Brixton Biosciences: Drug-free pain relief for knee osteoarthritis

Knee pain
Knee pain (Klaus Vedfelt)

Neural Ice: Is this long-lasting pain therapy revolutionizing treatment?

Sameer Sabir, CEO and co-founder of Brixton Biosciences, aims to revolutionize pain management. With Neural Ice, the company’s groundbreaking drug-free therapy, Brixton aims to offer ultra-long-lasting pain relief with a simple injection. Targeting knee osteoarthritis as its first focus, this novel technology uses a temperature-based mechanism to disrupt pain-transmitting nerves without addiction risks or systemic side effects. Neural Ice has the potential to transform chronic pain treatment, bridging the gap between short-term remedies and invasive procedures while addressing the urgent need for safer, accessible solutions in the post-opioid era.

Current pain management standards

What are the current standards of pain management, and what gaps do you see in providing non-addictive, drug-free therapies in clinical practice?

Current pain management frequently relies on opioids and other drugs, which carry significant risks such as addiction and adverse side effects. Invasive options, including injections, nerve ablation, and surgery, often come with variable clinical outcomes, operator dependency, and high costs. This has created an urgent demand for non-interventional, non-systemic, non-addictive therapies, driving our team to create Brixton Biosciences and develop Neural Ice™.

As the opioid crisis continues to escalate, developing safe, long-lasting pain relief solutions is increasingly crucial. For painful conditions like knee osteoarthritis (OA), the standard approach starts with medications, followed by steroid injections that, while initially effective, can contribute to joint degeneration and accelerate disease progression. When these treatments are no longer sufficient, patients are left with limited options before facing more invasive procedures like joint replacement. In addition, 20% of knee patients continue to experience chronic pain after joint replacement, with very few further options beyond systemic medication.

Our focus is on bridging the gap between short-acting treatments (hours/days that require frequent administration) and invasive procedures (that can be life-altering and carry their own set of medical risks). By developing a long-lasting, regionally delivered pain treatment via a simple injection—similar in approach to a local anesthetic but offering consistent relief for several months—we aim to provide a more sustainable and reliable pain management solution. This familiar delivery method could eventually be administered by a wide variety of healthcare providers, making it more accessible to patients.

There is a critical need for safer, non-addictive, and accessible treatments, like those being developed in Neural Ice, to address these gaps and provide patients with effective, long-term pain management solutions.

Market need for non-addictive solutions

How significant is the demand for non-addictive pain therapies in today’s healthcare landscape, and what are the main drivers behind this need?

Brixton Bio is first pursuing an indication for Neural Ice around treating knee pain, where there is significant demand and need for non-addictive, drug-free pain therapies in today’s healthcare landscape. Key drivers include the impact of the opioid epidemic, considering knee replacement surgery is the number one surgical cause of addiction in the US. Current treatments are limited and inadequate for managing both short-term and long-term pain and can even put patients at avoidable additional risks. There needs to be a therapy that can lead to improved patient-centered experiences. Once Neural Ice™ has demonstrated success in the knee, the company will craft a careful strategy to expand to other indications where nerves relevant to transmission of pain can be identified and targeted. We believe that although there is no such thing as a panacea for the treatment of pain, Neural Ice’s applicability could be very broad.

Sameer Sabir, CEO and Co-Founder of Brixton Biosciences
Sameer Sabir, CEO and Co-Founder of Brixton Biosciences (Brixton Biosciences)

Impact of Neural Ice

Can you explain how Neural Ice works to provide ultra-long-lasting pain relief?

Neural Ice therapy is a simple injection that aims to provide long-lasting pain relief in targeted anatomical areas. Neural Ice therapy is designed to deliver pain relief by creating a cold zone that selectively impacts nerves. The novel temperature-based mechanism of action disrupts nerves without impacting surrounding soft tissue. This targeted approach aims to provide sustained pain relief for several months by affecting the sensory nerves responsible for pain.

Animal models have shown that pain reduction can potentially last for 3+ months from a single injection. Recent clinical studies conducted in Australia and the US to provide preliminary evidence of the therapy’s safety and effectiveness in patients suffering from chronic pain secondary to knee osteoarthritis. These studies will serve an initial support for Neural Ice’s potential as a therapeutic option for long-term pain relief.

Neural Ice, Brixton Biosciences
Neural Ice, Brixton Biosciences (Brixton Biosciences)

What sets this technology apart from traditional pain management solutions?

Initial clinical data suggests that Neural Ice therapy can provide a single-shot treatment that can offer pain relief for several months, unlike traditional local anesthetics that only provide short-term relief on the order of hours or days.

Further, the non-addictive nature of Neural Ice stands in contrast to opioid-based pain medications, which can cause dependence and lead to abuse.

Neural Ice’s novel temperature-based mechanism of action creates a cold zone within a tissue area, selectively impacting only the nerves within the cold zone. This is optimal for branched or fine nerve structures, which are often difficult to target with traditional denervation therapies. The combination of the injection method and nerve-selectivity feature is expected to make the therapy easy to deliver, reducing the need for precise administration. This advancement has the potential to elevate the therapy to a new level of accessibility and efficacy in pain management.

