty of
founders, biotech founders andbuilders here at the show in all
sorts of modalities you saidthat you believe that we as an
(04:15):
industry are on the cusp of arenewal of drugs for the masses.
Yes, which?
you know, I mean, in the lastseveral years, Ben, we've been
covering this space and there'sbeen a ton, especially in the
ATMP arena.
There's been a ton of interestin, you know, ultra rare and
rare disease.
But even in those ATMP spaces,like at this show, I've had so
many conversations with folkswho are doing genetic therapies,
(04:37):
for instance, who want topursue big, big, giant
indications, which is awesome.
The indication you're workingin has a super big opportunity.
But getting back to the pointabout this being on the cusp of
an era of drug for the masses,what are the indicators for you?
What's indicating that for you?
Why do you say that?
Nima Farzan (04:58):
Why do I say that?
Well, I think a couple ofthings.
So I mean, things are a signalright, and for a long time rare
diseases were ignored becausepeople didn't think there was a
business model until a lot of it.
And then that became anopportunity.
People started investing theirsuccesses and there was more and
more in rare disease.
And at some point, the pendulumhas to swing back right.
We've now ignored R&Dinvestment in some of the larger
opportunities and you know,frankly, the obesity space and
(05:22):
some of the GOP ones havesuccesses in obesity that have
opened people's eyes to.
(05:46):
There really is still a lot ofunmet need in some of these
primary care segments.
Ben Comer (05:52):
Are there any incentives changing?
Because obviously part of thereason that there has been this
enormous focus on rare disease,aside from the unmet need which
we're acknowledging, is fastertime to market smaller trials,
sometimes better IP protectionFor the larger indication, more
expensive trials, primary caredrugs Are there any kind of the
(06:17):
dynamics that are shifting tohelp To help the group.
Nima Farzan (06:22):
I wish that were more true.
On the r&d side.
I think in pain there are somespecific things that are helpful
, um, but in general I don'tnecessarily can think of
something.
But what I will say is that someof the commercial incentives
are changing.
So if you think about what um,you know I I, as we talked about
when I was at novartis and Iwas looking primary care we had
(06:42):
thousands of reps sellinghypotensive drugs and now we've
gotten, you know, frankly, awayfrom those rep wars and you know
parallel lines and gottenbetter at using technology and
different ways to accessphysicians so that you can
actually commercialize primarycare drugs with.
You know a more reasonable,rational footprint, so that
(07:02):
helps in terms of the NPDanalysis, if you will.
On drug development side, youknow a more reasonable, rational
footprint, so that helps interms of the NPD analysis, if
you will.
On drug development side, youknow there's a lot of exciting
technologies.
I mean we can obviously talkabout AI and you know regulatory
innovation is important, butthose are still fairly nascent.
I mean it's still.
Ben Comer (07:19):
You're still having to do the safety studies and the
larger scale studies that youneed to do to access the primary
share market One strategy thatcompanies have used for years is
to go after a really raredisease first and get on the
market and then, of course,expand the indication later, go
for a larger population.
(07:40):
Is that something that couldhappen in pain?
Have you seen that kind ofstrategy?
Nima Farzan (07:49):
sure in in one very clear way.
It's exactly how it's playingout.
So it's not quite a super nicheindication of pain.
But acute pain versus chronic.
Okay, right, so acute painlet's talk about is primarily
post-surgical.
I've had a procedure, that's,my wisdom teeth taken out or
knee repair or something larger,uh, or it's some sort of severe
non-surgical pain.
I've sprained an ankle badly,I've thrown on my back or
(08:11):
something that doesn't.
It's not a niche indication butit is a much smaller indication
than chronic pain.
Osteoarthritis, like neuropathy, uh, you know, headache, muscle
, lower back pain, etc.
Um, but the big advantage ofacute pain relative to chronic
pain and the reason why it's afaster to market, it's a more
tenable development plan forsmall companies as well as large
(08:34):
companies is the duration oftreatment.
It's limited.
You know, typically when theFDA talks about acute pain it's
under 30 days and often actuallyyou're getting prescriptions
that maybe last two weeks and sowhen you're treating someone
for that duration of time, thereare a couple of things that
make the development that mucheasier, right?
So one clearly you don't have tohave long studies.
(08:56):
You can determine your endpointin a couple of days.
You know that's nice and infact our first endpoint that
you're going to look at is 15minutes.
You know like we want to seeonset of pain relief starting.
You know, ideally maybe not at15 minutes, but soon thereafter.
So you start looking at 15minutes.
So you know you're gettingimmediate help and because the
duration of treatment isn't thatlong.
(09:18):
the safety database you have tobuild for regulatory approval is
less Right.
