To allow pensions to grow, ABP invests your money as sustainably and responsibly as possible. In the series ‘From your money’ we show what we make possible with your money. In this episode: how a small biotech startup from UMC Utrecht wants to fight brain attacks more effectively with our help.
Everyone knows someone in their environment who has ever had a cerebral infarction or stroke. Every year, 15 million people worldwide are affected by blood clots in the body that cut off the oxygen supply to the brain. Of these, a third die and a third suffer physical damage. Only 1 in 3 people make a full recovery. Rapid intervention is essential to survive a stroke. “We always say: ‘Time is tissue’. The sooner you can administer medication, the more tissue you save. And the smaller the chance of permanent injury,” says Kristof Vercruysse, CEO of the startup TargED Biopharmaceuticals.
Old thrombosis drug does not always work
The problem is that the common 30-year-old drug doesn’t always work as well. “It only works in 40 percent of the cases,” says Coen Maas, Associate Professor at UMC Utrecht and associated with TargED Biopharmaceuticals. He thinks he may have the solution. Years ago he studied the rare autoimmune disease TTP as a scientist. “I have always been very interested in these kinds of orphan diseases. Not only because there is little attention for it, but also because patients who suffer from these diseases often do not also have other medical problems. And that makes the investigation faster, because other medical problems can obscure an investigation.”
Clots block blood supply
The estimated 150, mainly young people in the Benelux who suffer from TTP, have to deal with a lot of microscopic blood clots in their body because the “clot formation” is disturbed. Clotting is a natural reaction to a leak in the blood vessels, says Coen. “When a blood vessel is damaged, a chemical process starts in which the protein ‘Von Willebrand factor’ acts like Velcro and binds flying platelets to it. They pile up layer by layer. The protein fibrin is ultimately the cement: it ensures that the layers remain firmly together. This is primarily a natural process to prevent blood loss after injury. If the layers continue to build up, a clot forms in the bloodstream and the oxygen supply to vital organs is cut off.”
Aim for another part of the blood clot
In TTP there is less or even no fibrin. “For example, a clot breaks apart and you get a lot of small micro clots in the narrower blood vessels throughout the body.” The current drug against these and other forms of thrombosis targets the fibrin to remove the clot. “So if a blood clot contains almost no fibrin, this drug won’t work.” Coen discovered that fibrin is often also insufficiently present in other clots. “So if you want to save more lives, you should aim for a different component of the clot. We think this is the von Willebrand factor.” Within the UMC, he and his team developed a biological protein, Microlysis, which attaches itself to the clot and then quickly ‘cuts it up’.
Does it work for all forms of thrombosis?
The hope is that the drug will not only work for TTP, but also for other forms of thrombosis. Kristof: “We are now entering a phase where we can test it in healthy people. It is an advantage that we are investigating this drug for a rare disease like TTP. Because the government considers this so important, the process is somewhat shorter. That is very important for drug development.”
Wanted: financiers with seat meat
Drug development is simply very expensive, explain Coen and Kristof. “All investigations and compliance with regulations cost a drug manufacturer on average 1 billion euros. It takes 14 to 20 years for a drug to reach the market. So you can’t do without external financiers,” says Kristof. And preferably financiers with some sitting meat. Because Coen often sees things go wrong after a promising start. Coen: “There are so many people walking around with ‘gold in their heads’. They still find money in the form of subsidies for the start-up and discovery, but after that the ‘boring’ part starts for the follow-up development of medicines. The rigorous testing for regulatory compliance, the scaling, the paperwork. They also call it the valley of death, because most innovations fail during this phase.” Few financiers have the patience for this, Coen and Kristof know: “That’s why we are extremely happy that organizations such as ABP are willing to help us.” ABP’s help is not without potential rewards. It is estimated that the market for thrombosis medication is worth around 15 billion euros. A better medicine therefore yields a lot.
Learning to walk and talk again
And the profit for society can also be great. Coen: “Ultimately, with a better antithrombotic medication, you not only save a lot of lives, you also relieve the burden on care. Also realize: people who have a stroke are often scarred for life. They often have to learn to walk, talk and dress again. They often need care for the rest of their lives. Not only dramatic for these people, but it also puts a lot of pressure on care with all the associated costs. In the first covid wave, we saw that 30% of patients suffered from thrombosis, mainly in the lungs. The options to treat this are still limited.”
‘As a fund you can be proud of this’
Coen is a UMC employee and therefore also builds up pension with ABP. It feels good for his fund to invest in something that is so close to his heart. “Of course this is also my job. But I like that the fund invests in things that many participants deal with on a daily basis. What we do can change so many lives that you as a fund and participant can be proud of that.”