Otonomy OTO-413 — Treatment of Hidden Hearing Loss

Formal musical training is believed by some to improve speech understanding. Google 'auditory training'.
When I Googled "auditory training", the entire first page has topics on training hearing when hearing aids are required, or therapies involving hearing loss where hearing aids are not yet required. Nothing relating to music, musicians, singing, musical instruments, or anything of the like.

There is evidence that formal musician training helps musicians to better pick out and interpret voices in a noisy environment. It turns out it has to do more with their brain's ability to interpret minimal instrument signal in a noisy environment.

Personally knowing several musicians and learning of their experience with hearing loss/tinnitus, it seems like @tommyd87 may also have a good explanation for excluding musicians. Perhaps it is both?
 
When the topic of auditory training has come up in other places a common response has been you'd be better off doing formal musical training. A similar goal but musical training works better. That's the tenuous link.

Musical Training for Auditory Rehabilitation in Hearing Loss

They would exclude a violinist in a string quartet for noise exposure but take a drummer in a rock band?
 
Brb going to spend some hours on my treadmill!
Did it help? :)

If anything I perceive my tinnitus as louder in conjunction with cardio vascular exercise – at least it doesn't do anything to make it quieter. But maybe it takes time for the BDNF to have any effect in the ear. Wonder how much exercise we need for it to be optimal without having to spend too much time? :dunno:
 
anything I perceive my tinnitus as louder in conjunction with cardio vascular exercise
Same here, must be the increased bloodflow. I am trying Noopept, a nootropic that supposedly increases BDNF levels in your CNS. 3 weeks in, I am still getting worse. I think we need very high levels of neurotrophins to regenerate the lost synapses.
 
Did it help? :)

If anything I perceive my tinnitus as louder in conjunction with cardio vascular exercise – at least it doesn't do anything to make it quieter. But maybe it takes time for the BDNF to have any effect in the ear. Wonder how much exercise we need for it to be optimal without having to spend too much time? :dunno:
The pressure in my ears has improved, but I doubt the little bit of exercise I've had helped :p

No change in tinnitus, which I don't expect after many years.
 
Otonomy will give a presentation about OTO-413 next week:

https://investors.otonomy.com/news-...presentation-oto-413-clinical-results-aao-hns
SAN DIEGO, Sept. 27, 2021 (GLOBE NEWSWIRE) -- Otonomy, Inc. (Nasdaq: OTIC), a biopharmaceutical company dedicated to the development of innovative therapeutics for neurotology, today announced the presentation of previously disclosed clinical results from the successful OTO-413 Phase 1/2 trial at the upcoming American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) Annual Meeting to be held in Los Angeles October 3-6, 2021. The oral presentation will be delivered on October 3, 2021 at 3:15 p.m. PT by Peter G. Volsky, M.D., Assistant Professor of Otology and Neurotology at Eastern Virginia Medical School. Dr. Volsky was an investigator in the trial during his prior clinical service with South Florida ENT Associates.
 
It's such a shame that even with the successful Phase 1 results they are repeating again. I would just stick to the same dosage throughout the trials, then, once it comes out to the market, adjust dosage.
It's not a do-over, it's an extension. I think it's a smart move on their part tbh. They're able to build on what already looks promising, and use the additional data to construct better parameters for a Phase 2. Which should help reduce the likelihood of failure, and help them to better identify the ideal responder for any future trials.

Imagine if the guys over at FREQ did this with their Phase 1/2. We probably would have seen the shitshow of a Phase 2A collapse.

Bottom line, extending it now might save them a boatload of time and resources needed to get the drug through future trials.
 
In Otonomy's most recent press release they mention that Dr. Volsky (one of their investigators in the trial) was scheduled to give a "presentation of previously disclosed clinical results from the successful OTO-413 Phase 1/2 trial at the upcoming American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) Annual Meeting to be held in Los Angeles October 3-6, 2021".

I couldn't find any info about that talk online, so I reached out to Otonomy to see if they could provide me with the slides that were used in the talk. Remarkably they sent them right over. I've attached them to this post.

I don't believe there's anything we haven't seen before, and most of these seem to be repurposed from their corporate presentation, but it's a good summary of everything we currently know about OTO-413.
 

Attachments

  • AAO-HNSF 2021_OTO-413 Presentation_22Sept2021 Final.pdf
    727 KB · Views: 151
Otonomy issued a press release this morning on a number of presentations that they're giving at the upcoming Neuroscience 2021 meeting. These two caught my eye:
  • "Local delivery of BDNF (OTO-413) and a selective TrkB agonist (M3) restores hearing function in models of cochlear synaptopathy" by Fernandez et al.
  • "Novel fab fragments derived from Trk-selective agonist monoclonal antibodies are potent and selective antagonists of the TrkB and TrkC receptors" by Siegel et al
Anyone know what these mean? They're giving a separate presentation on OTO-413, and I don't think OTO-413 contains a selective TrkB agonist. Could this be a new formulation that they're working on that's more potent? Or is this somehow related to what they've already done?
 