You don't have to have long.
You don't have to haveyear-long studies with patients,
because treating them for thatkind of duration, so acute pain,
is where you would start as anoptician.
If you have a broad actinganalgesic, like we believe we do
, acute pain is where you startbecause that pathways faster
(09:40):
there and it is a more limitedmarket because these
prescriptions are two weeks,they're not lifelong
prescriptions because they havechronic pain right.
Matt Pillar (09:47):
So, uh, why?
Why pain?
That's a fundamental question.
We just kind of glossed rightover right.
Why did you want pain?
Yeah, why, why this company andwhy?
Nima Farzan (09:56):
pain.
Yeah, I mean, do you knowanyone who hasn't had pain?
Matt Pillar (10:01):
I'm in pain as we speak.
Exactly right, it touches allof us, right?
I mean we all.
It's almost, you know, notbecause of this.
Nima Farzan (10:06):
I'm in pain as we speak.
Exactly Right it touches all ofus right.
Matt Pillar (10:08):
I mean, it's almost , you know, Not because of this
conversation.
No, not physically.
It was here before we gottogether.
Nima Farzan (10:14):
That's good to know .
I mean, pain touches all of usand all been in pain at some
point of our lives or will be inpain at some point of our lives
, and we look at patients whoare dealing with chronic pain in
particular.
It is debilitating.
It's very hard to focus, tofunction and to operate in life.
(10:35):
So you know, I look back on mycareer and I've worked.
You know the biotechs that I'verun since my time in the bar.
One was in infectious diseaseand vaccines, one was in
precision oncology and what Iliked about vaccines was this
ability to impact a lot ofpeople.
Vaccines are something thatmany people can take but the
tangible benefit of that vaccineis not obvious to the patient.
I mean, if it works, they neverget the disease and never think
(10:57):
about it again.
You didn't actually.
You don't get that directimpact.
It's a theoretical impact.
You've made and you kind ofhave to calculate it on many
thousands of people taking yourvaccine, on many thousands of
people taking your vaccine.
Ben Comer (11:07):
So when I transitioned to the oncology
side.
Nima Farzan (11:10):
We're talking about patients with stage four
terminal cancer that have runout of all other options.
Many of them have diagnosedweak slant and if your drug can
reverse that, tumor growth haveregression and you can add
months or years to thatpatient's life, I mean that's an
amazing, amazing impact thatyou can have immediately on
years to that patient's life.
I mean that's an amazing,amazing impact that you can have
immediately on someone who hasno other options.
(11:31):
But the fundamentals of thatbusiness are very rare types of
cancer that we were doing andthe whole concept precision is
very genetically specificpatient populations that might
occur in 1% of the tumor typeand if that patient had that
mutation we have a drug for them.
So it's really small numbers ofpatients you're impacting.
Pain gave me the opportunity todo both, to have something that
(11:54):
impacts everyone but it alsohas a meaningful, tangible
benefit to their livesimmediately.
And I say that but we talkedabout within 15 minutes, 30
minutes or one hour that you canhelp alleviate pain.
And you know it doesn't takeliving in San Francisco to know
(12:14):
that the opioid crisis has beena huge societal challenge and
the problem in pain is not alack of efficacy from the drugs
we have.
Ben Comer (12:28):
We can completely eliminate your pain if you're
willing to take enough morphine.
Nima Farzan (12:30):
That's not the problem.
The problem is, can you developdrugs to have that pain relief
that are safe and tolerant?
And what Labigo is working onhas that opportunity and really
can create.
Not just have a health impact,like we've been talking about,
but a positive socioeconomic,sociopolitical impact by helping
eliminate, most likely reduce,the use of opioids.
Matt Pillar (12:55):
How is that proposition being received by an
investment community that hasbeen enamored of late with ATMPs
and super sexy fancy stuff?
Ben Comer (13:08):
Not that yours isn't right, but it's definitely a
world away from you.
Matt Pillar (13:14):
Know gene therapies , it is, and for some.
Nima Farzan (13:17):
I will say you know we've had success and there's
definitely been investors whoare, you know, very strong, bold
, lucid supporters of this, andyou know you can just you
understand intuitively andimmediately the patient need
here and the rationale, butthat's.
But there are definitelyinvestors who are used to saying
well, you know they're genericdrugs.
(13:37):
I need generic opioids anddon't you have to have I see
substantially better than thegeneric to get used.
You don't, because people don'twant to take an opioid.
Patients don't want to takeopioids.
Physicians don't want to takean opioid.
Patients don't want to takeopioids.
Physicians don't want toprescribe opioids.
There's a lot of bureaucracyassociated with tracking how
many opioid prescriptions youhave relative to the number of
patients you're seeing, andreporting that you have to do
state by state level.
