Heidelberg-based Exciva secures €51M to tackle agitation in Alzheimer’s care

When Alzheimer’s is discussed, it is usually about one thing: the progressive loss of memory and cognitive function. Yet for patients, relatives and carers, it is often very different symptoms that place the greatest strain on everyday life – agitation, aggression, anxiety, sleep disorders or depression. A substantial financing round now shows that these so-called neuropsychiatric accompanying symptoms are increasingly attracting the attention of the pharmaceutical industry.

The German-French private biotech company Exciva GmbH (Heidelberg) has completed a Series B financing of €51 million, led by Gimv and EQT Life Sciences. Investors include Andera Partners, which led the first €9 million financing round in 2021 (with LBBW also involved at the time), as well as new investors LifeArc Ventures, Fountain Healthcare Partners, Carma Fund and Modi VC. The capital is intended primarily to drive one goal: the entry of the lead project Deraphan into a Phase II study for the treatment of agitation in Alzheimer’s patients.

Agitation: an underestimated core problem

Agitation – meaning motor restlessness, aggressiveness, irritability or emotional disinhibition – is estimated to affect up to 60 per cent of all Alzheimer’s patients over the course of the disease. For relatives, it is often the decisive reason why home care is no longer possible. For patients themselves, it represents a major loss of quality of life and dignity.

Therapeutic options in this area are currently inadequate. In practice, antipsychotics or sedating drugs are often used, with limited efficacy and sometimes significant side effects, including an increased risk of mortality. This is precisely where industry interest comes in: symptomatic therapies that are safer and specifically target distressing behavioural symptoms.

Symptom relief as a strategic approach

Exciva’s approach is emblematic of a broader trend. Deraphan combines two already clinically validated active substances, including a new chemical entity, into a therapy that acts on central neuronal signalling pathways. Following the successful completion of a Phase I study, it will now be examined whether agitation in Alzheimer’s patients can be reduced in a clinically meaningful way. The Phase II study is designed as an international trial and is to be conducted in Europe, the UK, the US and Canada.

While the development of therapies against Alzheimer’s remains a “graveyard for drug candidates,” the first antibodies recently approved still leave many questions unanswered. Some have even been judged by the German institute IQWiG to offer no additional benefit, while the field of accompanying symptoms promises investors a more predictable development path. On the one hand, such programmes are clinically less risky than disease-modifying Alzheimer’s therapies that directly intervene in amyloid or tau pathologies. On the other hand, they address a clearly defined and previously underserved market in which even moderate clinical effects can have high medical and economic value.

Broader interest in accompanying symptoms

Agitation is only part of the picture. Sleep disorders, anxiety, depression, apathy and psychotic symptoms are also increasingly regarded as independent therapeutic targets. For pharmaceutical companies, this offers several advantages: shorter development timelines, more easily measurable endpoints and a direct benefit for patients and their care environment.

At the same time, the overall perspective on Alzheimer’s is changing. Instead of focusing exclusively on slowing disease progression, greater emphasis is being placed on making everyday life more manageable, even if the underlying neurodegeneration cannot be halted. For those affected, this could make a tangible difference. Effective treatment of agitation can help patients remain at home for longer, relieve pressure on care facilities and reduce the psychological and physical burden on relatives. From a health-economic perspective, this is also relevant, as neuropsychiatric symptoms are a major cost driver in Alzheimer’s care.

A market beyond the major breakthroughs

Exciva’s financing shows that investors and pharmaceutical companies no longer view Alzheimer’s solely as an “all-or-nothing” bet on a major disease-modifying breakthrough. Instead, a more pragmatic approach is gaining importance: clinically relevant symptom relief that delivers measurable benefits for patients, relatives and the healthcare system.

Exciva was founded as early as 2016, but for a long time encountered little interest in Alzheimer’s accompanying symptoms. Through the new German office of the French investor group Andera Partners, it became possible to generate greater attention for this area, leading to an initial financing round. Through this narrow opening, new investors have now joined Andera Partners in the latest round with significantly larger resources and commitment.

Raphaël Wisniewski, Partner at Andera Partners, commented to |transkript.de and European Biotechnology Magazine: “We were founding investors in Exciva and supported the seed financing as well as, to a significant extent, the Series A round in 2021. We already knew parts of the founding team from previous projects and were immediately convinced by the company’s approach to addressing the previously unmet medical need in the treatment of behavioural symptoms such as agitation in Alzheimer’s patients.”

Whether Deraphan can live up to this promise will have to be shown by the upcoming clinical data. What is already clear, however, is that the neuropsychiatric accompanying symptoms of Alzheimer’s are developing into an exciting and highly relevant field of innovation in dementia research for patients, relatives and care staff alike.