cinclus pharma header woman with gerd

About GERD

GERD is a progressive and unmet medical disease

About GERD

Billions of people around the world suffer from Gastroesophageal reflux disease, GERD. Still, present treatment methods and PPI-based drugs are not effective enough for all types of GERD. Heartburn is a common discomfort, caused by light versions of GERD. In severe stages, other symptoms and pain related to acid attacks often occur. Stomach tissue might also be affected or injured.

What is reflux disease?

Gastroesophageal reflux disease (GERD), or acid reflux, is a condition in which the content of the stomach regurgitates (backs up, or refluxes) into the esophagus. The refluxate is usually acidic and can cause inflammation and erosions.

  • A digestive disorder due to incompetent valve no longer preventing gastric content to reflux into the esophagus.

  • Though GERD symptoms vary from person to person, chronic heartburn and acid regurgitation are the most common symptoms.



Why does the disease occur?

  • GERD occurs when the esophageal defence mechanisms are overwhelmed by gastric contents that reflux into the esophagus

  • Relocation of the upper part of the stomach above the diaphragm, i.e. hiatal hernia, is a common indirect cause of GERD

  • Prevalence increases with age

Stages of GERD


GERD can occur in different stages, from Reflux hypersensitivity to severe chronical stages, complicated GERD.

  • Reflux hypersensitivity 
    Reflux hypersensitivity is recently classified as a stage of GERD. It comes with typical heartburn symptoms associated with reflux events. No tissue is damaged.

  • NERD
    Non-erosive GERD (NERD) is characterised by reflux symptoms, without visible tissue damage.

  • (eGERD)
    The stage Esophagitis or erosive GERD is defined by the presence of tissue damage, erosions, caused by acids.

  • Complicated GERD
    The symptoms of complicated GERD are ulcers, strictures and Barrett's esophagus.

 

Los Angeles Classification of Reflux Esophagitis

The Los Angeles classification system of GERD is a widely used system to describe the endoscopic appearance of reflux esophagitis and grade its severity.

 

GRADE A

One (or more) mucosal break(s) no longer than 5 mm, that does not extend between the tops of two mucosal folds.

GRADE B

One (or more) mucosal break(s) more than 5 mm long, that does not extend between the tops of two mucosal folds.

GRADE C

One (or more) mucosal break(s) that is continuous between the tops of two or more mucosal folds, but involve(s) less than 75% of the oesophageal circumference.

GRADE D

One (or more) mucosal break(s) which involve(s) at least 75% of the oesophageal circumference.

 

How do you manage the disease?

  • Erosions and symptoms require effective treatment

  • Current standard of care primarily include PPIs, e.g., Nexium, Takepron, Losec etc.

  • Surgery for those with ”volume reflux” which leads to higher costs and severe implications on quality of life

What are the challenges with current treatment?

There is an unmet medical need in eGERD, where traditional treatment methods have limited effect. A new solution is required for patients having insufficient treatment effect of current medication.

Facts

  • ~1/3 of patients with eGERD grade C remain unhealed after four weeks with standard PPI therapy

  • 56% of patients with eGERD grade D remain unhealed after four weeks with standard PPI therapy

  • ~10% of patients with eGERD grades A and B are unhealed after four weeks with standard PPI therapy 

  • ~85% of all eGERD patients suffer from nocturnal symptoms

Read more about life with GERD

 

Indication aspiration

Cinclus Pharma’s lead candidate, linaprazan glurate, addresses a significant unmet medical need of billions of patients in Europe and North America. The main target groups are patients with severe eGERD not adequately treated with available therapy.

Read more about linaprazan glurate