(13:57):
Governments don't wantprescribers prescribing opioids.
They want to limit it.
They're creating incentives tomove away from it and
restrictions from going to it.
So it is a little bit of adifferent mindset.
This thing I talked about,which is, you know, the efficacy
in pain, is not the unmet need,it's the safety and
tolerability.
It's not how investors are usedto thinking.
(14:18):
They're used to thinking aboutlike how are we more efficacious
than the generic so that you'llget reimbursed?
And this is a differentsocietal issue.
Matt Pillar (14:25):
I'd say most get it but definitely some need some
discussions around that.
Does that societal impact, thatmore global, broad societal
impact, open up for you perhapsa new pocket or a different
pocket of potential investmentthan traditional biotech pharma
(14:45):
investors?
Nima Farzan (14:45):
Yeah, I mean it has .
Here's what I would say we havestuck to the more traditional
investors.
Now, there are certainlynon-traditional investors that
we can go to, but within thetraditional investors there are
some that are a little moremachine-driven and we have found
that those do correlate in thatrespect, and I do think that
there are some of our investorsthat look at that and say there
(15:11):
are benefits here that we wantto get part of.
Matt Pillar (15:13):
Yeah, pain is, you know, famously hard to uh
measure objectively.
Yes, you know you, if you're inpain you know, and you're you
know often.
Ben Comer (15:18):
You know how much pain you're in is, you know
which face you point to.
You know, on the pain chart, doyou feel that there's a need
for, or maybe there are already,some new kinds of scales or
other types of objectivemeasures to assess different
types of pain.
Have you worked on that at all?
Nima Farzan (15:37):
Yeah, so there are a couple of things a couple of
ways I'd answer that there arestudies that you can run that
are going to be a little moreobjective or functional, so I'll
mention studies that are calledcompressor studies, right?
And so what this type of studyis is, you ask in this case it
would be a volunteer.
Put their hand in a bucket ofice water that's one degree
(15:59):
Celsius, see how long they cankeep it in there.
Measure that as a baselinescore.
Give them a randomized eitherplacebo or drug and ask them to
do it again and see how muchlonger they can keep their hand
in that water.
That's the same level of painstimulus.
Bucket of water at one degree.
Same person how much differencedoes the drug versus placebo
make on their ability totolerate that?
(16:20):
You can measure that in secondsor percentage increase.
That's more quantitative thanthan a scale, right?
That's really a valuable toolfor us.
It's not a pivotal study.
The FDA is not going to let youget your label based on that,
you're still going to have to gointo post-surgical pain or
others, but it's a very valuableway to objectively test your
drugs early on, and those arestudies that we've done.
(16:42):
The other thing I would say,which is less about endpoints
but protocol design to managethis issue, and there are things
you can do, and you would dothis more in chronic pain
studies than you would in acute.
But you can decide whichpatients you want to enroll in
your study based on you did do asort of rolling screening
(17:05):
period with patient diaries thatthey record their pain prior to
entering your study and youlook for patients that are good
pain responders, meaning theyactually do understand.
It's not everyone can maybeconceptualize that pain and
report it out.
So do I consistently reportscores?
Is there some variability?
Because if I say my pain is a 5, 5, 5, 5 every day, that's
(17:27):
probably not.
I'm probably not a good painreporter.
Matt Pillar (17:30):
If I say 1, 10,.
Ben Comer (17:31):
1, 10,.
Nima Farzan (17:32):
I'm probably not a good pain reporter.
So you want a little bit ofvariability, not too much, and
we consider those patients goodpain responders and those are
ones that maybe will give you alittle bit better answer in your
studies.
Ben Comer (17:42):
And you are doing those kinds of studies as well.
Nima Farzan (17:44):
Yeah.
Matt Pillar (17:50):
While you're on the studies subject, where are give
us an update on on where thestudies are right now.
Nima Farzan (17:52):
Yeah, we have a couple compounds that are in the
clinic right now.
Uh, our first program is inphase two for acute pain, you're
not.
So this is the development wetalked about.
We're in post-surgical pain, uh, we're currently running that
study.
Uh, and we're doing that in awisdom teeth extraction
post-surgical pain patientpopulation.
Our second drug that we intendto develop for chronic pain is
(18:14):
currently in phase one.
Matt Pillar (18:17):
My dentist growing up had a sign on the office door
that said modern dentistry ispainless.
So I'm not sure you know.
I mean when I had the wisdomteeth taken out.
I proved that theory wrong, ofcourse, so yeah, yeah, yeah, so
yeah.
Yeah, yeah.
So what are?
Nima Farzan (18:30):
the next steps then .
