Business Of Biotech

BoB@JPM: Nima Farzan, Latigo Biotherapeutics

• Matt Pillar • Episode 246

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In this final installment of our episodes recorded and filmed on-site at the JP Morgan Healthcare Conference, Nima Farzan, CEO of Latigo Biotherapeutics, shares his company's mission to change the pain management paradigm by way of novel, non-opioid medications that target NAV 1.8 sodium channels involved in pain signal transmission. It's a timely and important conversation that explores how these selective inhibitors could provide effective pain relief without the addiction risks and side effects of traditional opioids. In addition to the social and medical implications of Latigo's work, we discuss investor perceptions about pain management as a commercial opportunity and how Latigo is differentiating from traditional approaches by focusing on safety and tolerability rather than just efficacy

The 2025 BoB@JPM series is supported by Alston & Bird, whose national health care and life sciences practice has more than 100 attorneys actively involved and integrated across the full spectrum of legal disciplines including regulatory, compliance, public policy, transactional, corporate governance, securities, FDA, biotechnology, intellectual property, government investigations, and litigation practice areas. Learn more at www.alston.com.

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Ben Comer:

Pain management has been overdue for an overhaul for far too long. Nima Farzan is keen to change that paradigm. I'm Ben Comer and I'm Matt Pillar, and this is the Business of Biotech. Jp Morgan 2025 Edition.

Matt Pillar:

We are here in San Francisco at the beautiful law offices of Alston and Byrd, with Nima, ceo at Latico Biotherapeutics and one of the most enthusiastic CEOs. I might add that we've known to discuss his small biotech's intent on taking a big primary care problem in a biotech space that's often focused on very small and expensive problems. Thank you, nima, for joining us. My pleasure, I'm excited to be here.

Nima Farzan:

We're excited to have you?

Matt Pillar:

You've spent five and a half years now leading groups and marketing at Novartis before jumping into biotech and venture capital. So whenever you know, we often have biotech execs on the show who come from big pharma and jump into a biotech endeavor, and I'm always curious about the motivation to do so. So what was yours?

Nima Farzan:

Yeah, you know, I grew up in the Bay Area and so I grew up at a time when you know who you looked up to were the innovators in Silicon Valley and tech. Both of my parents were in tech and so I always wanted to be actually on the more innovative small company side. I actually did it before business school. I was at a genomics company in the early dot com boom time frame. I decided to go to business school and then realized, like you know, for me to be truly successful in this industry, I need to learn. It's a really complicated thing. You've got to learn it, and what better place to learn it than one of the biggest pharma companies that they know how to do these things?

Nima Farzan:

So I went to Novartis with the intention to learn the business, learn drug development, Actually ended up loving it and staying longer than I thought. I thought it'd be a check the box, couple of years come back, and it was actually about seven years before I was like you know I need to. I want to get back to what I've always wanted to do, which is something more entrepreneurial, something more innovative, and I came out of the artist with, you know, I think, the beginnings of understanding how to do drug development. It's a lifelong process, but I got the basics so that I could go into biotech and apply that.

Matt Pillar:

Yeah.

Ben Comer:

How did your time at Foresight Capital prepare you for the rigors of biotech building?

Nima Farzan:

Yeah, I mean I spent a couple stints as an executive resident at Foresight in between different CEO roles and what I'll tell you is that.

Nima Farzan:

It confirmed to me that I'm not a venture capitalist. I like to build companies Right. So it's funny when you, when you're sitting there and you're seeing companies several a day common pitch and invariably your reaction is like that's really cool. I'd love to like get in deep on that and help build that, figure that out and drive that. But as a venture capitalist you know onto the next and onto the next. So it was, it was great, you know, to pull up and kind of see the, the broader picture, what's going on in the industry, see trends, but also just reconfirms that like what I want to do is is build companies and develop drugs, um and and so uh, you know it's a great relationship with foresight. I've worked with them a couple times now. They show me exciting things in their portfolio.

Ben Comer:

When I get excited I jump in yeah, it probably helped you improve your pitches too.

Nima Farzan:

Oh, for sure To see, you see how it's interpreted on the back end, how it's discussed on the back end what, what resonates, what doesn't that it was very helpful.

Matt Pillar:

If any of your stints at Foresight overlapped with Vic Bajaj's time there. Yes, he's. He was on the podcast pre JPM and not too long ago, just a few weeks before we came to JPM, he was a guest on the podcast.

Ben Comer:

Fascinating.

Matt Pillar:

He's a great guy, man, incredibly smart, Incredibly smart, intimidatingly smart, yeah yeah.

Nima Farzan:

So the last.

