Novartis & Pfizer collaborate to advance NASH treatment

Oxford Drug Design wins UK-China antimicrobial resistance grant

Novartis and Pfizer enter a clinical development agreement which includes a study combining tropifexor and one or more Pfizer compounds as a NASH treatment. 

Novartis has entered into a clinical development agreement with Pfizer which will include a study combining tropifexor and one or more Pfizer compounds for the treatment of NASH, including an Acetyl CoA-Carboxylase (ACC) Inhibitor (PF-05221304, a Diacylglycerol O-Acyltransferase 2 (DGAT2) Inhibitor (PF-06865571, and a Ketohexokinase (KHK) Inhibitor (PF-06835919).

NASH (Nonalcoholic steatohepatitis) is a complex condition with no currently available treatment options. NASH is a form of NAFLD in which the patient has hepatitis -inflammation of the liver – and liver cell damage, in addition to fat in the liver. This liver cell damage and inflammation can cause fibrosis of the liver. NASH may lead to cirrhosis or liver cancer.

NASH presents a high unmet patient need, as it affects up to 6.5% of the population worldwide, and is largely asymptomatic. As fat builds up in the liver, it can trigger a vicious cycle of chronic inflammation and liver scarring called fibrosis. Over time, liver inflammation and fibrosis may progress to cirrhosis, which can lead to liver failure and death.

Novartis is developing a Farnesoid X receptor (FXR) agonist as a NASH treatment. The non-bile acid FXR agonist, tropifexor, is an oral treatment designed to address several features of NASH including; the buildup of fat in the liver, inflammation and fibrosis. Early studies with tropifexor in animal models have shown reduction in fat accumulation in the liver (steatosis), inflammation, and scarring, alongside a favorable safety profile. In Oct 2016, tropifexor was granted Fast Track designation by the US FDA for NASH with liver fibrosis.

In May 2017, Novartis announced it would exercise an exclusive option for a collaboration and license agreement with Conatus Pharmaceuticals Inc. to develop emricasan (VAY785), an investigational, first-in-class, pan-caspase inhibitor which works by inhibiting pathways that result in cell death (apoptosis) and inflammation.

In March 2017, Novartis announced a Phase IIb clinical trial collaboration with Allergan plc for the treatment of NASH fibrosis combining tropifexor and cenicriviroc (CVC), a once-daily, oral immunomodulator that blocks two chemokine receptors involved in inflammatory and fibrogenic pathways. Both collaborations with Conatus and Allergan have the potential to expand NASH treatment options for people in various stages of NASH, including those with the advanced form of the disease, NASH cirrhosis.

Eric Hughes, Global Development Unit Head, Immunology, Hepatology and Dermatology said, “Novartis has a leading development portfolio in non-viral liver diseases and I believe especially in our combination therapies. Liver diseases, including NASH, are multifaceted with various factors that contribute to the progression of the disease. This makes them difficult to treat with a single compound. We want to collaborate with multiple partners to drive the science and understanding of how to treat non-viral liver diseases. Targeting different pathways in NASH with a broad array of therapies is an essential strategy to bring the best treatments to patients.”