So the next steps after that onthe acute side, you move into
pivotal studies and pivotalstudies from a regulatory
pathway.
The agency would like to seeone post-surgical study in
patients who have had softtissue surgery and one efficacy
study in patients who've hadsoft tissue surgery and one
efficacy study in patientswho've had hard tissue surgery
(18:52):
or bony tissue.
So, typically, where we'veevolved to you know, different
models have been used over time,but today most people will do
abdominoplasty and bunionectomyas the soft tissue and hard
tissue studies.
So you go to patients havingthose surgeons and need to run
the studies in that and that isthe efficacy studies you need to
run for an acute indication,chronic, you have a lot more
(19:12):
options.
There's a lot of differenttypes of chronic pain and you
know roughly I bucket it asneuropathic pain or
musculoskeletal pain and ourfocus is going to be in the
musculoskeletal side inparticular where we started with
osteoarthritis.
Ben Comer (19:27):
I think everyone recognizes the unmet need for
new pain medications,non-opioids, Even regulators.
Matt Pillar (19:35):
I think would recognize that.
Ben Comer (19:38):
Do you anticipate any sort of accelerated regulatory
pathway breakthrough designation, anything like that?
Nima Farzan (19:47):
I would hope that and believe that the agency will
work with us in a number ofparameters, given the unmet need
.
I think it's too soon tospeculate on whether he would
have breakthrough designationsspecifically, but you know I
will say that to date in ourinteractions with the FDA
they've been very forthcoming inproviding good guidance for us
(20:09):
with the FDA.
They've been very forthcomingin providing good guidance for
us.
I do think the FDA wants to seehypnotic and fluid pain drugs
developed and so they've beenvery forthcoming.
Matt Pillar (20:17):
Our friends at Alston and Byrd set us up with
some amazing space to recordduring JPM week.
The firm's national healthcareand life sciences practice has
more than 100 attorneys activelyinvolved in the healthcare
(20:41):
industry across the fullspectrum of legal disciplines
compliance, public policy,transactional corporate
governance, securities, fda,biotech, ip, government
investigations and litigationpractice areas.
Alston Byrd represents lifesciences companies and their
(21:04):
partners in corporate stagesranging from private to newly
public to well-estab, and in avariety of stages of product
development, from preclinical topost-approval commercial launch
.
Learn more at alstoncom andtell them you learned about them
.
On the Business of Biotech,give us a sense for Latigo's, I
(21:26):
guess growth and I use the termlike like shape shifting as a as
a biotech moves from R&D into aclinical stage, into a
potentially manufacturingenvironment.
You know where are you now?
Yeah, on that.
And sort of what have you?
(21:47):
What have you had to growthrough in your time?
Nima Farzan (21:51):
there.
No, I mean, this is what I lovetalking about, because this is
what I've done the last fewtimes and this is where I I
think I can bring expertise tobears.
How do you transition from adiscovery company to a discovery
and development company andeven to a late stage chivalric
company, early stage commercialcompany?
I think that's kind of my sweetspot in you know who had been
in my career.
Matt Pillar (22:10):
I'm glad I asked.
Nima Farzan (22:14):
So I think you know , when I came in about six
months ago, the company hadprimarily a discovery team in
place, very strong discoveryteam that developed multiple
compounds that we're now takinginto the clinic.
But we're literally in the veryinitial stages of building
development capabilities.
So my focus has been primarilyon scaling development.
(22:35):
So when we say development,obviously that's clinical
development, it's clinicaloperations, it's biometrics,
it's regulatory, it is DMPK,clinpharm, these kind of
functions and capabilities,especially as you go beyond a
phase one study and you need tostart thinking about full
development program.
So that's been the people,growth on the organization that
(22:56):
always has this interestingtension in biotech, because, you
know, discovery will have beenfront and center for this case.
Five years, five years,bradwell and we've been around
and now they start to see thegrowth and development elsewhere
and what you have to do is makesure you're spending time
letting discovery team know thatthat's still a huge source of
value today and in the futureand maintaining excitement and
(23:19):
motivation there while most ofthe growth is happening on the
development side, yeah, and asfar as that development side,
growth, is concerned, what's itbeen like in your experience
gearing up, staffing up Like?
Matt Pillar (23:35):
have there been particular challenges to that?
Nima Farzan (23:38):
I, you know, I've been really lucky in the sense
that I think Lattigo is verywell positioned for everything
we've talked about and theexcitement around this class,
that we've been able to attractgreat talent.
I know that's not always thecase and I will say that you
know we're trying to bring in amix of people with pain
experience and not Right, andthere isn't the depth of um, you
(24:02):
know, companies working in painto have a whole sort of people,
you know a whole set of talentthat have experience in pain not
many companies to snipe from.
