Sufferers dosed with an experimental Skye Bioscience weight problems drug did not lose enough weight to fulfill the targets of a mid-stage research, dealing a setback to the biotech’s bid to revive a category of medicines as soon as written off as a result of security dangers. These problems didn’t emerge within the scientific trial, which Skye executives say counsel the drug could but show profitable with greater dosing.
The Skye drug, nimacimab, is an antibody designed to dam CB1, a receptor whose physiological roles embody regulating urge for food. San Diego-based Skye is evaluating the weekly injectable drug in a 136-patient Section 2a research. The preliminary outcomes reported Monday present individuals who acquired Skye’s nimacimab as a monotherapy misplaced a median 1.52% of their physique weight after 26 weeks in comparison with 0.26% weight reduction for the placebo arm — not sufficient to be statistically important.
The mix of the research drug with Novo Nordisk’s Wegovy was higher, attaining a clinically significant common 13.2% loss in weight in comparison with 10.25% within the arm that acquired Wegovy and a placebo. Whereas these outcomes fell wanting statistical significance, weight reduction didn’t plateau at 26 weeks, which the corporate mentioned signifies sufferers might proceed to lose extra weight with longer dosing.
Skye shares opened Monday at $1.81 every, down practically 62% from Friday’s closing value.
CB1 has each scientific and regulatory validation from Sanofi, which acquired European approval in 2006 for rimonabant, an oral small molecule inhibitor of the goal. Whereas focusing on CB1 within the gastrointestinal tract will help sufferers shed weight, this receptor can also be discovered within the central nervous system. Rimonabant hit these receptors within the mind, resulting in suicidal ideation in some sufferers. In 2008, Sanofi withdrew the drug from the market.
Skye designed nimacimab to be peripherally restricted, blocking CB1 within the gastrointestinal tract however avoiding the CNS. In an interview final 12 months, Chief Development Officer Tu Diep explained that as an antibody, nimacimab is too large to penetrate the blood-brain barrier — which ought to keep away from inflicting the complication dangers noticed with rimonabant. Within the Section 2a outcomes, Skye mentioned nimacimab alone and together with Wegovy confirmed a clear security profile. Not solely have been there no further gastrointestinal uncomfortable side effects, there have been additionally no neuropsychiatric antagonistic occasions reported.
Sufferers who accomplished the 26-week research have been eligible to enroll in a 26-week extension research. Enrollment is full and Skye expects knowledge will probably be accessible within the first quarter of subsequent 12 months. Extra detailed outcomes from the preliminary 26-week interval will probably be introduced subsequent month in the course of the ObesityWeek convention in Atlanta.
The 200 mg, once-weekly dose was based mostly on modeling from Section 1 testing suggesting important peripheral publicity of the drug however little to no publicity within the mind, Skye mentioned in an investor presentation. The corporate mentioned preclinical knowledge and modeling of the nimacimab’s pharmacokinetics (PK) — how the physique interacts with the drug all through its publicity within the physique — point out the drug’s potential at greater doses.
“With our preclinical knowledge, toxicology security margins, and PK modeling, we imagine we now have a path to help greater dosing, and we’re evaluating the subsequent stage of growth to optimize dosing in potential future scientific trials,” Chief Medical Officer Puneet Arora mentioned within the Skye announcement.
Skye is making an attempt to set itself aside in a small group of firms working to revive CB1 inhibition as a strategy to deal with weight problems. Novo Nordisk’s 2023 acquisition of Inversago Pharma introduced a lead program, now known as monlunabant, that’s an oral small molecule inhibitor of CB1. Whereas this drug has mid-stage knowledge displaying statistically important weight reduction, results showed neuropsychiatric effects. Corbus Prescription drugs’ CRB-913 can also be a peripherally restricted oral small molecule inhibitor of CB-1; the corporate expects to start a Section 1b dose-ranging research within the fourth quarter of this 12 months.
Skye mentioned within the investor presentation it can concentrate on a mix technique with Wegovy whereas persevering with to judge greater doses of nimacimab as a monotherapy. The corporate can even assess nimacimab’s potential as a upkeep remedy for sufferers who’ve achieved goal weight reduction with a GLP-1 weight reduction drug. Within the scientific trial outcomes up to now, nimacimab didn’t improve the frequency or severity of gastrointestinal uncomfortable side effects which are a standard cause cited for discontinuing remedy. That might give the Skye drug a security and tolerability benefit over power use of GLP-1 medication.
For Skye to proceed with greater dosing of nimacimab as a monotherapy, William Blair analyst Andy Hsieh mentioned it’s crucial to scale back the affected person dosing burden, which is at the moment two injections, 100 mg per syringe. Hsieh is extra intrigued by the Skye drug’s potential use together with Wegovy. The outcomes present that the 2 medication collectively led to a 13% placebo-adjusted weight reduction, which was throughout the double-digit vary that Skye had set and confirmed separation from remedy with Wegovy alone, he mentioned in a be aware despatched to traders.
“We’re upset by the scientific setback of nimacimab,” Hsieh wrote. “Nevertheless, we’re hopeful that with greater doses (equivalent to 600 mg or 1,000 mg per week), nimacimab might present extra substantial monotherapy exercise and intensify its capacity to be mixed with Wegovy.”
Photograph: Peter Dazeley, Getty Photos
