Trellus Health Share Discussion Threads

[senttothegallows] 15/12/2021 08:29

Price down at these levels is absolute insanity amazing how difficult they are to buy given how it has been walked down. Expecting a big bounce IMHO

[cambridgedon] 14/12/2021 10:43

Thanks Wan.
Seems that the RENX and TRls share prices are suffering at the same time! In one sense they both represent a lot lower risk than at the IPO/launch price but the recent falls have also got many to question what they are really worth. Thoughts?
CD

[wan] 14/12/2021 10:15

CD...The issue/IPO price per Trellus Share was 40 pence.

[cambridgedon] 14/12/2021 09:40

Can someone remind me what the IPO price was.
Thanks,
CD

[brummy_git] 14/12/2021 08:17

Find out all the news & commentary here wrt Trellus Health's trading update today.

www.linkedin.com/posts/paul-hill-a5994116_trls-trls-activity-6876434026043912192-JMdo

[wan] 14/12/2021 07:52

A welcome update today. And what sounds like a very promising 2022 ahead, starting as early as Q1 with several B2B payer contracts in late-stage negotiations with expected completion in Q1 2022.

With regard to my kidney disease food for thought post above, the license from Mount Sinai includes kidney disease. I previously confirmed that the disease categories beyond IBD that are covered by Trellus Health's license from Mount Sinai include: cancer, heart disease, diabetes, kidney disease, autoimmune diseases, COPD and Cystic Fibrosis.

[wan] 10/12/2021 09:44

Trellus Health is starting with IBD, but ultimately they are targeting coordinating and connecting multidisciplinary care for complex chronic conditions. So, the following is just food for thought (and we know where some of there stablemates are focused) -

Many Upsides for Telemedicine in Chronic Kidney Disease
Pam Harrison

December 07, 2021

Patients with chronic kidney disease (CKD) who receive treatment through video-based telemedicine consults have acceptable, if not comparable, clinical outcomes, generally fewer emergency room (ER) visits and hospitalizations, and improved efficiencies compared with those treated in person, a new review indicates.

Moreover, levels of patient satisfaction with telemedicine are uniformly high, the same study shows.

"The nature of CKD care makes it particularly amenable to virtual care given that relevant history, review of laboratory investigations, and counseling can all be conducted via virtual platforms," Ann Young, MD, PhD, University Health Network, Toronto, Ontario, Canada, said in a statement issued by the American Society of Nephrology.

"The main obstacle of virtual care is the lack of a physical exam [so] finding the appropriate balance between virtual visits and in-person visits is key," she added.

Many Benefits of Telehealth but Beware the Digital Divide
However, senior author, Stephanie Ong, BScPhm, MSc, also of the University Health Network, cautioned that the "digital divide" must be considered when assessing the use of telemedicine.

"[These results] are encouraging but as the latest technologies are streamlined into routine healthcare, the 'digital divide' will become more pronounced, negatively impacting those without access to broadband internet connections, video-capable devices, and those with limited technology literacy," she noted in the ASN statement.

"This is an area that deserves further study," she advised.

And in an accompanying editorial, Susie Lew, MD, and Neal Sikka, MD, both from George Washington University in Washington, DC, agree with Ong that the ability to effectively use a device such as a computer or a smartphone is a challenge for some patients who may have low health literacy.

On the other hand, they acknowledge the many benefits of telehealth. "Patients can benefit from access to their care providers, receive multidisciplinary care, include distant relatives in visits, and have the convenience of staying at home," they write. A visiting nurse could also participate in a home care visit and lab draws can be done in the local community.

"For those that are skeptical about telehealth, we feel that a telehealth visit is better than no visit at all for a new or existing patient," Lew and Sikka observe. "[And we believe that telehealth] has clearly become another useful tool for clinicians and patients attempting to increase touchpoints and simplify care delivery."

And in a Patient View published alongside the review and editorial, patient Julie Glennon, of West Palm Beach, Florida, notes that she has suffered from CKD for over three decades and has been on dialysis multiple times.

"There have been many times in my past that a telehealth visit would have been incredibly helpful," she writes, noting that whenever she went into kidney failure, she was very ill. "Gathering the strength to get dressed and drive to my doctor's office was a monumental feat [during those times]," she admits.

Patients who live in rural communities or those with mobility issues can also benefit from a virtual visit, which can help eliminate the stress of having to get to their physician's office, Glennon explains.

