Medicine can still sometimes look awfully primitive, despite all the whiz-bang developments in biotech. Take rheumatoid arthritis. Scientists don’t know what causes it, and clinicians have little hard data to help them diagnose it or measure patients’ progress over time.
But that’s starting to change, based on a new molecular test from South San Francisco-based Crescendo Bioscience. The company, whose test has been commercially available since November 2010, is seeking to help doctors get truly quantitative in analyzing how patients are doing with this painful inflammatory disorder of the joints.
“When we went out to talk to doctors, they would say things like ‘somebody needs to take this field into the next century,'” says Crescendo CEO Bill Hagstrom. “We think there’s an incredible opportunity in autoimmune diseases. It’s one of the next great frontiers.”
With the new test, which has quietly started to take hold over the past year, Crescendo could shake up the treatment of rheumatoid arthritis, and the way drugs for this condition get developed. Crescendo doesn’t disclose its revenues, but since the first commercial version of its Vectra DA molecular test debuted at the American College of Rheumatology meeting, the company has raised $56 million, expanded its team to 80 employees, and negotiated a deal in which Myriad Genetics (NASDAQ: [[ticker:MYGN]]) got a three-year option to acquire the company at a pre-determined price if Crescendo hits certain sales goals.
The opportunity is big for anyone who can provide better information to help treat rheumatoid arthritis. This disease, in which the immune system goes haywire and starts attacking healthy joint tissue like an invading virus, affects an estimated 1.3 million people in the U.S. There has been a massive amount of innovation with molecular targeted therapies over the past decade, from companies like Amgen, Johnson & Johnson, Abbott Laboratories, and Roche. The market for these therapies—which can cost $20,000 a year for patients with a chronic, lifelong condition—topped $12.7 billion in 2010 and is on pace to reach $17.3 billion in 2015, according to Visiongain, a London-based market research firm. And while those drugs can be very effective at relieving pain and swelling and stopping progressive joint damage, they don’t work for everybody. Researchers today can’t predict who will respond, and can’t accurately track how much good the drugs are doing at the molecular level.
Crescendo is seeking to answer some of these hard questions. It was founded by Michael Centola of the Oklahoma Medical Research Foundation, and secured its Series A financing in 2007. The company has gotten this far on backing from Mohr Davidow Ventures, Kleiner Perkins Caufield & Byers, and Aeris Capital.
Diagnosing the disease and monitoring progress today is a bit tricky, and rheumatologists rely heavily on what’s known as the DAS28 score. Essentially, they go down a list of 28 joints in the hands, feet, knees, hips, shoulders, and try to assess pain and swelling in each joint. They come away with a measurable score, but it’s arrived at in a highly subjective way. Physicians can also look at things like C-reactive protein, a measure of inflammation in the blood, but DAS28 is still the workhorse measurement. It’s so subjective, Hagstrom says, that the analysis of a given patient can vary by 30 to 50 percent from one physician to the next.
Given how sloppy the measurements are, it shouldn’t be any surprise that
