Medical Science 40

Why n-Lorem Must Sometimes Say No

November 4, 2026

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We’re addressing perhaps the most difficult decision n-Lorem has to make in our work, declining a patient application. Today, our acceptance rate is ~59%. These decisions are made with heavy hearts at n-Lorem, and we are aware of how heartbreaking the decision to decline an application may be for a patient and their family. In this episode, we’ll discuss the main reasons a patient’s application may be denied, including safety, geography, and other factors. 

In This Episode, We Explore:

  • 1:43 – Non-technical issues: Outside of USA, inability to find treating physician, patient population size, if the patient is being treated by another experimental medicine, including repurposed drugs
  • 7:15 – Definitions to better understand the conversation: Heterozygous mutation, haploinsufficiency
  • 9:40 – n-Lorem must understand the cause of the disease, the nature of the mutation, and n-Lorem must be confident that the ASO designed would deliver value to the patient
  • 12:35 – n-Lorem must be confident that only a single gene is causing phenotypes, and that the target is not a null mutation
  • 13:37 – n-Lorem may accept patients, but then discontinue a program if the patient cells are unable to be grown for lab use and testing
  • 14:56 – For patients requiring an allele-selective ASO, n-Lorem must identify non-pathogenic mutations to attempt to create an ASO capable of helping the patient

Watch on YouTube:

The host of the show is Dr. Stanley Crooke, a scientist, a physician, an entrepreneur and the father of antisense technology. Dr. Crooke is responsible for driving the development of antisense or ASO technology, an RNA-targeted technology responsible for the commercialization of three best- and first-in class medicines and more than 40 drugs in development. In 2020, Stan formed n-Lorem to use this powerful technology to develop experimental personalized ASO medicines for nano-rare patients (1 to 30 patients worldwide) for free, for life.

Credits

Hosted by: Dr. Stan Crooke.
Videographer: Jon Magnuson of Mighty One Productions.
Producers: Kira Dineen, Jon Magnuson, Andrew Serrano, and Amy Williford

Links

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