Emerging Opportunities with Cannabinoids

Abstract

This invaluable briefing provides a critical and far-reaching examination of current cannabinoid products and areas of unmet clinical need where the use of cannabinoids could be clinically beneficial and commercially profitable.

The psychotropic effects of Cannabis have been known for millennia  as have its medical uses, with the relief of cramps, rheumatic and menstrual pain being reported as early as 2,600 BC. The analgesic, appetite stimulant, anti-emetic, muscle relaxant and anticonvulsant properties of Cannabis were described by William O' Shaughnessy in 1839, leading to an expansion in its medical use. Today, with greater understanding of the cannabinoid receptor system, more targeted and specific agents are being developed with potential in a wide range of indications.

The industry has been excited most recently by the clinical and commercial success of sanofi-aventis' Acomplia (rimonabant) for the treatment of obesity (and with studies also undertaken in smoking cessation). High hopes for Acomplia' s sales potential in the rapidly-growing obese patient population have led to an increase in research and development activity in this area, and obesity and related metabolic disorders remain key indications of interest. In addition, CNS indications such as Parkinson' s disease and schizophrenia are being investigated in early stage development.

But considerable opportunities exist elsewhere. For example, the CB2 receptors are found primarily in the cells of the immune system, and have potential use in a range of indications, including pain and inflammation, allergies and cancer.

The report identifies three CB2 agonists which have entered Phase II clinical trials, and a number more in preclinical studies. The vast majority are being examined for their potential use in the treatment of pain and inflammation  high value markets where there are significant patient numbers and current therapies are less than ideal.

...to blood cancers

Studies with ligands of the cannabinoid receptors have shown to inhibit the proliferation in a number of cancer types. As CB2 receptors are found primarily in the cells of the immune system, it has been postulated that CB2 agonists may be able to induce apoptosis in transformed immune cells, leading to the development of a novel class of anticancer agents. Preclinical studies have confirmed this action in lymphoma and acute lymphocytic leukaemia (ALL) cell lines.

Clinical development of CB2 agonists in blood cancers has yet to take place. Nonetheless, the report highlights this as an area of potentially interesting future development.

• Who is developing synthetic cannabinoid agents and for what conditions?
• What regulatory and safety hurdles must Merck and Pfizer overcome if they are to launch taranabant and otenabant against sanofi-aventis' Acomplia?
• In a competitive and crowded market, which therapy areas offer the best opportunities for cannabinoid agents?

Opportunity areas

• Emesis
• Cachexia
• Pain & Inflammation
• Traumatic brain injury
• Cancer
• Obesity
• Smoking cessation
• Schizophrenia
• Parkinson' s disease

• Acomplia
• Taranabant
• Otenabant
• Ibipinabant
• Surinabant
• Marinol
• Cesamet
• Sativex
• Cannabinor
• KN38-7271
• Drinabant