Lloyd Mencinger Presents Aqua Medical at LSI USA '23

Transcription

Lloyd Mencinger  0:05  

Okay, so a bit about what we're doing at Aqua Medical. And so our target is type two diabetes. And I think this headline staggering cost really captures it. I pulled this infographic from the ad a website at the end of last year. And already all the numbers are much bigger. So it says here 34 million in the US with type two diabetes, diabetes, it's 37 million now it says 88 million with pre diabetes. It's 93 million now. So more than one in three adults. And with more than 50 pharmacologic 's out there patients are not well controlled, and you know, the host of complications including mortality. So true epidemic, enormous spending, and that really changing the course of the disease. So what are we doing at Aqua? Well, our goal is to change the course of the disease and in part to minimize or potentially eliminate injectables and certain cohorts of patients. And we have a device based approach to this. It's a 30 minute outpatient procedure, it's a catheter goes through an endoscope goes through the mouth, and we use hot water vapor ablation in the GI tract. And here's what the procedure looks like. It's really sort of a garden variety upper endoscopy procedure, you can see a common endoscope go through the esophagus through the stomach, and into this 10 inch or so section called the duodenum. You can see our blue catheter coming through the endoscope, and what we do is we deploy these two self expanding discs, and they create this really neat little treatment chamber. And from that center shaft, we precisely dosed the hot water vapor for the ablation, and how water is the perfect ablation agent, because it has high energy, it can get uniform coverage in the irregularities and it can get a controlled ablation into the mucosa. And it produces this beautiful effect we call it the box effect and searing almost like you would see or a tuna just a millimeter or so of the surface of the mucosa. Okay, so the big question is, how can this work for type two diabetes. And it's actually not not really much of a surprise, because there's decades of experience with bariatric procedures for obesity. So gastric bypass, biliary pancreatic diversion ruin why, and in common, they basically exclude the duodenum. And what they find in those procedures is that patients, the obesity resolves over weeks and months, but the diabetes is almost immediately resolved. And then a company came out with a very clever, it was a very clever idea, sort of a tube or a sleeve, fix the lower stomach covering the duodenum, so food would bypass the duodenum. And they found very similar results that patients lost weight over weeks and months, but almost immediate dramatic improvement in diabetes and metabolic values. Now, unfortunately, the company had problems keeping the device in place, but notwithstanding they validated the concept. And now more recently, there have been endoscopic approaches that have been had very impressive results. So I extracted one this from this company fractal is probably ahead of most and they they have a number of studies. This is one extract you can see significant improvement hemoglobin a one C and actually durability. I was impressed with this in some cases 24 months for an outpatient procedure. So now this is a sort of a subset of the who's who in GI endoscopy. And these Doc's when we started our company, we were working, they were getting us into esophageal ablation present to prevent esophageal cancer moving along first inhuman publication etc. But after time, they came to us and they said, you know, guys, you know, two things. Number one, this ablating The duodenum to treat Type Two Diabetes, this is a real effect. And number two, it's enormous. And you guys have the perfect product for it. So and this is what they refer to the product on the left. The catheter is larger than the endoscope, and you can see it requires a physician to basically negotiate to devices through the patient's mouth. So what does that mean immediately, it's an expert task, a very constrained market, very cumbersome to use. Our procedure, as you saw, goes through the endoscope pretty much any GI endoscopy, this can do our procedure, 30 minutes, maybe even 20 minutes, very easy to use. The company on the left, some of you may know has raised over $300 million. Their post money on that round was almost 900 million. We've gotten to this point with less than $15 million. And the advantage we have we are a platform technology. So by going through the endoscope, just by changing the design of catheter tips, we can address different therapeutic targets throughout the GI tract. So do Edina for example esophagus pancreas and this is really perfect for a strategic Salesforce where I used to work at Boston Scientific this would be sort of a Nirvana because this is one customer call point it's a GI endoscopy is the person who drives the endoscope. All right, we do have a human study first in human study in the esophagus, it's with our focal device. And we do have a publication, so it was very successful. We also have a reimbursement code we can use for esophagus. But the biggest thing we have as a company is we've secured three 510 K clearances and two parts of this one in the green. That gives us all the indications the market leader has Medtronic radiofrequency ablation for Barrett's ablation and associated so that's key, but in the red is the most important read gives us the ability to bleed throughout the entire GI tract. So even though we don't have a diabetes specific indication, we can actually ablate the duodenum and then back in to fast track a diabetes indication afterwards. So we're thrilled we're actually on the cusp of launching our first inhuman for type two diabetes are first study. Now lastly, we think we have a great team. This is Greg Barrett. He actually created the market for esophageal ablation with the radiofrequency radiofrequency technology. He sold his company to Covidien Medtronic for 425 million. You can see all these other exits. His idea was that Aqua was the next thing. We were the Tesla versus his combustion combustion engine. Bill starlings, also on our board, many of you may even know him, I tried to try to put his CV on on one page, I said, it's impossible. And I said, Well, Bill, how many IPOs Do you have? He says, Well, three, I think or maybe four? You know, what does that mean? He says, Well, we were doing our fourth IP IPO and we were acquired before he could complete it. So I said, okay, that counts. So we added up all the startups he created out there, they're selling more than $4 billion in sales annually. So great guy, wonderful guy. We're lucky that he's that he joined our board. This is the late Pete Nicholas, who founded Boston Scientific. They were with us from the beginning of the company and invested in every round, and even can he set it up to continue legacy. So if the partners continue to invest in our next round, noble, amazing man, we're just so thankful for his support and advice all along. Xiang Bay, you may know Shang been there three years in a row. They were rated as the most active VC firm. William dies a great partner, they lead our Series A and I've had many battle scars and blue chip and startup companies as well. So I've been around the block. We have a CMO, BK Sharma, serial entrepreneur, also a GI practicing gi so he's perfect because any ideas that run by it runs by the true sniff test of someone that does procedures. So takeaway platform technology, we can address huge needs, but our laser focus is diabetes. Three 510 ks clear, strong early clinical work and reimbursement in the SAPA geospace topcoat. I mean, all the KOLs will work with us. And I think you'll agree we have a veteran team. We've raised 21 million to date. And we're not really raising at the minute, but we always love to talk to like begin a relationship. That's how we like to start it because we really love the team kind of esprit de corps. We have a good we have a good team. Bill Starling has a thing called he says it's the No aihole rule. He says yeah, before he joined, he says you have any of those guys in your company. He said, Well, we had a few we got rid of them. He says okay, all right. I'm in. So that's Aqua. Thank you