Roche makes obesity play with $2.7bn deal to buy Carmot

Roche has agreed a deal to acquire US biotech Carmot Therapeutics that, if consummated, will thrust it into the increasingly competitive market for incretin-based therapies for diabetes and obesity.

The Swiss pharma group has agreed to pay $2.7 billion upfront in cash when the deal closes, with shareholders in the US company also in line for up to $400 million if the drug programmes covered by the agreement meet various milestones.

Carmot’s pipeline includes three clinical-stage programmes, headed by CT-388, a dual GLP-1/GIP agonist – in the same class as Eli Lilly’s tirzepatide-based Mounjaro and Zepbound products for type 2 diabetes and obesity, respectively.

Roche said CR-388 is ready to start phase 2 testing and will be developed for the treatment of obesity in people with and without type 2 diabetes. Like Zepbound and Novo Nordisk’s rival obesity therapy Wegovy (semaglutide), a GLP-1 agonist, the experimental drug can be administered as a once-weekly subcutaneous injection.

Carmot’s other candidates include CT-868, a dual GLP-1/GIP agonist already in phase 2 testing as a once-daily injection to treat type 1 diabetes patients with obesity or who are overweight, and CT-996, a once-daily oral, small molecule GLP-1 receptor agonist currently in phase 1 and intended as an obesity therapy.

The move is an interesting one for Roche, which does not have a strong history in the diabetes and metabolic disorders category, and is another indicator of the massive potential seen for this new generation of incretin-modulating obesity therapies.

Analysts at JP Morgan recently doubled their predictions for the class to $71 billion within the next 10 years, with Novo Nordisk and Lilly sharing the bulk of the market. Both companies are struggling to meet massive demand for their obesity therapies.

Roche clearly has aspirations to grab its own share of that fast-growing market, tapping into what JP Morgan says is a shift in treatment strategy for cardiovascular and metabolic diseases that focuses on a weight-centric approach.

Its pipeline does include a small number of cardiovascular candidates, such as zilebesiran for high blood pressure, and the company said that, if the deal goes through, it will also have exclusive access to Carmot’s Chemotype Evolution discovery platform in metabolism that will bolster its R&D in cardiovascular and metabolic diseases.

The pharma group said that Carmot’s lead asset CT-388, in particular, “suggests a best-in-class potential to achieve and maintain weight loss with differentiated efficacy.”

A presentation of phase 1 data with the drug at the ObesityWeek congress in October showed statistically significant weight loss after four weeks of treatment, averaging at around 8% over the dose range, which was accompanied by a decrease in waist and hip circumference and improvements in oral glucose tolerance testing (OGTT), which is an indicator of pre-diabetes.

Roche said it also has plans to combine the drugs with some of its pipeline candidates, including drugs aimed at preserving muscle mass. Its pipeline includes anti-myostatin drugs headed by GYM329, an antibody designed to target skeletal muscles and increase their size and growth.

“Obesity is a heterogeneous disease, which contributes to many other diseases that together comprise a significant health burden worldwide,” said Roche’s chief executive, Thomas Schinecker.

“By combining Carmot’s portfolio with programmes in our pharmaceuticals pipeline and our diagnostics expertise and portfolio of products across cardiovascular and metabolic diseases, we are aiming to improve the standard of care and positively impact patients’ lives,” he added.