Frequency Therapeutics — Hearing Loss Regeneration

It's not likely that Europe will get it as soon as the US does. FX-322 will likely have to go through each European country's drug approval agency, the way it went through the FDA here. Lots of Europeans have discussed flying over here and getting the treatment when it comes out.
If it works I'm definetly flying. Not going to wait any longer than necessary with this horrendous tinnitus. And if the doses need be done in a period of 4 weeks, I will stay as long as needed and possible.

@Christiaan I'm also situated in The Netherlands so we can share a bunk bed over there. LOL.
 
However, a 10 dB deviation (improvement or worsening) is within the error range of an audiometric test. I mean, sometimes one finds differences of up to 20 dB in different audiograms, performed with the same audiometer and they dont mean anything in the long run. The differences can be due to congestion, blocked eustachian tube, and many other things.
I talked to an audiologist about FX-322 phase 1 results and she said the word score results were "completely unheard of" and "remarkable." I think you are really downplaying what they were able to achieve with a single shot of their phase 1 dosing (which is less than phase 2 per shot).

Also I believe 5dB is within the error margin, not 10 dB, but sure ET issues could cause a difference but it would be improbable multiple people had that and it only affected 8 kHz.
 
However, a 10 dB deviation (improvement or worsening) is within the error range of an audiometric test. I mean, sometimes one finds differences of up to 20 dB in different audiograms, performed with the same audiometer and they dont mean anything in the long run. The differences can be due to congestion, blocked eustachian tube, and many other things.
So you're saying that all the people who received the placebo had these issues, and the ones who got the real dose didn't?

I don't think that's very likely. They've also actually examined and visually observed hair cell & synapse regeneration in a human cochlea.

You can find anxiety-driven reasons to poke holes in anything all day. At some point, it becomes counterproductive.
 
You might find this study interesting:

https://www.researchgate.net/public..._Unusually_Good_Speech_in_the_Profoundly_Deaf

It turns out the high and the low frequencies both help with speech clarity, so in your case you were able to compensate for the higher losses with good low frequency hearing.

This is also why audiologists worry about that range, it's what hearing aids can cover and as long as they have that base covered, speech is relatively easy. Hearing aids don't do much for higher frequencies because of the high sampling rate that is required and the limitations of current technology. So while there is more speech information at the lower frequencies, profoundly deaf people with normal ultra high frequency hearing (rare but does occur) have "unusually good speech."
Interesting. It is quite counter-intuitive. In my experience, when one perceives sounds in frequencies that are normal, healthy, and specially in the lower range, the sound is perceived quite balanced. With mild hearing loss in high frequencies (20 - 30 dB) the sound is perceived enhanced once the sound hits that frequency above the hearing threshold. This is maybe due to recruitment.

But I had never heard before of someone with profound hearing loss in low frequencies being able to hear better due to the high frequencies and, as pointed out in the article, I understand that this is due to the use of hearing aids and amplification. Obviously, having remaining hearing helps combined with the use of hearing aids.
 
Interesting. It is quite counter-intuitive. In my experience, when one perceives sounds in frequencies that are normal, healthy, and specially in the lower range, the sound is perceived quite balanced. With mild hearing loss in high frequencies (20 - 30 dB) the sound is perceived enhanced once the sound hits that frequency above the hearing threshold. This is maybe due to recruitment.

But I had never heard before of someone with profound hearing loss in low frequencies being able to hear better due to the high frequencies and, as pointed out in the article, I understand that this is due to the use of hearing aids and amplification. Obviously, having remaining hearing helps combined with the use of hearing aids.
It's too bad Frequency took down the presentations because they took a phrase ("Oh say can you see") and broke it down by frequency and you can see some parts had quite a lot of speech information extend into the ultra high frequencies even if the bulk of that information was lower.
 
It's too bad Frequency took down the presentations because they took a phrase ("Oh say can you see") and broke it down by frequency and you can see some parts had quite a lot of speech information extend into the ultra high frequencies even if the bulk of that information was lower.
It's still there. Page 17.
 
I had a look at the updated presentation and it was stated that they had 50% people enrolled and they haven't recruited anyone new.

