RARECast is a Global Genes podcast hosted by award-winning journalist Daniel Levine. It focuses on the intersection of rare disease with business, science, and policy.
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Leveraging AI to Address the Neuropsychiatric Conditions Associated with a Rare Disease
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Though many drug developers today are applying artificial intelligence and machine learning to accelerate and improve drug discovery, the results they produce, in part, may be limited to the quality of the data they are able to use. Nobias Therapeutics is not only using public and private data, but it boasts unique and proprietary access to one of …
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In Pursuit of a Treatment for His Son, A Lawyer Becomes a Biotech Executive
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Alex Nemiroff took an unusual path to becoming the general counsel at Praxis Precision Medicines. Nemiroff’s son was diagnosed with a rare genetic epilepsy, and he co-founded the biotechnology company RogCon to develop an antisense oligonucleotide to treat it. Praxis licensed the project and hired Nemiroff as its general counsel. Now, the company h…
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In Push for Treatment, a Patient Organization Becomes a Trial Sponsor
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Pazopanib, a targeted therapy marketed as Votrient, is used to treat certain cancers. The drug has shown promise as a potential treatment for the rare genetic blood vessel disorder hereditary hemorrhagic telangiectasia (HHT), but when a change in ownership of the drug took place, efforts to develop the drug for HHT ended. That led the patient advoc…
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Delayed Diagnosis of Rare Diseases Takes Staggering Economic Toll
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The economic impact of a delayed diagnosis of a rare disease can result in up to $517,000 in avoidable costs per patient, according to a recent analysis from the Everylife Foundation for Rare Diseases and the Lewin Group. On average, the report found, it takes more than six years and nearly 17 doctor visits, hospitalizations, and other health-relat…
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A Cell Therapy to Control Heart-Damaging Inflammation in Duchenne
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Duchenne muscular dystrophy is a rare neuromuscular disease that causes muscle degeneration and premature death. As the condition progresses, heart muscle cells die and are replaced with scar tissue. This leads to heart failure, which is currently the leading cause of death among people with Duchenne. Capricor Therapeutics is developing a therapy t…
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Stimulating the Growth of Muscle Mass in People with Neuromuscular Diseases
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While there have been significant advances in the treatment of the rare, neuromuscular condition spinal muscular atrophy, existing therapies that slow or halt progression of it don’t regenerate muscle that has been lost. Biohaven is developing a therapy designed to inhibit myostatin, a protein that regulates the growth of skeletal muscle growth. We…
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The Yaya Foundation recently achieved a milestone in advancing towards treatments for 4H leukodystrophy when it successfully developed a mouse model. It reflects a broader effort that has allowed the organization to drive towards the development of a gene therapy to treat the rare, neurodevelopmental. We spoke to Ron Garber, co-founder and board pr…
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A Plea to the FDA to Give an Ultra-Rare Disease Drug a Fair Hearing
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In 2021, the U.S. Food and Drug Administration notified Stealth Biotherapeutics it would not consider its application seeking approval for elamipretide as a treatment for the ultra-rare mitochondrial disease Barth syndrome. The agency wants the company to produce evidence of the drug’s efficacy in a larger population of Barth syndrome patients then…
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How the Woolly Mammoth Beat a Path to Better Gene Therapies
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A Genetic Counselor’s Journey into Patient Advocacy
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Finding a diagnosis for a child with a rare condition can be challenging, even when his mother is a genetic counselor. Danielle Bonadies’ son Ethan was born with a brown birthmark known as a café au lait spot. But as the spots proliferated over the next few months, his pediatrician recognized it as a potential sign of a rare, genetic disorder. It w…
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A Company in the Fold of Rare Disease
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Protein misfolding is an underlying issue for many diseases, including lysosomal storage disorders and some neurodegenerative conditions. When a protein misfolds, its three-dimensional structure is disrupted, and it can no longer function properly. Gain Therapeutics is using its AI-driven discovery platform to identify novel targets to fuel a pipel…
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Disabling Antibodies that Drive Rare, Immunological Conditions
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Antibodies play an important role in the protective immune response. In some situations, though, such as autoimmune diseases, antibodies can cause harm by attacking healthy tissue. Hansa Biopharma has developed an antibody-cleaving enzyme technology platform to target pathogenic antibodies involved in autoimmune disease, organ transplantation, and …
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Keeping the Sentinels of the Brain Vigilant
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Microglia are specialized immune cells in the central nervous system that act as sentinels to maintain healthy brain function. They protect the brain against processes that can ultimately lead to neurodegeneration. Vigil Neuroscience is developing precision medicines designed to target microglia and restore and enhance the performance of these cell…
