Vertex Navigates into new pain territory

With its dominance of the cystic fibrosis market almost complete Vertex is moving into new waters: pain. And the company’s progress with a mechanism that has proven tricky for other groups, sodium channel inhibition, might bode well for this new focus, although there is still a lot to prove. Vertex now has positive phase II data with its Nav1.8 blocker, VX-150, in small fibre neuropathy, adding to previous wins in osteoarthritis and bunionectomy. The project still has to clear pivotal trials, not easy in pain, but success could make it a big seller as an alternative to opioids. Still, investors seemed sceptical, with Vertex's stock down 2% yesterday. Setbacks in the space might not be helping: Biogen’s lead sodium channel inhibitor, BIIB074, recently failed in painful lumbosacral radiculopathy, and two phase III trials in trigeminal neuralgia are on hold as the company awaits data in small fibre neuropathy. Roche also recently canned a Xenon-partnered project, RG6029. Even if it gets VX-150 to market is not clear whether Vertex, whose sales force is more suited to niche markets, would be able to go it alone, Stifel analysts noted.

Selected sodium channel blockers in clinical development for pain
Project Company Pharma class Indication(s) Note
Phase II
VX-150 Vertex NaV1.8 inhibitor Acute and neuropathic pain, osteoarthritis Three positive proof-of-concept studies, phase IIb to begin in bunionectomy (NCT03764072)
BIIB074/vixotrigine Biogen NaV1.7 inhibitor Neuropathic pain Failed in painful lumbosacral radiculopathy (NCT02935608), small fibre neuropathy trial ongoing (NCT03339336)
Phase I
BIIB095 Biogen NaV1.7 inhibitor Neuropathic pain Phase I to complete Jan 2019 (NCT03454126)
Status unclear
ASP1807/CC8464  Astellas Pharma/Chromocell  NaV1.7 inhibitor Neuropathic pain Phase I began Jun 2017
DSP-2230 Sumitomo Dainippon Nav1.7/1.8 inhibitor Neuropathic pain Phase I completed, no data
RG6029 Xenon/Roche NaV1.7 inhibitor Pain  
Source: EvaluatePharma.

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