That ringing sound in your ears, or tinnitus may not have a cure yet, but researchers are dedicating their time and money to understanding the root cause of these phantom sounds. In the meantime, people with tinnitus can use any of the several scientifically proven treatment techniques to manage their symptoms. These techniques range from talk therapy to electrical stimulation and sound therapy.
Many people in the tinnitus community hope for a prescription medication that will eliminate the phantom sounds, and/or change perception and responses to them. This is a bit complicated since tinnitus has several known and unknown causes, which means how we approach treatment will differ. For instance, tinnitus caused by ototoxic medication wouldn’t be treated in the same manner as a migraine or jaw problems.
NHPN-1010 is an emerging drug candidate for noise-induced tinnitus, which is caused by damage to sensitive inner ear cells in the hearing organ. Recent studies presented at the Auditory Research Society have provided compelling evidence on how NHPN 1010 may mitigate tinnitus symptoms by targeting the central auditory system and the inner hair cells to ‘reverse tinnitus’.
What is NHPN-1010?
NHPN-1010 is an exciting pharmaceutical development aimed at treating noise-induced hearing loss, which could potentially treat symptoms of tinnitus and hyperacusis. The oral pill combines two antioxidant compounds, HPN 07 and NAC, and acts as an otoprotectant against acute hearing loss, and to prevent the development of chronic hearing disorders.
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"Treble Health helped me turn down the sound of my tinnitus. Now I can breathe, and get on with my life!"
– Elisa
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NHPN-1010 was created by researchers at the Hough Ear Institute (HEI) and the Oklahoma Medical Research Foundation. The Hough Ear Institute was founded in the 1980s to continue the work of pioneer, Dr. Jack Van Doren Hough, a world-renowned otologist and ear surgeon, whose microsurgical procedures and instruments have been adopted for modern use. Currently Otologic Pharmaceuticals is collaborating with The Hough Ear Institute and Oklahoma Medical Research Foundation on developing the pipeline for clinical trials for the drug.
The independent, not-for-profit research organization, HEI, aims to support research projects, as well as education, and humanitarian efforts. NHPN-1010 is one of many advances the organization hopes to make in the field of otolaryngology.
What The Science Says
A huge part of overcoming tinnitus has to do with understanding what it is, and what areas of the body it affects. This will help keep you up to date with the latest news and developments in the tinnitus community.
For instance, anyone with tinnitus should be familiar with the cells of the cochlea, better known as the ‘inner ear cells’ or the stereocilia. (They’re not actual hairs, they’re microscopic cells deep inside the hearing organ.)
The inner ear cells allow us to hear, and any damage can play a role in the development of hearing loss, as well as tinnitus. The antioxidant components of NHPN-1010 aim to repair any kind of damage to the inner ear, particularly the hair cells. Researchers believe when used appropriately, it could reduce the damage that may have been caused by excessive noise exposure.
HPN 07 and NAC have already been researched extensively, and already scientists know it has neuroprotective effects. This can be useful for a wide range of damage caused by traumatic brain injuries as well as noise-induced hearing loss, ototoxic medications, etc. have been observed.
People with tinnitus should also be familiar with the dorsal cochlear nucleus (DCN), part of the auditory pathway located in the brain. Experts believe hyperactivity in these regions could explain tinnitus sounds. NHPN-1010 works on GABA type A receptors by helping to change the way that they function within the dorsal cochlear nucleus.
The dorsal cochlear nucleus (DCN) is the area of the auditory system that processes auditory information, and other sensory information, like head and body movements, and touch. This area of the brain has been heavily studied, as researchers believe it holds the key to understanding tinnitus. A popular theory is that these GABA receptors reduce neural firing in the dorsal cochlear nucleus which could help reduce tinnitus or reverse tinnitus.
Another well-known scientific fact about tinnitus is that roughly 90% of people with tinnitus also have some degree of hearing loss. This means that treating any hearing loss often results in an improvement in tinnitus symptoms. Oftentimes, this includes using hearing aids (with tinnitus features), but in instances where there’s evidence of loud noise exposure over many years, this may indicate damage to the inner ear cells.
Reversing Tinnitus With NHPN-1010
One study found that noise exposure leads to an upregulation of GABA type A receptors in the dorsal cochlear nucleus of rodents. This upregulation, or amplification is believed to be a defense mechanism potentially suppressing the chronic tinnitus perception and it enhances this inhibitory neurotransmission in the brain.
