NS2359 is a triple monoamine reuptake inhibitor, which blocks the reuptake of dopamine, norepinephrine, and serotonin and may displace the dopamine reuptake inhibitor cocaine. NS2359 dissociates slowly from the transporters and has a long human half-life (up to 10 days) which makes frequent dosing unnecessary. NS2359’s pharmacological profile means that it may be able to reduce cocaine withdrawal symptoms, reduce cocaine craving and reduce cocaine-induced euphoria. In preclinical trials, NS2359 has been shown to reduce the reinforcing effects of cocaine and may have effects on cue induced drug craving. In a NIDA sponsored Phase 1 human laboratory interaction study, NS2359 was able to reduce the rewarding valence of 20 or 40 mg of cocaine, and it attenuated the cardiovascular effects of IV cocaine. Thus NS2359 does not show adverse interactions with cocaine. Furthermore, other human trials with NS2359 have shown that NS2359 has little or no abuse potential.
Cocaine dependence is a significant public health problem. In 2012, the National Survey on Drug Use and Health revealed that in the US 1.1 million persons were classified as dependent on or abusing cocaine. Cocaine abuse and dependence leads to significant morbidity and mortality. Other problems associated with cocaine use include increased rates of crime, violence, poverty, and family disruption. The standard treatment for cocaine dependence consists of individual and group psychotherapy and self-help groups. Although progress has been made in developing new psychosocial treatments, psychotherapy alone does not provide substantial benefit for many patients. Dropout rates in outpatient treatment programs are very high. Even among patients who complete treatment, relapse is common. Thus, medications have been sought to augment psychosocial treatment. Currently, there are no medications approved for the treatment of cocaine dependence. According to The Treatment Research Center (TRC) at University of Pennsylvania, the market value for an effective medication for cocaine addiction may exceed USD 1.8 billion in the U.S.
Saniona is collaborating with TRC on developing NS2359 for cocaine addiction. A clinical proof-of-concept study with NS2359 for treatment of cocaine addiction is currently ongoing and is supported by grants from the Dana Foundation and the Groff Foundation. Saniona and TRC intend to apply for additional public funding to continue the development of NS2359 if the trial proves to be successful. Saniona retains the commercial rights to NS2359.
NS2359 salt products are covered by issued patents in the U.S. expiring in 2028. In addition, the company expects to obtain data exclusivity, which provides protection in five years in the U.S. and ten years in Europe after market approval.