Israel Means Canna-Business

The Bulletin by the BE Forum

Israel Means Canna-Business

By: Joe Straus, MD, Editor

Whereas the quality of medical services in Israel is excellent in general, there are a number of areas in which the local medical system truly is first-in-class, including for example IVF and stem cell research and therapy. If Cannatech, the first International Cannabis Conference in Israel, is a harbinger of things to come, we may soon add medical marijuana, or MMJ to the list of medical treatments in which Israel is a world leader. The conference, which was organized by Saul Kaye and his team at iCAN, took place on March 7-9 and attracted participants from over 20 countries.

Israel is home to various cannabis-based biotech and pharma innovations, but a number of cannabis vaporizers-inhalers, both portable and stationary, are also being developed here. These devices are designed to deliver the active compounds into the lungs without the deleterious by-products of combustion found in smoke. Heating the cannabis, either by conduction or convection, to a temperature just below the point of combustion, vaporizes it without burning it.

Lee Ben-Yossef recently graduated the Bezalel Academy of Arts and Design in Jerusalem with a degree in Industrial Design. Her company, Vapora, is now developing a pocket sized cannabis oil vaporizer-inhaler which she initially designed as her final project at the Academy, after seeing an elderly MMJ patient smoke cannabis using a bong. Her own grandfather was also using cannabis in order to cope with his cancer pain. Ms. Ben-Yossef felt there must be a better, more dignified way for MMJ patients. She and her colleagues are now completely redesigning their patent-pending device to make it more user friendly, to more precisely and consistently dispense the cannabis and to better exploit its natural properties. Vapora is raising capital in order to fund proprietary chemical research, formulation, and clinical trials.

Another company is Canigma, founded by CEO Amit Edri as an outflow of a project he undertook as part of the prestigious Zell Entrepreneurship Program, while studying Business Administration at the Interdisciplinary Center in Herzliya. Students in the program form teams and are challenged to identify trends and needs, and to propose a solution that can be built and executed. Mr. Edri’s team read about the need and growing demand for cannabis for the treatment of medical conditions on the one hand, and the lack of reliable delivery devices on the other, and understood the opportunity.

Different from Vapora, Canigma is developing a stationary device which will vaporize ground buds in capsules. The R&D team is focused on maximizing the vaporization of cannabis from the solid phase to the gaseous phase by optimizing the interplay between heating and air flow. The company has now built its second prototype which it says will deliver a consistent dose in a user friendly and elegant manner.

Canigma received a $250 K investment towards patenting and the development of their proof-of-concept from MMJ PhytoTech, a public company based in Perth, Australia. PhytoTech had plans to develop a vaporizer-inhaler internally but, after meeting with Canigma during a trip to Israel, decided to invest in their technology. PhytoTech has its own subsidiary in Israel, PhytoTech Therapeutics, which is developing cannabis based therapeutics. Canigma is also seeking capital to fund its ongoing development efforts.

But the dominant player at this time is Syqe medical (pronounced “sigh-key”). Formed in 2011, the company has developed a first-in-kind, metered vaporizer-inhaler that uses cartridges filled with uniform granules made from cannabis buds which Syqe procures in the Netherlands. The standardized granules allow dosing in precise 100 microgram increments which, instead of physicians and patients having to rely on trial and error to achieve the desired therapeutic effect, provides a reliable, reproducible, safe and effective way of administering the correct dose.

For the first time, physicians can individually titrate the dose for each patient and each circumstance to achieve an optimal balance between therapeutic efficacy and the psychoactive effects of the cannabis. In September 2014, the Journal of Pain & Palliative Care Pharmacotherapy published a first phase 1a clinical study of the Syqe device in eight patients with neuropathic pain, in which pharmaceutical standards for inhaled drugs were achieved. This medicinal approach to cannabis prescription and administration is expected to give physicians more confidence in cannabis as a bona fide therapeutic alternative.

The device is wifi enabled and treatments can be programmed and adjusted remotely in real time by means of smart-phone and tablet apps. Data sharing will also make it much easier for researchers to learn how best to tailor doses to varying medical conditions and circumstances.

Syqe medical raised $2.5M from the crowdfunding company OurCrowd, in addition to a $1 M grant from the Israeli Office of the Chief Scientist. Subsequently, in January of this year, Philip Morris made a $20M investment which reportedly was part of a larger $30M deal in which earlier investors again participated.

Both Philip Morris and Syqe are playing their cards close to their chests. While the announcement on Israeli news-site Calcalist stated that “Syqe medical will develop technologies for Phillip Morris that will help reduce health risks associated with smoking”, it is likely that Phillip Morris also has an interest in establishing a strong position in the emerging medical cannabis industry. Syqe reportedly, is also working to expand the application of their technology to other medicinal botanicals.

And so, the race is on for medical vaporizers-inhalers. Most will have unique features and benefits that may help to differentiate them in a marketplace that is expected to boom. But, the challenge for these and other companies in this new industry which is poised to “get high”, is just that: to gain the credibility and respectability it will need to free itself from such pithy remarks. Medical cannabis will need to rise above the sullied image and stigma of marijuana, and the negative associations many in the government and the medical establishment have with this plant.

This, of course, is mostly due to the traditional “recreational” abuse of marijuana, but is also related to the cloud of unconvincing or inadequate clinical data. According to PDQ (www.cancer.gov) “Clinical trials conducted on medicinal cannabis are limited… At present, there is insufficient evidence to recommend inhaling cannabis as a treatment for cancer-related symptoms or cancer treatment–related symptoms or cancer treatment-related side effects; however, additional research is needed…. The U.S. FDA has not approved the use of cannabis as a treatment for any medical condition” (updated April 16, 2016).

But, on the other hand, as Mr. Edri points out, there is an interesting difference between medical cannabis and most conventional medications: Whereas doctors prescribe medication for patients, when it comes to cannabis patients self-medicate and will request the treatment from their doctors – pull vs. push. Furthermore, the medical cannabis industry will greatly benefit from the advent of new, highly innovative technology that will overcome traditional concerns related to inconsistency of both constituents and dose. These two factors will pave the way for rigorous clinical trials which are likely to produce the data regulators, physicians, payers and patients require in order to legitimize medical cannabis and recast it as an important mainstream therapeutic modality.

Another version of this article by the same author was published previously in Medical Device Daily.

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