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Considering the Unfinished Work in Cystic Fibrosis
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Cystic fibrosis is a rare disease that has been an area of significant innovation. New therapies have provided life-changing treatments for most patients, but about 10 percent of people with the condition don’t benefit from these treatments because of the specific mutations underlying their condition. We spoke to Jamie Chang, senior medical directo…
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How to Advocate for Yourself as You Battle Cancer
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At 41, Bill Potts received a diagnosis of thyroid cancer. He listened to the recommendations from his primary care physician and didn’t seek out a second opinion. It was only six months later, during a follow up visit when his doctors wanted to repeat his treatment with radioactive iodine that he began to ask questions and started to advocate for h…
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Targeting Neuroinflammation to Treat ALS
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Regulatory T cells target systemic inflammation and neuroinflammation, but when they fail to function properly, they can drive serious health conditions including neurodegenerative, metabolic, and autoimmune diseases. Coya Therapeutics is developing a pipeline of therapies designed to restore the ability of Tregs to modulate the immune system and r…
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Leveraging Community Partnerships to Address a Rare Disease Behind a Medical Mystery in New Mexico
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Cristóbal Baca and Ana Ortiz came to New Mexico in 1600. Today, they have as many as 5 million descendants. A four-year effort involving community volunteers and workers, medical professionals, researchers, and families across New Mexico unraveled what had been a long-standing medical mystery. It turns out Baca and Ortiz are the source of a founder…
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Accelerating Gene Editing Therapies for Rare, Neurological Conditions
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In June, the National Institutes of Health’s National Institute of Neurological Disorders and Stroke made a five-year, $22.8 million grant to a group led by The Jackson Laboratory to develop gene-editing therapies for four rare, neurological conditions. The use of a platform approach to develop therapies for multiple indications follows other effor…
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Inhibiting Electrical Activity in Rare, Seizure Disorders
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CDKL5 deficiency disorder (CDD) is a serious and rare, genetic condition characterized by early onset and difficult to control seizures, as well as severe neuro developmental impairment. Last year, the U.S. Food and Drug Administration approved Marinus Pharmaceuticals Ztalmy to treat seizures associated with CDD, the first FDA approved therapy for …
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Improving the Function and Usability of Clothing for People with Disabilities
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Clothing is both functional and a means of self-expression, according to Open Style Lab, a nonprofit that works with designers, engineers, and occupational therapists to create clothing that addresses the needs of people with disabilities. In September 2022, as part of Genentech’s SMA My Way initiative, Open Style Lab and the SMA community joined f…
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Treating Cardiopulmonary Disease with Inhaled Targeted Therapies
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Pulmonary arterial hypertension is a rare and progressive condition characterized by high blood pressure in the arteries of the lungs due to their narrowing or a blockage. This causes the heart to work harder to pump blood and leads to heart failure, the need for lung transplantation, and death. Aerami is developing an inhaled form of the targeted …
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A Patient-Driven Registry Focused on Health-Related Quality of Life Data
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Patients may be the experts on their own conditions, but data that captures health-related quality of life is often underutilized in research. The PKD Foundation is working with IQVIA to create a registry of patients with autosomal dominant polycystic kidney disease, a rare kidney condition. The ADPKD registry focuses on patient-reported, health-re…
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An Ally for the Undiagnosed Emerges
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The search for a diagnosis can take many years and requires going from doctor to doctor without finding a definitive answer for people with ultra-rare conditions, atypical presentations, or yet-to-be discovered diseases. A group of undiagnosed and ultra-rare diseases patients and their family members, medical providers, and advocacy partners launch…
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Help for Rare Disease Patients That’s Just a Click Away
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Mary Morlino knows what it’s like to search for information and resources for a loved one with a rare disease or yourself. She had two nephews who were diagnosed with the rare neuromuscular disease Becker muscular dystrophy and later she was diagnosed with the rare autoimmune condition sarcoidosis. She now performs that search for information and r…
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Diagnosing Autism with a Single Strand of Hair
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Our interactions with the environment can have unexpected effects on our genes and trigger a biologic response that leads to the onset of disease. These interactions can also leave a measurable record in what’s referred to as the exposome. LinusBio, which emerged from the exposome laboratory at Mount Sinai Health System, has developed a test for au…