On page 41 it talks about Astellas about having clinical trials in Europe and Asia. I did not understand this part. Is it suggesting that if Frequency Therapeutics did Phase 2b and Phase 3 trials in Europe and Asia, Frequency Therapeutics would get extra money?

Does this mean FX-322 would be released quicker if these clinical trials were done in Europe and Asia?
 
However, a 10 dB deviation (improvement or worsening) is within the error range of an audiometric test. I mean, sometimes one finds differences of up to 20 dB in different audiograms, performed with the same audiometer and they dont mean anything in the long run.
That's what statistical tests are for. To sort out what's significant and what's random.

In general, I agree with you. When I started following Frequency Therapeutics, they were talking about 'reversing' hearing loss. I was hoping for a complete cure. Now it's some level of improvement at very high frequencies. That's presented as a positive btw. Almost as though their formulation targets those areas by design. Great news for those whose tinnitus is in those areas. For their sake I'm glad and I hope that the multiple doses increase the effect.

It's not clear to me how multiple doses are going to penetrate any deeper into the cochlea. Sure, I'd go for some improvement at 3500 Hz (hopefully) and above if it was available and affordable. I'd probably still need my hearing aids. I'm still awaiting the results of the current study with interest, but I don't think it's going to change my world any more. Happy, happy, happy to be proved wrong.
 
I had a look at the updated presentation and it was stated that they had 50% people enrolled and they haven't recruited anyone new.

On page 41 it talks about Astellas about having clinical trials in Europe and Asia. I did not understand this part. Is it suggesting that if Frequency Therapeutics did Phase 2b and Phase 3 trials in Europe and Asia, Frequency Therapeutics would get extra money?

Does this mean FX-322 would be released quicker if these clinical trials were done in Europe and Asia?

Everyone should take the time to read their 10-K. It is a required filing for a publicly traded company, and available on their website.

As it relates to the agreement with Astellas and payment. On Page 21:

"As consideration for the licensed rights under the Astellas agreement, Astellas paid us an upfront payment of $80.0 million in July 2019 and has agreed to pay potential development milestone payments up to $230.0 million. Specifically, we would receive development milestone payments of $65.0 million and $25.0 million upon the first dosing of a patient in a Phase 2b clinical trial for SNHL in Europe and Asia, respectively, and $100.0 million and $40.0 million upon the first dosing of a patient in a Phase 3 clinical trial for SNHL in Europe and Asia, respectively. If the Astellas licensed products are successfully commercialized, we would be eligible for up to $315.0 million in potential commercial milestone payments and also tiered royalties at rates ranging from low to mid-teen percentages."


Phase 2b and 3 will include Europe and Asia. I don't interpret that as being any quicker, but it would give the study a larger footprint and access to more patients. The partnership with Astellas may expedite the recruiting of patients in Europe and Asia.

I'd also like to add, that royalties in the teens is an insanely good deal. Frequency stands to collect substantially well from sales in EU and Asia. Most royalty deals that I have seen in business agreements are MAX 5%, average 3%.
 
Everyone should take the time to read their 10-K. It is a required filing for a publicly traded company, and available on their website.

As it relates to the agreement with Astellas and payment. On Page 21:

"As consideration for the licensed rights under the Astellas agreement, Astellas paid us an upfront payment of $80.0 million in July 2019 and has agreed to pay potential development milestone payments up to $230.0 million. Specifically, we would receive development milestone payments of $65.0 million and $25.0 million upon the first dosing of a patient in a Phase 2b clinical trial for SNHL in Europe and Asia, respectively, and $100.0 million and $40.0 million upon the first dosing of a patient in a Phase 3 clinical trial for SNHL in Europe and Asia, respectively. If the Astellas licensed products are successfully commercialized, we would be eligible for up to $315.0 million in potential commercial milestone payments and also tiered royalties at rates ranging from low to mid-teen percentages."


Phase 2b and 3 will include Europe and Asia. I don't interpret that as being any quicker, but it would give the study a larger footprint and access to more patients. The partnership with Astellas may expedite the recruiting of patients in Europe and Asia.
Thanks. Just double checking and making sure I understood correctly what that part meant.

They could still potentially bypass Phase 2b and go on to Phase 3 or be able to release it once they receive breakthrough therapy status.
 
Everyone should take the time to read their 10-K. It is a required filing for a publicly traded company, and available on their website.

