Boehringer targets NASH/MASH with $2bn Ribo alliance

Boehringer Ingelheim has signed a multi-target collaboration with China’s Suzhou Ribo Life Science and its Swedish unit Ribocure to develop treatments for non-alcoholic or metabolic dysfunction-associated steatohepatitis (NASH/MASH) using RNA drugs.

The specifics of the deal have not been revealed, but it could be worth up to $2 billion, including upfront and milestone payments, according to the privately-held German pharma group.

Ribo is working on small, interfering RNA (siRNA) candidates generated by its RIBO-GalSTAR platform that can be used to switch off messenger RNA (mRNA) and protein production in the body. The targets involved have not been revealed, but include some that were “previously inaccessible”, said Boehringer.

It is the latest in a string of alliances announced by Boehringer in the NASH area in recent years, coming after earlier deals with Dicerna and MiNA Therapeutics – which both involved RNA-based drugs – as well as others, including an IL-11 programme from Enleofen and an SSAO/VAP-1-targeting drug from Pharmaxis.

Its in-house pipeline in NASH is led by survodutide (BI 456906), a glucagon/GLP-1 receptor dual agonist partnered with Zealand Pharma that is also being developed as an obesity therapy and is heading for phase 3 testing.

Last year, Boehringer started clinical testing of the Enleofen drug, an antibody now known as BI 765423, although the Pharmaxis candidate was discontinued in 2020 because of off-target effects that could lead to side effects.

So far, there has been little news on the Dicerna and MiNA alliances, both signed in 2017 and valued at around $200 million and $330 million, respectively.

Neither has generated a clinical-stage candidate yet, but in 2021 Boehringer selected a lead RNAi compound from Dicerna called DCR-LIV2 to take forwards in development, shortly before the company was acquired by Novo Nordisk for $3.3 billion. There is no mention of the Boehringer alliance on MiNA’s pipeline listing.

“Our goal is to develop the next wave of innovative medicines that will lead to a holistic health gain for patients,” said Søren Tullin, global head of cardiometabolic diseases research at Boehringer.

“This new partnership is part of our commitment to collaborate with peers worldwide to address the interconnected nature of [cardio-renal-metabolic] diseases.”

More than 440 million people worldwide are estimated to live with NASH, an inflammatory liver disease that is caused by the accumulation of fat in the liver and has no approved therapies. Over time, NASH causes scar tissue formation, which in many cases leads to liver cirrhosis and related serious complications, including liver failure or liver cancer.