Bain goes big again, leading $350M round to fund oral challenger to blockbuster asthma biologics

Bain Capital Life Sciences is at it again. Biotech’s go-to source for big-ticket financing rounds has stepped up to lead a $350 million series A round in Areteia Therapeutics, positioning the newly created startup to run phase 3 trials of an asthma candidate designed to have biologiclike efficacy in an oral dosage form.

Knopp Biosciences created Areteia with private equity firm Population Health Partners to take its oral small molecule dexpramipexole into late-phase clinical trials. The molecule caught the eye of the asthma community early last year when Knopp linked it to significant reductions in blood eosinophils in a phase 2 clinical trial. Jorge Bartolome, then the president of Canada for Johnson & Johnson’s Janssen unit, was among the people who sat up and took notice when the data became public.  

“We were able to see an 80% reduction in eosinophilia. That's similar to what you saw with biologic therapy,” said Bartolome, who has been appointed CEO of Areteia. “It was dose dependent, and we saw a 250-mL improvement in lung function. Obviously, that created significant excitement, both at Knopp as well as in the investor community. And so we decided to launch an organization that is fully dedicated to asthma and improving the lives of asthmatic patients.”

Areteia starts life with rights to dexpramipexole and the means to take it through three phase 3 clinical trials, the first of which is set to start by the end of the third quarter. Access Biotechnology, GV, Arch Venture Partners, Saturn Partners, Sanofi and Maverick Capital round out the investor syndicate.

With deep-pocketed investors in its corner, Areteia has the means to enroll 3,000 patients across the three clinical trials. Two of the studies will assess the ability of dexpramipexole to reduce exacerbations. The third trial will look at the effect of the molecule on lung function and on eosinophils. 

“It'll be the first oral medication to be able to target eosinophilic asthma. Dexpramipexole inhibits the maturation and release of eosinophils, similar to what IL-5 biologics do,” Bartolome said. “By lowering eosinophils, it improves lung function and has the potential to reduce exacerbations. It can step before biologics and expand the population of patients that are getting the benefit of targeted therapy to lower eosinophilic production, and therefore significantly reduce exacerbations and improve lung function.”

If Bartolome, an executive well versed in respiratory diseases from his time at GSK, is right, the asset is a threat to the $8 billion market for biologic asthma treatments. Patients end up on biologics such as the anti-IL-5 antibodies Cinqair, Fasenra and Nucala, sold respectively by Teva, AstraZeneca and GSK, after being failed by earlier lines of treatment. Bartolome sees dexpramipexole giving physicians an alternative to oral steroids, inhaled corticosteroids escalation and biologics when initial treatments fail.

The success of dexpramipexole in phase 3 would represent a dramatic turnaround for a drug candidate that looked to be heading to the scrapheap when it failed a phase 3 trial in amyotrophic lateral sclerosis. While the trial missed its primary endpoint, it generated evidence of an effect on eosinophils that Knopp investigated in subsequent studies, leading to the phase 2 readout that caught Bartolome’s eye.