Eli Lilly licenses early-stage non-opioid pain drug from Belgian biotech Confo

Eli Lilly has licensed a Phase I non-opioid pain candidate from Confo Therapeutics, adding to the handful of pain drugs the pharma company is trying to develop.

Lilly will pay Confo $40 million upfront for the drug, with another potential $590 million in downstream milestones and royalties. Confo has an option to co-invest in the drug after proof-of-concept for additional royalties.

The first drug, dubbed CFTX-1554, is an angiotensin II type 2 receptor inhibitor for neuropathic pain. It goes after the same target as a pain drug Novartis dropped in 2020. Novartis had acquired its candidate, EMA401, when it bought Australian biotech Spinifex for $200 million upfront in 2015. While it was in Phase II studies, Novartis stopped its trials after new preclinical toxicity data emerged, according to a federal clinical trials database.

Lilly can also pick up a second Confo drug, an antibody for the same target, and if it does, it would add an additional $590 million in milestones to the deal.

CFTX-1554 is currently in healthy volunteer studies. CEO Cedric Ververken said they’ve finished enrolling that study, but data would likely come later in the year.

Lilly adds a fourth clinical pain candidate to its pipeline through the deal. Lilly is one of the few Big Pharma companies left trying to develop non-opioid pain drugs after the field has seen failures in trial after trial. AstraZeneca and Bayer are also working on potential pain drugs.

Perhaps more notable is Vertex, which is developing a non-opioid pain drug VX-548 that’s currently in late-stage trials for acute pain. According to a federal clinical trials database, those trials are set to complete by March 2024. The results of those trials could be the basis for a potential FDA approval.

Vertex is also studying the same candidate in a mid-stage trial for neuropathic pain.

Cedric Ververken

For Confo, the $40 million upfront payment will be invested into its pipeline and keep it running for a few years, Ververken said. Confo’s platform does high throughput screens not of small molecules, but of fragments, to develop drugs for G-protein-coupled receptors. Ververken equated it to Tetris.

“In a [high throughput screening] campaign, you have to test really big Tetris blocks and you have to be lucky to find one that fits the pocket of interest,” he said. “In our case, we use fragments, which are the squares, the building blocks of the Tetris block, so it’s much easier for us to find something that fits in the pocket of interest.”

That gives them a smaller compound to start with, which they then design the rest of the drug around.

Confo didn’t initially plan on developing a pain drug, according to Ververken. “It was more or less serendipity,” he said. They had been studying a number of options, including angiotensin II receptor agonists for fibrosis and inflammatory disease. But they also developed some antagonists for the target, which led to the basis of CFTX-1554.

Moving forward, Confo plans to nominate new candidates for development this year, though Ververken was vague on what indications and how many it was planning. Confo’s website lists the next programs in its pipeline as “rare disease 1” and “rare disease 2.”

“I think what I can say is that the diseases that we’re targeting in these programs are diseases where it is, let’s say, quite cost- and time-efficient to get a program to clinical proof-of-concept,” he said.

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