The Peter Attia Drive · Podcast summary
#409 ‒ Inside modern drug development: the science, economics, and regulatory hurdles behind bringing new medicines to patients | Lloyd Klickstein, M.D., Ph.D.
Dr. Lloyd Klickstein, a physician-scientist and drug developer, unpacks the complex journey of discovering and developing new medicines, using the muscle-preserving drug bimagrumab as a case study to reveal the science, economics, and regulatory challenges behind modern drug development.
Listen on the show ↗Key takeaways
- 🧬Drug discovery begins by identifying unmet clinical needs, not random screening of compounds.6:37
- 💊Small molecules and biologics differ fundamentally in structure, development, and patent protection strategies.12:09
- 🐭Inhibiting myostatin in mice can massively increase muscle mass, but human biology is more complex and less responsive.37:01
- 🧪Therapeutic antibodies require extremely high affinity to outcompete natural ligands binding to receptors.48:14
- 💰Developing a new drug can cost billions and take over a decade, with high failure rates at every stage.53:49
- 🦠Antibodies tend to have fewer off-target toxicities than small molecules, allowing higher success rates in early development.1:13:34
Chapters
- 0:00🎙️ Introduction and Guest Background
- 6:00🔬 Drug Discovery Process
- 12:00💉 Drug Modalities and Patents
- 37:00💪 Bimagrumab Discovery and Preclinical Work
- 54:00🧪 Clinical Trials and Challenges
- 1:09:00💰 Economics and Regulatory Landscape
- 1:23:00⚖️ Bimagrumab in Obesity and Combination Therapy
- 1:40:00🩺 Safety and Future Directions
- 2:00:00🧬 Emerging Areas: mTOR and Cancer Prevention
The digest
From Physician-Scientist to Drug Developer
Dr. Lloyd Klickstein began his career as a rheumatologist and NIH-funded researcher at Harvard Medical School and Brigham and Women's Hospital. His passion for science and medicine led him to earn an MD-PhD and later transition into industry, joining Novartis where he pioneered translational medicine and led efforts to discover new therapeutic indications. Today, as CEO of Coslap Therapeutics, Klickstein brings over two decades of experience across the full spectrum of drug development.
Keep reading in The Digest
The full 4-minute article, 10 more sections, and every new episode from The Peter Attia Drive and the creators you follow.
- The Black Box of Drug Discovery
- Choosing Drug Modalities: Small Molecules, Biologics, and Beyond
- The Journey of Bimagrumab: Targeting Muscle Loss
- Preclinical and Clinical Development Challenges
- Measuring Efficacy and the Role of Nutrition
- Economic and Regulatory Realities
- Bimagrumab’s Pivot to Obesity and Combination Therapies
- Safety Signals and Future Directions
- Broader Perspectives: mTOR Inhibition and Cancer Prevention
- Conclusion: The Complex, Collaborative Path to New Medicines
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