British biotech firm Zihipp has big ambitions: the London-based start-up is developing a drug to combat the global obesity and diabetes pandemic.
Thanks to Abu Dhabi funding, the medicine is now in the trial phase with hopes it will hit shelves within nine years, a move that could revolutionise health care around the world.
In January last year, Zihipp, a spin-out company of Imperial College London, secured £3.3 million ($4.54m) in Series A funding led by the Mubadala Investment Company.
The biopharmaceutical company is developing peptide hormones to combat soaring rates of diabetes and obesity, with obesity the biggest “health tsunami” in the world, according to Professor Sir Stephen Bloom, the executive chairman of Zihipp, who also heads a large research team in Imperial College London.
With food so plentiful, delicious and easily available in the modern world and transport systems so efficient, Dr Bloom says exercise levels have plummeted.
“If you're a farmer, you drive a tractor. If you're working in a building, you take a lift, and spend a lot of time looking at LCDs,” he says.
“This has greatly diminished the amount of exercise we take in our everyday lives and every country in the world is getting obese. It’s a massive burden in terms of cost, the unfortunate diseases as a complication of the obesity and the quality of life for the people that are obese.”
Obesity has nearly tripled worldwide since 1975, according to the World Health Organisation, with 39 per cent of adults aged 18 years and older overweight in 2016, and 13 per cent obese.
To combat this, Zihipp’s drug suppresses hunger, a development that means people never have to get overweight in the first place, in turn transforming health and the care and cost needed to manage the condition globally.
“People will live longer and be happier,” says Dr Bloom.
If Zihipp succeeds in its bid to solve the obesity crisis, Dr Bloom estimates it is a “trillion-dollar profit area” for the company’s investors, “because our aim is to succeed in helping the entire world”.
Dr Bloom describes the UAE as "a particular hotspot” for the condition with "a greater tendency in the Emirates to get fat and about 10 years later to develop diabetes”.
Diabetes - a serious condition where your blood glucose level is too high - shortens lives and produces nasty side effects such as blindness, heart attacks and loss of limbs such as feet.
“So just as we've developed much better health care, better nutrition and safe working environments, unfortunately because of this tsunami of obesity and then diabetes, people are not living longer,” says Dr Bloom.
This is where Zihipp’s drug comes in. By curbing the rise in obesity, it will, in turn, reduce the incidence of diabetes.
While humans could do the work themselves by taking more exercise and eating less, they often can’t because the temptation to eat more is too great and society has made it too easy to avoid regular exercise.
While bypass surgery is one solution for the chronically obese, there is the risk of dying in surgery, plus it is a very expensive route to take.
“So our aim was to produce a medical bypass, a medication that you could take that would produce the same effect, the same weight loss, the same improvement of health as bypass by mimicking what happens after bypass,” says Dr Bloom.
The team set about researching what happens to patients after bypass surgery to understand why people feel less hungry.
“What we found was that after we eat food, the gut releases certain peptide hormones, which switch off your appetite and then after the meal is digested, the levels go down, and you feel hungry again for the next meal,” says Dr Bloom.
“If you have any sort of gut illness, the food doesn't get digested as quickly, the hormones stay up for longer and you feel less hungry. Bypass surgery, which bypasses the upper small intestine mimics a disease of the gut without you actually having a disease and thereby increases the level of these hormones. We call them satiety hormones.”
For research workers that meant modifying the hormones to make them suitable as drugs and then giving them to people and seeing what happens.
“So we did that and lo and behold, people lost weight, and they no longer felt hungry,” says Dr Bloom. It’s an area he has worked on for 40 years ago, with the first human infusions taking place 30 years ago.
But the hormones had a problem, they did not last long, meaning someone taking them as a drug would have to take them every three hours.
So the team redesigned the hormones, modifying them to make the drug more potent and able to last up to two weeks.
“We were successful in doing that and got the patents and Mubadala has funded turning this into a practical medication,” says Dr Bloom.
In a standard pattern for the pharmaceutical industry, Dr Bloom says, the basic research is carried out in university laboratories and then investors come on board to aid the extremely expensive and arduous process of proving the drug is safe through a series of clinical trials.
While Zihipp has completed some trials with patients, the regulatory process to get the drug approved and into the market for consumers to use it is ongoing.
Dr Bloom expects it will take nine years before it is available in chemists, with the company looking to comply medical standards across the globe.
“That requires a lot of boxes to be ticked,” says Dr Bloom. “It’s a very slow process with lots of people poring over all the data to make quite certain it is safe.”
The £3.3m in funding arose from a tight relationship between Imperial College in the UK and the Imperial College London Diabetes Centre Abu Dhabi (ICLDC), with the UK centre advising the UAE facility on how to handle the “tsunami of diabetes in the Emirates”.
“We were helping make sure that it was the most up to date, international quality service, and it is a very good place to have diabetes – frankly, better than the UK - because the facilities are modern, the people are well trained and there's not much of a queue,” says Dr Bloom.
With Mubadala Health funding the Abu Dhabi facility, Imperial College helps to provide education facilities.
“We're gaining information about how diabetes behaves in a different setting, so Imperial College is actually very proud of the relationship and proud of the fact that the quality of diabetic care that ICLDC delivers is very good,” says Dr Boom.
It was this relationship with ICLDC that helped to secure the funding for Zihipp, which spun out from Imperial College in 2012 to commercialise the research conducted under Dr Bloom’s team.
The “sizeable” figure invested by Mubadala Health has gone towards bringing the medication safely to market and paying for the lengthy and expensive trial process for the drug to be approved for consumer use.
Most drugs are developed on a world scale, so if this drug is effective it will be sold across the globe.
“Of course the world will have to pay for it because the investors need a return. But this will be extraordinarily profitable,” said Dr Bloom.
“We think it's a very low-risk area with a very high return. We find it very exciting. Our only problem is that we need to raise enough capital to stay ahead of the competition.”
Investing in a high net worth area, such as the pharmaceutical industry, can be very lucrative, says Dr Bloom, because “you don't need heavy machinery or coal or anything else”.
“You can develop this with capital and it is a very good future industry to be involved with because it has the enormous advantage, particularly in our case of dealing with a problem that's particularly local to the Emirates.”
When Mubadala first announced its investment in Zihipp, Abdulla Al Shamsi, head of health care at Mubadala Investment Company, said “these new treatments promise to make a significant impact on public health”.
“We are always seeking to invest in cutting-edge healthcare-related technologies that can benefit our patients.”
When the drug eventually goes live, Dr Bloom expects patients to inject themselves 26 times a year, adjusting the dose according to how much weight they need to lose.
“It’s a very tiny injection, we think it'll actually be virtually painless,” he says.
But with the expenditure necessary to develop a drug between $100m to $200m, Dr Bloom says Zihipp will need more funding to complete the project.
While the $3.3 million is a good start, he says, ensuring the company is solvent for the next three, “we do need some more capital”.
Currently people pay more than $7,000 per patient for weight-loss medication, with Dr Bloom expecting Zihipp’s drug to come in “cheaper than anything on the market”.
“We're now looking to plan for the next stage and there's another factor which is the patent on any agent lasts 20 years," he says.
“So you only get a return when it's still within the patent, so if we fast forward, everyone's going to automate the drugs that we make in 25 years’ time, so we need both to get to market well within our patent life so that we can have a period of financial return, otherwise people won't invest in us.
“We’re very young in the patent life, so we've got probably 19 years ahead of us, which is more than enough time."