Is the IPO window inching open again? February has seen two upsized flotations, with the latest to go public, Mineralys, raising $192m. Not only is this the largest IPO of 2023 so far, the sum also rivals the biggest hauls amassed last year. One of those big 2022 floaters was Cincor, a competitor to Mineralys in the burgeoning resistant hypertension space; Cincor, along with its aldosterone synthase inhibitor baxdrostat, was acquired by Astrazeneca this year. Mineralys investors might be hoping for a similar outcome: the group’s lead project, MLS-101, has the same mechanism, and phase 2 data look promising. A mean placebo-adjusted systolic blood pressure reduction of 9.7mmHg at the most effective dose, 50mg once daily, makes MLS-101 look almost as good as baxdrostat did in its successful Brightn study, with the usual caveats about cross-trial comparisons. The picture is complicated, though, by baxdrostat’s failure in Halo in less refractory patients. Another rival is J&J and Idorsia’s aprocitentan, but there have been questions about the effect size seen in phase 3. A recent arrival in the mid-stage pipeline is Novartis’s XXB750; meanwhile, phase 2 data have yet to emerge on Ionis’s IONIS-AGT-LRx, despite being promised last year.
| Mid-late stage projects for treatment-resistant hypertension | |||
|---|---|---|---|
| Project | Company | Mechanism | Status |
| Aprocitentan | J&J/Idorsia | Endothelin A & B receptor antagonist | Ph3 Precision data at AHA 2022; filed in US & EU |
| Firibastat | Quantum Genomics | Aminopeptidase A inhibitor | Ph3 Fresh failed Oct 2022; extended treatment Refresh terminated |
| Baxdrostat (CIN-107) | Astrazeneca (via Cincor) | Aldosterone synthase inhibitor | Ph2 Brightn succeeded; ph2 Halo failed; ph3 to start 2023 |
| MLS-101 (MT-4129) | Mineralys (licensed from Mitsubishi Tanabe Pharma) | Aldosterone synthase inhibitor | Ph2 Target-HTN toplined positive Nov 2022 |
| IONIS-AGT-LRx | Ionis | Angiotensinogen antisense | Ph2 Astraas had been due to report H2 2022 |
| ION904 | Ionis | Angiotensinogen antisense | Ph2 ended Jan 2023 |
| Zilebesiran (ALN-AGT01) | Alnylam | Angiotensinogen RNAi therapeutic | Ph2 monotherapy Kardia-1 to report mid-2023; ph2 add-on Kardia-2 to report YE 2023 |
| XXB750 | Novartis | NPR1 agonist | Ph2 ends Feb 2024 |
| Source: Evaluate Pharma & company statements. https://www.evaluate.com/vantage/articles/news/deals-snippets/mineralys-takes-jj-and-astrazeneca | |||
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