Last month, I had the good fortune to interview Rick Kopke, MD, FACS, the CEO of the Hough Ear Institute (HEI) in Oklahoma City, Oklahoma. HEI, or Hough for short, is a non-profit 501(c)(3) organization with the vision that “all who have ears will hear.” Hough’s mission is three-pronged: hearing restoration research, education (training otolaryngologists), and humanitarian efforts to send doctors to underdeveloped countries to perform ear surgeries. “We’re a small but mighty organization,” Dr. Kopke says. “By God’s grace, we’ve come up with some real breakthroughs.”
The Hearing Loss Pill
The most recent breakthrough is the advancement of a hearing loss pill, which is moving from phase 1 to phase 2 of clinical trials to test for safety and efficacy. An agreement between HEI’s pharmaceutical partner, Auditus LLC (Auditus), a wholly owned subsidiary of Otologic Pharmaceutics Inc. (OPI), and Oblato Inc. (Oblato) made the move possible. “The hearing loss pill was originally designed for use in the military,” Kopke explains. “It was designed to be taken shortly after an explosion, being in a fire fight, or other loud noise to reduce permanent hearing loss.” But HEI’s researchers found an interesting surprise: the nerve endings between the auditory nerve and the inner hair cells, called the synapses, can be regenerated with the pill too. That means it may also help treat tinnitus, the incessant ringing in the ears that plagues many people with hearing loss.
Although the hearing loss pill was originally developed for noise-induced hearing loss, Kopke says it could also help other groups: those with age-related hearing loss; those who receive antibiotics or other medications that can be toxic to the ear; and cochlear implant recipients, by helping to preserve more of their natural hearing after cochlear implant surgery. “The pill could also improve ability to hear speech in noise – restoring nerve fibers helps to restore hearing,” says Kopke.
Other projects Hough is working on include regeneration of auditory hair cells to restore hearing through gene therapy (a regenerative injection technology), and a new way to deliver drugs to the inner ear. They aren’t pursuing other projects at this point due to the organization’s size. “If you have too many things going on, if you lose your focus, then you stop making progress,” Kopke says.
What Will Future Treatments for Hearing Loss Look Like?
Because there are different types of hearing loss, Kopke anticipates that there will be different treatments in the future – and these might not entail a full restoration of hearing in more severe cases. “There won’t be a silver bullet, a drug that restores all types of hearing loss,” he says. “The causes of hearing loss are so varied and the pathology that underlies sensorineural hearing loss is so varied that there’s not going to be one medication that’s effective in all cases.”
Rather, Kopke thinks the hearing loss pill and other treatments will offer significant partial restoration of hearing. For example, a person with mild hearing loss who would wear hearing aids could receive a regenerative medicine and might not need hearing aids, or someone who might need a cochlear implant could get medicine and might go to using hearing aids. Or for others, they might still need to use hearing aids or cochlear implants, but with the medication, their devices would work much better. “So, I think there will still be hearing aids and cochlear implants, but I think there will be a lot of people who benefit very significantly from these medications if we can take them through phase three of clinical trials,” Kopke says. After phase three, a drug can be approved by the FDA to go on the market.
While this may sound discouraging to people with hearing loss who are hoping to have their hearing fully restored, it’s actually good news that this type of advancement doesn’t seem as far off as before. “I really think the prospects are very good. I’m quite hopeful that our technology, or some of the technology others are working on, will work out and get all the way through phase three.” Kopke says when he started working in the hearing field in the late 1990s, technology companies had almost no interest in funding pharmacological treatments for hearing loss. “But there are now clinical trials and many pharma companies are interested,” he says. “I still think we’re going to get some winners here. It seems like the pace is increasing.”
What Can You Do to Speed Up Development of a Treatment for Hearing Loss?
If you are looking to donate to an organization that is working on hearing restoration research, Kopke says there are many to choose from. “People should take time to do their homework. There are great organizations to donate to,” Kopke says. “See if the organization has a track record of making discoveries and making progress, and don’t feel shy about contacting people before you donate.” Rather than focus on one organization, Kopke says it may be best to spread the wealth when donating. “I think it’s good to support the research broadly, because you don’t know which drugs are going to make it [to market].”
In addition, it’s important to keep your expectations realistic – if you donate today, a treatment for hearing loss isn’t going to be ready by tomorrow. “Research takes so much time,” he says. “Certainly, with more funding you can speed things up, but it just takes time.”
Kopke says that a major benefit of donations is that they help to keep research going over the long term, which isn’t a guarantee with government funding. HEI has Department of Defense (DoD) funding and has had National Institutes of Health (NIH) grants, as well as OCAST grants from the state of Oklahoma, but “the allocation for research money for DoD and NIH and other granting agencies goes up and down. After a few years, even if you’re doing tremendous work, those monies can dry out. That’s where consistent donors can help keep research moving forward and on track.”
Sometimes it can be hard for donors to give money to an organization when they don’t know what specifically it’s going towards. “Some people like to give to a particular project, or for equipment,” he notes. Currently, Hough is looking for funding for a few different projects: an advanced proof-of-study concept for tinnitus; and to look into tau protein, which causes the nerve cells in the auditory pathway to degenerate over time. And on the equipment side, they need funding for a special freeze-dryer system to help with reliable synthesis of nanoparticles used for inner ear drug delivery.
Other Ways to Speed Up Development of a Treatment for Hearing Loss
It’s also important for people with hearing loss to share their stories, as people with full hearing often don’t know how much a person can struggle with hearing loss and how much it can affect relationships, education, and work. “We realize that if we help restore hearing we can help restore or improve relationships,” says Kopke. “We are created to thrive in relationships with one another, and sometimes hearing loss can really impair relationships.”
You can also let legislators know, either at the state level or federal level, that you think hearing loss is an important condition that deserves attention and funding.
Donating to Hough Ear Institute
HEI wants to thank donors for being able to reach the breakthroughs they’ve accomplished, like the hearing loss pill. “We are extremely grateful for the support we’ve had over the years,” Kopke says. “We’ve had donors from all over, and we want to thank people who’ve made our work possible.”
Hough is now focused on the future and hopefully getting the hearing loss pill through phases two and three. “We are very efficient in the way we use our research dollars and try to stretch them as much as we can,” Kopke says. At the end of the day, the staff at Hough has tremendous motivation to help the hearing loss community. “All our researchers are really driven by passion to help people,” Kopke says. “We love what we’re doing.”To keep that work going, you can donate to Hough Ear Institute, and if you’d like your donation to go to a specific cause, note that in the comments.