Roivant CEO: Yes, we failed in Alzheimer’s, but we’re not giving up

Bucking a growing and depressing trend in biotech, Roivant’s Vivek Ramaswamy is not spinning the failure of his company’s Alzheimer’s disease (AD) therapy in September.

Ramaswamy, just 32 but running Roivant and its ever-growing family of biotechs, said at the Financial Times Biotech and Pharma event in London yesterday that the failure of his 5HT6 receptor antagonist intepirdine in a phase 3 test was a result of taking a risk, and that he would not be backing away from the fight to find a treatment that works as so many others have done in the face of failure.

For sure, he talked up its chances, hoping it would buck the 15-year negative trend in biopharma AD research, but with a sense of statistical inevitability, it flopped six weeks ago in almost every outcome.

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Usually, this would lead to a biotech’s leader trying to dig into the data, find a tiny subpopulation where there was a glimmer of clinical relevancy and then hustle to the FDA in an attempt to save face, share price and the company's future. Or, simply cut loose and run from AD, like a number of his peers have done.

Ramaswamy didn’t do either. He admitted the failure upfront and told the U.K. audience yesterday: “I think failure is an option to learn; we should be open about it, learn from it, but communicate honestly what has happened while not at the same time overreacting to it.”

The drug was developed originally by GlaxoSmithKline but licensed to Axovant, a Roivant company now headed by former Medivation CEO David Hung.

It had always been considered a high-risk project after similar drugs developed by Pfizer and Lundbeck failed late-stage trials. But Ramaswamy defended the decision to try again with the med.

“I think companies such as Axovant have an obligation to step into areas that Big Pharma may be unwilling to continue in, such as Alzheimer’s, where research isn’t easy and you need a smaller, more focused approach. And we’re here to give these assets the light of day and give them the opportunity to realize the potential they may not have got under a bigger company.”

He also argued for the federalist-like structure of the Roivant companies, where he is the young millennial in charge of people much more experienced than him (such as former Celgene exec Jackie Fouse, who now runs its skin disease biotech Dermavant, or Hung), as he believes he can learn from them and they in turn can make a real impact, with equity stakes, in these smaller companies than they could being at the top of much bigger corporations.

“Productivity runs down in bigger companies,” he said. “When you’re running something more focused, you can give complete attention to the science at hand; that’s why I have this structure.”

Axovant is still working on a phase 2b study of intepirdine, as well as ex-Arena med nelotanserin, the highly selective inverse agonist of the 5-HT2A receptor also in phase 2, both of which are being evaluated in patients with dementia with Lewy bodies.