While the initial focus of Brixton Biosciences is to develop Neural Ice therapy to target pain associated with the musculoskeletal system, there is potential to expand Neural Ice to treat pain, disease, and disorders in other areas of the body that are pathologically driven by nerves.

Challenges with current medications

Human brain frozen inside an ice-cube
Pain relief - neural ice (Ekaterina Chizhevskaya/Getty Images)

What limitations do current systemic medications present for patients, and how does your approach address these shortcomings?

One of the key limitations of current opioid pain medications is the dangers of addiction. Neural Ice’s non-systemic and non-pharmacological mechanism of action is expected to provide an alternative that minimizes these potential dangers.

Additionally, traditional local anesthetics only offer short-term pain relief, whereas Neural Ice could provide relief for more extended periods. Its longevity addresses the need for more durable pain control that goes beyond the initial acute phase.

Many existing pain treatments also rely on systemic medications that can have broader side effects throughout the body. Neural Ice’s localized, non-systemic approach targets pain at the source without the need for widespread drug distribution.

Feedback from medical professionals

What kind of feedback are you receiving from medical professionals regarding the need for alternative pain management methods? Are there any specific concerns or interests they have expressed?

Medical professionals are increasingly recognizing the need for alternative pain management methods due to growing concerns about the limitations and risks associated with current treatments.

Many professionals are concerned about the risks of opioid addiction and are seeking safer alternatives. They are looking for methods that minimize the reliance on opioids while effectively managing pain.

There is also a general dissatisfaction with the short-term efficacy of traditional pain management options, such as local anesthetics and steroid injections, which often require repeated administration, have unreliable results, and may have adverse effects.

Clinicians are keen to see robust evidence supporting the safety and efficacy of new therapies. They are particularly interested in clinical data demonstrating how these treatments perform compared to existing options.

Investment interest

What are you hearing from investment arms about the potential for drug-free pain therapies? How important is investment in driving innovation in this area?

Investors are attracted to the innovative approaches of drug-free pain therapies, such as Neural Ice, which offer novel mechanisms of action and the potential for disruptive impact in pain management. They are particularly interested in technologies that provide long-term relief with minimal side effects. The strength of clinical data supporting the safety and efficacy of new therapies is crucial. Investors are looking for compelling evidence that demonstrates not only the potential of the technology but also its practical benefits and market viability.

Legislative developments

How do upcoming legislations like the NOPAIN Act impact the development and adoption of non-opioid solutions for pain management? What role does Brixton Biosciences play in this landscape?

The Act reflects a broader policy shift towards prioritizing non-opioid solutions, which aligns with the growing demand for safer pain management alternatives. This creates a favorable environment for companies that are developing innovative therapies to meet this need. Furthermore, legislation can increase awareness and advocacy for non-opioid solutions among healthcare professionals and patients.

By focusing on innovative, long-lasting pain relief methods, Brixton is well-positioned to contribute to the shift away from opioid dependence. The company’s technologies align with the objectives of the NOPAIN Act, providing effective, drug-free alternatives that address the critical need for safer pain management options.

Recent Funding Success:

Can you share more about Brixton’s recent Series B funding round of $33 million? How will these funds be utilized to advance your research and development efforts?

We recently completed a $33 million Series B funding round, which we plan to utilize to advance our research and development efforts for Neural Ice™. The key focus area includes conducting a large randomized pivotal clinical study in patients with chronic pain secondary to knee osteoarthritis.

Through the funding, we also added the expertise of Pain Medicine physician Dr. Michael Fishman. Ultimately, we aspire to make Neural Ice™ as ubiquitous as traditional local anesthetics, providing a non-addictive pain management solution to address the significant clinical and societal need for innovative, non-systemic therapies.

Future of Pain Management:

Looking ahead, what do you envision for the future of pain management? How do you see the landscape evolving with the introduction of new technologies like Neural Ice?

Innovative, long-lasting, and non-opioid pain therapies will become a standard part of the pain management landscape. They will help address the current limitations of systemic medications, reduce opioid dependence, and provide more effective, durable pain relief for patients suffering from both acute and chronic conditions.

We aspire for Neural Ice to become as “ubiquitous as a traditional local anesthetic” in the future.

Clinical Applications:

In which clinical settings do you foresee Neural Ice being most beneficial? Are there specific patient populations that you believe will benefit the most from this therapy?

Chronic osteoarthritis of the knee is our initial focus. This condition affects a significant patient population that could benefit from long-acting, non-opioid pain therapy.

Another clinical setting we see our therapies being beneficial for is post-operative pain management for total knee replacement. Total knee replacement surgery is often a painful procedure and is a leading cause of opioid addiction.

We see the potential for expansion to other musculoskeletal conditions beyond the knee and we aim to bring Neural Ice to other joint/muscle pain conditions.