Stories and Viewpoints

Access & Impact

By: Niki Kapsambelis

March 26, 2025

As a young cardiologist in Paris and Montreal, Sebastien saw firsthand what a heart attack looks like in a hospital setting. Working in catheterization laboratories, where doctors use imaging equipment to diagnose and treat cardiovascular disease, helped him understand the patient experience and the profound impact that a heart attack can have.

When his career later turned to research, he carried that experience with him as he looked for new treatments.

Sebastien, a medical expert in cardiovascular therapeutics, has been working on the complex cascade of events leading to heart attacks for more than three decades. He is part of the research and development team collaborating to develop selatogrel, a potential self-administered medicine for patients with a history of acute myocardial infarction (AMI).

“It’s very important to put the patient at the center of the story,” he said. “My work is all about patients’ perception of the disease and how they really manage their own health. It’s a tight collaboration between the hospital team and the patients.”

In the early 1990s, while working in a preclinical research laboratory, Sebastien established models of heart attacks – specifically a condition where platelets (fragments of blood cells) form blood clots that block blood flow in the coronary arteries, potentially causing a heart attack. Working with antiplatelet compounds, he tried to see if there would be an impact in giving these medicines to a patient early enough when they experience a heart attack.

“This is where I started to link the two together,” Sebastien said.

While the concept was not new, it was a revelation for Sebastien to see it happen with his own eyes. It was not an experience he had as a cardiologist, even though he knew intellectually what was happening.

“I could really feel it, you know, under my fingers,” he recalled. “This is the reality, the beauty of this type of research.”

The challenge was the compound had to be injected in a hospital setting in order to work – making it impractical at the time, because if patients did not get to the hospital soon enough, it wouldn’t be as effective.

The idea was shelved, but Sebastien never stopped thinking about it, returning to the idea about 10 years ago. He began working with a compound that was then known as 475. Although it was promising, it was not appropriate for oral use, like other common antiplatelet medicines.

That was when the idea for putting it into an autoinjector was born. The compound, now known as selatogrel, was placed into an autoinjector that patients could, theoretically, administer themselves – as long as they were trained in the injection process and to recognize the symptoms of a heart attack.

“There is a critical time at the start of a heart attack that we call the ‘golden hour’,” Sebastien said. “It is a time where early intervention is extremely important.”

That was when the idea for putting it into an autoinjector was born. The compound, now known as selatogrel, was placed into an autoinjector that patients could, theoretically, administer themselves – as long as they were trained in the injection process and were able to recognize that they were experiencing symptoms of a heart attack.

“There is a critical time at the start of a heart attack that we call the ‘golden hour’,” Sebastien said. “It is a time where early intervention is extremely important, because it offers the greatest opportunity to save the heart and potentially lives.”

Currently, selatogrel is the subject of a global Phase 3 multi-center trial, Selatogrel Outcome Study in suspected Acute Myocardial Infarction (SOS-AMI), which began enrolling patients in 2021. The trial team worked with experts in research, training and education for patients working through the aftermath of a heart attack and concluded that self-administration would be possible.

The advent of personal medical devices and greater access to information means patients are more knowledgeable about their own health. “People are much more informed,” Sebastien said. “This is an advantage today. I think that people are more conscious, more cognizant about the disease and the conditions … this concept has been brought in at the right time.”

The Selatogrel Outcome Study in suspected Acute Myocardial Infarction (SOS-AMI) trial is actively enrolling patients around the world. The study has received Special Protocol Assessment agreement and Fast Track designation from the U.S. Food and Drug Administration (FDA). Fast Track is a process designed to facilitate the development and expedite review of drugs to treat serious conditions and fill an unmet medical need.

Note: Selatogrel is an investigational drug currently under evaluation in a global Phase 3 clinical trial and has not been approved for use in any country.