“When used for long periods of time to treat chronic diseases, the accumulated steroid-toxicity can wreak havoc on a patient.”
Noreen Henig, MD has built a distinguished career as a physician, scientist and executive in the healthcare industry. She recently held the role of Chief Medical Officer at Kezar Life Sciences where she focused on developing treatments for autoimmune diseases and oncology, and currently serves on the board of directors at Avidity Biosciences.
Dr Henig began her medical career in academia, where she developed a profound interest in the immune system's intricate role in human health. Prior to joining the biotech industry, she led the Lung Transplant Program and the Adult Cystic Fibrosis Center at Stanford University.
"I've always been fascinated by the immune system. It's a fine balance between protecting us and causing disease. This duality led me to explore ways to modulate it more effectively."
This passion eventually led to her transition from clinical practice to the field of drug development, where she could make an impact on patient care on a broader scale.
Steroids are a cornerstone in managing countless diseases because of their potent anti-inflammatory properties. However, their widespread use comes with significant downsides.
"Everyone has likely encountered steroids at some point, whether for something minor like a rash or a more serious condition. The medical community thinks of steroids as a highly effective way of turning off the immune system very quickly - and in acute settings they are incredibly powerful. However, when used for long periods of time to treat chronic diseases, the accumulated steroid-toxicity can wreak havoc on a patient.”
“I’ve seen the whole spectrum of benefits and risks associated with steroids. When I was the director of the lung transplant program at Stanford, patients who received a transplant often needed to be on steroids for many years to avoid organ rejection. Patients would be so much better thanks to the transplant, but as the dosage from steroids accumulated, so too did the impact of the toxicities.”
The crux of Dr Henig's work in the biotech industry lies in evaluating the risk-benefit ratio of treatments.
"In life-threatening conditions, steroids are indispensable despite their risks. However, for chronic diseases, newer therapies might offer similar benefits with fewer side effects."
This perspective is crucial in clinical trials, where the standard of care often includes steroids. Dr Henig's approach involves maintaining stable steroid doses during trials to isolate the effects of new treatments and then, progressively tapering steroids to demonstrate the efficacy of the new therapy alone.
A significant advancement in understanding steroid-toxicity is the introduction of tools like the Glucocorticoid Toxicity Index (GTI).
"The GTI helps quantify the negative impacts of steroids, which is crucial for illustrating the long-term costs and health consequences, and helps patients get off steroids more quickly. If a clinician can see the negative impact the steroids are having, their immediate response will be to want to reduce those side effects.”
“But the other part of it is that it helps justify why a new drug might be better than steroids. If they are both equally efficacious, but one causes a quantifiable set of negative outcomes, and the other does not, then it makes a strong case for trying the new, more targeted intervention.”
Dr Henig also discussed the challenges in patient care, particularly in educating patients about the side effects of steroids.
"In today's healthcare systems, there's little time for comprehensive patient education, which is a significant barrier to effective treatment adherence and shared decision-making. Even in systems with better access to care, like those with universal healthcare, challenges remain. However, the ability to focus on patient care rather than administrative tasks can significantly enhance the quality of care.”
Dr Henig underscores the importance of innovative tools like the Steritas GTI in advancing patient care and developing safer, more effective therapies.
Dr Henig has built a distinguished career as a physician, scientist and executive in the healthcare industry. She is a graduate of Yale University and received her MD with a distinction in Immunology from the Albert Einstein School of Medicine. She completed her internship and medical residency at the University of California, San Francisco during the peak of the AIDS crisis, an experience that underscored the critical need for quality care and effective therapeutics. Her fellowship at the University of Washington further honed her expertise in Pulmonary, Critical Care and Allergy/Immunology, particularly focusing on T-cell function and leukotrienes.
Her notable contributions include leading the Lung Transplant Program and the Adult Cystic Fibrosis Center at Stanford University. She also worked at California Pacific Medical Center, where she supported the transplant ICU and directed the Pulmonary Fellowship program. Transitioning to the biotech industry, Henig played a vital role at Gilead Sciences in pulmonary and cardiovascular development, encompassing clinical trial phases, medical affairs and business development.
As Chief Development Officer at ProQR, she was instrumental in transitioning the company from private to public status. She then became the Chief Medical Officer at Breath Therapeutics, leading to the company's acquisition. At Kezar Life Sciences, she focused on developing treatments for autoimmune diseases and oncology. Currently, Dr Henig serves on the Board of Avidity Biosciences and is pleased to support Steritas's mission to enhance patient health through improved medication use.