Cassiopeia’s Breezula is the Real Deal

Cassiopeia Logo

Cassiopeia has just released excellent news regarding very positive interim Phase 2 results of Breezula. They now also call the product by its new chemical name of Clascoterone. Note that these are interim 6-month results and the trial is still ongoing.

Update: Cassiopeia stock almost doubled in the past week. This was due to their July 10 press release regarding positive Phase 3 clinical trial results for their topical anti-androgen acne cream Winlevi 1%. This Winlevi (Clascoterone) product is very similar to Breezula (h/t Tommy).

Breezula (Clascoterone) Timeline

— I first covered Italian company Cassiopeia’s Breezula topical anti-androgen product in 2014. At the time, the product was known as CB-03-01. And Cassiopeia itself was known as Cosmo Pharmaceuticals. The CB-03-01 product was touted as a treatment for acne, hirsutism and male pattern baldness (MPB).

— In 2016, I provided an update on Breezula concerning favorable Phase 2 proof-of-concept results.

— In my post about the AHRS conference in May 2018, I mentioned how one of my insider sources told me that there was a great deal of excitement surrounding the Breezula presentation. This source was clearly on to something.

Clascoterone Phase 2 Results

Per this latest 6-month interim analysis of phase 2 dose ranging clinical trials for Clascoterone (Breezula®):

  • When it comes to target area hair count (TAHC): 7.5% Clascoterone solution twice per day gave similar results after 6 months as oral Propecia did after 12 months. It is expected that 12-month results from Clascoterone will be even superior.
  • The ongoing double-blind trials at 6 sites in Germany involve a sizable 404 male patients. They are being tested at one of four different dosages, or placebo.
  • Cassiopea expects that the side effects from topical Clascoterone will be far less in comparison to those from existing oral anti-androgen type drugs. Clascoterone does not interfere with the hormonal profile of patients, especially testosterone. To date, no sexual side effects have been seen in clinical trials.
  • The company will soon start proof-of-concept (POC) trials for women.
  • Final Phase 3 trials for men are also being planned for the future.
  • If approved, Clascoterone would be the first FDA-approved topical anti-androgen product for the treatment of androgenetic alopecia.
  • Cassiopeia’s product pipeline page has a Breezula market launch goal of 2022. The related acne product will come out by the end of 2020.
  • Will SKIN:SW trend upwards in Monday’s trading?

52 thoughts on “Cassiopeia’s Breezula is the Real Deal”

  1. @Scott
    A lot of researchers like a topical instead of an oral drug. So it is not only the patients’ demand for less side effects.

    Topical Polichem
    Topical Aclaris
    Topical Rivertown
    Topical Cassiopeia

    1. @netshed – like I said, if the cure turns out to be a painful big needle up the ass I would still take it. You can sit there and wait for a lotion version if you want but I am taking the first ride out of here.

  2. This is hardly enough data to tout it as “the real deal”. It’s an interim analysis just six months in, and while those are good results in that length of time, that’s nowhere near enough time for them to be certain its effective at maintaining hair long-term.

    Don’t get me wrong, a topical anti-androgen that actually works would be great, but this is still years away, and will likely be less relevant by the time it comes out than it would’ve been years ago, as competitors with better tech, especially where new growth is concerned, are nearer to commercialization.

    1. They have been testing this drug for a few years and I would be shocked if 12 month results were not at least as good as 6 month results.

      It is “the real deal” unless you are looking for it to be the cure.

      A potential godsend for those who get sides from Propecia.

      1. It is also the “real deal” if nothing else that is better comes to market before these guys. A lot in the pipeline with hopes that many treatments come to fruition but there are no guarantees. Unlike some commenters on this blog I don;t have the ability to predict the future!

      2. Yeah, but the only way for them to really know this is to do the follow up after years. Which, unless I’m missing it, they have not.

        It could still easily fail to maintain yet.

  3. The only cure and realistic hope will come from Replicel and Sheseido … and I am saying that for two reasons :
    1- It is almost impossible to figure out how hair loss happens.
    2- Replicel avoided wasting time in trying to cure the sensitive hair and decided to replace it all together by new healthy hair from the back of the head.
    just forget about all solutions and pills.