NHPN-1010 has shown promise in reversing these changes leading to a reduction in tinnitus symptoms in animal models whose auditory symptoms share similarities with those of humans. The studies indicate that NHPN-1010’s efficacy might be linked to its ability to modulate those neurons in the DCN, that part of the auditory brain that has already been linked to tinnitus symptoms. Other studies have found that NAC can help prevent side effects caused by drug reactions and toxic chemicals. NAC breaks down the disulfide bonds in mucus proteins. This process reduces the thickness of mucus, making it easier to clear from the body, which in turn supports healthy cell function.
These discoveries provide a new avenue for tinnitus treatment, and the drug is currently in clinical development in the United States. The next steps involve testing the drug on humans and exploring its efficacy, applications, and side effects. The hope is that at some point in the future, the drug can be given preventatively by physicians who experience sudden onset of tinnitus after loud noise exposure.
What’s Next For NHPN-1010
At this stage in the research, a large pharmaceutical partner is needed to sublicense the therapeutic and pay for the rest of its clinical development through Phases II and III of the FDA approval process. In other words, greater funding is needed.
Securing this funding is as complex as tinnitus itself, as anyone who agrees to fund NHPN-1010’s clinical development is agreeing to an almost $500 million investment in a single first-in-class drug for this indication (an ototoxic protectant to prevent and treat acute hearing loss and by doing so, prevent the development of permanent hearing disorders). So far, the Otologic Pharmaceuticals website indicates some collaboration there from some pretty serious players and a lot of investment behind NHPN-1010.
NHPN-1010 has already completed a Phase I clinical trial, and a Phase II clinical trial is in development. Future research should provide answers on whether this treatment can be effective for patients with noise-induced hearing loss that is neither acute nor recent.
Understanding Clinical Trials
Transitioning from research to offering NHPN-1010, or any drug, to patients is complex and rigorous. The guidelines set by the FDA and similar agencies help to guarantee safe and effective treatment for patients. Clinical trials are a key part of this process and are how researchers prove their new medicine (drug, therapy, device, or treatment) can be useful, and is not harmful.
- Phase I trials focus on safety and dosage. In this phase, NHPN-1010 was given to an animal or human group to determine how the body processes the drug and to identify any side effects.
- Phase II trials include a larger group of subjects to demonstrate effectiveness, fine tuning dosage and monitoring side effects for longer.
- Phase III trials include a more diverse population to confirm the efficacy of the medicine and its side effects. NHPN-1010 is currently in this phase, as researchers are hoping to learn more about its long-term effects and patient feedback. This will include all the comprehensive data needed for regulatory approval.
Once a New Drug Application (NDA) is submitted, the data is evaluated to ensure the drug is safe and effective for its intended use. This may take anywhere from a few weeks to a few months and may include additional data requests and more studies.
Phase IV is the post-approval stage where the drug is already on the market, and furher studies are done to measure its long-term effects, risks, and benefits. Healthcare professionals are also encouraged to give feedback, and report any adverse effects.
Who Can Benefit From NHPN-1010?
Future research should expand the list of patients this drug could benefit. So far, military veterans exposed to loud trauma blasts, as well as firefighters and police officers who’ve worked alongside firearms, explosives, and unexpected loud blasts are the obvious choices.
With more answers, researchers hope to attract investment from the Department of Defense, as they already spend a lot of money treating hearing loss and tinnitus through the Veteran Affairs hospital system and other medical centers. The ability to get in front of the noise exposure and its effects is a smart investment.
NHPN-1010 can also be useful for civilians who experience loud noises that lead to hearing issues and/or tinnitus. This includes:
- Musicians
- Film and music crew
- Airline personnel
- Factory workers
- Automotive workers
- Sports officials
- Farmers
- Veterinarians
Tinnitus Retraining Therapy For Tinnitus Treatments That Work
Tinnitus Retraining Therapy (TRT) is a treatment specially designed to address the psychological symptoms of tinnitus, as well as the ringing or buzzing. It combines Cognitive Behavioral Therapy (CBT) with Sound Therapy, and is considered the gold-standard for tinnitus treatment.
Manage tinnitus with evidence-based strategies that work for thousands of patients like you. Experienced audiologists agree the most effective treatments for tinnitus today include:
- Hearing aids
- Mindfulness-Based Stress-reduction
- Progressive Muscle Relaxation
- Lifestyle changes
- Neuromodulation (invasive and non-invasive electrical stimulation)
Treat Tinnitus With The Treble Health Team
NHPN-1010 is currently in phase two of clinical development, which means that researchers are now ready to begin testing this drug with human subjects. As we learn more about the next steps for this new treatment, we will keep our community informed. In the meantime, there are several proven techniques available to help manage tinnitus.
Learn more about tinnitus in a complimentary 20-minute telehealth session with our doctors! Discover the root cause of your tinnitus and receive a customized approach to care from the expert audiologists on the Treble Health team.
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