Matt Pillar:

We had the luxury of a conversation with you a couple of weeks ago and one of the things that you've said that is, you know, not necessarily clairvoyant, but it's proving true in the conversations that I'm having with plenty of founders, biotech founders and builders here at the show in all sorts of modalities you said that you believe that we as an industry are on the cusp of a renewal of drugs for the masses. Yes, which?

Matt Pillar:

you know, I mean, in the last several years, Ben, we've been covering this space and there's been a ton, especially in the ATMP arena. There's been a ton of interest in, you know, ultra rare and rare disease. But even in those ATMP spaces, like at this show, I've had so many conversations with folks who are doing genetic therapies, for instance, who want to pursue big, big, giant indications, which is awesome. The indication you're working in has a super big opportunity. But getting back to the point about this being on the cusp of an era of drug for the masses, what are the indicators for you? What's indicating that for you? Why do you say that?

Nima Farzan:

Why do I say that? Well, I think a couple of things. So I mean, things are a signal right, and for a long time rare diseases were ignored because people didn't think there was a business model until a lot of it. And then that became an opportunity. People started investing their successes and there was more and more in rare disease.

Nima Farzan:

And at some point, the pendulum has to swing back right. We've now ignored R&D investment in some of the larger opportunities and you know, frankly, the obesity space and some of the GOP ones have successes in obesity that have opened people's eyes to. There really is still a lot of unmet need in some of these primary care segments.

Ben Comer:

Are there any incentives changing? Because obviously part of the reason that there has been this enormous focus on rare disease, aside from the unmet need which we're acknowledging, is faster time to market smaller trials, sometimes better IP protection For the larger indication, more expensive trials, primary care drugs Are there any kind of the dynamics that are shifting to help To help the group.

Nima Farzan:

I wish that were more true. On the r&d side. I think in pain there are some specific things that are helpful, um, but in general I don't necessarily can think of something.

Nima Farzan:

But what I will say is that some of the commercial incentives are changing. So if you think about what um, you know I I, as we talked about when I was at novartis and I was looking primary care we had thousands of reps selling hypotensive drugs and now we've gotten, you know, frankly, away from those rep wars and you know parallel lines and gotten better at using technology and different ways to access physicians so that you can actually commercialize primary care drugs with. You know a more reasonable, rational footprint, so that helps in terms of the NPD analysis, if you will. On drug development side, you know a more reasonable, rational footprint, so that helps in terms of the NPD analysis, if you will. On drug development side, you know there's a lot of exciting technologies. I mean we can obviously talk about AI and you know regulatory innovation is important, but those are still fairly nascent. I mean it's still.

Ben Comer:

You're still having to do the safety studies and the larger scale studies that you need to do to access the primary share market One strategy that companies have used for years is to go after a really rare disease first and get on the market and then, of course, expand the indication later, go for a larger population. Is that something that could happen in pain? Have you seen that kind of strategy?

Nima Farzan:

sure in in one very clear way. It's exactly how it's playing out. So it's not quite a super niche indication of pain. But acute pain versus chronic. Okay, right, so acute pain let's talk about is primarily post-surgical. I've had a procedure, that's, my wisdom teeth taken out or knee repair or something larger, uh, or it's some sort of severe non-surgical pain. I've sprained an ankle badly, I've thrown on my back or something that doesn't.

Nima Farzan:

It's not a niche indication but it is a much smaller indication than chronic pain. Osteoarthritis, like neuropathy, uh, you know, headache, muscle, lower back pain, etc. Um, but the big advantage of acute pain relative to chronic pain and the reason why it's a faster to market, it's a more tenable development plan for small companies as well as large companies is the duration of treatment. It's limited. You know, typically when the FDA talks about acute pain it's under 30 days and often actually you're getting prescriptions that maybe last two weeks and so when you're treating someone for that duration of time, there are a couple of things that make the development that much easier, right?

Nima Farzan:

So one clearly you don't have to have long studies. You can determine your endpoint in a couple of days. You know that's nice and in fact our first endpoint that you're going to look at is 15 minutes. You know like we want to see onset of pain relief starting. You know, ideally maybe not at 15 minutes, but soon thereafter. So you start looking at 15 minutes. So you know you're getting immediate help and because the duration of treatment isn't that long.

Nima Farzan:

the safety database you have to build for regulatory approval is less Right. You don't have to have long. You don't have to have year-long studies with patients, because treating them for that kind of duration, so acute pain, is where you would start as an optician. If you have a broad acting analgesic, like we believe we do, acute pain is where you start because that pathways faster there and it is a more limited market because these prescriptions are two weeks, they're not lifelong prescriptions because they have chronic pain right.

Matt Pillar:

So, uh, why? Why pain? That's a fundamental question. We just kind of glossed right over right. Why did you want pain? Yeah, why, why this company and why?