Matt Pillar (24:10):
Is that what?
Nima Farzan (24:10):
you're saying exactly right, there's not as
many um, but it's also lesscompetition.
You know, because, like I meanfrom oncology, for example, like
you know, if you're an mdclinical oncology experience,
you know you're gonna have 10offers um and uh.
So we've been, I think, lucky inbeing able to attract people
who have pain expertise acrossdifferent functions, even
(24:34):
bioethics and the like.
But then I've also beencognizant about mixing in some
people with capabilities inother therapeutic areas to
augment this right.
Because, as we think about thedevelopment and what's been
interesting is a lot of peoplewill say, well, okay, you're in
pain, so you've got to go getCNS people.
That's, you know, like thetherapeutic area we kind of fall
(24:57):
under.
But the answer is we'reactually not a cns company we're
a science company, but.
Ben Comer (25:02):
But.
Nima Farzan (25:02):
But you know, it's a very different experience from
um if you've been working ondegenerative disease, spark
concerns, dementia etc.
Um, actually, what I kind ofwant are people who've had more
primary care.
You know drug developmentexperience right and really
understand the drug, druginteraction work, the clinical
(25:23):
pharmacology work.
You know the scale up on themanufacturing side et cetera
that we need for the kind ofbusiness.
Matt Pillar (25:30):
Yeah.
Ben Comer (25:33):
Tell us about LTG 101 , and you know it works.
Maybe at a high level, sure.
Nima Farzan (25:42):
So LTG-101 is a NAV 1.8 inhibitor.
It's a small molecule, oralcompound and it inhibits very
selectively and potently NAV 1.8.
So what is NAV 1.8?
Why is that matter of opinion?
Nav 1.8, in this case NAVsodium voltage channel 1.8.
There, that you know, matter ofpain.
Uh, now 1.8, in this case navsodium voltage channel 1.8.
There are uh, nine of thesechannels.
Um, we're targeting 1.8 veryselectively.
(26:02):
That's important because othernav channels play other
important roles in the body thatyou don't want to interfere.
But now 1.8 is exclusivelyreserved by the body for the use
of propagating the pain signalfrom the periphery back to the
world.
And so whatever that painsignal may be that could be an
inflammatory brain signal, likefrom prostaglandins or cytokines
, it could be nociceptive, frompressure, heat, cold, it could
(26:26):
be neuropathic, from glucosedamage to the nerves All those
signals, that action potential,that electrical firing, is
carried through thissodium-molded channel that helps
propagate that signal back tothe brain.
So inhibiting that channel canreduce the perception of pain
that's coming from the peripheryback to the brain.
(26:47):
And if you do that selectively,without hitting other sodium
channels that play importantroles in the body, like 1-1, 1-5
, 1-7, then you can have a verysafe and fast danger.
Ben Comer (26:59):
Is there a danger, then, of the old hand on the
stove and not feeling it?
Matt Pillar (27:05):
There's the frog in the boiling pot.
No.
Nima Farzan (27:11):
For a couple reasons.
Matt Pillar (27:12):
One is you thought maybe you caught Neiman on that
that like wait a minute I'll betyou didn't think about that?
No, I know we thought aboutyeah, no, I'm curious about why,
right like I would have askedthe same question.
Yeah, yeah, you first of allthis is more.
Nima Farzan (27:32):
I'm gonna blunt the pain, that you're going to
completely not feel pain, um,and you still have senses.
You still can feel heat, youcan feel cold, um, and so it
does block pain effectively,does not eliminate all pain.
You're not going to walk around, you know, grab your hand on
that.
So there are no.
You got your hands on um and,frankly, if we ever got to a
(27:55):
level of analgesia that was thatmuch of it Probably pretty
stiff, you know, and not providethat.
Matt Pillar (28:02):
So good, yeah.
Yeah.
I remarked the first time wetalked a couple weeks ago that
your disposition is likeuncommonly cheery and pleasant,
I mean this is a tough businessthat we're in.
I mean, you're working in amarket that has, as you
mentioned, big socialimplications.
That, can you know, if youthink about it long and hard,
(28:23):
could bring you down right, likethinking about the opioid
epidemic, for instance.
I'm just curious a totallypersonal question but how do you
maintain this disposition?
Nima Farzan (28:36):
I mean, I think I have it naturally.
I think I I'm surprised thatanyone can be a biotech ceo and
not be naively optimistic allthe time, because we enter a
business where things fail 90 ofthe time.
Ben Comer (28:46):
Well, I know you don't think that this one's
gonna work.
Matt Pillar (28:48):
I believe like you gotta be optimistic right yeah,
yeah, but I mean that could becausing, I mean that stress.
