Astra follows Novo’s lead, for a third of the price

Today’s tie-up with Neurimmune for the phase 1 antibody NI006 sees Astrazeneca move further into ATTR amyloidosis, just a month after the UK group licensed Ionis’s phase 3 antisense asset eplontersen. The latest deal also mirrors a July 2021 transaction Novo Nordisk signed to bring in the only other clinical-stage antibody for ATTR amyloidosis, Prothena’s PRX004. It will not go unnoticed that while the Prothena deal cost Novo $100m up front Astra has had to give Neurimmune only $30m for global NI006 rights. Both deals assume that there is space for a latecoming conventional antibody approach in ATTR amyloidosis, a competitive area controlled by Pfizer’s oral TTR stabiliser Vyndaqel and featuring two recently approved therapies, Alnylam’s RNAi Onpattro and Ionis’s antisense Tegsedi. PRX004 and NI006 both target wild-type/hereditary ATTR cardiomyopathy, the subtype in which Bridgebio’s acoramidis failed in phase 3 last month. Interestingly, Astra is also in AL amyloidosis, a non-genetic disease unrelated to the ATTR type, via last September’s takeover of Caelum Biosciences. Investors might be familiar with Neurimmune for another reason: the private Swiss firm partnered with Biogen to discover the antibody that became Aduhelm.

The ATTR cardiomyopathy landscape
Project Company Description Status
Vyndaqel Pfizer Oral TTR stabiliser Approved
Onpattro Alnylam IV TTR RNAi therapeutic Phase 3*
Vutrisiran Alnylam SC TTR RNAi therapeutic Phase 3**
Eplontersen Ionis & Astrazeneca SC TTR antisense Phase 3
Acoramidis Bridgebio Pharma Oral TTR stabiliser Failed phase 3
NTLA-2001 Intellia & Regeneron IV Crispr-associated Cas9 gene therapy Phase 1
NI006 Neurimmune & Astrazeneca IV anti-TTR antibody Phase 1
PRX004 Prothena & Novo Nordisk IV anti-TTR antibody Phase 1 terminated owing to Covid-19^
Notes: *approved for hereditary polyneuropathy; **filed for hereditary polyneuropathy; ^ph2 to start in 2022. Source: Evaluate Pharma & clinicaltrials.gov.

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