SipNose - Topiramate: A Novel Breakthrough Approach to Binge Eating Management

Abstract

Abstract Background: Binge eating disorder) BED) is the most common eating disorder in the United-States. Chronic, orally administered topiramate has shown BED treatment efficacy, but with two major limitations: frequent and severe side effects and slow time to action. SipNose is a novel-non-invasive-intranasal (IN) direct nose-to-brain (DNTB) drug delivery platform that delivers drugs to the central nervous system (CNS) consistently and fast. Herein, we study SipNose-topiramate combination product, as an acute "as needed"(PRN) solution for BED management. Methods: First, we evaluate the innovative SipNose-topiramate's pharmacokinetics (PK) and safety. The second part aimed to demonstrate SipNose-topiramate's PRN-treatment efficacy in reducing the number of binge-eating episodes in 12-BED patients (2-weeks of baseline monitoring [BL], 8-weeks of treatment [TX], 2-weeks of follow up [FU]). In this part 251 treatments were used by the 12 BED patients participated in the study. Results: The PK profile showed peak plasma levels at 90 minutes post-administration, and a t1/2 > 24hr, and demonstrated consistent topiramate delivery with no AE. In the second part, mean weekly binge events (WBE) and binge event days per week (DPW) showed a significant reduction from baseline to treatment period that was maintained in follow up period. Efficacy was corroborated by improved patient illness severity scales. There were no adverse events during all administered treatments. Patients were exposed to less drug when compared with accepted oral dosing. Conclusions: This study introduces the novel SipNose-topiramate drug-device combination as a safe, effective, and controlled method for BED management. Its findings represent a breakthrough approach to BED management both as an intranasal and "as needed" therapy for reducing binge eating episodes with a large-scale reduction in patient drug exposure and thus side effects and with improved patient quality of life. Further studies are needed with larger patient populations to establish SipNose-topiramate as a mainstream treatment for BED. Trial registration: Registration number and date of registration of the clinical studies reported in this article are as follows: 0157-18-HMO, August 15th 2018 and 6814-20-SMC, December 2nd 2020.