Nima Farzan:

pain. Yeah, I mean, do you know anyone who hasn't had pain?

Matt Pillar:

I'm in pain as we speak. Exactly right, it touches all of us, right? I mean we all. It's almost, you know, not because of this.

Nima Farzan:

I'm in pain as we speak. Exactly Right it touches all of us right.

Matt Pillar:

I mean, it's almost, you know, Not because of this conversation. No, not physically. It was here before we got together.

Nima Farzan:

That's good to know. I mean, pain touches all of us and all been in pain at some point of our lives or will be in pain at some point of our lives, and we look at patients who are dealing with chronic pain in particular.

Nima Farzan:

It is debilitating. It's very hard to focus, to function and to operate in life. So you know, I look back on my career and I've worked. You know the biotechs that I've run since my time in the bar. One was in infectious disease and vaccines, one was in precision oncology and what I liked about vaccines was this ability to impact a lot of people. Vaccines are something that many people can take but the tangible benefit of that vaccine is not obvious to the patient. I mean, if it works, they never get the disease and never think about it again. You didn't actually. You don't get that direct impact. It's a theoretical impact. You've made and you kind of have to calculate it on many thousands of people taking your vaccine, on many thousands of people taking your vaccine.

Ben Comer:

So when I transitioned to the oncology side.

Nima Farzan:

We're talking about patients with stage four terminal cancer that have run out of all other options. Many of them have diagnosed weak slant and if your drug can reverse that, tumor growth have regression and you can add months or years to that patient's life, I mean that's an amazing, amazing impact that you can have immediately on years to that patient's life. I mean that's an amazing, amazing impact that you can have immediately on someone who has no other options. But the fundamentals of that business are very rare types of cancer that we were doing and the whole concept precision is very genetically specific patient populations that might occur in 1% of the tumor type and if that patient had that mutation we have a drug for them. So it's really small numbers of patients you're impacting. Pain gave me the opportunity to do both, to have something that impacts everyone but it also has a meaningful, tangible benefit to their lives immediately.

Nima Farzan:

And I say that but we talked about within 15 minutes, 30 minutes or one hour that you can help alleviate pain. And you know it doesn't take living in San Francisco to know that the opioid crisis has been a huge societal challenge and the problem in pain is not a lack of efficacy from the drugs we have.

Ben Comer:

We can completely eliminate your pain if you're willing to take enough morphine.

Nima Farzan:

That's not the problem. The problem is, can you develop drugs to have that pain relief that are safe and tolerant? And what Labigo is working on has that opportunity and really can create. Not just have a health impact, like we've been talking about, but a positive socioeconomic, sociopolitical impact by helping eliminate, most likely reduce, the use of opioids.

Matt Pillar:

How is that proposition being received by an investment community that has been enamored of late with ATMPs and super sexy fancy stuff?

Ben Comer:

Not that yours isn't right, but it's definitely a world away from you.

Matt Pillar:

Know gene therapies, it is, and for some.

Nima Farzan:

I will say you know we've had success and there's definitely been investors who are, you know, very strong, bold, lucid supporters of this, and you know you can just you understand intuitively and immediately the patient need here and the rationale, but that's.

Nima Farzan:

But there are definitely investors who are used to saying well, you know they're generic drugs. I need generic opioids and don't you have to have I see substantially better than the generic to get used. You don't, because people don't want to take an opioid. Patients don't want to take opioids. Physicians don't want to take an opioid. Patients don't want to take opioids. Physicians don't want to prescribe opioids. There's a lot of bureaucracy associated with tracking how many opioid prescriptions you have relative to the number of patients you're seeing, and reporting that you have to do state by state level. Governments don't want prescribers prescribing opioids. They want to limit it. They're creating incentives to move away from it and restrictions from going to it. So it is a little bit of a different mindset. This thing I talked about, which is, you know, the efficacy in pain, is not the unmet need, it's the safety and tolerability. It's not how investors are used to thinking. They're used to thinking about like how are we more efficacious than the generic so that you'll get reimbursed? And this is a different societal issue.

Matt Pillar:

I'd say most get it but definitely some need some discussions around that. Does that societal impact, that more global, broad societal impact, open up for you perhaps a new pocket or a different pocket of potential investment than traditional biotech pharma investors?

Nima Farzan:

Yeah, I mean it has. Here's what I would say we have stuck to the more traditional investors. Now, there are certainly non-traditional investors that we can go to, but within the traditional investors there are some that are a little more machine-driven and we have found that those do correlate in that respect, and I do think that there are some of our investors that look at that and say there are benefits here that we want to get part of.

