Shots, Shots, Shots: Is There Such a Thing as One Too Many?

And you maybe kind of hit on this already a little bit, but I'm thinking of almost like a chicken and egg type situation in that the question is, does recognizing disease burden, the unmet need, does that drive drug development? Or is it more that drug development is actually helping us better recognize the true magnitude of disease burden and the gaps that ultimately that drug can help fill, let alone open the door for more opportunities in research and And you kind of hit on that with where you start in looking at that number that unfortunately, at least as far as we know, has not changed, though it will take a long time to see that change, that delay in seven to 10 years from start to diagnosis.

But yeah, what are your thoughts about that kind of, you know, dichotomy in that, you know, does, you know, appreciating the burden first really drive drug development or is it something else? But I think, and I don't want to bias you, I think actually when we get new drugs, especially drugs that are very targeted towards the underpinnings of the disease, we actually learn a lot more about the disease.

Yeah, I agree with you.

I think it is kind of a chicken or an egg.

And I think every, um, every great innovation in science we've had is not always deliberate right like sometimes we find these by accident and the the good thing is that we're invested in the research um and and just to let you know right this just goes to history we know that like i'm once again concentrating on hs here a little bit that if you uh looked at like the epidermal histology of psoriasis lesions and hs lesions they're very similar I don't want to say it's easier, but it's definitely a recognition from researchers and manufacturers to say, okay, if we have medicines and research that are already deep with psoriasis, maybe this can contribute to HS.

Now, that was the thinking back then, but as we go down this endeavor of understanding HS more, Knowing that it's, oh my God, there's a huge unmet need and there's a lot of different opportunities to kind of attack this condition from different ways.

That may have been how we started, but it's not where we are now.

Now we're deliberately saying, okay, there's still other elements where there's unmet needs with this disease that we can attack if we use a different mechanism of action or a different delivery route or whatever it is that we're trying to kind of solve for.

You know, in hearing you talk about, and it makes perfect sense from, you know, especially with the, you know, bimicizumab story from psoriasis to HS, it almost makes me think that there really is an opportunity for collaboration there because to your point of, how diseases, while distinct, and we're seeing this maybe in parallel talk about, you know, the kind of the T2 spectrum of inflammatory diseases, distinct diseases with shared biology or pathophysiology in these cases can then lend itself to say, well, hey, if they have similar underpinnings, then maybe targeting this here as well will be useful.

So that's kind of what I'm hearing in terms of maybe the what lit the match.

But then, of course, as you're seeing the impact, you start learning more and more about the disease.

And I think, you know, for example, you know, in the pathway from that lateral transition or the lateral expansion from the psoriasis, right arthritis indication to Hedrona separativa, I think we learned a lot about HS in what is, not necessarily there's a direct linear correlation, but knowing that, well, interesting, we're seeing that there's more IL-17F versus A, not that we know what that necessarily translates into clinically, but Correct me if I'm wrong, that wasn't even part of the conversation until this pipeline

began, correct? Yeah, exactly.

And we're so lucky because there's so many researchers out there doing all of this work in advance, right? So even how this actually conversation even started with HS was way before the clinical trials started, right? So about seven, eight years ago, when we already knew that we wanted to go into HS, we're like, okay, let's scour the internet.

Let's go through different literature.

Let's talk with experts and see what their thoughts are on targeting and modeling in this disease.

And there's like this one article, one study that we always refer back to.

And this study probably started more in like 2016, 17, but they published their results in 2021.

It's out of Jim Kruger's lab.

And they're actually the ones that like kind of did all of this work to show about why certain diseases uh you have this up regulation of genes that are related to psoriasis but then things not related to psoriasis and that's how we found out like hs is a neutrophilic disease and guess what like our mechanism of action has this big play in neutrophils right in neutrophil chemotaxis so let's we're going to dive right into it and so that's how we translate the theory or our hypothesis from kind of a bench to bedside matter, because that's how we then created the clinical trials, right?

Yeah, you walked into where I was hoping you were headed so beautifully.

And I think what you've clearly described is the opportunity for industry academic partnership.

And I think this is a good kind of description for those who are listening and out there wondering, okay, how can my research move the needle? What is the importance of even publishing? You just said it.

And I can relate to my own work.

I'll have folks reach out to me based on publications from five, six years ago, wanting to talk because that work, even though it's not directly associated with what they're doing, they could see the kind of connection.