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Welcome to the Empowered Patient Podcast with Karen Jagoda.  This show offers a glimpse into the latest innovations in applying generative AI, novel therapeutics and vaccines, and the evolving dynamics in the medical and healthcare landscape. One focus is on how providers, pharmaceutical companies, and payers are empowering patients.  In addition, conversations often focus on how technology is empowering providers, care facilities, pharmaceutical companies, and payers to improve patient outcomes and reduce friction across the healthcare landscape.  Popular Topics Include: Virtual and digital health Use of AI, ML, and robots for clinical and administrative purposes  Value-based healthcare  Precision and stratified medicine Next-generation immuno, cell, and gene therapies Vaccines for infectious diseases and oncology Biomarkers and diagnostics Rare diseases MedTech and medical devices Clinical trials  Population health Chronic conditions l Clinician and staff burnout Smart hospitals The audience includes life science leaders, researchers, medical professionals, patient advocates, digital health entrepreneurs, patients, caregivers, healthcare solution providers, students, journalists, and investors.

May 11, 2026

Dr. Javier Szwarcberg, CEO of Spruce Biosciences,  is developing drugs for rare diseases with a primary focus on Sanfilippo Syndrome Type B, a devastating genetic neurodegenerative disease affecting children.  The source of this condition is a lack of an enzyme, which results in a buildup of a toxic substance in the brain.  The company's drug is an enzyme replacement therapy administered directly to the brain to bypass the blood-brain barrier, and clinical trial data is showing a strong effect on the toxic substrate in the brain and a meaningful benefit on cognition.

Javier explains, "It's a devastating, profoundly affecting disease whereby children are typically born normally and born asymptomatic. And over time, they develop an accumulation of a toxic substrate throughout the body, but primarily the brain. And because of that, it eventually results in a fairly young age, usually between two and a half and I would say three and a half, in symptoms starting. That toxic substance builds in throughout the brain and starts affecting initially learning behavior. Sleep patterns are very much affected, whereby children don't sleep at night and sleep during the day, and they're very hyperactive. And sometimes the diagnosis is confused, and there's no clarity as to what is going on with the child, early in the onset of the disease."  

"Yes, it's a genetic disease that's inherited. There's a missing enzyme responsible for the metabolism of this toxic substrate, which I talked about, called heparan sulfate. So when heparan sulfate builds up in the brain, it causes inflammation and neurotoxicity, ultimately resulting in neurodegeneration. Think about it as a disease that is very similar to what you end up seeing with Alzheimer's, whereby the toxic substrate in Alzheimer's is between neurons and outside of the actual cell. In this case, in this disease, the toxic substance, which is different than the one that accumulates in Alzheimer's but builds within the neural cells. Yes, so that's very well-known and very well-characterized."

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