Right, the acceptance of thatrisk could be cause for, you
know, for concern enough tobring a guy down.
Nima Farzan (29:01):
Well, it is the hardest part of the job.
I had this conversation with acolleague last night who's
thinking about transitioning toa senior role and you know,
obviously you have to have somelevel of technical capabilities
and you know intelligence andbackground in joint development.
So let's check the box things,um.
And then we talked a lot aboutthe energy you need to be a ceo,
(29:23):
right, that's?
That's, I think, clear.
I think most people would saylike you just gotta have energy,
you gotta have passion, and andthe thing that I raise is like
here's the last part.
That is hard is the emotionalroller coaster component.
And this is a business likemany businesses, but we have
this binary outcomes where thedata is revealed or you know,
and there's going to be ups andthere's going to be downs, and
(29:45):
you know I will tell you,whatever what it's been almost
10 years as a CEO in differenttimes you don't get better at
riding that rollercoaster.
It's still euphoric when it'shigh and crushing when it's low.
And I think I've gotten betterat all the other aspects of the
job over time as you learnexperience, but I haven't been
(30:07):
able to get better at that andyou just have to ride the
rollercoaster and then you knowto manage this on home.
Sometimes it is.
Ben Comer (30:19):
We talked about LTG 101.
What could you tell us about, Iguess, your pipeline beyond?
That, such as it is, and anysort of plans to add additional
campaigns.
Nima Farzan (30:29):
Yeah, so we have a second compound in the clinic
305.
That's the one we're developingfor chronic.
The characteristics of the drugthe first compound is twice
daily.
The second compound is oncedaily.
That makes more sense for ahuman patient Actually acute
pain sometimes twice dailydosing is actually an advantage.
(30:50):
Patients will tend to take thedrug whenever they want.
So you want to have quick onsetor offset, so that they're not
taking a one-stage drug multipletimes.
But in chronic pain you reallywould rather have one day a day
dosing.
So that's the second compoundthat's in the clinic, that's the
one that's in phase one, thatwill start arthritis studies
later this year.
We have a third NAV18 inhibitorthat we're intending to bring
(31:13):
into the clinic.
What's exciting about that onefor us is that it has the
potential to have a really lowdose, which gives you the
opportunity to develop differentformulations.
And if you think about paindrugs that you would get in OTC
the opportunity to have a patchor a spray or something like
that could be really interesting.
To do that you have to have avery low-matter drug, and so
(31:35):
that's the opportunity of thethird.
The third time we are continuingto work on other pain targets.
I think we're very excitedabout that.
One is your.
We've doubled down triple downif in it, as you will.
But we are also working onother pain targets.
We're looking at one calledasic, which is acid sensing ion
channel, which is triggered whenyou have acid driven pain, and
there are obviously certaintypes of pain, like ischemic
(31:57):
pain, that is, cancer pain, thatis specifically often
acid-driven but also can be acidand now in hatred.
So you got combinations as wellto better block pain.
Ben Comer (32:10):
For those different delivery mechanisms that you
mentioned.
Would you, is that somethingyou would work on in-house?
Would you partner for thosekinds of yeah?
Nima Farzan (32:19):
that's a great question.
I mean, I think those arethings that we're still thinking
through.
I think you could probablythink about some early proof of
concept work that you could do,demonstrating bioavailability or
the like, or technicalfeasibility.
But yes, ultimately those areprobably benefit from having
partners.
Matt Pillar (32:38):
What have you been doing here at JPM during JPM
week, like what's been theagenda?
Nima Farzan (32:44):
Getting steps in.
Well, I mean, yeah, that'shappening regardless.
Matt Pillar (32:48):
right, it just comes yeah.
Nima Farzan (32:50):
Yeah, you know our focus.
This is a great conference.
I live in San Francisco so it'salways fun for me.
I can pop over and go home whenI need to.
Can I sleep in your own bed?
Ben Comer (33:01):
I have a hypothesis that JP Morgan Week is the week
that there are the most peoplein suits in San Francisco on the
street, is that?
Accurate.
Can you verify?
Nima Farzan (33:11):
that I can verify that in three days here you will
see more people in suits andyou will see in 362 days, put
together over 10 years, the restof it.
Ben Comer (33:20):
Okay, 10 years, wow, yeah, I mean 100%, I mean.
Nima Farzan (33:27):
I will also say that over the years I've been
coming to JP Morgan it's gottenmore casual.
Ben Comer (33:33):
So I've noticed that too.
Nima Farzan (33:34):
Student tie right and now we moved a few years
back to, like we didn't want tohave to wear ties, and now a lot
of people wear sneakers, andthis year I saw a lot of people
not even wearing suits, you know, jacket, blazers and sneakers.