As it relates to the agreement with Astellas and payment. On Page 21:

"As consideration for the licensed rights under the Astellas agreement, Astellas paid us an upfront payment of $80.0 million in July 2019 and has agreed to pay potential development milestone payments up to $230.0 million. Specifically, we would receive development milestone payments of $65.0 million and $25.0 million upon the first dosing of a patient in a Phase 2b clinical trial for SNHL in Europe and Asia, respectively, and $100.0 million and $40.0 million upon the first dosing of a patient in a Phase 3 clinical trial for SNHL in Europe and Asia, respectively. If the Astellas licensed products are successfully commercialized, we would be eligible for up to $315.0 million in potential commercial milestone payments and also tiered royalties at rates ranging from low to mid-teen percentages."


Phase 2b and 3 will include Europe and Asia. I don't interpret that as being any quicker, but it would give the study a larger footprint and access to more patients. The partnership with Astellas may expedite the recruiting of patients in Europe and Asia.

I'd also like to add, that royalties in the teens is an insanely good deal. Frequency stands to collect substantially well from sales in EU and Asia. Most royalty deals that I have seen in business agreements are MAX 5%, average 3%.
This sounds like they are definitely planning a phase 2b and 3 then because Astellas has agreed to pay them for it, no? Or am I reading too much into it?

These just apply to FDA phases as well and not European/Asia regulatory phases (regardless of where trials are held), right? It would be a confusing deal between Frequency and Astellas if they planned to skip the later phases. Trying to figure out what this means timing wise.
 
Everyone should take the time to read their 10-K. It is a required filing for a publicly traded company, and available on their website.

As it relates to the agreement with Astellas and payment. On Page 21:

"As consideration for the licensed rights under the Astellas agreement, Astellas paid us an upfront payment of $80.0 million in July 2019 and has agreed to pay potential development milestone payments up to $230.0 million. Specifically, we would receive development milestone payments of $65.0 million and $25.0 million upon the first dosing of a patient in a Phase 2b clinical trial for SNHL in Europe and Asia, respectively, and $100.0 million and $40.0 million upon the first dosing of a patient in a Phase 3 clinical trial for SNHL in Europe and Asia, respectively. If the Astellas licensed products are successfully commercialized, we would be eligible for up to $315.0 million in potential commercial milestone payments and also tiered royalties at rates ranging from low to mid-teen percentages."


Phase 2b and 3 will include Europe and Asia. I don't interpret that as being any quicker, but it would give the study a larger footprint and access to more patients. The partnership with Astellas may expedite the recruiting of patients in Europe and Asia.

I'd also like to add, that royalties in the teens is an insanely good deal. Frequency stands to collect substantially well from sales in EU and Asia. Most royalty deals that I have seen in business agreements are MAX 5%, average 3%.
No mention of Canadian trials? Or would that be included in further trials with the U.S.?
 
Thanks. Just double checking and making sure I understood correctly what that part meant.

They could still potentially bypass Phase 2b and go on to Phase 3 or be able to release it once they receive breakthrough therapy status.
It is certainly possible that EMA (Europe's FDA) could grant a ''prime'' (breakthrough therapy status) if it is proven that the medicine has proven to make a complete difference for patients in a clinical trial elsewhere, such as the US.

One example is PRV-031, a medicine that prevents diabetes type 1. Link: http://investors.proventionbio.com/...-Designation-by-the-European-Medicines-Agency
 
If it works I'm definetly flying. Not going to wait any longer than necessary with this horrendous tinnitus. And if the doses need be done in a period of 4 weeks, I will stay as long as needed and possible.

@Christiaan I'm also situated in The Netherlands so we can share a bunk bed over there. LOL.
Sounds like a great plan @BBakkers. ! I will hold you to that. Maybe if we can go over there with a larger group of tinnitus suffering Dutchies, we could get a group discount at the local clinic. Two ears for the price of one perhaps;)

But I am really thinking about partaking into the trial at Astellas (if they decide to continue trial 2B and 3). They have facilities in many European countries. Leiden (Leyden) also has one. So there's the possibility that they start a trail there. If you're from the other part of the country, you can also rest at my place in The Hague if you're also interested.
 
