NGM’s Nash data delivers, but not quite enough


Read out from the fourth cohort from NGM Biopharmaceuticals’ phase II trial of NGM282 confirms the project’s impact on reducing liver fat – but also that this comes at a cost. Patients registered a big jump in LDL – an average of 47.6mg/dL – a side-effect that could yet render this project irrelevant. Not that the signal is new: it was one of the main reasons for testing a lower 1mg dose in this final stage of the trial. Another drawback to this project is that it has to be injected once a day – an onerous ask unless the company can prove that NGM282 has a big impact on fibrosis. Firmer evidence of this will come with biopsy data, due next year, but against expectations of a 55% reduction in relative liver fat, according to Stifel analysts, the data have disappointed, and the share price drop today suggests that investors are cooling on this project. A look at rival agents suggests that on liver fat reduction NGM282 can hold its own – the caveats of cross trial comparison notwithstanding – but given the safety and administration, at the end of the day this might matter very little.

Data from NGM282's phase II trial (NCT02443116)...
  Cohort 1 Cohort 4
Time 12 weeks 24 weeks
Patient population Nash, F1-F3 Nash, F2-F3
Dose 3mg 6mg Placebo 1mg Placebo
Change in relative liver fat content -48% -60% -3% -40% -6%
Source: Company presentations.


...Vs the competition
  Madrigal's MGL-3196 (NCT02912260) Viking's VK2809 (NCT02927184)
Time 36 weeks 12 weeks
Patient population Nash, F1-F3 NAFLD/hypercholesterolaemia
Dose All  High Placebo 10mg QOD 10mg QD 5mg QD Placebo
Change in relative liver fat content -37% -49% -9% -57% -60% -54% -9%
QD: Once daily; QOD: Every other day. Source: Company presentations, Evercore ISI note Aug 13, 2019.

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