As a prime cause of disability, rheumatoid arthritis (RA) affects over 1.5 million Americans according to the Arthritis Foundation. A majority of patients are adults who are in their prime, aged between thirty and sixty. The way to conquer the disease is to first understand the immunology of the condition and then, figure out how best to manage it. A new solution is being explored by a company called Inmedix.
Inmedix Inc. is a Seattle-based life science company among a select group, including GSK, SetPoint Medical and Galvani, leading the medical world in the new field of immuno-autonomics. The autonomic nervous system (ANS) within the brain controls all housekeeping systems, such as cardiovascular, digestive, thermoregulatory function, sleep and fight-or-flight survival (stress). The concept of immuno-autonomics is the confluence of immune function and stress modulated by the ANS. Through immuno-autonomics, Inmedix is trying to initiate a conversation about how mitigation of adverse ANS stress responses in daily life can improve the treatment of RA. Founded in 2006 by Andrew J. Holman, MD, and Mr. Timothy Sciarrillo, its first project addressed the treatment
of fibromyalgia with dopamine agonists. During that project, additional connections between stress, fibromyalgia and immune function were identified. In five human studies, Inmedix then explored how ANS stress state influenced underlying autoimmune diseases and their response to treatment.
The Inmedix ANS NeuroscanTM prototype conducts ANS stress research with next-generation heart rate variability (HRV). By 2019, Inmedix aims to provide a commercial diagnostic version specifically appropriate to the clinical setting. The tool is not designed to predict ‘the best’ treatment option for ‘the right’ patient. Rather, ANS state is thought to directly affect autoimmune disease activity itself. Stress flares autoimmune disease and consequently, greater disease activity is harder to control. ANS state is thought of as a tide that raises or lowers all ships agnostic to the immunosuppressive chosen.
This sophisticated, cloud-based diagnostic is a 5-minute ECG tool with current CPT reimbursement codes. Inmedix anticipates transforming healthcare by introducing immuno-autonomic diagnostic and therapeutic strategies to mitigate how adverse stress drives an autoimmune disease to excess. The tool is currently awaiting FDA 510(k) clearance and UK CE marking.
“ANS state is arguably the most overlooked element of precision, personalized medicine. Its impact on immune function is often remarkable,” says Inmedix CEO and Co-Founder, Andrew J. Holman, M.D. “And although ANS stress may not be the primary cause of disease, activation of the fight-or-flight component of the ANS (sympathetic) often drives many diseases to untreatable excess.”
Given this immuno-autonomic effect, measuring and managing ANS stress response could provide an innovative, adjunctive approach to reduce disease activity and consequently, enhance currently available therapies. Methods of reducing the biochemical drivers of adverse ANS stress state have been reported by Inmedix, SetPoint Medical, GSK and researchers in Japan and Amsterdam. Soon, entirely new divisions at pharmaceutical companies may compete to discover new pathways and therapeutics to reduce how stress within the brain drives so many diseases.
Inmedix aims to disrupt the diagnostic market by first changing the way clinicians view autoimmune diseases. Their initial targets are rheumatoid arthritis (RA), multiple sclerosis (MS), inflammatory bowel disease (IBD), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS). This diagnostic market is estimated to exceed $2.5 billion annually based on current reimbursement codes. Next, Inmedix will address all diseases adversely affected by stress, including cardiovascular, metabolic, psychiatric diseases and oncology.
Inmedix is also keen on making B2B collaborations to minimize costs pertaining to ineffective care. Independent health economists have projected Inmedix’s immuno-autonomic strategy to increase QALYs (quality-adjusted life years) by 800,000 and reduce biological costs to payers in the US for RA over the next ten years by up to $35 billion. ANS state measurement may also offer a ‘fast-fail’ solution to reduce the cost of new clinical trials. Finally, through its cloud database, Inmedix aims to apply its platform to the discovery of new therapeutics to manage the adverse ANS state measured by its diagnostic.
The 12th Annual New England Venture Summit was presented by youngStartup Ventures, the premier industry gathering and connecting venture capitalists, corporate VCs, angel investors, technology transfer professionals, senior executives of early stage and emerging growth companies, university researchers, incubators and premier service providers. There were 144 participants in the Venture summit among which Inmedix was deemed a “Top Innovator”.
“Our team is profoundly grateful for this recognition,” said Andrew J. Holman, MD, Inmedix CEO.
Meet the Visionary
Andrew J Holman MD co-founded Inmedix to commercialize the discoveries he made in his rheumatology office in Seattle. He is a Clinical Associate Professor of Medicine at University of Washington. He is also the founding rheumatologist at Pacific Rheumatology Associates Inc PS, and Director of Research at Pacific Rheumatology Research Inc. His extensive career has spanned over 25 years in clinical and 19 years in research pertaining to rheumatology. He has published 16 papers as the lead author and has been the lead author of 25 published abstracts.
Dr.Holman has designed and published 15 clinical studies for Inmedix. These include FDA negotiations, involving nearly 1500 patients. His work includes discovering and licensing use of dopamine agonists as a treatment of fibromyalgia, improving the understanding of pain in patients with PC3 (positional cervical cord compression) using dMRI, and applying autonomic nervous system analysis with HRV to raise treatment remission rates in patients with rheumatoid arthritis and other autoimmune diseases.
“Through immuno-autonomics, we help patients with autoimmune diseases get their lives back.”