However, "there are times when physically going into a doctor's office or imaging facility is necessary," Glennon acknowledges. Nevertheless, she feels that the quality-of-care she received during a virtual visit was equal to the care she would get in a doctor's office. Virtual visits also save time, money, and energy.

"The high patient satisfaction and acceptable clinical outcomes cited in the CJASN study should encourage continued telehealth support and options," Glennon concludes.

Review Included 24 Studies on Telemedicine vs In-Person Care
Young and colleagues reviewed 24 studies across 10 countries that were published between 1997 and 2020. The studies included seven in patients with CKD, eight in patients on dialysis, and eight in kidney transplant recipients.

Earlier studies primarily reported on the use of institution-specific technologies linking main hospital sites to more remote healthcare locations.

However, more recent studies connected patients — often from their own homes — to their nephrologists using web-based video-conferencing solutions on personal devices with a microphone and webcam.

Across the seven studies that used video-based telemedicine for patients with CKD, there were few differences in reported clinical outcomes, need and timing of dialysis, change in kidney function or blood pressure, or other biochemical markers relative to in-person care.

Moreover, "ER visits and hospitalizations were no more frequent in the telemedicine group compared to in-person care," the investigators note, "and all studies reported improved efficiency with telemedicine, including a reduction in the waiting time to see a specialist, fewer clinic cancellations, [and a] reduction in travel time and distance traveled."

Over 95% of patients also expressed high levels of satisfaction with telemedicine, most noting that the care received was the same level as the care they got being seen in person.

For patients on dialysis who received video-based care, reported clinical outcomes were similar if not better than they were for patients treated in-person. They had fewer ER visits and hospital admissions than those receiving in-person care.

Also, among kidney transplant recipients, clinical endpoints were equal among patients receiving video-based telemedicine compared with those who received in-person care. Hospital admissions were lower in telemedicine patients in one study, although another study reported higher rates of ER visits and hospitalizations after receiving a video-based transplant follow-up.

Full article -

[wan] 10/12/2021 08:01

'Quietly' things are happening/evolving. I note at least two new hires with Tyler Martin previously hailing from Optum which is a subsidiary of UnitedHealth Group which is the world's eighth largest company by revenue and second-largest healthcare company behind CVS Health by revenue-

Tyler Martin
Chief Strategy O​fficer

Former SVP, Strategic Growth & Development, Optum
Former VP, Strategy & Development, Healthgrades
Former Executive Director, Children’s Hospital Colorado
Former Bain & Company Consultant
Developed & launched multiple businesses across healthcare, media & retail, scaling operations and growth for long-term sustainability and competitive advantage


Susan Rose
Financial Controller

Former management at Kindred Healthcare, Inc., and other healthcare organizations


According to Wikipedia, Kindred Healthcare is a post-acute healthcare services company that operates long-term acute-care hospitals and provides rehabilitation services across the United States.

Kindred's headquarters and support center are located in Louisville, Kentucky.[3]

As of March 2018, Kindred Healthcare had approximately 38,300 employees in 45 states and approximately $3.4 billion in annual revenues.

[wan] 04/12/2021 06:42

Trellus Health mentioned/tipped in the following article -

UK life sciences investing – High rewards but also high risk
Analysis
2 DEC 2021
Lawrence Gosling

This has driven investors, many non-specialists, into these high- profile opportunities. But the UK biotech sector has a troubled past, and to inform a view of the current market we take three case studies to illustrate how things can go wrong for investors in this sector. We’ve contrasted each of these with more recent examples of how things have changed and what we would categorise as high-quality, well-validated opportunities.

There are still crazy ideas on the market, but the type of opportunities we are drawn to are those with sufficient validation to convince us that risks are suitably managed, and where the products will make a real difference to patients.

Companies coming out of the Mount Sinai hospital system in New York are a good example. The founding intellectual property, the core idea of companies such as Renalytix, Verici Dx and Trellus Health, has been tried and tested in real-world clinics and there is a tangible benefit to patients.

Renalytix and Verici Dx are developing diagnostics, which are generally lower-risk than drug development. Importantly, these companies are augmenting diagnostic testing with data and machine learning. In the case of Renalytix, a machine learning algorithm is used to combine blood biomarkers of disease and data from a patient’s electronic health record to prognosticate a risk score for kidney failure.