    1. @ali almansouri – finally someone who does not insist the cure be a magic lotion :-)

      If what I have read is correct, this Clascoterone is promising to be merely a slightly better alternative to the current Propecia, to be out in 2022. By 2022, it would be very disappointing if this is all there is in terms of extra to use, but good work I guess. I will stick to my hair systems.

      1. @Scott: Winlevi is the same active ingredient that Breezula with a bit of luck is possible that this before in the market.

      1. Because they published Phase III data for WinLevi (based on the same active ingredient of Breezula) and they were very good. Check their homepage.

  4. Wow! Thats fantastic News! Guess I will try Winlevi in 2020. … Cassiopeia seems to be the next great European Company next to Follicum. Together with the 2 Japanese and 2 American Aclaris and Samumed we get more and more where we want to be. :-)

  5. Will there be any promising (topical or oral) treatments avaible in 2019? Or is the general expectation that things will not happen until 2020/2021/2022?

    And to all the people that are in this space for quite some time (like 5 years or more), has it ever been such an exciting time as it is now?

  6. A lot of déjà vu here as topical spiro was put forward as a better anti-androgen than propecia as it didn’t cause sides. Suprise suprise – it could cause sides (pretty notable ones at that) even when in topical form due to it going systemic.

    What makes this any different? Why won’t this go systemic and cause sides?

  7. Does the acne treatment grow hair? If so, how well?

    I am for anything that works (to grow hair). And Phase III completion is great.

  8. Putting on this stuff twice a day will be a pain. If it works once a day then it will be a good replacement over minox. The big question here is does it grow good amount of hair and stabilization? Does it work for more than 80% of people? Something like this should have came out in 2000s not 2020s. Seems assbackwards. Anywho I won’t have enough hair in 2022 for this to really give me benefit. I’m in the fue zone now unless follica comes out later this year or next year. That’s our real only hope. Susheido would be great but the wait list and accessibility to it being all the way in Japan will be a huge hurddle. All I know is that it’s 2018 and histogen should have been out by now lol.

    1. @MJones – If Shiseido works, they have a licence to the whole of Asia. It will be licensed to clinics all over that territory. There won’t be a waiting list. There will be competition!

      Also, Japan is far but an easy place to get to. No VISA required for Japan, or South Korea, Hong Kong, Thailand and most of South-East Asia.

        1. It’s not entire Asia but what Scott mentioned though is true. It’s been stated that they have exclusive licence in several Asian countries. All you gotta do is wait a few more months until they publish the phase 2 results, if successful then you’ll be celebrating like there’s no tomorrow. Like Scott, I’m a firm believer that the cure will most likely come from companies like shiseido/replicel over aclaris, and I too will take the first flight to Japan. Even if there was a waiting line, knowing that there’s actually a cure would put everyone’s mind as ease

          1. I am new here. Can you tell me where you find the latest news and research coming from Japan? What is looking the most promising at this point? Thank you!!!

            1. @Lisa – for Japan’s Replicel work, do any Google/YouTube search containing RCH-01. This is their codename for the treatment. This is currently the most promising because they only need to pass phase 2 for market release and the results are due this year. Others will mention RIKEN but their tests and release date is years away.

              1. And prior to the most previous mentioned topical lotions that tries to maintain the hair you got (i.e. not a cure), this would actually serve as THE cure, if successful.

  9. Really enthused by this I have to say, fin is a great product with respect of efficacy. To essentially have it (possibly better) in topical form with no effect on your hormonal profile, is amazing!

    That said, once again, timing is dis-appointing – 2022 is a hell of a way yet :(

  10. I want to get a hair system with french lace. I have still a very good amount of hair with an intact hairline. Only 1 cm recession. But overall diffuse thinning.

    I went to the best hair system specialist in germany. Heydecke hairsystem but they told me that I have too much hair and that they would not recommend it. I still want to do it and i dont have a problem taking off the system every night for shaving but do you think that it will still do any damage to my thin hair? Any experience or opinion on this?