Matt Pillar:

Yeah, pain is, you know, famously hard to uh measure objectively. Yes, you know you, if you're in pain you know, and you're you know often.

Ben Comer:

You know how much pain you're in is, you know which face you point to. You know, on the pain chart, do you feel that there's a need for, or maybe there are already, some new kinds of scales or other types of objective measures to assess different types of pain. Have you worked on that at all?

Nima Farzan:

Yeah, so there are a couple of things a couple of ways I'd answer that there are studies that you can run that are going to be a little more objective or functional, so I'll mention studies that are called compressor studies, right? And so what this type of study is is, you ask in this case it would be a volunteer. Put their hand in a bucket of ice water that's one degree Celsius, see how long they can keep it in there. Measure that as a baseline score. Give them a randomized either placebo or drug and ask them to do it again and see how much longer they can keep their hand in that water. That's the same level of pain stimulus. Bucket of water at one degree. Same person how much difference does the drug versus placebo make on their ability to tolerate that? You can measure that in seconds or percentage increase. That's more quantitative than than a scale, right? That's really a valuable tool for us. It's not a pivotal study.

Nima Farzan:

The FDA is not going to let you get your label based on that, you're still going to have to go into post-surgical pain or others, but it's a very valuable way to objectively test your drugs early on, and those are studies that we've done. The other thing I would say, which is less about endpoints but protocol design to manage this issue, and there are things you can do, and you would do this more in chronic pain studies than you would in acute. But you can decide which patients you want to enroll in your study based on you did do a sort of rolling screening period with patient diaries that they record their pain prior to entering your study and you look for patients that are good pain responders, meaning they actually do understand. It's not everyone can maybe conceptualize that pain and report it out. So do I consistently report scores? Is there some variability? Because if I say my pain is a 5, 5, 5, 5 every day, that's probably not. I'm probably not a good pain reporter.

Matt Pillar:

If I say 1, 10,.

Ben Comer:

1, 10,.

Nima Farzan:

I'm probably not a good pain reporter. So you want a little bit of variability, not too much, and we consider those patients good pain responders and those are ones that maybe will give you a little bit better answer in your studies.

Ben Comer:

And you are doing those kinds of studies as well.

Nima Farzan:

Yeah.

Matt Pillar:

While you're on the studies subject, where are give us an update on on where the studies are right now.

Nima Farzan:

Yeah, we have a couple compounds that are in the clinic right now. Uh, our first program is in phase two for acute pain, you're not. So this is the development we talked about. We're in post-surgical pain, uh, we're currently running that study. Uh, and we're doing that in a wisdom teeth extraction post-surgical pain patient population. Our second drug that we intend to develop for chronic pain is currently in phase one.

Matt Pillar:

My dentist growing up had a sign on the office door that said modern dentistry is painless. So I'm not sure you know. I mean when I had the wisdom teeth taken out. I proved that theory wrong, of course, so yeah, yeah, yeah, so yeah. Yeah, yeah. So what are?

Nima Farzan:

the next steps then. So the next steps after that on the acute side, you move into pivotal studies and pivotal studies from a regulatory pathway. The agency would like to see one post-surgical study in patients who have had soft tissue surgery and one efficacy study in patients who've had soft tissue surgery and one efficacy study in patients who've had hard tissue surgery or bony tissue. So, typically, where we've evolved to you know, different models have been used over time, but today most people will do abdominoplasty and bunionectomy as the soft tissue and hard tissue studies. So you go to patients having those surgeons and need to run the studies in that and that is the efficacy studies you need to run for an acute indication, chronic, you have a lot more options. There's a lot of different types of chronic pain and you know roughly I bucket it as neuropathic pain or musculoskeletal pain and our focus is going to be in the musculoskeletal side in particular where we started with osteoarthritis.

Ben Comer:

I think everyone recognizes the unmet need for new pain medications, non-opioids, Even regulators.

Matt Pillar:

I think would recognize that.

Ben Comer:

Do you anticipate any sort of accelerated regulatory pathway breakthrough designation, anything like that?

Nima Farzan:

I would hope that and believe that the agency will work with us in a number of parameters, given the unmet need. I think it's too soon to speculate on whether he would have breakthrough designations specifically, but you know I will say that to date in our interactions with the FDA they've been very forthcoming in providing good guidance for us with the FDA. They've been very forthcoming in providing good guidance for us. I do think the FDA wants to see hypnotic and fluid pain drugs developed and so they've been very forthcoming.