The success of Renalytix’s approach in an area of little innovation is clear to see.

Verici Dx understands the power of data to elevate the utility of testing. It plans to build a data repository of whole genome sequences of patients that pass through its trials and use its products. This may not be leveraged immediately but being able to use this database either for discovery of new biomarkers or to boost test performance is an exciting prospect.

Full article, What Investment -

[wan] 12/11/2021 09:58

Whilst we patiently wait for the number of demonstration projects to expand during the remainder of 2021 (precise timing could of course change or slip), potentially involving several hundred patients in aggregate. I caught up briefly, amongst other things, with an enquiry regarding the disease categories beyond IBD that are covered by Trellus Health's GRITT license from Mount Sinai. I can confirm that these include: cancer, heart disease, diabetes, kidney disease, autoimmune diseases, COPD and Cystic Fibrosis.

I wanted to get this confirmed as Trellus Health considers its approach to have potential utility and demand across many chronic conditions. And the Directors estimate that chronic and mental health conditions and IBD, represent over $3 trillion and $30-50 billion in total annual costs in the US, respectively. So, IBD is potentially a very large market on its own (hence pharma interest), but obviously there is a collectively even larger market to go after too for other chronic conditions, and with IBD providing the proving ground, there will be a medium-term opportunity to replicate the approach to other chronic conditions.

There is a lot pharma interest in this area, and it should not be overlooked that
clinical disease management and monitoring approach is also an integral part of Trellus Health's approach. So, I would also like to see at least one pharma collaboration materialise for IBD in the not too distant future. For which I believe discussions are live/active, with Julian Baines, Non-executive Chairman of Trellus recently stating (in Half-year Report) that -

“We are also very pleased with the progression of our dialogue with large organisations outside of health plans and employers, including those within the pharmaceutical industry, who have recognised the potential value of our platform to support their goals, as well as third parties interested in applying our methodology to other illnesses.”

[melody9999] 04/11/2021 09:41

thanks - would be grateful for any latest insights

[hastings] 04/11/2021 09:39

Spoke with the CEO last week and well worthwhile, but haven't got round to penning anything yet. Hopefully I'll get on to it next week.

[melody9999] 04/11/2021 09:31

any reason for the share price dip? Hastings - anything to report?

[wan] 03/11/2021 08:07

The following provides for an insightful read regarding the current and future growth in telehealth -

AWS physician expert talks new use cases for telehealth, machine learning, cloud

Dr. Rowland Illing, director of international public sector health at Amazon Web Services, offers a tutorial on some leading-edge technologies, and how they're being deployed across healthcare.

By
Bill Siwicki
November 02, 2021

During the COVID-19 pandemic, telehealth and remote monitoring have found their place in routine clinical practice like never before. According to a study published by the Journal of the American Medical Informatics Association, during the pandemic, telehealth services for urgent care have grown by 683% and by 4,345% for non-urgent care.

Q. You mentioned earlier the growth of telemedicine that has taken place during the COVID-19 pandemic. Given the expansion of these services and the ability of patients to seek care anywhere around the world, does this make the issue of interoperability even more pressing?

A. Indeed, the changes have been profound. Over the last 18 months, Brazil has legalized the use of telemedicine, and Australia has made telehealth a part of the national health service going forward.

The Indian government built the eSanjeevani telemedicine platform on AWS in 19 days across four states, free to patients and available 12 hours a day, seven days a week.

This pilot was such a success that it was scaled up to cover all of India, enabling more than one billion people to seek virtual care – 80% of the Indian population. It now provides more than 6,000 consultations a day across 23 states, involving 4,000 doctors in 150 outpatient clinics.

Full article -

[wan] 27/10/2021 16:39

Thank you Hastings, I look forward to that!

[hastings] 27/10/2021 15:56

Speaking with the CEO tomorrow pm and will endeavour to put something together that will hopefully be of use!

[wan] 27/10/2021 10:01

When my own research (prior to Trellus listing) revealed how many large (and small) Pharma's were actively working on addressing different aspects of IBD (with some nearing FDA approval), combined with how Trellus plan to enter strategic industry partnerships with pharmaceutical companies to leverage its proprietary, anonymised longitudinal database to develop new products and inform clinical trials for existing and prospective drug treatments etc, it added to my rationale to significantly increase my investment in Trellus over and above my EKF in specie shares(via application and early market purchases).

