Our Mission
Quadra Therapeutics is a 501(c)(3) nonprofit pharmaceutical company with a mission to develop and expand access to quality medication-assisted treatment (MAT) for Opioid Use Disorder (OUD) for all patients, regardless of their socioeconomic status, insurance or geography.
OUD is a chronic relapsing illness characterized by repeated, compulsive opioid seeking or use despite harm. Opioid addiction generally refers to moderate to severe OUD, which the American Society of Addiction Medicine defines as “a primary, chronic disease of brain reward, motivation, memory, and related circuitry.The standard of care for OUD is MAT which combines behavioral therapy and medications to provide a “whole-patient” approach to the treatment. MAT can help sustain recovery by decreasing opioid use, opioid overdose deaths, criminal activity and infectious disease transmission, and increasing social functioning and treatment retention.Three drugs (buprenorphine, methadone and naltrexone) are approved for MAT. However, treatment adherence, overall abstinence and long-term efficacy remain suboptimal. When combined with behavioral therapy, Quadra’s next generation medicines using Depotrol™ technology aim to improve both short-and long-term treatment outcome for patients with OUD.
Limitations of Current Medication-Assisted Treatments
Drawbacks of Oromucosal Medication-Assisted Treatments
Our drug development efforts are aimed at providing clinicians with both pharmaceutically and pharmacologically differentiated MATs to overcome the limitations of current treatments. For example:
- Methadone is proarrhythmic and associated with long QT syndrome, leading to potentially lethal ventricular tachyarrhythmias, torsades de pointes and sudden death. It is also a full μ-opioid receptor agonist and therefore carries a greater risk of death in overdose settings.
- Naltrexone does not control symptoms of withdrawal or reduce craving, so it is only appropriate for relapse prevention in opioid abstinent patients. Oral naltrexone is no longer recommended due to low patient acceptance and high nonadherence rates.
- Sublingual buprenorphine also has limitations, including: (i) low adherence; (ii) significant diversion; (iii) accidental poisoning; and (iv) high relapse. In one study, relapse was 10x greater when adherence was ≤80%. In addition, there were >8,100 emergency department visits by children ≤ 6 yr, with 62% needing hospitalization due to accidental poisoning between 2008-2015. Finally, buprenorphine can also result in long QT syndrome at high doses when used with other drugs that prolong the QT interval.
Therefore, there is a need for new therapeutics that provide reduced diversion and improved abstinence, treatment satisfaction, program retention, and long-term outcomes.
Extended-Release Medication-Assisted Treatments Are No Panacea
- Naltrexone and buprenorphine, two extended-release (depot) MATs virtually eliminate the risk of diversion and accidental poisoning, and remove the burden of daily adherence, thus providing the potential for enhanced treatment retention and greater focus on psychosocial treatment.
- Depot naltrexone (Vivitrol®) is given as a monthly gluteal injection to block activity at the μ-opioid receptor. It does not control symptoms of withdrawal or reduce craving and is suitable only for a minority of patients who are both highly motivated and abstinent.
- Probuphine® and Sublocade® are two marketed depot buprenorphine MATs. Probuphine® is a 6-month subdermal surgical implant suitable only for patients with very low dose (≤ 8mg/day) buprenorphine requirements. It releases buprenorphine over 6 months and requires surgical removal and replacement. Sublocade® is a recently approved monthly subcutaneous depot buprenorphine. In one high dose Sublocade® study, 90% abstinence and study completion were achieved only by 24%, and 62% of patients respectively, and injection site reactions occurred in 14-and 19% at low and high doses. Additionally, Sublocade® is not room temperature stable, and it can only be given at one of two dose levels monthly through a 19 Gauge needle into abdominal subcutaneous tissue.
Our R&D Efforts in Opioid Use Disorder
- In view of the limitations of currently available treatments for OUD, we are developing new pharmaceutically and pharmacologically differentiated treatments using our Depotrol™ technology. These MATs have the potential to provide improved patient and clinician acceptance, and more favorable long-term outcomes.
- Pharmaceutical Differentiation: Our MATs hold the promise of (i) weekly, biweekly and monthly dosing at a wide range of doses to individualize treatment; (ii) room temperature stability to reduce storage and logistics costs, particularly in low and middle-income countries; and (iii) injection into virtually any subcutaneous site using a 50% thinner needle diameter.
- Pharmacological Differentiation: Our MATs hold the promise for improved short-and long-term outcomes through different mechanism of action, when compared with currently available treatments.