Matt Pillar:

Our friends at Alston and Byrd set us up with some amazing space to record during JPM week. The firm's national healthcare and life sciences practice has more than 100 attorneys actively involved in the healthcare industry across the full spectrum of legal disciplines compliance, public policy, transactional corporate governance, securities, fda, biotech, ip, government investigations and litigation practice areas. Alston Byrd represents life sciences companies and their partners in corporate stages ranging from private to newly public to well-estab, and in a variety of stages of product development, from preclinical to post-approval commercial launch. Learn more at alstoncom and tell them you learned about them. On the Business of Biotech, give us a sense for Latigo's, I guess growth and I use the term like like shape shifting as a as a biotech moves from R&D into a clinical stage, into a potentially manufacturing environment. You know where are you now? Yeah, on that. And sort of what have you? What have you had to grow through in your time?

Nima Farzan:

there. No, I mean, this is what I love talking about, because this is what I've done the last few times and this is where I I think I can bring expertise to bears. How do you transition from a discovery company to a discovery and development company and even to a late stage chivalric company, early stage commercial company? I think that's kind of my sweet spot in you know who had been in my career.

Matt Pillar:

I'm glad I asked.

Nima Farzan:

So I think you know, when I came in about six months ago, the company had primarily a discovery team in place, very strong discovery team that developed multiple compounds that we're now taking into the clinic. But we're literally in the very initial stages of building development capabilities. So my focus has been primarily on scaling development. So when we say development, obviously that's clinical development, it's clinical operations, it's biometrics, it's regulatory, it is DMPK, clinpharm, these kind of functions and capabilities, especially as you go beyond a phase one study and you need to start thinking about full development program.

Nima Farzan:

So that's been the people, growth on the organization that always has this interesting tension in biotech, because, you know, discovery will have been front and center for this case. Five years, five years, bradwell and we've been around and now they start to see the growth and development elsewhere and what you have to do is make sure you're spending time letting discovery team know that that's still a huge source of value today and in the future and maintaining excitement and motivation there while most of the growth is happening on the development side, yeah, and as far as that development side, growth, is concerned, what's it been like in your experience gearing up, staffing up Like?

Matt Pillar:

have there been particular challenges to that?

Nima Farzan:

I, you know, I've been really lucky in the sense that I think Lattigo is very well positioned for everything we've talked about and the excitement around this class, that we've been able to attract great talent. I know that's not always the case and I will say that you know we're trying to bring in a mix of people with pain experience and not Right, and there isn't the depth of um, you know, companies working in pain to have a whole sort of people, you know a whole set of talent that have experience in pain not many companies to snipe from.

Matt Pillar:

Is that what?

Nima Farzan:

you're saying exactly right, there's not as many um, but it's also less competition. You know, because, like I mean from oncology, for example, like you know, if you're an md clinical oncology experience, you know you're gonna have 10 offers um and uh.

Nima Farzan:

So we've been, I think, lucky in being able to attract people who have pain expertise across different functions, even bioethics and the like. But then I've also been cognizant about mixing in some people with capabilities in other therapeutic areas to augment this right. Because, as we think about the development and what's been interesting is a lot of people will say, well, okay, you're in pain, so you've got to go get CNS people. That's, you know, like the therapeutic area we kind of fall under. But the answer is we're actually not a cns company we're a science company, but.

Ben Comer:

But.

Nima Farzan:

But you know, it's a very different experience from um if you've been working on degenerative disease, spark concerns, dementia etc. Um, actually, what I kind of want are people who've had more primary care. You know drug development experience right and really understand the drug, drug interaction work, the clinical pharmacology work. You know the scale up on the manufacturing side et cetera that we need for the kind of business.

Matt Pillar:

Yeah.

Ben Comer:

Tell us about LTG 101, and you know it works. Maybe at a high level, sure.

Nima Farzan:

So LTG-101 is a NAV 1.8 inhibitor. It's a small molecule, oral compound and it inhibits very selectively and potently NAV 1.8. So what is NAV 1.8? Why is that matter of opinion? Nav 1.8, in this case NAV sodium voltage channel 1.8. There, that you know, matter of pain. Uh, now 1.8, in this case nav sodium voltage channel 1.8. There are uh, nine of these channels.

Nima Farzan:

Um, we're targeting 1.8 very selectively. That's important because other nav channels play other important roles in the body that you don't want to interfere. But now 1.8 is exclusively reserved by the body for the use of propagating the pain signal from the periphery back to the world. And so whatever that pain signal may be that could be an inflammatory brain signal, like from prostaglandins or cytokines, it could be nociceptive, from pressure, heat, cold, it could be neuropathic, from glucose damage to the nerves All those signals, that action potential, that electrical firing, is carried through this sodium-molded channel that helps propagate that signal back to the brain. So inhibiting that channel can reduce the perception of pain that's coming from the periphery back to the brain. And if you do that selectively, without hitting other sodium channels that play important roles in the body, like 1-1, 1-5, 1-7, then you can have a very safe and fast danger.

