Wake-up haul: an Ozempic moment for the brain
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What is the episode’s opening overview and who are the hosts?
The Economist. Hello and welcome to the Intelligence from The Economist. I'm Jason Palmer.
And I'm Rosie Blore.
Today on the show why Japan has had such a weak startup scene and how to beat procrastination and just get on with it.
First up though.
Peptides are just huge at the moment. They're the P in GOP1 drugs like Ozempic. But the pharma industry is, as always, looking for the next big thing. And our global business writer Shilesh Chitness has been looking into which peptide might be it.
There seems to be a lot of excitement in the pharmaceutical industry around a class of peptides. The new kit on the block is orexin. It's a neuropeptide that's found in the brain. And there is a new class of medicines called orexin agonists. Agonists are essentially medicines that mimic the action of a particular molecule.
How do orexin peptides work and why are they being called the next “Ozempic” for the brain?
In this case, Orexon's main job is to regulate wakefulness in a person. So the boundary between sleep and wakefulness, it is essentially the body's master switch that controls that. A whole new generation of drugs that are based on the Orexin agonist are now approaching the market, and at least a few in the drug community are wondering whether this could be as big as the GLP medicines.
So there are new drugs being developed around these things. Tell me about them.
Yes, so just at the beginning of this month, a new drug called ovoperexton, which is made by Takeda, a Japanese pharmaceutical firm, was approved by the FDA to treat narcolepsy, which is a condition where the boundary between sleep and wakefulness is blurred. People who have narcolepsy typically without any indication or any warning may suddenly fall asleep. There's a more severe strain of narcolepsy, which is accompanied by cataplexy, where your muscles essentially freeze. So it's a pretty dangerous condition for people that suffer from it. And orexins have been found to be really impactful in treating it. And This particular medicine is based on an agonist of Orexin, which we just talked about. But it's not just Takeda.
There are a whole host of pharmaceutical companies that are actually working on drugs based off the Orexin agonist. There's Alchhermes, which is an Irish biotech firm that has a few candidates in the pipeline.
Which new orexin‑agonist drugs have been approved and which companies are developing them?
And really the biggest is Eli Lilly, which I think all our listeners would probably know from their GLP drug. drugs, they acquired a company called Centesa Pharmaceuticals, which is a biotech firm for a deal worth almost seven point eight billion dollars. And Centesa has drugs in the pipeline that are based on the Orex and Agonist as well. So let's wind back a bit. Tell me
how these things came to be
known about
in
the first place. In the late 1990s, a group of researchers working independently converged on this neuropeptide. In fact, there's a very fascinating case of a researcher in Stanford called Dr. Emmanuel Mignon, who was studying the cause of narcolepsy in certain breeds of dogs, particularly dobomens and labradors. And these dogs had a very high propensity to inherit this particular disease, and he wanted to know why. And through various experiments, he was able to narrow it down to a particular genetic mutation in their brain that made. them not respond to the orexin molecule. And so that gave very early clues that was then subsequently verified through human trials that people having narcolepsy essentially do not have enough orexin molecules in their brain.
And that set the drug makers on the part to actually create agonists, which essentially mimic the activity of a particular molecule to create drugs based on that.
So all of this is around treating narcolepsy.
Yeah, so that is the first step. Now, narcolepsy is a fairly rare condition which afflicts between one in a thousand to one in two thousand people worldwide, depending on various estimates. And what Erexin does is by regulating the sleep and wakefulness cycle in the brain, it can actually help patients who suffer from narcolepsy control that boundary a lot better. But beyond that, it also Mm. has been shown in animal trials to be able to regulate other conditions in the brain, for example, the reward-seeking behavior, motivation, things like that.
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Chapters
8 chapters
1
What is the episode’s opening overview and who are the hosts?
0:03–1:20
2
How do orexin peptides work and why are they being called the next “Ozempic” for the brain?
1:20–2:50
3
Which new orexin‑agonist drugs have been approved and which companies are developing them?
2:50–5:29
4
What market size could orexin‑based medicines reach and how does that compare with GLP drugs?
5:29–9:26
5
Why has Japan’s post‑war startup boom stalled and what are the three main problems?
9:26–14:19
6
How is procrastination measured and what impact does it have on earnings and health?
14:19–17:58
7
What evidence‑based techniques can help people stop procrastinating?
17:58–20:51
8
What are the key take‑aways and what’s next for orexin drugs, Japanese unicorns, and beating procrastination?
20:51–21:51