It is indeed always interesting to speculate on what condition(s) these pharmas might be attempting to address.  I had the opportunity to review the UCB pipeline to determine what they might want to use Transcend for.  The only drug that made any sense to me, is their flagship product Cimzia (certolizumab) an Anti-TNF Monoclonal Antibody for the treatment of Rheumatoid Arthritis.  When looking at the other candidates for the CNS, they are either oral or small molecule.  Now it could be something they haven't published any material on, but with this collaborative coming so quickly after the MedImmune collaborative,  leads me to believe that the most likely candidate is something in the pain management area. You might say what does RA have to do with the CNS?  Well a couple of weeks ago when the MedImmune release came out, I wrote the following as it relates to Anti-tnf:


"What is of more interest to me and seems to have a bit more consensus around it, is that of an Anti-TNF inhibitor and it's role in pain management in the CNS.  Most recently, I read through a paper that was written on the subject as it relates to arthritis pain and how pain had dramatically decreased with the administration of an Anti-TNF.  The paper focused on the idea that most of the pain management was done in the CNS as there was no way the Anti-TNF could have acted that quickly at the inflammation site.  Not  entirely sure how the MAB crossed the BBB on it's own and I am assuming there may have been compromise in the BBB to have allowed this.

Now what makes this even more interesting, is that Medimmune was bought by AstraZeneca in 2007.  AstraZeneca also bought Cambridge Antibody Technology at around the same time and merged them with Medimmune.  Cambridge Antibody Technology were the original discoverers of Humira.  Humira is owned by Abbott and they sell about $8.2 billion dollars a year worth of it for the treatment of rheumatoid arthritis (among some other conditions).  Humira is an Anti-TNF.  How does that get into the brain in efficacious quantities?  Seems that we might have some common interests by some parties - wouldn't you think?

Pain management is an enormous market and dwarfs most any other drug market.  The marketplace for the relieve of chronic pain is in excess of $20-25 billion per year.  It may even be more, since many people do not use pain killers for extended amounts of time because of the side effects of long term usage.  Could you imagine, if you could get an injections every 6-8 weeks for the relieve of chronic pain with next to no side effects?

With the size of the pain management market and BTI's unique ability to transport drugs (like Anti-TNF MAB's) across the BBB, one would think that we would be in a good position to extract some very good upfront pre-clinical dollars.  We should have the ability to say to the interested parties:  Look guys, this market place is huge, you know it and I know it.  You guys are still fiddling around with what works and what doesn't work in the CNS.  If you wanna stay in the game, you have to pay for the priviledge to do so.  Not tying our cart to your specific horse.  The upside for you is a blockbuster drug.  Do you really think that you can be out of the game?  On the street, we call this setup a "stickup".

Medimmune hasn't told us what the targets are, but when you look at their pipeline for the CNS, it deals only with Anti-Interleukin 6 for pain/inflammation, but we know that MED1578 is part of the strategy (or at least was) and we know from third parties that the Anti-TNF is part of it as well.  Suffice to say that MedImmune sees the need to take one of these three (if not all) across the BBB."


Subsequent to this, I’ve done further reading on tnf blockers and the mechanisms by which pain is perceived/controlled in the CNS.  Some have hypothesized there are other communication/signalling networks working in conjunction with an Anti-TNF at the inflammation site to effectively decrease the pain perception in the CNS and that these communication/signalling networks readily traverse the BBB.  Other studies have utilized intrathecal injections of an Anti-TNF for the regulation of chronic pain and therby concluded that delivering an Anti-TNF to the CNS is efficacious.  Suffice to say that there appears to be an interest in delivering an Anti-TNF into the CNS.

Abbott's flagship product is Humira (adalimumab) which is an Anti-TNF Monoclonal Antibody for the treatment of rheumatoid arthritis.  We know that Anti-TNF is used for treatment of a number of different conditions and with Humira coming of patent in 2016, I would think they are looking at everything that might extend the patent life of an $8.2 billion per year drug.

Seems to me, that the delivery of an Anti-TNF or Anti-NGF to the CNS is a big, big prize and it would appear that we might have not 1, not 2 but 3 pharmas chasing the same prize.