Courage Therapeutics

The inspiration to start a company can come from anywhere. After graduating from the Massachusetts Institute of Technology in the mid-1990s with a degree in molecular biology, Dan Housman became a serial entrepreneur, launching several startups and developing website-building tools and health system databases. One of Dan’s startups was eventually sold to Deloitte. After the sale, Dan stayed on at Deloitte as the Chief Technology Officer of the firm’s ConvergeHEALTH solution. His plans changed in 2018, however, after his daughter was diagnosed with anorexia nervosa. Dan was inspired to start his latest venture, Courage Therapeutics, to find new medicines to treat anorexia nervosa and other eating disorders. Dan has first-hand experience of the impacts of anorexia nervosa, but the problem of eating disorders is widespread; according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD.org), eating disorders affect at least 9% of the population worldwide.1

  • 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime.2
  • Less than 6% of people with eating disorders are medically diagnosed as “underweight.”1
  • 28-74% of the risk for eating disorders is genetically heritable.1
  • Eating disorders are among the deadliest mental illnesses, second only to opioid overdose.1
  • 10,200 deaths each year are the direct result of an eating disorder—that’s one death every 52 minutes.2
  • About 26% of people with eating disorders attempt suicide.1
  • The economic cost of eating disorders in the US is $64.7 billion every year.2

The NIH currently spends only $.88 per patient annually to fund research on anorexia.1 Historically, anorexia and other eating disorders have been treated with at least one of two main methods: 1) selective serotonin reuptake inhibitors (SSRIs) and atypical antipsychotics or 2) family-based therapies, where the family is responsible for getting the patient to eat. The SSRI treatment relies on the similarities between anorexia and obsessive compulsive disorder (which can be helped by treatment with high doses of SSRIs), whereas the atypical antipsychotic treatment relies on two of the typical side effects of such drugs: weight gain and appetite. According to Dan, his personal experience with these treatments was like “shooting a grizzly bear with a BB gun,” They had little to no discernible effect. Further, SSRIs have several known possible side effects including short-term increases in suicidal ideation, and antipsychotic exposure can lead to side effects like tardive dyskinesia, a loss of control of facial movements.3 Family based therapy is also not without risks to the emotional and physical health of the family as they become the primary team trying to get the anorexia patient to eat.

Current treatments for restrictive eating disorders are focused on weight restoration, with the experience that many root psychiatric causes resolve once the lack of calories is halted, the endocrine system normalizes, and the brain has become sufficiently nourished. Dan and his team believe there is also a biological component to anorexia, a root cause that is not addressed by traditional therapies but could be remedied through the use of targeted therapeutics. The idea that there is a biological component to eating disorders is not just a flight of fancy. Twin studies and family studies support the idea of a genetic component to anorexia with the onset usually starting during puberty. The response to leptin and signaling of available energy through LEPR, PSCK-9, and POMC make up a biological ‘circuit’ that when disrupted is the primary cause of genetic obesity. In reverse, this circuit can also be used to stimulate food intake. This ‘circuit’ signals to the melanocortin receptor (MCR) system, specifically receptors 3 and 4 (MC3R and MC4R). One of the world’s foremost experts on MCRs is here at the University of Michigan: Professor Roger Cone.

Roger Cone at the Life Sciences Institute

Dan’s journey to conquer these disorders led him to collaborate with Professor Cone, who is the Director of the Life Sciences Institute at the University of Michigan and the founding scientist at Courage. Professor Cone was already working on MC3R and MC4R when Dan approached him to help him work on an anorexia treatment. The partnership blossomed and led Dan to work with Dr. Ed Pagani, Associate Director of Licensing, at the University of Michigan Office of Technology Transfer (OTT), on an option agreement to patents claiming novel chemical matter developed through Professor Cone’s research at Michigan. The team at OTT, including the Venture Center, has helped Courage to develop a sponsored research relationship with Professor Cone’s laboratory with the goal of identifying additional potential therapeutics. At Courage, Dan and Roger have assembled a team of scientists and drug hunters to develop melanocortin-based drugs for the treatment of eating disorders. The team was fortunate to recruit Dr. Tomi Sawyer, one of the world’s leading melanocortin peptide chemists, following a long and successful career in the pharmaceutical industry, to lead drug design for the company.

Drug Discovery Funding
At its core, Courage could be described as a social venture as much as a startup company. Courage Therapeutics is dedicated to conducting continuous research to discover and develop promising new medicines for eating disorders in a long-term battle to make recovery from these devastating diseases faster and easier. The company has made it clear that it will not compromise its mission for profits and will work to balance the need to rapidly fund key research and development while establishing a path for sustainable and enduring progress.

The market potential for Courage’s licensed intellectual property (and two potential compounds in their pipeline) is not limited to anorexia. Such treatments also have the potential to help treat cachexia, genetically-based obesity, avoidant/restrictive food intake disorder, binge eating disorder, potentially treat veterinary feeding issues, enhance agricultural production, and more. The company is focusing on biologic and small-molecule treatments; as Dan says, “we are trying to find drugs” to treat these disorders. There is currently only one approved drug on the market for any eating disorder, Vyvanse, which treats binge eating disorder and was discovered as an expansion following approvals in ADHD. Companies aren’t making eating disorders drugs so the opportunity to create eating disorders drugs faces low competition with an enormous unmet need.

Currently, the venture is at the pre-clinical phase of development. The venture was initially self-funded by the founders, but they recently closed their initial seed financing round. The University’s Michigan Biomedical Venture Fund (MBVF) is the lead investor and currently the largest investor in the $1M+ round of funding raised by Dan Housman and his team. The round included founders, industry veterans and MIT Angels.

The Courage team boasts considerable experience with balancing licensing, research and development, as well as bringing products into clinical trials and through the long FDA approval process. Courage is looking for like-minded people to help them discover and commercialize drug-based treatments for eating disorders, particularly individuals or families with strong personal connections or missions to impact the lives of people with eating disorders.