Napodano: Expecting Steady News Flow From Zalicus

We are expecting Zalicus, Inc. (ZLCS) to offer-up a steady flow of news over the next several months, with the key event being the release of top-line data from the phase 2b SYNERGY trial expected in the third quarter 2012.
Top-Line Data From Phase 2b SYNERGY Expected Q3-2012
In June 2011, Zalicus announced it has initiated a phase 2b clinical trial evaluating Synavive for the treatment of rheumatoid arthritis (RA). The trial, SYNERGY (SYNavivE for Reducing signs and sYmptoms of rheumatoid arthritis trial), is a 12-week, 5-arm, double-blind, placebo-controlled study to evaluate the safety and efficacy of Synavive as a treatment for the signs and symptoms of rheumatoid arthritis (RA) in approximately 250 subjects with moderate to severe disease. The trial will be conducted in up to 50-60 centers throughout the U.S., Europe, and Latin America. We expect enrollment to be evenly split between the three regions. We estimate the program will take approximately 10 months to complete (looking for enrollment to complete in April 2012), thus we are expecting top-line data in the third quarter 2012 ( best guess is August 2012). Full data should be available later in 2012. If timelines hold, management should be able to sit down with the FDA for a post-phase 2 meeting early 2013.
The primary endpoint is efficacy measured by the Disease Activity Score in 28 Joints (DAS28). DAS28 is a common, patient specific, outcome tool used in therapeutic trials to assess disease improvement or response. Key secondary objectives include evaluating the efficacy of Synavive compared to its individual components (2.7mg of prednisolone and 360mg of dipyramidamole) as well as how Synavive performs in comparison to 5mg of prednisolone. We expect the typical patient will have moderate-to-severe RA, over the age of 60, currently on stable doses of methotrexate (MTX) but not yet progressed to biologics.
Subjects who complete the core SYNERGY trial (or at least 6 weeks on drug) will be eligible to participate in a one-year extension study designed to investigate the long-term safety and durability of response for Synavive. Key safety and tolerability issues will be weight gain and glucose levels, along with cataract formations or changes in visual acuity. Besides demonstrating efficacy on par with the 5mg prednisolone cohort, we believe it is paramount that Synavive demonstrate meaningful improvements in overall tolerability vs. 5mg prednisolone and 360mg dipyridamole (immediate release).
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Under the terms of the agreement, Zalicus will pay Hydra an upfront payment (undisclosed) and fund research and development activities at Hydra for a two-year period. Hydra will perform the preclinical development activities necessary and Zalicus will retain all intellectual property and commercial rights to its product candidates. In connection with the collaboration agreement, Zalicus also announced it will discontinue its Vancouver, British Columbia-based ion channel discovery research operations, resulting in a workforce reduction of 16 employees (approximately 28% of the workforce).
We expect Zalicus to record a one-time restructuring charge of $1.1 million in the first quarter 2012. However, the costs savings from closing down Vancouver, the old Neuromed headquarters, should be in the area of $3 to $4 million for 2012 alone. The upfront payment to Hydra was undisclosed, but we are modeling the deal to be cash neutral in 2012. In 2013, Zalicus will continue to fund preclinical activities at Hydra, but the costs will be more variable as opposed to fixed costs associated with owning the Vancouver facility. We note that Zalicus has provided written notice of termination of the sublease agreement to the facility in Vancouver. Additionally, Dr. Christopher Gallen, Zalicus’ Executive Vice President, Research and Development, resigned effective March 1, 2012, as part of the announcement.
…Z160 Successfully Completes Phase 1…
On March 5, 2012, Zalicus announced it had successfully completed a phase 1 (n=16) pharmacokinetic and safety study with new formulations of Z160 (formerly NMED-160), a novel oral N-type calcium channel blocker. Management noted that Z160 has been reformulated to overcome bioavailability and food effect challenges from previous studies. One formulation demonstrated substantially improved bioavailability based on the PK/PD analysis.
Additional formulation studies continue, but we expect that Zalicus should be in position to commence a phase 2 trial in neuropathic pain during the second half of 2012. We remind investors that preclinical data suggests Z160 is effective across multiple models of inflammation and neuropathic pain. We believe the new formulations being developed by Zalicus may also improve patent protection. With position phase 2 data in neuropathic pain, we believe Z160 will be an attractive in-licensing candidate for a larger specialty pharmaceutical company. The profile of Z160 should provide for utility in patient suffering from chronic pain such as with PHN, DPN, or fibromyalgia.
