NPXe has several additional opportunities to explore. If the Phase III trial’s data support a neuroprotective effect of XENEX™ in hypoxic disease, then there are a number of potential applications and related indications which would lend themselves to the treatment including:
Following success in the hospital trial, which targets PCAS, NPXe intends to develop the use of XENEX™ in the pre-hospital emergency response setting by way of a portable device for use in an ambulance. Approximately 60 percent of OHCA patients (approximately 487,000 people in the EU and US) survive to be treated by emergency medical services (‘‘EMS’’) each year. As time to intervention is critical, administration of XENEX™ in the field may improve the performance of the therapy further.
One indication which is particularly sensitive to the ‘time to treatment’ is stroke. The availability of a portable device could enable EMS to provide neuroprotectant XENEX™ at an early stage. Importantly, unlike current treatments, , there is no evidence to suggest that xenon interferes with the subsequent treatment pathway for either of the principal causes of stroke (ischaemia or harmorrhage) and could therefore be administered before the cause of the stroke is established. This means that the entire patient population suffering from stroke (some 795,000 in the US alone) could be eligible for XENEX™ treatment.
Researchers at Turku University Hospital in Finland will start a Phase II investigator-initiated study using XENEX™ in 2019 to evaluate the use of xenon gas in subarachnoid haemorrhage. As this is a narrow indication, it may result in a narrow approval. Nonetheless, this could provide data which will reduce the overall regulatory requirement for a broader stroke label and accelerate the development of an ambulance device.
In addition to the above, the following indications may also benefit from the neuroprotective effects of xenon:
- Traumatic Brain Injury
- Anaesthesia Induced Developmental Neurotoxicity
- Hypoxic Ischaemic Encephalopathy