Ben Comer:

Is there a danger, then, of the old hand on the stove and not feeling it?

Matt Pillar:

There's the frog in the boiling pot. No.

Nima Farzan:

For a couple reasons.

Matt Pillar:

One is you thought maybe you caught Neiman on that that like wait a minute I'll bet you didn't think about that? No, I know we thought about yeah, no, I'm curious about why, right like I would have asked the same question. Yeah, yeah, you first of all this is more.

Nima Farzan:

I'm gonna blunt the pain, that you're going to completely not feel pain, um, and you still have senses. You still can feel heat, you can feel cold, um, and so it does block pain effectively, does not eliminate all pain. You're not going to walk around, you know, grab your hand on that. So there are no. You got your hands on um and, frankly, if we ever got to a level of analgesia that was that much of it Probably pretty stiff, you know, and not provide that.

Matt Pillar:

So good, yeah. Yeah. I remarked the first time we talked a couple weeks ago that your disposition is like uncommonly cheery and pleasant, I mean this is a tough business that we're in. I mean, you're working in a market that has, as you mentioned, big social implications. That, can you know, if you think about it long and hard, could bring you down right, like thinking about the opioid epidemic, for instance. I'm just curious a totally personal question but how do you maintain this disposition?

Nima Farzan:

I mean, I think I have it naturally. I think I I'm surprised that anyone can be a biotech ceo and not be naively optimistic all the time, because we enter a business where things fail 90 of the time.

Ben Comer:

Well, I know you don't think that this one's gonna work.

Matt Pillar:

I believe like you gotta be optimistic right yeah, yeah, but I mean that could be causing, I mean that stress. Right, the acceptance of that risk could be cause for, you know, for concern enough to bring a guy down.

Nima Farzan:

Well, it is the hardest part of the job. I had this conversation with a colleague last night who's thinking about transitioning to a senior role and you know, obviously you have to have some level of technical capabilities and you know intelligence and background in joint development. So let's check the box things, um. And then we talked a lot about the energy you need to be a ceo, right, that's? That's, I think, clear.

Nima Farzan:

I think most people would say like you just gotta have energy, you gotta have passion, and and the thing that I raise is like here's the last part. That is hard is the emotional roller coaster component. And this is a business like many businesses, but we have this binary outcomes where the data is revealed or you know, and there's going to be ups and there's going to be downs, and you know I will tell you, whatever what it's been almost 10 years as a CEO in different times you don't get better at riding that rollercoaster. It's still euphoric when it's high and crushing when it's low. And I think I've gotten better at all the other aspects of the job over time as you learn experience, but I haven't been able to get better at that and you just have to ride the rollercoaster and then you know to manage this on home.

Nima Farzan:

Sometimes it is.

Ben Comer:

We talked about LTG 101. What could you tell us about, I guess, your pipeline beyond? That, such as it is, and any sort of plans to add additional campaigns.

Nima Farzan:

Yeah, so we have a second compound in the clinic 305. That's the one we're developing for chronic. The characteristics of the drug the first compound is twice daily. The second compound is once daily. That makes more sense for a human patient Actually acute pain sometimes twice daily dosing is actually an advantage. Patients will tend to take the drug whenever they want. So you want to have quick onset or offset, so that they're not taking a one-stage drug multiple times. But in chronic pain you really would rather have one day a day dosing.

Nima Farzan:

So that's the second compound that's in the clinic, that's the one that's in phase one, that will start arthritis studies later this year. We have a third NAV18 inhibitor that we're intending to bring into the clinic. What's exciting about that one for us is that it has the potential to have a really low dose, which gives you the opportunity to develop different formulations. And if you think about pain drugs that you would get in OTC the opportunity to have a patch or a spray or something like that could be really interesting. To do that you have to have a very low-matter drug, and so that's the opportunity of the third.

Nima Farzan:

The third time we are continuing to work on other pain targets. I think we're very excited about that. One is your. We've doubled down triple down if in it, as you will. But we are also working on other pain targets. We're looking at one called asic, which is acid sensing ion channel, which is triggered when you have acid driven pain, and there are obviously certain types of pain, like ischemic pain, that is, cancer pain, that is specifically often acid-driven but also can be acid and now in hatred. So you got combinations as well to better block pain.

Ben Comer:

For those different delivery mechanisms that you mentioned. Would you, is that something you would work on in-house? Would you partner for those kinds of yeah?

Nima Farzan:

that's a great question. I mean, I think those are things that we're still thinking through. I think you could probably think about some early proof of concept work that you could do, demonstrating bioavailability or the like, or technical feasibility. But yes, ultimately those are probably benefit from having partners.