Ah that would be awesome, for some reason Hungary seems to be a favored destination for these types of clinical trials, we also had the AM-101 trial (in fact I got Google Ads asking if I'd be interested in trying out a drug for acute tinnitus). Catch me camping outside the recruitment office at 4AM if this happens for FX-322!
You may be in luck @hans799, because Astellas also has facilities in Budapest. I really do hope for you that they also decide to start trials in your country.
 
This sounds like they are definitely planning a phase 2b and 3 then because Astellas has agreed to pay them for it, no? Or am I reading too much into it?

These just apply to FDA phases as well and not European/Asia regulatory phases (regardless of where trials are held), right? It would be a confusing deal between Frequency and Astellas if they planned to skip the later phases. Trying to figure out what this means timing wise.
I think, based on the Frequency Therapeutics presentation, they will get money if Astellas' clinical trials in Europe and Asia for Phase 2b and Phase 3 are successful. That's how I interpreted it as.

So there's still a chance that once Frequency Therapeutics' Phase2a clinical trials in the USA are completed they could skip Phase 2b and go on to Phase 3. Or if they received breakthrough therapy status they could release the drug.
 
I talked to an audiologist about FX-322 phase 1 results and she said the word score results were "completely unheard of" and "remarkable." I think you are really downplaying what they were able to achieve with a single shot of their phase 1 dosing (which is less than phase 2 per shot).
I work in a noisy place where I have to understand sounds that totally overlap or partially overlap, so basically this is like a daily speech in noise test. I have also been submitted to speech in noise tests at several different ENTs. The performance can vary from one day to another for no reason we know. It is just like some days your ears interpret sound better depending on many things, like how you slept, if you are a morning person and the test is in the morning, and many small variables. Sometimes one hears loud but not very clear and suddenly words sound clearer, this just happens for no reason.

Sometimes the input of sound through our ears is exactly the same one day and the next, but what our hearing system do with the input in terms of speech recognition is different and I haven't read why anywhere, so it would be interesting to know the rationale for this. Maybe synapses? Better conduction through the hearing nerve, for some reason? Even cramps in neck area, or areas connected to the ear? I honestly don't know...

I know there are people who are pretty new to hearing problems, but I have been reading about the possibility of hearing loss being reversed and the miracle hearing pill or injection for like 15 years, so sorry I'm skeptical :)
Also I believe 5dB is within the error margin, not 10 dB, but sure ET issues could cause a difference but it would be improbable multiple people had that and it only affected 8 kHz.
Sorry, but that's not improbable, it is just the most common thing, and can tell you first hand after 10 years of hearing tests. It happens all the time with audiometric tests, even the ones performed with the same audiometer. There are usually slight differences in hearing performance, and 10 dB is a very small difference, particularly in a high frequency.

Honestly I am hoping for a cure for hearing loss as much as anyone, but in those slides I didn't find much valuable information. The slides are very vague, and the tests and results are derived from a very small sample of people.
 
It's not likely that Europe will get it as soon as the US does. FX-322 will likely have to go through each European country's drug approval agency, the way it went through the FDA here. Lots of Europeans have discussed flying over here and getting the treatment when it comes out.
Nope, I think there's just one authority for the entire EU, called the EMA. So it's just one process, not 27.

However, the EU is not equal to Europe, so what you said will unfortunately hold for the non-EU European countries (one of which is, sadly, the UK).
 
Sounds like a great plan @BBakkers. ! I will hold you to that. Maybe if we can go over there with a larger group of tinnitus suffering Dutchies, we could get a group discount at the local clinic. Two ears for the price of one perhaps;)

But I am really thinking about partaking into the trial at Astellas (if they decide to continue trial 2B and 3). They have facilities in many European countries. Leiden (Leyden) also has one. So there's the possibility that they start a trail there. If you're from the other part of the country, you can also rest at my place in The Hague if you're also interested.
Sounds like a plan. I was already planning to do some when the time comes. I know a few people with some bad tinnitus, so we should be good for that group discount. Haha.

I wasn't aware of the fact that they have a facility here in The Netherhands and of all places Leiden. I live in Alphen aan den Rijn. Leiden is a 10 min drive. So if you need a place to rest. Haha. Yeah I would definitely considering partaking in such a case. We can discuss further details privately (y). Don't want to spam this thread too much.
 