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Bringing Regenerative Medicine to a Rare Bone Condition in Children
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Congenital pseudarthrosis of the tibia is a rare condition that can cause spontaneous fractures, mobility problems, and impede proper growth. It is treated surgically, but because the bone often breaks again, it can lead to amputation. Novadip is developing an autologous cell therapy to allow tissue regeneration of large bone defects. We spoke to D…
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Bringing Precision to CRISPR-Based Genome Editing
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CRISPR genome editing has the potential to revolutionize the treatment of diseases, but the imprecision of its editing abilities has limited its value. Emendo Biotherapeutics argues that rather than trying to make every disease fit into the standards CRISPR model, the answer lies in making CRISPR fit each disease. We spoke to Rafi Emmanuel, executi…
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Capturing Patients’ Experience in Their Daily Lives
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One of the challenges with rare diseases is how different their effects can be from one person to another. In order to get a deeper understanding of the impact and variation of the rare autoimmune condition myasthenia gravis on people, Argenx launched MyRealWorld MG, an app-based study that’s collecting real-world, longitudinal data from 2,000 pati…
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When Terry Pirovolakis’ son Michael was diagnosed with the ultra-rare neurodegenerative disease spastic paraplegia type 50, he set out to raise money and engage researchers in developing a treatment. Now, after successfully dosing Michael with an experimental gene therapy as the first patient in a clinical trial, he has launched Elpida Therapeutics…
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A Nasal Spray to Curb Excessive Eating in Prader-Willi
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Parder-Willi syndrome is a rare, genetic disease that is characterized, in part, by hyperphagia—an intense and insatiable hunger. People with the condition are driven to constantly eat and seek out food. The syndrome is associated with severe obesity and obesity-related mortality. Tonix Pharmaceuticals is developing an experimental oxytocin nasal s…
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How One Foundation Is Laying the Groundwork to Advance Treatments for an Ultra-Rare Disease
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A week before Deborah Ondrasik’s daughter Gabrielle turned 1, she suffered her first seizure. Within a year, Gabrielle was diagnosed with CACNA1A-related disorder, a rare, neurodegenerative condition. At the time she was the eighth known person to be diagnosed with the disorder. We spoke to Ondrasik, who is a pediatrician, along with CACNA1A Founda…
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Forging a New Path for Medicine
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Amy Dockser Marcus, in her new book We the Scientists, tells the story of a group of parents of children diagnosed with the rare and fatal genetic lysosomal storage disorder Niemann-Pick disease type C. When they were confronted with the fact that no treatment existed or would likely be developed in time to save the lives of their kids, they began …
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Restoring Hearing through Gene Therapies
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About 10 percent of children who are diagnosed with hearing loss at birth have an auditory neuropathy that is usually due to a genetic cause. One of the most common genetic causes of hearing loss is due to a mutation of the otoferlin gene, which encodes for a protein that enables communication between the sensory cells of the inner ear and the audi…
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Creating a Sustainable Reimbursement Model for Ultra-Rare Therapies
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While there is growing ability to pursue the development of therapies for ultra-rare diseases, they remain challenging because of economics. One major barrier is the difficulty in getting reimbursement for therapies in the absence of well-powered clinical trials that recruit enough participants to satisfy payors demands for adequate proof of the va…
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Lumos Hopes Its Oral Alternative to HGH Will Fuel Its Growth
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Growth hormone deficiency is a rare condition that is the result of inadequate secretion of growth hormone from the pituitary gland. Though recombinant human growth hormone has long been used to treat people with pediatric growth hormone deficiency, it requires either daily or weekly injections and when injections are missed, results can be sub-opt…
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Advancing a Gene Therapy for a Rare and Fatal CNS Disorder
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GM1 gangliosidosis is a rare and deadly lysosomal storage disorder that causes progressive damage to neurons in the brain, as well as the heart, liver, bones and other tissues throughout the body. There are currently no approved therapies to treat the condition. Passage Bio, which has a collaboration with the Gene Therapy Program at the University …
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Addressing the Barriers to Patient Participation in Clinical Trials
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A significant obstacle to getting patients to participate in rare disease clinical trials, particularly children, is the burden placed on patients and their families to address the logistical challenges of arranging travel, fronting expenses, and completing paperwork for reimbursement. In fact, nearly two-third of patients and caregivers say travel…
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A Venture Philanthropist Makes the Case for Advocates Taking Equity