Matt Pillar:

What have you been doing here at JPM during JPM week, like what's been the agenda?

Nima Farzan:

Getting steps in. Well, I mean, yeah, that's happening regardless.

Matt Pillar:

right, it just comes yeah.

Nima Farzan:

Yeah, you know our focus. This is a great conference. I live in San Francisco so it's always fun for me. I can pop over and go home when I need to. Can I sleep in your own bed?

Ben Comer:

I have a hypothesis that JP Morgan Week is the week that there are the most people in suits in San Francisco on the street, is that? Accurate. Can you verify?

Nima Farzan:

that I can verify that in three days here you will see more people in suits and you will see in 362 days, put together over 10 years, the rest of it.

Ben Comer:

Okay, 10 years, wow, yeah, I mean 100%, I mean.

Nima Farzan:

I will also say that over the years I've been coming to JP Morgan it's gotten more casual.

Ben Comer:

So I've noticed that too.

Nima Farzan:

Student tie right and now we moved a few years back to, like we didn't want to have to wear ties, and now a lot of people wear sneakers, and this year I saw a lot of people not even wearing suits, you know, jacket, blazers and sneakers. So that's definitely the trend, yeah.

Matt Pillar:

But I, like, actually felt guilty about not wearing a tie today. I wore a tie the last two days and I today we're tied the last two days and I noticed to your point that I was one of the few guys who ties off Ben's holding out.

Ben Comer:

I've been going back and forth a little bit. I'm not really sure which one is the right view. I cut you off on JP Morgan.

Nima Farzan:

Great conference for a couple reasons. One clearly the world's investment community is here. It's a good conference for meeting for investors, but honestly, there are other conferences where you have access to investors and pretty regular cadence of those. This is one of the few conferences where you can access strategics and not just business development teams but senior executives, and so that's really unique about this, and so the opportunity certainly to have conversations with strategic is a focus and need for this week.

Matt Pillar:

Are those senior executives generally? I mean, that's the expectation of them while they're here, and how do you access them?

Nima Farzan:

You know it is. Certainly the thing with the senior executives here in pharma is that they kind of have a million options to pick from and they'll kind of go with what strikes their fancy right. And you can try to work with your colleagues in the business development team and see if there's enough excitement to get a C-suite executive to pop into your meeting. Sometimes they do come, sometimes they don't come. Um, you know, I think it'd be fun to be a pharmacist.

Nima Farzan:

I can just be like looking at a calorie every day Like I want to get that one, that one, that one half of this one, you know, but that's that's kind of how it works. It is still speed dating, but it's it's still a unique kind of access.

Ben Comer:

Yeah, yeah, I mean, interest in certain therapeutic areas swings back and forth. You know, different things become hot, different things aren't. Or you know, when there was a lot of reporting on opioid deaths and the CDC changed its guidance there, I think there was a huge focus on non-opioid pain medications and a recognition of the need for them. Do you have a sense that that sentiment still exists and is still just as strong? Has it decreased? Has it increased?

Nima Farzan:

Yeah it's a great point because I mean we're seeing a national decrease in the number of opioid deaths, right, certainly locally and nationally, and a lot of people are, you know asserting that it's related to these efforts to reduce opioid prescriptions, and so we can look at it one of two ways.

Nima Farzan:

One is like you know, phew, it's getting better, we don't have to focus on it, or no, what we've been doing has actually worked, and we should keep doubling down and pushing up, because it's not like opioid deaths have gone. I mean, they're down maybe 20% from last year. Yeah, they haven't disappeared, but they haven't disappeared, it's still many, but they haven't disappeared so many X, what they were 10 or 15, 20 years ago.

Nima Farzan:

So I think, that the latter is where I'm hopeful and I believe it is which is these interventions that we've been putting in place are starting to work. Let's continue and continue to double down, and we're seeing that snowballing in. You know, dependency, opioid dependency, translating to you know a lot of the society levels that we see related to that.

Nima Farzan:

as other non-opioid pain medicines become available, I think they'll become even greater incentive to be like look, it's been working already, now we have even more therapeutic options. We should be even stricter about letting opioids be used. Why should we have, why should it even be allowed to have opioids be prescribed for low risk surgical procedure? Why should we send an 18 to 20 year old child, young adult, back to their college dorm with a bunch of opioids after wisdom teeth extraction? We probably shouldn't let that happen.

Ben Comer:

Yeah, and I would imagine payers that would think about it the same way. Right, and when more therapies become available, I would think you know that there would be a pretty strong push to prevent people from getting hooked to an opioid because it's costly. It's costly.

