Khepri

By Khepri, Inc. · New York, NY

You know the moment. The dog who used to explode off the couch when the leash came out, now barely lifts his head, looks at it and stays put. The one who used to clear stairs three at a time, now stands at the bottom and waits, because he knows that the climb will hurt. Owners describe it the same way, again and again: “He just got old.”

He didn’t just get old. He has developed osteoarthritis, one of the most common conditions that affects companion animals and, unfortunately an under-treated disease, attributed to natural aging.  

A disease we’ve been taught to accept

Osteoarthritis (OA) is the leading cause of chronic pain and reduced mobility in dogs. Roughly one in five (20%) of adult dogs shows clinical signs of OA, and among dogs over eight years old, the figure climbs to 80%. In a country with nearly 89 million pet dogs, that translates into tens of millions of animals living with a disease that grinds away at their joints a little more every day.

And here is the part that should make every dog lover angry: OA is not just a mobility problem. It is a pain problem, and pain changes who a dog is. Dogs in constant pain sleep more and play less. They withdraw. They stop greeting you at the door. Veterinary behaviorists see the downstream snowball effects of reduced movement and disrupted sleep. It’s irritability, weight gain, and depression. The bright, busy buddy you brought home slowly goes quiet.

Worse still, OA is a progressive disease. DEpendign on disease severty, some dogs eventually can no longer stand to eat, can no longer make it outside without support. That is very often where the story ends.   According to Canine Arthritic Management magazine (hyporlink: https://caninearthritis.co.uk/home-pet-guardians/), severe osteoarthritis and associated mobility loss rank among the most common medical reasons pet owners elect elective euthanasia. OA doesn’t just steal a dog’s comfort. It steals years of life.

Everything we sell treats the symptom, not the disease

Until now, when you walk into a veterinary clinic and you will be offered a traditional menu of NSAIDs and steroids. These are usually tablets that pet parent has to give their dog for pain management and reduction of inflammation. These treatments cause a cumulative damage to the gut, liver and kidneys.  The most advanced treatment is the recently approved monoclonal antibody, which is a monthly injection to reduce pain.  This treatment does not prevent the damage from OA, it only blocks the pain signal while the joint underneath keeps degrading. 

Every one of these treatments only manages symptoms. Not one of them stops the disease. With every one of these band-aid therapies the cost build up. The financial burden for the owner, health cost for the dog.  

Silencing pain alone is actually more dangerous for the dog and regulators have grown concerned about pain-blockade approaches. In the recently published study, FDA found that dogs taking the monoclonal antibody Librella were nine times more likely to suffer severe joint problems compared to other arthritis medications. The study compared the frequency of ligament and tendon injuries, fractures, abnormal bone growth and joint infections. FDA updated the U.S. label of the market-leading monthly injectable Librella, following post-market reports that included rapidly progressive joint disease..

To date, there are no approved therapies that treat the disease itself. That is a major gap. And it is exactly why Khepri exists – to close this gap with a disease modifying solution.

One vet. Dogs treated. Lives extended.

Dr. Phillip Putter, DVM, has spent his career at SpotOn Veterinary Hospital in Connecticut watching good dogs decline on the standard treatment menu. So, when a he was approached with an offer to collaborate on developing a disease-modifying solution for OA, he was thrilled beyond reason to give hope to his pet parents and bring a much needed solution for his four-legged patients. Not every vet gets to do that- to treat the untreatable disease. 

Over the course of the pilot research study in collaboration with Icahn School of Medicine At Mount Sinai, NY, Dr. Putter treated several dogs with naturally occurring osteoarthritis with a single-injection of metabolic gene. Seeing these real dogs respond to therapy, seeing lives of real families change in front of his eyes. Being able to help when he and the families have run out of good options. 

One injection into the joint. One and done. He became committed to help Khepri bring  the therapy forward so more pets can have access to it soon.

“These are dogs that I know very well. I’ve watched them grow up in my hospital, I’ve been in their homes doing house calls, and I’ve watched them struggle. What I saw after a single treatment wasn’t subtle. It was owners telling me their dogs were acting like puppies again—months and even years later—from a single injection per joint.

I’ve been practicing veterinary medicine for more than 15 years, and there’s not another medication that behaves like this. Period. For many of these dogs, we had run out of good options. This provided an option we simply had never had before.

Take Benjamin, a Labrador retriever with osteoarthritis in both hips and both stifles. Before treatment, he couldn’t climb the stairs in his own house and even had difficulty getting up from his bed. And he was only five years old.

Two weeks after a single injection in each affected joint, Benjamin used those stairs for the first time in four years. At two months, his owners watched him run and jump across the yard, playing joyfully again.

What was equally remarkable was what happened afterward: the gains didn’t simply fade the way the effects of a pain medication wear off between doses. They held. We also didn’t see the loss of efficacy over time that can occur with some immunomodulatory therapies, such as Librela. Those treatments have their own duration of effect and potential adverse effects.

The durability is what stands out. It is the signature of a therapy that appears to be addressing the disease process itself, rather than simply muting the alarm.”

— Dr. Philip Putter, DVM, SpotOn Veterinary Hospital

That is one dog. However, it happened dozens of times, with the longest follow-up now stretching five years after a single dose, and, importantly,  no drug-related adverse events observed throughout the pilot study. The mobility gains didn’t fade the way a painkiller wears off between doses. They held. That durability is the signature of a therapy that is treating the disease, not just muting the alarm.

Why this matters now

For the first time, a treatment for canine osteoarthritis is aimed at the biology driving the disease rather than the pain it causes. The mechanism is elegant: chronic joint inflammation is fueled by the build-up of a lipid called ceramide, which pushes joint cells toward senescence and death, releasing yet more inflammation in a self-reinforcing loop. KHP-1 delivers the gene for the enzyme that clears ceramide to breake the loop, and let the join recover from inflammation.  

This is a disease-modifying treatment, a treatment that changing its course of disease.

Our dogs give us their entire lives. They ask for almost nothing back. In their elderly years when the years they need us most, the very least we owe them is to give them the best quality of life we can. And best care, including health treatments, and not yours of pain just management.

Dr. Putter’s experience with KHP-1 and the amazing responses he saw in the dogs, supported by anecdotal evidence from the pet parents, is the proof that a different approach for treating OA is possible with KHP-1. Now it is Khepri’s work to bring it to the other fourteen million pets. 

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Khepri, Inc. is developing KHP-1, a single-dose gene therapy for canine osteoarthritis. Learn more at khepribio.com.

This article is for general informational and educational purposes only. KHP-1 is an investigational veterinary therapeutic and is not approved by the FDA or any regulatory authority; it is not available for commercial sale. Statements regarding pilot outcomes reflect uncontrolled, real-world clinical experience in client-owned animals and are not a substitute for controlled clinical trial data. Individual results vary. Nothing herein constitutes medical or veterinary advice.