Lloyd Mencinger Presents Aqua Medical at LSI Europe '23

Aqua Medical aims to treat type 2 diabetes and GI disease with a 30 minute, out-patient, endoscopic ablation therapy.
Lloyd Mencinger
Lloyd Mencinger
President & CEO, Aqua Medical



Lloyd Mencinger  0:05  
All right, so a bit about what we're doing at Aqua Medical. Our target is type two diabetes. And there are so many of these infographics out there on diabetes. I thought this one really captured it. Well, the notion of staggering costs. But the problem is none of the numbers are accurate because they're all changing so fast. So this one happens to be the US has 34 million in the US with type two diabetes, it's more like 40 million right now. This one says 88 million on pre diabetes, it's 94 million now. So one in three adults. And despite more than 50, pharmacologic 's out there, most patients are not well managed. All the host of complications, including mortality. So a true epidemic, enormous spending, and not really changing the course of the disease much. Okay, so what are we doing at Aqua medical? Well, our goal is to change the course of disease and in part, minimize and potentially eliminate injectables in certain cohorts of patients. And we have a device based approach to this. It's a 30 minute outpatient procedure, it's a catheter goes through an endoscope goes through the mouth, and we use hot water vapor as an ablation agent in the GI tract. And here's what it looks like. It's a garden variety upper endoscopy procedure, here's an endoscope going through the esophagus through the stomach into this 10 inch or so section below the stomach called the duodenum. And you can see here's our blue catheter coming out the end of the scope. And what we do is we deploy these to shape memory disk and they create a neat little treatment chamber and from the center shaft to that chamber, we precisely dose the hot water vapor and vapors like the perfect ablation agent because it has high energy, it can get uniform coverage in the irregularities and it gets a nice controlled depth of ablation into the mucosa and produces what we call the box effect a beautiful sort of a searing effect into the mucosa. Okay, so the big question, maybe on your mind is how does this work to address type two diabetes. And surprisingly, it's not actually a surprise because there's decades of knowledge and, you know, bariatric procedures for obesity, like gastric bypass and ruin why those procedures they exclude the duodenum are somehow affected. And what happens to those procedures, people lose weight over weeks and months, but almost immediately, type two diabetes is resolved. So that a company came along with I thought was a clever idea with a sleeve or a tube and they fix it to the lower stomach and it covered the duodenum. So food would go bypass the duodenum. And interesting they found a similar effect that weight loss over weeks and months, but almost immediate dramatic improvement in diabetes and the metabolic values. So since that time, there have been endoscopic approaches that basically ablate the duodenum, and some with some very, very impressive results. This is an extract from one of the companies one of their studies, you can see improvement in hemoglobin a1c and what I was really impressed by in some cases durability to up to two years and a very high responder rate as well. And there are several companies in this space. Okay, so this is a this is a subset of the who's who in the GI endoscopy space. And when we started our company origin story was basically we were ablating the esophagus to treat Barrett's esophagus. And we they got us into a first in human study as successful publication. But then as time went on in this markets evolved, they said, hey, you know, three things, Lloyd. They said, Look, number one, this ablation to treat diabetes, this is real. Number two, it's an enormous opportunity. And number three, you guys basically have the perfect product for it. And what I mean is they were talking about this. So the leader, the leader in this field has this product, you can see the the catheter is bigger than an endoscope. So the physician basically has to manipulate two devices through the patient's mouth. It's very cumbersome, it's very difficult a time, you know, time consuming procedure. And you can see us on this side, you saw it go out through the end of the scope, it goes through the working channel. Any gi Doc can do this procedure. They do these every day. So basically, this is a constrained market, ours can be democratized and commercialized broadly. This company on the left has raised over $300 million. And their post money of that round was 870 million. We've gotten to this, this point with only $16 million. And additionally, we are a platform technology. Because we go through the endoscope just by changing the catheter tip. We can address different therapeutic targets throughout the GI tract. So this is perfect for a strategic because this customer called Point is one person the GI endoscopy is the person who drives the endoscope. Okay, this just is a representation of our first in human study for the esophagus, which was published. And we do have a reimbursement code coding coverage and payment for the esophagus. But the biggest the biggest, I'd say, biggest success of the company right now is we have three 510Ks. And there are two parts the green box says we are cleared for all the indications for use that the Medtronic market leading product has 95% Share radiofrequency ablation, so we're cleared for that. But more importantly, the red box is saying that we can ablate anywhere throughout the GI tract. So even though we do not have an indication for diabetes, now, we can ablate the duodenum back into fast track into a diabetes indication. And we're actually very excited. We just had clearance ethics and IRB approval for our first in human study. We're screening and we'll be treating patients in the next couple of weeks for our diabetes study. Alright, so finally, we think we have a great team actually. So this is Greg Barrett. So he was basically the father of radiofrequency ablation, he sold barracks to Covidien Medtronic for 425 million. It was one of his many deals. Being our our chairman. He's basically saying that Aqua is the Tesla compared to his radiofrequency, like the combustion engine. So we're thrilled to have him. Bill Starling. Some of you may know, Bill, I tried to get his CV on one page. It's impossible. I basically could get his IPOs all on one page. He started so many companies, they represent refigured for over $4 billion in sales today, out there. So we're lucky to have him. Bill a great guy. And this is the late Pete Nicholas. So he founded Boston Scientific, grew it to $10 billion and wonderful man he was with us from the beginning. Even though he passed his Ithaca partners continues to support us and invest going forward so we're we're just blessed to have him and his you know his son and continue with us to support Aqua. This is William Dive Xiang Bay, maybe some of you know him. They were rated four years in a row now I guess for the most active VC firm, Silicon Valley, another great guy. So he led our Series A I've been around the block before as well. Our founder VK Sharma is the ex Mayo he's a serial entrepreneur, so NLGI and endoscopy practice and hospice as well. So really, the takeaway is platform technology, we can address some enormous clinical needs, but our laser focus right now is diabetes. 510ks strong, early clinical work, reimbursement for the esophageal code coding coverage payment. We have strong IP, all the KOLs to work with us, of course, and I think you'll agree we have a veteran team. We've raised 21 million today, and we're raising our series B 25 million. So love to talk to anyone that may have an interest. Thank you

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