Nima Farzan:

And you know it's really easy to focus on and we should on the dependence component of opioids. But there are other issues with opioids, right. So obviously there is the nausea and constipation that they're well known for, but also just you know, intuitively, the CNS, the somnolence, the, you know, the being out of it, right, and the impact that has. So one of the anecdotes that I was hearing is how surgeons are really, you know, looking forward to a non-opioid, an additional non-opioid to add to the mix, to reduce opioid use. Because if you think about how they're measured, it's often 30-day mortality, morbidity, post-surgery, and if the surgery goes great but you give someone an opioid, especially someone more elderly, and they're out of it and they have a fall, that's actually one of the things that brings people back into the hospital and that counts against your mortality, morbidity, on that operation.

Ben Comer:

So there are a lot of concerns with opioids.

Nima Farzan:

The dependence is the obvious one, but even if you don't become dependent, you're not very functional yeah.

Matt Pillar:

Yeah, and are you finding that that sort of the nuance of that story is being well received as well?

Nima Farzan:

Yeah.

Matt Pillar:

Is it just a big story that resonates?

Nima Farzan:

It's that, yeah, you know that. I'd say that we're finding greater traction on the nuance of the story as people start to be like, no, actually, maybe this is a real opportunity. But there are still a lot of people who will say, like, it's not about opioid replacement, they're generic. The acute market's small. Who cares about these things? It'll be whether you develop a, you know, a big neuropathic or musculoskeletal problem. But I think this opportunity to replace opioids for all these scenarios you're talking about is yeah.

Ben Comer:

Yeah, well, I mean, the cost of generic opioids, I think has been one of the challenges to overcome for for alternatives, right, I mean, how do you? You have to develop a medicine that is not so so much more expensive that you know an insurance company, for example, is you know may end up choosing an opioid over over your new drug.

Nima Farzan:

It's not going to potentially get someone addicted and put them into a fog and cause them to fall and all sorts of other things.

Nima Farzan:

That's right. I mean, look, you can make all those arguments that we just made about that. You can have regulatory and government policy pressures to not let people just take the easy way out with the cheaper drug that has all these effects. And you can also think about the big picture. If I walked, walked in, you know for most procedures the range of cost. You know it's a $10,000, $15,000, $20,000, maybe $30,000 procedure and then for the cost of a $30 to $40 a day drug for a week you're going to put them on an opioid.

Matt Pillar:

You know, in the context of the surgery. It's a very small percentage of what they expect you know, uh, we got a pretty good lay of the clinical land for. Let it go. Uh, let's go post show next week. You're back in the office, next steps, big thing you're working on like what's on your agenda. Yeah, sleep Same yes.

Nima Farzan:

Same.

Matt Pillar:

But no, but seriously Take a few non-opioid analgesics, that's right, right, I think a couple of things.

Nima Farzan:

So one is you know, the engagement you have with investors and strategics at a meeting like this is a two-way street. So one obviously we're telling our story, but we're hearing feedback about like here's how we would do things.

Nima Farzan:

Here's how we think about things. So I can just debrief with my team at London today and we have four or five things we want to explore in some detail about. How should we look at that potential indication? What would a proof of concept look like in that idea? What kind of study can we run? How do we want to think about this timing of the study? So there's some of these concrete things, and actually it can be draining as a CEO to be constantly doing the pitch, but you can get feedback back. That's useful and in an event like this you do. So there are a few things that we want to explore. So that's the kind of unique thing coming out of the conference. The other thing, of course, is, between the holidays and JP Morgan, just getting back into good operational planning, tracking our objectives and being back in the flow of the operations Also same.

Matt Pillar:

Yeah, yeah, yeah, we find ourselves just rolling right out of the holidays. Also same, yeah, yeah, yeah, we find it. We find ourselves just come rolling right out of the holidays into jpm. Then we get back and it's like, okay, let's let's get grounded.

Matt Pillar:

Let's get grounded, yeah, yeah. Well, that's uh, that's about all the time we have for today, but there's so much more to talk about. We'd love to have you back on the show at some point, um, to talk about what's going on there and clinical progress. I appreciate you taking time out of your super busy schedule to spend with us. This has been great. I enjoyed it. Yeah, so if we Thank you, thank you. So that's Latigo Therapeutics CEO, nima Fawzan. I'm Matt Piller, and I'm Dave.

Matt Pillar:

Bummer and you just listened to the business of biotech from JPM 2025. Also from the beautiful law offices of Alston and Beard. Thank you to Alston and Beard for hosting us this week. Listen and subscribe. Wherever you listen to podcasts, Make sure you take in our video casts under the Listen and Watch tab at Bioprocess Online or under the Business of Biotech tab that is on lifescienceleadercom. We drop every Monday, so we'll see you next week and thanks for listening.

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