Otonomy issued a press release this morning on a number of presentations that they're giving at the upcoming Neuroscience 2021 meeting. These two caught my eye:
  • "Local delivery of BDNF (OTO-413) and a selective TrkB agonist (M3) restores hearing function in models of cochlear synaptopathy" by Fernandez et al.
  • "Novel fab fragments derived from Trk-selective agonist monoclonal antibodies are potent and selective antagonists of the TrkB and TrkC receptors" by Siegel et al
Anyone know what these mean? They're giving a separate presentation on OTO-413, and I don't think OTO-413 contains a selective TrkB agonist. Could this be a new formulation that they're working on that's more potent? Or is this somehow related to what they've already done?
Probably a pre-clinical study on mice or rats.
 
Otonomy issued a press release this morning on a number of presentations that they're giving at the upcoming Neuroscience 2021 meeting. These two caught my eye:
  • "Local delivery of BDNF (OTO-413) and a selective TrkB agonist (M3) restores hearing function in models of cochlear synaptopathy" by Fernandez et al.
  • "Novel fab fragments derived from Trk-selective agonist monoclonal antibodies are potent and selective antagonists of the TrkB and TrkC receptors" by Siegel et al
Anyone know what these mean? They're giving a separate presentation on OTO-413, and I don't think OTO-413 contains a selective TrkB agonist. Could this be a new formulation that they're working on that's more potent? Or is this somehow related to what they've already done?
The more I dig into this, the more it does look to me like follow-on pre-clinical work for an improved OTO-413 - though probably something in the early stages. TrkB agonists seem to help BDNF.

Fernandez was a previous co-author on some of their previous BDNF studies. I can't really see any reason for them to do these presentations unless they're working on an improvement of some sort - though maybe I'm seeing what I want to see? I guess we'll find out soon enough though.
 
Just for your interest @patorjk, as you are knowledgeable in corporate matters and that is a a useful background to have {but most people here shouldn't go paddling in shark-infested waters}.

Auris Medical seem to have changed their name to Altamira Therapeutics but still have the web address as aurismedical.com. Just sayin' like Not much moving there except their stock price on the six month interval, but it's up overall on the year. But then the other hearing research stock seem to be facing headwinds too.
 
Otonomy has released its Q3 financial results. Most interesting updates:
  • OTO-413 study is ahead of schedule and results are now expected in early Q2 of 2022.
  • The expanded OTO-413 study is now being called a "Phase 2a" study in their press releases.
  • They're adding a "full dose" cohort to the expanded study. It'll be a higher dose than they've tested before. They didn't say how big this dose would be (at least I didn't catch anything related to it). This new cohort will consist of 12 additional patients (8 getting the drug, 4 getting placebo).
  • They expect to start a Phase 2b study for OTO-413 using the full dose version by the end of 2022 (assuming favorable results to the current Phase 2a study).
  • Nothing was said about the 2 presentations I mentioned above. I'm guessing the science is too early to be of interest to investors, at least at this point.
 
Otonomy has released its Q3 financial results. Most interesting updates:
  • OTO-413 study is ahead of schedule and results are now expected in early Q2 of 2022.
  • The expanded OTO-413 study is now being called a "Phase 2a" study in their press releases.
  • They're adding a "full dose" cohort to the expanded study. It'll be a higher dose than they've tested before. They didn't say how big this dose would be (at least I didn't catch anything related to it). This new cohort will consist of 12 additional patients (8 getting the drug, 4 getting placebo).
  • They expect to start a Phase 2b study for OTO-413 using the full dose version by the end of 2022 (assuming favorable results to the current Phase 2a study).
  • Nothing was said about the 2 presentations I mentioned above. I'm guessing the science is too early to be of interest to investors, at least at this point.
Good news on the OTO-413 front; and encouraging to see them ahead of schedule.

As far as the addition of the TrkB antagonist study, I suspect that would need to be a separate round of trials. So, they may not be ready to comment until the outcome for OTO-413 is much more clear (IE: Clearly targeted patient population, appropriate primary outcomes, stat sig patient outcomes).
 
It looks like the summer of 2022 is when we will have the results to all of these studies; PIPE-505, FX-322 severe trial and now OTO-413. I don't know how much longer I can wait. Every day just drags on, knowing we might be so close to a cure.
 