I also find it reassuring that EKF, via ADL Health, could quickly provide any crucial/complimentary biomarker testing in the US for Trellus Health via their CLIA approved laboratory. Indeed, EKF highlighted the potential in their Growth Strategy for any CLIA lab purchase for diagnostic tests to link to Trellus, Renalytix and Verici.


Now part of the EKF Diagnostics Group

[wan] 27/10/2021 09:25

A bit more detail regarding the above trial -

At Week 104, 75% of Patients with Ulcerative Colitis Taking Mirikizumab Maintained Symptomatic Remission in Phase 2 Study
October 1, 2021

INDIANAPOLIS, Oct. 1, 2021 /PRNewswire/ -- Patients taking mirikizumab for their moderately to severely active ulcerative colitis (UC), were in symptomatic remission for up to two years as demonstrated in new results from Eli Lilly and Company's (NYSE: LLY) Phase 2 study. Symptomatic remission is defined as no more than two bowel movements more than an individual's normal bowel frequency, and no blood in their stool.

"Millions of people around the world are living with ulcerative colitis, a chronic inflammatory bowel disease that affects the lining of the colon and causes abdominal pain, bowel urgency and frequency, and bloody stools. These symptoms can be unpredictable and severely disrupt a person's daily life, even making it hard for them to leave their home, go to work or see family and friends. We need therapies that provide long-term symptom control in order to give patients their lives back," said Remo Panaccione, M.D., University of Calgary, Inflammatory Bowel Disease Center, and lead author of this analysis. "These exciting Phase 2 results reinforce the potential for mirikizumab to provide that long-term, symptomatic remission from some of the most common and distressing symptoms of ulcerative colitis, specifically stool frequency and rectal bleeding."

In a separate, post-hoc analysis of patients treated with mirikizumab in this Phase 2 study, an absence of bowel urgency (the sudden or immediate need for a bowel movement) in patients with moderately to severely active UC at 12 weeks was strongly associated with reduced levels of inflammatory biomarkers, an indicator of disease activity. Both analyses will be presented virtually at United European Gastroenterology Week (UEG Week), taking place October 3-5, 2021.

Three Out of Four Patients Continuing Treatment with Mirikizumab Maintained Symptomatic Remission At Two Years

Post-Hoc Analysis Showed Relationship Between Patient-Reported Bowel Urgency and Inflammatory Biomarkers in UC

Patients who responded to mirikizumab at week 12 and reported no bowel urgency had significantly greater reductions from baseline measures in two inflammatory biomarkers, C-reactive protein (CRP) found in the blood and fecal calprotectin (fCLP) found in the stool, compared to patients who reported bowel urgency. Absence of bowel urgency was defined as no bowel urgency reported for three consecutive days prior to each scheduled visit, regardless of bowel urgency status at baseline. Levels of CRP and fCLP continued to decrease from 12 weeks to one year for both patient groups.

For methodology and additional results, see the "About the Analyses" section below.

"Results from this analysis suggest that among patients with ulcerative colitis treated with mirikizumab, the absence of bowel urgency may be associated with reduced levels of inflammatory biomarkers, which are important indicators of disease severity," said Lotus Mallbris, M.D., Ph.D., vice president of immunology development and U.S. and global medical affairs at Lilly. "Taken together, we are excited to share at UEG Week a range of data that showed mirikizumab, if approved, may potentially be the first anti-IL-23p19 therapy that reduces disease activity and offers remission from the debilitating symptoms of stool frequency and rectal bleeding for patients with moderately to severely active ulcerative colitis."

Mirikizumab is currently being studied in Phase 3 trials for UC and Crohn's disease.

Full release -

Recall that Trellus is already in discussions with pharma

[wan] 27/10/2021 07:52

Very interesting, especially regarding biomarkers.

Scroll down to read about the trial and watch video interview of Trellus Co-Founder Marla C. Dubinsky, MD: Measuring Urgency in Ulcerative Colitis
October 27, 2021
Kenny Walter

The absence of urgency could be a useful metric in gauging colonic inflammation in patients with ulcerative colitis.

In data presented during the 2021 American College of Gastroenterology (ACG) Annual Meeting, a team led by Marla C. Dubinsky, MD, Professor of Pediatrics, Icahn School of Medicine at Mount Sinai, found patients with the absence of urgency had significantly greater reductions in levels of inflammatory biomarkers C-reactive protein (CRP) and fecal calprotectin (fCLP) in a cohort of patients treated with mirikizumab.