…Z944 To Complete Phase 1 Soon…
In December 2011, Zalicus announced the initiation of a phase 1 clinical trial evaluating the pharmacokinetics and safety of Z944, a novel oral T-type calcium channel blocker with demonstrated preclinical potential for the treatment of acute and inflammatory pain in animal pain models. We are expecting results from the trial to be announced in the second quarter 2012. Keep in mind, this is a maximum tolerated dose (MTD) trial, so conceivably, the longer it runs the better. Based on what we have seen with previous phase 2a programs in pain / inflammation, this study can move rather quickly (at low cost), which would put Zalicus in position to seek out-licensing partners for Z944 in 2013.
…Out-Licensing To Come…
Between the above two candidates and the preclinical pipeline now being developed at Hydra, we believe Zalicus has the potential to sign ion channel development partnership in 2013 and 2014. We find it interesting that in January 2012, Roche announced a collaboration agreement with privately-held Xenon Pharmaceuticals to discover and develop compounds for the treatment of pain. Under terms of the agreement, Xenon could earn up to $646 million in research, development, and commercialization related milestones plus royalties from Roche. Xenon’s most advanced candidate, XEN402, is an oral Nav1.7 inhibitor currently in phase 2 clinical trials. This could provide a good valuation road-map for Zalicus in 2013 when it seeks to partner or out-licenses its phase 2 candidates.
Prednisporin Still Alive At Sanofi
Sanofi continues its formulation scale-up work on Prednisporin. We remind investors that Sanofi initiated a phase 2b clinical program testing Prednisporin in subjects with persistent allergic conjunctivitis in June 2010. This trial has completed in December 2010, but Sanofi has not shared the results. However, the fact that Sanofi has moved into scale-up for a commercial formulation is a clear sign that the data was positive. We are expecting Sanofi to conduct a bridging study with this new formulation later this year, and then move into a phase 3 program sometime during the second half of 2012.
Zalicus is eligible for $3 million milestone payment from Sanofi when the phase 3 trial initiates. If commercialized, Zalicus is eligible to receive milestone payments of up to approximately $65 million and tiered royalty payments of up to 12% on the development and commercialization of certain products generated from the Zalicus platform. The milestone $65 million schedule includes: $25 million in development and regulatory milestones, $25 million in sales-related milestones, and $15 million in additional indication approval milestones. We note prednisporin may have potential for the treatment of dry eyes as well.
32mg Exalgo Filing Soon
We have learned that Covidien plans to file for approval of a 32mg dose tablet with Exalgo during the first half of 2012. Exalgo has been tight-lipped on the status of the filing. It is possible that the application is currently under review. As noted in our previous reports, the 32mg dose of Exalgo will make the product more competitive with Endo’s Opana-ER. We note that gaining approval of a 32mg dose for Exalgo will also extend the intellectual property protection for Covidien, as Watson has not challenged the 32mg dose (as of yet).
In December 2011, Covidien announced it would spin-out its pharmaceutical division to shareholders. We think this is good news for Zalicus, as the new stand-alone pharmaceutical company will be seeking to expand its top-line and provide growth through new products. We think driving Exalgo growth with a 32mg tablet will be key to this goal for the new pharma division once independent.
Cash Position & New ATM & Recommendation
In December 2011, Zalicus borrowed $8.5 million under Term-C of its existing loan agreement with Oxford Finance Corporation. Cash on hand at the end of 2011 was just shy of $50 million.
On January 10, 2012, Zalicus entered into an equity distribution agreement with Wedbush Securities whereby Wedbush may make available up to $15 million in value of common stock. We have no update on the status of the At-The-Market (ATM) financing. However, we expect that management has been using the ATM over the next several weeks, and will continue to use it, to maintain a healthy cash position ahead of the phase 2b SYNERGY results and plan for the phase 2a programs on Z160 and Z944.
We are maintaining our Outperform rating, and $3 price target on shares of Zalicus. The biggest driver of the stock in 2012 will be the results of the SYNERGY trial in the third quarter 2012.
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