Tinnitus Talk

Very few commercial drug companies focus on hearing disorders. Even fewer focus on tinnitus. Otonomy does both. In this exclusive interview, we took a deep dive with Otonomy’s executives into their drug pipeline.

We spoke to David Weber (PhD), President and CEO, and Alan Foster (PhD), Chief Scientific Officer. They shared their views on what they see as the “renaissance” of hearing research and how there is currently more investor appetite to address hearing issues. We discussed why Otonomy is not only seeking solutions for different kinds of hearing loss, but also tinnitus specifically.

The interview covers each of the company’s drugs in-depth, from its mechanism of action to commercialization plans. Tinnitus drug OTO-313 targets overexcitation of the auditory nerve, which is theorized to cause tinnitus. Which types of tinnitus will benefit remains an open question, but the tinnitus community will no doubt follow the drug’s future with keen interest.

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A major obstacle to developing better treatments for tinnitus is the lack of a test or measure that can objectively assess whether someone has tinnitus and how severe it is. Making tinnitus measurable allows researchers to more easily assess the effectiveness of new treatments and meet the expectations of regulators in order to get those treatments to market.

We spoke with Mehrnaz Shoushtarian (PhD) from the Bionics Institute in Australia, who are working on an objective measure of tinnitus based on Functional near-infrared spectroscopy (fNIRS) and a machine learning program. They believe that their technique will not only be able to distinguish whether someone has tinnitus or not, but also how loud it is.

We cover the technical ins and outs of the objective measure, the underlying theories the work is based on, the future commercialisation of the technique, and the ultimate impact the Bionics Institute is hoping for.

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The two conditions are eerily similar: visual snow and tinnitus. The patient experience is often one of being misunderstood, and research is in its infancy. What can be done? Two pioneers in this field, patient advocate Sierra Domb and neurologist Dr Peter Goadsby, talk about their incredible experiences in trying to push the envelope for visual snow sufferers.

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This episode is an opportunity to learn about what’s going on in the brain of someone with tinnitus. Dr Will Sedley explains, in very clear and easy-to-understand terms, his own theory on the mechanisms underlying tinnitus, as well as the main other theories in the field.

We also cover topics like: the factors that trigger the onset of tinnitus, whether there are many different causes of tinnitus or really only one, the analogy with other conditions like chronic pain, the reliability of animal models, the need for an objective marker of tinnitus, and the thorny issue of whether tinnitus subtypes really exist.

Understanding the origins of tinnitus is key to developing better treatments, which is why we’d like to see more neurologists follow Will Sedley’s lead.

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The company we interviewed for this episode, Frequency Therapeutics, is the subject of the most active thread on the Tinnitus Talk forum, with nearly 1 million views. So of course, we wanted to hear from directly!

Frequency Therapeutics is working on a new hearing regeneration treatment. Preliminary results suggest the drug might work particularly well to improve speech intelligibility, something which traditional hearing aids have not been able to achieve.

We spoke with Carl LeBel, PhD, the company’s Chief Development Officer, about how the drug was discovered, whether it might benefit tinnitus, and why speech intelligibility should be the primary measure of hearing. We also touch on the burning question of when FX-322 might hit the market.

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A drug to quieten your tinnitus. It’s what most people struggling with tinnitus desire. We had the pleasure of interviewing Thanos Tzounopoulos, PhD, director of the Pittsburgh Hearing Research Center, on his work to develop just such a drug.

His work builds on the previously somewhat successful off-label tinnitus drug Retigabine. That drug was taken off the market due to severe side effects. Thanos is now attempting to re-develop it, without the side effects, and better targeted at the source of the neural hyperactivity perceived as tinnitus.

In this episode, we speak extensively about Thanos’ theory of how tinnitus is generated in the brain and the role of (broken) potassium channels in this. He explains all the trial and error that went into re-developing the drug and speaks about the upcoming phases of research needed before the drug can come to market.

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This episode is quite different than what we’ve done before. You’ll hear from four people with tinnitus about how the current situation, being quarantined, has affected their lives and their tinnitus. One of these people was infected with the Coronavirus and describes how it affected his entire family and impacted his tinnitus.

We also spoke with a researcher, Raj Shekhawat, about how the crisis has affected tinnitus research because of clinical trials being stalled. And we spoke with Alan Hopkirk, an audiologist who has now shifted his patient support efforts completely online.

Through this compilation episode, we are aiming to connect with all of you out there who are feeling isolated!

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Tinnitus Talk spoke with the Hough Ear Institute, a non-profit research organization that focusses on restoring hearing. They are working on two hearing regeneration treatments that could very well have benefits for tinnitus sufferers.

In this episode, we spoke with Dr. Richard Kopke and Justin DeMoss. They explain the mechanisms behind their treatments and how hearing restoration can be achieved. They take us through the different phases of research and development required to get new drugs to market, and some of the challenges faced along the way. Of course, we also touch on the topic of whether restoring hearing could cure tinnitus.

The episode includes an announcement about an exciting new partnership with pharmaceutical company Oblato to take Hough’s hearing loss pill through the next phases of clinical trial and assess its potential for tinnitus.

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Tinnitus Talk spoke with Bryan Pollard, the president of Hyperacusis Research Limited, based in Boston. Bryan himself suffers from hyperacusis, which he believes is due to sound exposure from a loud woodchipper several years ago.

In this episode, Bryan talks about his personal experience with hyperacusis, and how this drove him to start Hyperacusis Research to raise funds for scientific research.

We spoke about the concept of pain hyperacusis and how it only recently became recognized due to the scientific breakthrough proving that the cochlea has pain receptors. Bryan also gives advice to hyperacusis patients regarding treatment options. And of course, we spoke about the most exciting new research developments.

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It’s been the talk of the town on the Tinnitus Talk forum for the past few months: the launch of Neuromod’s Lenire treatment for tinnitus. We got a chance to sit down with their CEO Dr. Ross O’Neill and ask him everything (well, nearly) you want to know about this device.

It’s an extra-long episode, because so many questions were raised on our forum about Lenire – the thread has been viewed over half a million times – that we felt we needed to do our best to gather as many answers as possible.

In the episode, Hazel and Ross talk about the basic principles of the treatment, its effectiveness, and risks. We also covered clinical trial results and go in-depth on what the treatment actually looks like. We clarify whom Lenire is suitable for, and Ross makes some projections about future roll-out of the device.

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