Yes.
So, this is also an important question. And obviously, before I mean I started with the team to be interested in seltorexant and to put in place is collaboration with Janssen, we obviously thought a lot about this. And as you know, I mean, our molecule is a specific orexin-2 antagonist, whereas all the other molecules, who are on the market, I mean the molecule and the other molecules in development are dual antagonists, so they are antagonizing orexin-1 and orexin-2 pathway. And I mean, why I was personally so interested in the orexin-2 pathway or just specificity of this pathway is that I think this pathway is enough to induce the effect we hope to see on sleep and here we have already a lot of data coming out from polysomnography, which is objective way to measure sleep. And clearly, it is enough to help patients suffering from insomnia, but more interestingly, it is also already demonstrated with the data we have is that you are able to preserve the sleep physiology and different sleep stages you need to have in order to have what we call restorative sleeps, in other words, deep sleep is maintained.
We have no major effect on REM sleeps. All this is really contributing to this restorative sleep that people when they wake up, they function better and they can also be better in terms of cognitive aspects, because with existing treatments, you have often the physiology, which is not there in terms of sleep and you have some impairment during daytime functioning.
So, clearly, this was the reason why. What is also interesting is that when you think about dual antagonists we know that the orexin-1 pathway is mostly mediated via dopamine and this brings several side effects by going to mediate something via dopamine, whereas I mean, specific orexin-2 like our molecule is mostly mediated via histamines. And I mean, the side effect profile is definitely much better and the experience we have with our molecule is that the safety or the tolerability profile is extremely good with our molecules.
So, there are lot of aspects which are really speaking in favor of orexin – specific orexin-2 sorry – approach. Last but not least, speaking about the mechanism of action, as you know, the hypothesis with orexin is that you are modulating somehow the activation level of the brain. And you have also some impact on the autonomic nervous system, which as you know when there is stress, when there is insomnia, when there is depression is over-activated and is signaling to the brain that something is not going extremely well.
You have also HPA axis, which is which is related to all the stress hormones, which is also controlled by the orexin pathway.
So by having this specific orexin-2 activity and not having the dual activity and avoiding the orexin-1 antagonism by having a molecule, which is really controlling this over-activity of these different systems I just described, I think you end up with a molecule, which is extremely efficacious in terms of insomnia, but also has a direct effect on mode and this is also something we have demonstrated.
So, I think these are really the reason why we have really focused on this molecule and we wanted really to have this development going on with Janssen.
So, obviously the future, I mean, the study is currently ongoing.
We will test several other aspects like for example what is going on that we have already some hints, but what is going on for example when you wake up someone in the night is he able to cope with standing up going to the bathroom, because this is something which quite often happens, is he able to go back to sleep, this is something we are exploring in addition to the effect on sleep insomnia and on depression. But I mean all these kind of things are very important in order to cover the complete and mathematical need we have today in insomnia and in depression and we know very well that with the diverging molecules we have currently available for insomnia, we have a lot of side effects with cognitive impairment, we have also these difficulties to standup and not to have problems particularly in the elderly.
So, there are a lot of attributes of this molecule, which I think make this approach unique.