Mrkt BUZZ Modus: Benefiting from sepsis care initiative

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Mrkt BUZZ Modus Therapeutics 8 nov 2021

Approximately 40.000-60.000 Swedes suffer from sepsis/septic shock with a high mortality rate every year. Sepsis is the medical term for severe blood poisoning. Fortunately, SKR (Sweden Municipalities and Regions) approved a coherent care pathway for sepsis in the first half of 2021. The joint initiative includes some initiatives to detect sepsis/septic shock earlier. Modus candidate sevuparin is, in our view, a drug that should be used as early as possible in the treatment line and could potentially benefit from the possibility of an earlier- and more precise diagnosis of patients classified with sepsis and facing treatment.

A serious condition with a high incidence

The graph below illustrates the incidence of sepsis and septic shock in the seven largest markets in the world (US, EU5, and Japan). According to GlobalData, more than 2.1 million Americans are diagnosed with the condition each year. Comparing the US and Sweden, the market is relatively small. It is worth mentioning that around 28 000 people suffer from acute myocardial infarction in Sweden each year, while according to the Sepsis Foundation, over 40 000 people suffer from sepsis. More people die from sepsis in Sweden alone than from breast cancer, prostate cancer, and bowel cancer combined, which is remarkable.

Early diagnosis is key

One of the biggest challenges in sepsis is to detect the condition in time to ensure the correct treatment (antibiotics in the first stage). If the patient does not receive proper treatment relatively promptly from diagnosis, fatal outcomes increase dramatically. A number of studies support the thesis that early detection and diagnosis are crucial for the patient. The primary concern is to avoid the patient developing septic shock, a subset of sepsis with a much higher mortality rate and usually requires the patient to be treated in an ICU. This patient pattern is relatively similar both in Sweden and in the seven largest markets.

Sepsis alarms installed to facilitate rapid diagnosis

Already in 2011, a model with a so-called sepsis alarm began to be developed at Skåne University Hospital in Malmö. The model was developed to facilitate the diagnosis of the most seriously ill patients – those who often have potentially life-threatening abnormal vital parameters such as respiratory rate, oxygenation, blood pressure, pulse, and level of consciousness. In our initial coverage report, we discuss how the definition of sepsis and septic shock is established in more detail.
Between 2011-2016, a number of pilot projects were conducted in Malmö with good results. Among other things, 90 per cent of sepsis patients received antibiotics within one hour. In 2011, the figure was around 22 per cent. Following the pilot projects, the “Malmö model” is now spreading widely across the country – a spread that is expected to continue given the news this year of a common care pathway for the condition. In practice, the provision will lead to more significant investment in sepsis care by improving the ability of emergency departments to care for patients with severe sepsis. The aim is that a greater proportion of patients with severe sepsis will be detected earlier to initiate the right treatment.

In simple terms, the “Malmö model,” also known as the sepsis chain, is as follows:

 A seriously ill patient calls 112 – the ambulance arrives, and staff checks blood pres-sure, breathing, pulse, and blood oxygenation. If the patient is suspected of having sepsis, a nurse is informed immediately, who presses the sepsis alarm.
 When the alarm sounds, the emergency team prepares, and an infectious disease doctor is called in to ensure the patient receives the right antibiotics quickly.
 After adequate treatment, follow-up, and monitoring, patients can be discharged.

We expect Mods to benefit from earlier diagnosis

We believe and have good faith that Modus’ drug candidate, sevuparin, should be used as early as possible in the treatment regimen of sepsis. As soon as a patient has been diagnosed with sepsis, sevuparin should be raised for discussion. Although the Swedish market is, as mentioned earlier, very small, similar initiatives are taking place in larger markets in the EU. Several companies are also developing better and more specific diag-nostic tools for sepsis, including the Swedish companies Q-linea and Gradientech.

We assess that it is positive for the Company that initiatives in sepsis care are being taken and implemented. Other things being equal, the fastest possible diagnosis and a confirmed case of sepsis will potentially increase the demand for sevuparin in the event of market approval.

Read our initial coverage report here.

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