Lilly cuts $1bn deal for Centrexion’s non-opioid painkiller

Eli Lilly has signed another bolt-on deal to bulk up its pipeline, this time paying $47.5 million upfront for rights to a non-opioid analgesic drug developed by US biotech Centrexion Therapeutics.

Add in $575 million in development and regulatory milestones, plus another $375 million for meeting sales targets, and the total value of the deal creeps over the $1 billion mark.

It also adds another opioid to Lilly’s stable just as the prospects for its late-stage nerve growth factor (NGF) inhibitor tanezumab have come under scrutiny thanks to a stubborn safety concern that just can’t seem to be banished.

Centrexion’s small-molecule drug CNTX-0290 has a different mechanism to tanezumab, acting as a somatostatin receptor type 4 (SSTR4) agonist. SSTR4 is found on neurons and is thought to act as a ‘master control’ that can dial down the activity of several other pain receptors.

While in the early stages of development, CNTX-0290 gives Lilly a backup in the non-opioid painkiller game should Pfizer-partnered tanezumab fail to be approved for marketing.

The NGF inhibitor has posted encouraging efficacy data in osteoarthritis and chronic lower back pain, but persistent cases of rapidly progressing joint destruction in some patients have a number of analysts questioning whether it will be approved, or indeed will see much use if it does get the green light.

The NGF inhibitor class has a lengthy list of failed programmes, with candidates from Johnson & Johnson/Amgen, AstraZeneca/Medimmune and AbbVie all abandoned after failing to balance efficacy with safety in clinical trials.

Tanezumab and Regeneron/Sanofi’s fasinumab are now the last survivors of a category that at one time were predicted as multibillion dollar blockbusters, sidestepping the addiction problems associated with opioids that are driving an epidemic of abuse and overdose-related fatalities in the US and other countries.

“Lilly is committed to developing new medicines for people struggling with chronic pain,” said the company’s head of pain and neurodegeneration research Mark Mintun.

“We are pleased to license this early-phase molecule from Centrexion, and look forward to developing it further as a potential non-opioid treatment option for multiple pain conditions.”

The licensing deal comes a few months after Lilly paid $8 billion to acquire Loxo Oncology and its Vitrakvi (larotrectinib), which became the first TRK inhibitor to be approved by the FDA last year, and also follows the acquisition of immuno-oncology candidate pegilodecakin from ARMO BioSciences in a $1.6 billion deal.

Lilly has had a run of poor news in the wake of the Loxo deal however, with a clutch of mid-stage pipeline failures – including a BTK inhibitor for arthritis, DACRA KBP-042 for diabetes and Chk-1 and PI3K/Mtor kinase inhibitors for cancer. It also had a setback for Lartruvo (olaratumab) in a confirmatory trial that resulted in it being withdrawn from the market.