$250m Pfizer deal brings Akcea even closer to Ionis

Two weeks after a surprise boardroom clearout at Ionis’s almost wholly owned subsidiary, Akcea, rights to AKCEA-ANGPTL3-LRx have been sold to Pfizer for an initial $250m. This is a sizeable sum for an asset that has yet to generate much data – a 144-patient phase II trial is due to report next year but perhaps Pfizer was given a peek at some blinded data. The antisense project is aiming at some big diseases, including Nash, which helps explain the terms of the deal; potential milestone payments could reach $1.3bn. Elevated levels of angiopoietin-like 3 protein (ANGPTL3) are associated with an increased risk of heart attacks, thickening of the arterial walls and multiple metabolic disorders; the ongoing trial is recruiting patients with type 2 diabetes, high triglycerides or non-alcoholic fatty liver disease, though rare hyperlipidaemias are also a focus. As such, deep-pocketed Pfizer, which is also interested in orphan cardiac disorders, makes sense as a partner. Another notable aspect of the deal is that it will increase Ionis’s stake in Akcea; the two companies will share the up-front cash, with Ionis then receiving $125m in Akcea stock. Considering that Ionis already owns 76% of the shares, the distinction between these two groups seems increasingly irrelevant.

Pfizer's cardiovascular/metabolic pipeline
Project Pharmacology  Target uses Note
Vyndaqel (tafamadis)  TTR-dissociation inhibitor Transthyretin familial amyloid polyneuropathy  Approved in US to treat cardiomyopathy of wild-type or hereditary transthyretin-mediated amyloidosis 
Phase II
AKCEA-ANGPTL3-LRx  ANGPTL3 antisense  Various dyslipidaemias or metabolic conditions, including rare hyperlipidaemias  Large phase II ongoing: NCT03371355 plus small trial in FPL: NCT03514420
PF-05221304 ACC inhibitor Nash with liver fibrosis NCT03248882
PF-06835919 KHK inhibitor Nash NCT03916406
PF-07055341 ACC & DGAT 2 inhibitor Nash  NCT03776175
Phase I
PF-06882961 GLP 1 agonist Type 2 diabetes

No ongoing trials

PF-06865571 DGAT 2 inhibitor Nash  NCT03776175
Metabolic disease projects  ApoC 3 antisense, others undisclosed  Nash and other metabolic diseases  Collaboration with Wave; Pfizer has options over five candidates that move into the clinic. 
Source: EvaluatePharma & company websites. 

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