So that's definitely the trend,yeah.
Matt Pillar (33:49):
But I, like, actually felt guilty about not
wearing a tie today.
I wore a tie the last two daysand I today we're tied the last
two days and I noticed to yourpoint that I was one of the few
guys who ties off Ben's holdingout.
Ben Comer (34:01):
I've been going back and forth a little bit.
I'm not really sure which oneis the right view.
I cut you off on JP Morgan.
Nima Farzan (34:10):
Great conference for a couple reasons.
One clearly the world'sinvestment community is here.
It's a good conference formeeting for investors, but
honestly, there are otherconferences where you have
access to investors and prettyregular cadence of those.
This is one of the fewconferences where you can access
strategics and not justbusiness development teams but
(34:32):
senior executives, and so that'sreally unique about this, and
so the opportunity certainly tohave conversations with
strategic is a focus and needfor this week.
Matt Pillar (34:44):
Are those senior executives generally?
I mean, that's the expectationof them while they're here, and
how do you access them?
Nima Farzan (34:53):
You know it is.
Certainly the thing with thesenior executives here in pharma
is that they kind of have amillion options to pick from and
they'll kind of go with whatstrikes their fancy right.
And you can try to work withyour colleagues in the business
development team and see ifthere's enough excitement to get
a C-suite executive to pop intoyour meeting.
Sometimes they do come,sometimes they don't come.
Um, you know, I think it'd befun to be a pharmacist.
(35:15):
I can just be like looking at acalorie every day Like I want to
get that one, that one, thatone half of this one, you know,
but that's that's kind of how itworks.
It is still speed dating, butit's it's still a unique kind of
access.
Ben Comer (35:27):
Yeah, yeah, I mean, interest in certain therapeutic
areas swings back and forth.
You know, different thingsbecome hot, different things
aren't.
Or you know, when there was alot of reporting on opioid
deaths and the CDC changed itsguidance there, I think there
was a huge focus on non-opioidpain medications and a
(35:49):
recognition of the need for them.
Do you have a sense that thatsentiment still exists and is
still just as strong?
Has it decreased?
Has it increased?
Nima Farzan (36:01):
Yeah it's a great point because I mean we're
seeing a national decrease inthe number of opioid deaths,
right, certainly locally andnationally, and a lot of people
are, you know asserting thatit's related to these efforts to
reduce opioid prescriptions,and so we can look at it one of
two ways.
One is like you know, phew, it'sgetting better, we don't have
(36:22):
to focus on it, or no, whatwe've been doing has actually
worked, and we should keepdoubling down and pushing up,
because it's not like opioiddeaths have gone.
I mean, they're down maybe 20%from last year.
Yeah, they haven't disappeared,but they haven't disappeared,
it's still many, but theyhaven't disappeared so many X,
what they were 10 or 15, 20years ago.
So I think, that the latter iswhere I'm hopeful and I believe
it is which is theseinterventions that we've been
(36:43):
putting in place are starting towork.
Let's continue and continue todouble down, and we're seeing
that snowballing in.
You know, dependency, opioiddependency, translating to you
know a lot of the society levelsthat we see related to that.
(37:04):
as other non-opioid painmedicines become available, I
think they'll become evengreater incentive to be like
look, it's been working already,now we have even more
therapeutic options.
We should be even stricterabout letting opioids be used.
Why should we have, why shouldit even be allowed to have
opioids be prescribed for lowrisk surgical procedure?
Why should we send an 18 to 20year old child, young adult,
(37:27):
back to their college dorm witha bunch of opioids after wisdom
teeth extraction?
We probably shouldn't let thathappen.
Ben Comer (37:34):
Yeah, and I would imagine payers that would think
about it the same way.
Right, and when more therapiesbecome available, I would think
you know that there would be apretty strong push to prevent
people from getting hooked to anopioid because it's costly.
It's costly.
Nima Farzan (37:50):
And you know it's really easy to focus on and we
should on the dependencecomponent of opioids.
But there are other issues withopioids, right.
So obviously there is thenausea and constipation that
they're well known for, but alsojust you know, intuitively, the
CNS, the somnolence, the, youknow, the being out of it, right
, and the impact that has.
So one of the anecdotes that Iwas hearing is how surgeons are
(38:14):
really, you know, lookingforward to a non-opioid, an
additional non-opioid to add tothe mix, to reduce opioid use.
Because if you think about howthey're measured, it's often
30-day mortality, morbidity,post-surgery, and if the surgery
goes great but you give someonean opioid, especially someone
more elderly, and they're out ofit and they have a fall, that's
(38:34):
actually one of the things thatbrings people back into the
hospital and that counts againstyour mortality, morbidity, on
that operation.