I had a look at the updated presentation and it was stated that they had 50% people enrolled and they haven't recruited anyone new.

On page 41 it talks about Astellas about having clinical trials in Europe and Asia. I did not understand this part. Is it suggesting that if Frequency Therapeutics did Phase 2b and Phase 3 trials in Europe and Asia, Frequency Therapeutics would get extra money?

Does this mean FX-322 would be released quicker if these clinical trials were done in Europe and Asia?
Does that mean I can get the treatment in Europe rather than the United States? May be my home country, the UK?
 
This new information on trials in Europe and Asia is very confusing. Does this mean that phase 2b and 3 can be done in Europe/Asia without having to have a phase 1 and 2 first? Presumably it does.

And if they do take place in Europe/Asia will there still be a 2b in the US, and if so is breakthrough status still a possibility in the US?

Also, when they say Europe, I presume they mean the EU. Astellas has facilities in most countries it seems, including non-EU European countries.

The fact, it seems, that they are going to do trials in Europe and Asia is very good news as I feel it shows confidence in the drug. Just hope it doesn't slow down the US side of things.
 
This new information on trials in Europe and Asia is very confusing. Does this mean that phase 2b and 3 can be done in Europe/Asia without having to have a phase 1 and 2 first? Presumably it does.

And if they do take place in Europe/Asia will there still be a 2b in the US, and if so is breakthrough status still a possibility in the US?

Also, when they say Europe, I presume they mean the EU. Astellas has facilities in most countries it seems, including non-EU European countries.

The fact, it seems, that they are going to do trials in Europe and Asia is very good news as I feel it shows confidence in the drug. Just hope it doesn't slow down the US side of things.
I also found it confusing as well. From what the presentation stated I assume it may be possible for the EU and Asia to skip the earlier trials and start from Phase 2b since they would have data from the previous trials in the US.

With the trials in the EU and Asia could allow them to collect more data and actually have more proof that the drug works.
 
I also found it confusing as well. From what the presentation stated I assume it may be possible for the EU and Asia to skip the earlier trials and start from Phase 2b since they would have data from the previous trials in the US.
That makes sense, and I hope it's correct.

I just can't see them releasing the drug in the US before any trials are completed in Europe/Asia though. I hope I'm wrong though, as it could mean waiting a further number of years for a phase 3 trial to finish.

These are definitely questions for the Tinnitus Talk Podcast.

Has anybody contacted Astellas? On their worldwide site they don't seem to have an email address, but they do on some of their country specific sites.
 
That makes sense, and I hope it's correct.

I just can't see them releasing the drug in the US before any trials are completed in Europe/Asia though. I hope I'm wrong though, as it could mean waiting a further number of years for a phase 3 trial to finish.

These are definitely questions for the Tinnitus Talk Podcast.

Has anybody contacted Astellas? On their worldwide site they don't seem to have an email address, but they do on some of their country specific sites.
Probably next important date is October this year. Then we know if this drug can lower tinnitus. If this turns out to be the case and they have optimised their dosing they may be open up for compassionate use as FGG said. So you may get your shot earlier. What I find a bit unfortunate is that they have not listed hyperacusis as an outcome measure of the trial. But probably out of 96 participants with hearing loss it is quite unlikely that someone has hyperacusis.
 
This sounds like they are definitely planning a phase 2b and 3 then because Astellas has agreed to pay them for it, no? Or am I reading too much into it?

These just apply to FDA phases as well and not European/Asia regulatory phases (regardless of where trials are held), right? It would be a confusing deal between Frequency and Astellas if they planned to skip the later phases. Trying to figure out what this means timing wise.
I think that Astellas and Frequency would be happy to save that money and go right to market (they won't turn a profit until then). They need a plan to make it through the full regulatory process, banking on breakthrough status would be poor form.

Plus phase 3 is not like other phases, it is focused of clinical efficacy and has a huge patient base compared to phase 2. An international phase 3 would be great news for patients imho. Breakthrough status would be even better.

Edit: I originally said "essentially early access" but that's too strong wording. It is a very large trial compared to phase 2 though, potentially with thousands of patients. It focuses on clinical use.
 

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