In the study, 249 patients were equally randomized to receive intravenous placebo, 50 or 200 mg mirikizumab with exposure-based dose increase possibility or fixed mirikizumab 600 mg every 4 weeks.

Full article and interview -

American College of Gastroenterology
Annual Scientific Meeting & Postgraduate Course
The Premier GI Clinical Meeting
October 22-27, 2021

[wan] 22/10/2021 09:26

Mount Sinai is both a partner and significant investor (25%) in Trellus Health.

Press Release
Mount Sinai Leader Awarded 2021 Sherman Prize for Advancements in Understanding IBD Genetics

New York, NY (October 21, 2021) The Bruce and Cynthia Sherman Charitable Foundation has announced Judy H. Cho, MD, Dean of Translational Genetics and Director of The Charles Bronfman Institute for Personalized Medicine at the Icahn School of Medicine at Mount Sinai, as a recipient of the 2021 Sherman Prize, which recognizes excellence in the field of Crohn’s disease and ulcerative colitis, two forms of inflammatory bowel disease (IBD).

Dr. Cho was awarded a $100,000 Sherman Prize for her pioneering genetics research that has advanced understanding of the underlying causes of IBD and paved the way for personalized treatment approaches. A leader of the team that identified the first gene for Crohn’s disease, NOD2, Dr. Cho has contributed to virtually every major discovery in IBD genetics over the past 20 years.

Dr. Cho’s work explores how to prioritize new therapeutic targets and tailor biologic agents for individual patients who don’t respond to current therapies. Her research on the involvement of the protein IL-23 in the disease cascade led to anti-IL-23 therapies that are widely used to treat Crohn’s disease and ulcerative colitis. Now she’s exploring new targets and combination therapies and supporting junior colleagues in their research to help ensure the work continues. Her hope for the future is that with greater understanding of the genetics of these diseases, gene therapies will be made possible—putting the potential for true cures within reach for even the most severe forms of disease.

Dr. Cho joined the Icahn Mount Sinai faculty in 2013, following appointments at the Yale University School of Medicine and the University of Chicago Pritzker School of Medicine. She earned her MD at The Ohio State University College of Medicine, and completed both a residency in Internal Medicine and postdoctoral research training at Northwestern University Feinberg School of Medicine.


For further interest, there are numerous examples of co-authored publications/work involving both Judy H. Cho, MD, and Trellus Health co-Founder Marla C. Dubinsky, MD. For example, the identification of novel blood protein biomarkers associated with future Crohn’s disease complications.

[pldazzle] 19/10/2021 09:22

Rivaldo #136 - What your tax adviser writes is not, in fact, inconsistent with note 30 to EKF's accounts. Trellus had not floated at the date of the distribution in Dec 2020 (it did so only in May 2021) and hence the fair value at the date of distribution was deemed by EKF's auditors to be the same as the value at the date of EKF's acquisition a few months earlier, in August 2020. In this context, there is no difference for practical purposes between "fair value" and "market value". In my view it would clearly offend against proportionality for HMRC to argue the toss on this.

JakNife - s1075 CTA 2010 references ss1076, 1077 and 1078. The last two are not relevant here: s1076 is about in-specie distributions of >75% subsidiaries. I don't think Trellus was ever a subsidiary of EKF, and I don't think s1075 applies here.

Edit: If still in doubt, I suggest you seek confirmation from the EKF company secretary. In my experience he has responded helpfully in the past.

[rivaldo] 18/10/2021 14:55

Many thanks for your replies. However....my tax adviser has replied as follows (I've changed the numbers to continue the example above):

"It is my understanding that you still hold 100,000 shares in EKF Diagnostics PLC. You received 6,154 shares in Trellus Health PLC as dividend in specie from EKF Diagnostics PLC. Therefore, the market value of Trellus shares on the date of the distribution should be the dividend income reportable on the tax return."

Has anyone submitted their 2020/21 tax returns to HMRC yet or agreed the divi in specie calculations with your accountants or tax advisors?

[pldazzle] 12/10/2021 17:23

james - you beat me to it. Rivaldo, I confirm that I agree with james and that the formula is (in your illustration) 100,000 x £0.008374 i.e £837.40.