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Debra Miller’s son Hawken was diagnosed with Duchenne muscular dystrophy at the age of 5. Rather than just accept his fate with the rare neuromuscular condition, Miller and her husband Paul launched CureDuchenne to stimulate the development of treatments and potential cures for the condition. The organization subsequently launched a venture philant…
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Seeking a Sustainable Business Developing on N-of-1 Therapies
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The ability to pinpoint the underlying genetic causes of diseases and rapidly generate genetic medicines to address them has created the potential for the development of individualized therapies to treat patients with ultra-rare diseases. EveryOne Medicines is seeking to industrialize this process and scale the development of N-of-1 therapies. We s…
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How One Drugmaker Reaches out to Communities at Greater Risk for Rare Heart Condition
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A Next-Generation RNA Therapy Targets Telomere Disorders
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Telomere biology disorders are a set of rare genetic diseases caused by a shortening of the protective DNA that appears at the ends of chromosomes. Between 80 and 90 percent of people with these conditions will suffer from bone marrow failure by age 30, the leading cause of mortality for people with these disorders. The only available treatment tod…
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BridgeBio Advances Therapy for Limb-Girdle Muscular Dystrophy that Started with Two Patient Families
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Limb-girdle muscular dystrophy type 2i is a rare, genetic condition that causes progressive muscle degeneration that can impact skeletal, respiratory, and cardiac muscles. As the condition progresses, people lose the ability to perform routine daily activities, such as walking or standing up without assistance. There are no therapies available toda…
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Translating Urgency into Science
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The National Institutes of Health in November named Joni Rutter Director of the National Center for Advancing Translational Sciences. Rutter had served as acting director since April 2021. She succeeded Chris Austin, the first permanent director of NCATS, who stepped down after ten years on the job. NCATS is charged with developing technologies and…
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Empowering Ultra-Rare Disease Patients to Pursue the Discovery of Treatments
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Casey McPherson hasn’t taken a typical path to becoming a bioentrepreneur. The singer-songwriter is the frontman for Alpha Rev, an up-and-coming indie band from Austin, Texas. Rather than focus on his music career, McPherson instead put his energy into finding a treatment for his daughter Rose, who was diagnosed with an ultra-rare, neurodevelopment…
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Why a Topical Cannabidiol Gel May Help Treat the Behavioral Symptoms of Fragile X
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Fragile X syndrome is a rare, genetic, developmental disorder that is the leading known cause of both intellectual disability and autism spectrum disorder. People with the condition can have a range of behavioral symptoms, such as social avoidance and irritability. Zynerba is developing its experimental therapy Zygel, a topical cannabidiol gel that…
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An Ultra-Rare Disease Drug Developer Tries to Navigate Regulatory Uncertainty
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When Stealth Biotherapeutics sought approval for its experimental therapy to treat the ultra-rare and life-threatening condition Barth syndrome, the U.S. Food and Drug Administration said it wouldn’t review its application because the clinical studies the company performed involved too few patients to make a determination about the efficacy of the …
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Powering Cells in People with Rare Mitochondrial Diseases
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Primary mitochondrial myopathies are a group of rare, often life-threatening disorders caused by genetic mutations that affect the energy needs of skeletal muscles and can impact the ability to walk, lift, or do other everyday activities. High energy tissues like the heart, brain, and muscle are most affected by these disorders. Currently, there ar…
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Powering Weakened and Stressed Cells in ALS to Function Better with Nanocrystal Therapy
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In neurodegenerative diseases like ALS, cells in the brain suffer a decline in their ability to produce energy. These impairments help to drive the progression of these diseases. Clene Nanomedicine is developing a nanocrystal suspension of gold atoms that are small enough to enter mitochondria—the cellular organelles that power activity—to increase…
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Developing a New Class of Therapies Based on a Natural Cargo Carrier
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One of the greatest challenges emerging therapies face is being able to reach the tissues and cells in the body where they need to go to provide benefit. Rather than using viral vectors or lipid nanoparticles, Evox is harnessing exosomes, a natural transporter within the body, to carry therapeutic cargo to desired targets. The company has developed…
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Reaching Beyond the Limits of Enzyme Replacement Therapies with Gene Therapies
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Though enzyme replacement therapies have proven a viable strategy for treating lysosomal storage disorders, one problem is that these medicines face challenges reaching all of the cells throughout the body that are affected by these conditions, particularly in the brain. Avrobio is developing one-and-done gene therapies to treat cystinosis and othe…
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