    1. I wear hair systems that are glued on for weeks. What you have been told is true, as is your concern about long term damage on your existing hair. That being said, it is hair you are going to lose anyway and the more you completely lose the better the hair systems will last. You won’t need to shave it every night. You don’t feel the hairs poking until after 2 weeks.

      1. Hi scott,

        Thanks for your answer. I am not a native speaker. Did I understand it correctly? So it does damage my remaining thin hair? Even if I take off the system every night or every 2 days for cleaning anf shaving.

        I dont have a problem spending time on this but how do you think can a hair system damage my thin hair if I choose a breathable french lace system and I will not wear it for weeks. I just want to relax the next 2 years until something new will come out. I am sure that my thin hair will survive during the next 2 years BUT I am not sure if it really can damage my hair because if I take it off regularly and if I use a breathable hairsystem with as less glue/ strips as possible.

        And Thank you very much for your youtube videos!

        1. @Royaume – if you have thin hair but it covers all the area then you will be much more suited to hair fibres/spray-on-hair to fill in the gaps.
          You will save a lot of money and time doing this instead of a hair system. I used to do this but I lost so much in the end there was nothing left to thicken.

    2. is there a method to turn thining hair to nomal? i am also have overall hair-thining problem as you.i think it is due to the DHT attacking cause it happen my early 20s.maybe fin can solve but i am afraid of the side effect.so i exepect CB now.

      1. Yeah but I would not take fin now. If I knew it 3 years ago I would immediately jump on it but right now its not worth it. The potential side effects are not worth to save those dying hairs.

        Where are all the treatments? Where is our Hair loss superstar Cotsarelis? Spent 20 years for research and nothing came out.

        I am so disapponted my friends. How long should we wait? Let me guess? 5 years?

        Forget all the american and european researchers. The only thing they come up with are fake combover techniques.

        Did you even see the latest histogen picture? What a fake combover trick.

  11. Privately held Histogen is in more advanced testing of an earlier version of HSC660 in men.”

    “A late-stage or Phase 3 trial for men has begun in Mexico, Naughton said. Anticipating success, the company is looking toward commercialization.”

    “We’re in very late-stage negotiations with some huge retail partners,” Naughton said. A deal should be concluded in the next few months, she said.”

    1. Can someone post more details about this (Admin maybe?). Europeans don’t have access to the San Diego Union Tribune article about HSC660 for men.

  12. Do you think there is a chance that only once a day may be enough.
    As it is for minox, 2 times are recommended, but only once works..

  13. Great article Admin.. I had actually suggested a few posts ago that when WinLevi comes out it can be used. It is same compound at a lower dose… In that case we are less than 2 years out guys.

  14. Can women use this? Where can I buy it from?
    I hAve thin hair and thinning on the top at the front. Please help! Thanks

  15. The only data point relevant for side effects is plasma DHT (dihydrotestosterone). If this drug reduces plasma DHT levels as much as finasteride does, it will have the same side effect profile. Subjective measurement of side effects is variable and inaccurate.

    Topical finasteride reduces plasma DHT as much as oral finasteride does, as shown in this study:
    https://www.ncbi.nlm.nih.gov/pubmed/25074865

    I’m worried the same will be true for Clascoterone. Neither topical nor oral finasteride has any effect on serum testosterone, because finasteride blocks the conversion of testosterone to DHT, but the level of DHT produced in the conversion is minuscule relative to testosterone level.

    1. I just did some more research, and it seems Clascoterone does not affect DHT levels, as it acts by inhibiting androgen receptors rather than DHT conversion/production. It also shows strong selectivity for the local tissue where it is applied with minimal peripheral uptake/activity, as it is rapidly metabolized in the blood. The fact that it is rapidly metabolized may be a reason why the phase II clinical trial showed it is more effective when applied twice daily rather than once.

      Most of that came from this study:
      https://pubs.rsc.org/en/Content/ArticleLanding/2014/MD/c4md00049h#!divAbstract
      Early research in rodents and human tissue in vitro investigating the biochemical pathways of Clascoterone’s active form (cortexolone-17α-propionate).

      Anyway, this is very promising!

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