Assistant Managing Editor

Founded in 2006 to develop what CEO Carl-Johan Dalsgaard calls an "overlooked biology," small Swedish biotech Cardoz AB hopes to offer the first therapeutic for treating abdominal aortic aneurysms.

Known as a silent disease, AAA is characterized by the weakening and dilation of the aortic wall. It's often diagnosed only by chance if patients happen to have an ultrasound or X-ray taken during physical exams; in many patients, its remains undiagnosed until rupture, and at that point, it's often too late.

"Many patients present with rupture," Dalsgaard told BioWorld Today. "About 50 percent of those make it to the hospital, and of those, about 50 percent survive the surgery."

If patients are diagnosed early, they are monitored and usually end up having surgery.

But Cardoz is hoping its therapeutic approach will be more palatable to patients, as well as encourage more routine testing to identify AAA.

To do that, the company is targeting mast cells. "They are the body's most trigger-happy cells," Dalsgaard said.

They trigger other enzymes to break down the structural proteins such as collagen in the aneurismal wall, so inhibiting that mast cell degranulation should help prevent the breakdown of those proteins.

And preclinical studies have been promising, he added, with data showing that treatment appeared to prevent AAA formation in animal models.

The Stockholm, Sweden-based firm, which was incubated by venture firm HealthCap, has raised about SEK130 million (US$17.1 million) to date, including a recently closed SEK100 million Series A round led by Forbion Capital Partners and included participation by Ysios Capital Partners and HealthCap. With those funds in hand, Cardoz plans to accelerate its Phase II program in AAA.

A randomized, double-blind, placebo-controlled trial is set to start by the end of this year or early next year. It's a one-year trial, so Dalsgaard anticipates reporting data in about three years.

At that time, Cardoz could consider striking up a big pharma partnership. "That's the ideal situation," he said, though the AAA indication is aimed at a concentrated physician group, which would allow a small biotech to consider marketing on its own.

The Phase III program likely would not be "as big and as elaborate" as other trials in the cardiovascular space, he said. And if Cardoz can prove that the mast cell degranulation approach works in AAA, that could pave the way for its use in larger CV indications such as atherosclerosis.

Of course, part of succeeding in the AAA market will rely on educating the medical community.

AAA affects men to a greater degree, with an estimated 5 percent to 7 percent older than 65 diagnosed. So that's about 210,000 men in the U.S., but Dalsgaard estimated that the number might actually be five times or six times that because the condition is so often underdiagnosed.

It's very simple to identify via ultrasound, so having an oral therapy available would mean that routinely checking patients for signs of AAA also would translate into a more manageable and cost-effective approach in terms of the overall health care environment.

Beyond its work in AAA, Cardoz has earlier-stage programs, though the firm is not yet disclosing any details on those. Like many start-ups, it's operating as a virtual company and has only a small staff of five.

In connection with the Series A financing, Sander van Deventer, of Forbion, joined Cardoz's board.