When Vima Therapeutics launched last year to take its drug candidate into human testing, the lead indication was isolated dystonia, a neurological movement disorder whose few treatment options leave a clear unmet patient need. But the biology that drives dystonia also applies to other movement disorders, and Vima scientists believed their drug could address them, said CEO Bernard Ravina. Early clinical testing has provided some validation.
Isolated dystonia is rare, affecting an estimated 160,000 in the U.S. Vima is now expanding to the much more prevalent Parkinson’s disease, the Cambridge, Massachusetts-based startup announced Wednesday. It’s supporting that work with an additional $40 million that brings its Series A financing to $100 million. With the capital, Vima will conduct separate mid-stage tests of its drug, VIM0423, in dystonia and Parkinson’s.
“We’ve always been thinking about Parkinson’s,” Ravina said. “It was the progress on the Phase 1 [clinical trial] showing over 28 days in healthy volunteers and a small dystonia cohort that VIM0423 was well tolerated. That’s what catalyzed this additional financing and it’s what really catalyzed the interest in, we should expand and do Parkinson’s and dystonia in parallel — and there’s more we can do after that.”
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In isolated dystonia, involuntary muscle contractions happen in any part of the body. These contractions not only interfere with movement, they are also painful and disabling, said Ravina, who earlier in his career practiced as a neurologist specializing in movement disorders. Treatment of isolated dystonia includes regular injections of Botox to weaken overactive muscles, but this option offers partial relief or, for some patients, doesn’t work at all, he said. Even when these shots work, many patients don’t like frequent injections so they stop treatment. Deep brain stimulation is an alternative, but many patients don’t want to undergo this invasive procedure. Dystonia has no oral drug options.
Ravina’s experience includes serving as chief medical officer for Voyager Therapeutics and most recently Praxis Precision Medicines, but it was joining Atlas Venture about four years ago that brought him back to dystonia. Ravina said he came across a thesis that regardless of the body part involved in dystonia, there’s a hyper-cholinergic state — too much signaling of acetylcholine receptors in the brain. Drugs are already available that block muscarinic cholinergic receptors for Parkinson’s, but they have such poor tolerability that no one takes them, Ravina said. Atlas formed Vima in 2023 to develop a muscarinic receptor-blocking drug with improved tolerability.
Vima targets muscarinic receptors with the pairing of two different drugs. If this approach sounds familiar, Ravina notes that Karuna Therapeutics pursued selective targeting of muscarinic receptors with a combination drug that became the FDA-approved schizophrenia medication Cobenfy. Vima’s VIM0423 blocks muscarinic acetylcholine receptors in the brain with a compound called trihexyphenidyl, an old drug used to treat Parkinson’s. Dry mouth, blurry vision, dizziness, and nausea are common side effects of trihexyphenidyl. Vima attenuates them by pairing the compound with another old drug, bethanechol, which is prescribed for urinary retention. The Vima drug combination is also optimized to drive exposures in the brain to improve the symptoms of dystonia.
In the completed Phase 1 test of VIM0423, Vima said the study drug showed a favorable safety profile and was well tolerated. Results also showed the drug exceeded target exposure levels, laying the groundwork to proceed to Phase 2. The first patient has been dosed in a Phase 2 dystonia trial.
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Vima expects to begin a mid-stage study in Parkinson’s this year. Parkinson’s patients typically take many drugs to address the lack of dopamine in their brains that drives their disease. Ravina said these drugs don’t treat, or don’t treat well enough, the dystonia and tremors of Parkinson’s. The company is still working out the design of the Phase 2 test in Parkinson’s. But Ravina said patients would be able to continue taking the drugs they are already taking because VIM0423 will address things that those therapies are not adequately treating.
Vima emerged from stealth last May backed by $60 million, a Series A financing led by Atlas with participation from Access Industries and Canaan Partners. The new financing extends the Series A round by adding new investor Frazier Life Sciences along with additional participation from Atlas, Access, and Canaan. Ravina said the capital will enable Vima to complete two Phase 2 trials of VIM0423 for isolated dystonia and Parkinson’s. Preliminary data from both studies are expected early next year. Ravina said other potential applications include cerebral palsy, where as many as half of patients experience dystonia.
There’s been a a groundswell of patient interest in the dystonia clinical trial given the dearth of therapeutic prospects for the indication, Ravina said. He added that he had not seen any developments in dystonia since he was a neurology resident in the 1990s.
“As a movement disorders neurologist going back 25 to 30 years now, it’s really gratifying to see this progression,” he said.
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