Interview with Dr. Steve Schachter on Investigational Therapy

Clubmoss Growing in Forest

Epilepsy News From:

Tuesday, March 12, 2019

This past fall, Biscayne NeuroTherapeutics merged with Supernus Pharmaceuticals. Biscayne had been developing a therapy for epilepsy based on a new synthetic form of the herbal supplement huperzine A. Huperzine A has its roots in traditional Chinese medicine. Supernus has renamed this compound as SPN-817 and will be further developing and clinically testing it.

In 2006, the Epilepsy Foundation supported the first clinical trial for testing the safety and tolerability of this compound as an add-on therapy for people with uncontrolled seizures. The grant was awarded to Dr. Steve Schachter, co-founder of Insero Health, which soon after became Biscayne NeuroTherapeutics.

Senior Director of Innovation at the Epilepsy Foundation Dr. Sonya Dumanis sat down with Steve to talk about his efforts and the journey of getting this therapy closer to being available for people whose seizures are not controlled. 

What is huperzine A?

Huperzine A is a compound found in the Chinese clubmoss Huperzia serrata and to a lesser extent in other related clubmosses around the world. It is available as a dietary supplement in the United States for memory enhancement. But the amounts of huperzine A in the supplement vary widely from pill to pill, even in the same bottle. Also, the dose is far less than what we think will be needed for seizure control.

If I can get Huperzine A as a dietary supplement, why should I wait until it is FDA approved? 

Most importantly, right now we do not have enough proof that huperzine A is safe or effective in people with epilepsy to recommend that someone try it. We also don’t know how it might interact with other seizure medications. Just as important, as noted above, the manufacturing quality of dietary supplements is not as carefully monitored as it is for prescription drugs.

Why did you think that huperzine A might be helpful to people with epilepsy?

I had set up a program at Harvard Medical School to test botanicals in animal models of epilepsy. I chose huperzine A to test first because it was known to block glutamate (a chemical which is excitatory in the brain), which could be important as a way to stop seizures. I was able to send a sample of huperzine A to the Anticonvulsant Screening Program, which was supported by the National Institute of Neurological Disorders and Stroke. (The program is now known as the Epilepsy Therapy Screening Program.) There it was tested in a variety of epilepsy animal models to see how effective it was in stopping seizures. The results that came back showed that huperzine A was indeed really good at stopping seizures in these experiments. It didn’t seem to cause serious side effects in the animals. 

How is huperzine A working to stop seizures?

We now believe that huperzine A actually does not work by affecting glutamate after all. Rather, it interacts with a different pathway in the brain called the cholinergic pathway. This would be a completely new mechanism for an epilepsy therapy which is one of the things that makes it so exciting.  

Once you learned that huperzine A was effective at stopping seizures in animal models, what did you do?

Well, I wanted to test whether it could work to prevent seizures in people with epilepsy. At the time, it was being studied in people with Alzheimer’s disease, and it appeared to be well tolerated at the doses used in that study. I applied to the Epilepsy Therapy Project at the Epilepsy Foundation for support of an early-stage clinical trial. It took a while to get up and running, but the results were promising and so a company called Insero Health (later renamed as Biscayne NeuroTherapeutics) was started to help with further testing. Eventually, Dr. Stephen Collins joined the company as the CEO and his efforts eventually resulted in the merger with Supernus Pharmaceuticals.  It’s been a long but extremely exciting journey so far.

How helpful was the Epilepsy Foundation award in moving this compound through the clinical pipeline?

The backing from the Foundation was extremely important because of the seed funds provided and also because of the advice and support of fellow epilepsy doctors and scientists.

It takes a village to go from an idea to a promising new treatment and the Epilepsy Foundation was a huge part of that. 

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Authored by: Sonya Dumanis PhD on 3/2019
Reviewed by: Jacqueline French MD on 3/2019

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The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives.

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