Ben Comer (38:40):
So there are a lot of concerns with opioids.
Nima Farzan (38:44):
The dependence is the obvious one, but even if you
don't become dependent, you'renot very functional yeah.
Matt Pillar (38:54):
Yeah, and are you finding that that sort of the
nuance of that story is beingwell received as well?
Nima Farzan (39:00):
Yeah.
Matt Pillar (39:01):
Is it just a big story that resonates?
Nima Farzan (39:03):
It's that, yeah, you know that.
I'd say that we're findinggreater traction on the nuance
of the story as people start tobe like, no, actually, maybe
this is a real opportunity.
But there are still a lot ofpeople who will say, like, it's
not about opioid replacement,they're generic.
The acute market's small.
Who cares about these things?
It'll be whether you develop a,you know, a big neuropathic or
(39:24):
musculoskeletal problem.
But I think this opportunity toreplace opioids for all these
scenarios you're talking aboutis yeah.
Ben Comer (39:33):
Yeah, well, I mean, the cost of generic opioids, I
think has been one of thechallenges to overcome for for
alternatives, right, I mean, howdo you?
You have to develop a medicinethat is not so so much more
expensive that you know aninsurance company, for example,
is you know may end up choosingan opioid over over your new
(39:54):
drug.
Nima Farzan (39:55):
It's not going to potentially get someone addicted
and put them into a fog andcause them to fall and all sorts
of other things.
That's right.
I mean, look, you can make allthose arguments that we just
made about that.
You can have regulatory andgovernment policy pressures to
not let people just take theeasy way out with the cheaper
drug that has all these effects.
And you can also think aboutthe big picture.
(40:16):
If I walked, walked in, youknow for most procedures the
range of cost.
You know it's a $10,000,$15,000, $20,000, maybe $30,000
procedure and then for the costof a $30 to $40 a day drug for a
week you're going to put themon an opioid.
Matt Pillar (40:37):
You know, in the context of the surgery.
It's a very small percentage ofwhat they expect you know, uh,
we got a pretty good lay of theclinical land for.
Let it go.
Uh, let's go post show nextweek.
You're back in the office, nextsteps, big thing you're working
on like what's on your agenda.
Yeah, sleep Same yes.
Nima Farzan (41:03):
Same.
Matt Pillar (41:06):
But no, but seriously Take a few non-opioid
analgesics, that's right, right,I think a couple of things.
Nima Farzan (41:11):
So one is you know, the engagement you have with
investors and strategics at ameeting like this is a two-way
street.
So one obviously we're tellingour story, but we're hearing
feedback about like here's howwe would do things.
Here's how we think about things.
So I can just debrief with myteam at London today and we have
four or five things we want toexplore in some detail about.
How should we look at thatpotential indication?
(41:34):
What would a proof of conceptlook like in that idea?
What kind of study can we run?
How do we want to think aboutthis timing of the study?
So there's some of theseconcrete things, and actually it
can be draining as a CEO to beconstantly doing the pitch, but
you can get feedback back.
That's useful and in an eventlike this you do.
(41:54):
So there are a few things thatwe want to explore.
So that's the kind of uniquething coming out of the
conference.
The other thing, of course, is,between the holidays and JP
Morgan, just getting back intogood operational planning,
tracking our objectives andbeing back in the flow of the
operations Also same.
Matt Pillar (42:14):
Yeah, yeah, yeah, we find ourselves just rolling
right out of the holidays.
Also same, yeah, yeah, yeah, wefind it.
We find ourselves just comerolling right out of the
holidays into jpm.
Then we get back and it's like,okay, let's let's get grounded.
Let's get grounded, yeah, yeah.
Well, that's uh, that's aboutall the time we have for today,
but there's so much more to talkabout.
We'd love to have you back onthe show at some point, um, to
talk about what's going on thereand clinical progress.
(42:36):
I appreciate you taking timeout of your super busy schedule
to spend with us.
This has been great.
I enjoyed it.
Yeah, so if we Thank you, thankyou.
So that's Latigo TherapeuticsCEO, nima Fawzan.
I'm Matt Piller, and I'm Dave.
Bummer and you just listened tothe business of biotech from JPM
2025.
Also from the beautiful lawoffices of Alston and Beard.
(42:58):
Thank you to Alston and Beardfor hosting us this week.
Listen and subscribe.
Wherever you listen to podcasts, Make sure you take in our
video casts under the Listen andWatch tab at Bioprocess Online
or under the Business of Biotechtab that is on
lifescienceleadercom.
We drop every Monday, so we'llsee you next week and thanks for
listening.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy And Charlamagne Tha God!
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.