Otonomy has released its Q3 financial results. Most interesting updates:
  • OTO-413 study is ahead of schedule and results are now expected in early Q2 of 2022.
  • The expanded OTO-413 study is now being called a "Phase 2a" study in their press releases.
  • They're adding a "full dose" cohort to the expanded study. It'll be a higher dose than they've tested before. They didn't say how big this dose would be (at least I didn't catch anything related to it). This new cohort will consist of 12 additional patients (8 getting the drug, 4 getting placebo).
  • They expect to start a Phase 2b study for OTO-413 using the full dose version by the end of 2022 (assuming favorable results to the current Phase 2a study).
  • Nothing was said about the 2 presentations I mentioned above. I'm guessing the science is too early to be of interest to investors, at least at this point.
Great to hear about OTO-413. I thought the repeat trial with higher dosage was Phase 1b but I'm glad they are calling it Phase 2a. Still a bit sad they delayed OTO-413 but at least Phase 2b will start end of next year so it would a year or two behind FX-322.
 
Good news on the OTO-413 front; and encouraging to see them ahead of schedule.
I hope it's good news too, but I assume that the "full dose" trial is also due to early data suggesting that a stronger dose would yield better results. I wonder what results they were (or weren't) getting that inspired this adjustment.

That said, I do not know how much data they would have so far. I am also purely just speculating and reading into the news—I hope everything is looking promising and it's always great seeing the wheels in motion.
 
Great to hear about OTO-413. I thought the repeat trial with higher dosage was Phase 1b but I'm glad they are calling it Phase 2a. Still a bit sad they delayed OTO-413 but at least Phase 2b will start end of next year so it would a year or two behind FX-322.
The Q3 call and press release were very strange, they didn't address the name change at all. Even the clinical trials page still has it listed as Phase I/II. Apparently the reason they're so ahead of schedule is because they're receiving a high demand for OTO-413 from their clinical sites, which recruit using existing patients (i.e. patients that have been seeing doctors for quiet some time regarding their hearing loss). To me this could indicate that OTO-413 works, as maybe word has gotten around and that's why so many are signing up?

I'm glad they upped the dose too, I was surprised they didn't do that when they announced the expanded trial. Apparently they had to get permission from the FDA - my gut assumption is that that just took forever and it's why they're only tacking that on now near the end of the trial. It should give the trial a much better chance of success though, as they said that the 0.3mg dose cohort (the highest dose cohort of the original study) showed the most improvement and that dosing seemed to impact results. I actually think their Otividex drug failed due to being under dosed.
 
Otonomy has released its Q3 financial results. Most interesting updates:
  • Nothing was said about the 2 presentations I mentioned above. I'm guessing the science is too early to be of interest to investors, at least at this point.
Am I only one who thinks it's awesome both Otonomy and Frequency Therapeutics are already working on improved versions of their drugs? Progress in the field seems to be quite steady.

Things might improve even faster once these companies get cash from a released drug (a darn shame that their Meniere's trial was a failure!)
 
I decided to contact Otonomy about the Select TrkB Agonist talk and they sent me the slides - they're attached to this post. I was wrong in my assumption that it was for a next-generation OTO-413. Instead it's related to the preclinical work for OTO-413 and how they tested 2 drugs for possible advancement (BDNF and M3). The IR person told me that they have IP covering M3 and could develop the molecule in the future if appropriate.

I'm a little bummed, as I was hoping this was hinting at something exciting on the horizon, but I suppose if OTO-413 is a success this coming Spring they'll be looking into ways to improve it anyway. I also wonder if I gave them any ideas with my questions, as maybe mixing the two would have a synergist effect.
 

Attachments

  • Otonomy 2021 SfN presentation - BDNF and M3.pdf
    766.3 KB · Views: 86
I decided to contact Otonomy about the Select TrkB Agonist talk and they sent me the slides - they're attached to this post. I was wrong in my assumption that it was for a next-generation OTO-413. Instead it's related to the preclinical work for OTO-413 and how they tested 2 drugs for possible advancement (BDNF and M3). The IR person told me that they have IP covering M3 and could develop the molecule in the future if appropriate.

I'm a little bummed, as I was hoping this was hinting at something exciting on the horizon, but I suppose if OTO-413 is a success this coming Spring they'll be looking into ways to improve it anyway. I also wonder if I gave them any ideas with my questions, as maybe mixing the two would have a synergist effect.
They're talking about improvement when the subject gets injected OTO-413 the day following the noise trauma. So it doesn't work for people who got noise trauma years ago?
 
I decided to contact Otonomy about the Select TrkB Agonist talk and they sent me the slides - they're attached to this post. I was wrong in my assumption that it was for a next-generation OTO-413. Instead it's related to the preclinical work for OTO-413 and how they tested 2 drugs for possible advancement (BDNF and M3). The IR person told me that they have IP covering M3 and could develop the molecule in the future if appropriate.

I'm a little bummed, as I was hoping this was hinting at something exciting on the horizon, but I suppose if OTO-413 is a success this coming Spring they'll be looking into ways to improve it anyway. I also wonder if I gave them any ideas with my questions, as maybe mixing the two would have a synergist effect.
Is there a timeframe for when OTO-413 can be used? It looks like they tested immediately after noise trauma and 7 days after.
 

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