Eli Lilly said it has acquired exclusive worldwide rights to the non-opioid pain candidate CNTX-0290 from Centrexion Therapeutics, in a deal that could generate up to about $1 billion, plus royalties, for Centrexion.

CNTX-0290 is a non-addictive novel, small molecule somatostatin receptor type 4 (SSTR4) agonist now under study in a Phase I trial as a potential non-opioid treatment for chronic pain conditions. Centrexion has said CNTX-0290 is in development for chronic pain associated with inflammatory, neuropathic, and mixed pain conditions.

CNTX-0290 is Centrexion’s next-advanced candidate behind lead candidate CNTX-4975, a Trans-capsaicin injection now in Phase III development. According to Centrexion, CNTX-4975 has been shown in clinical studies to provide significant and durable relief from localized moderate to severe knee OA pain by the second day

“Lilly’s robust pain management portfolio and successful track record developing and commercializing novel therapies make them an ideal company to advance CNTX-0290,” Centrexion CEO Jeffrey B. Kindler said in a statement. Kindler is a former chairman and CEO of Pfizer. “Importantly, this agreement aims to efficiently deliver an innovative new treatment to patients that can address the significant unmet medical need of chronic pain.”

Centrexion acquired CNTX-02902 and two other pain candidates from Boehringer Ingelheim in March 2016 for an undisclosed price. At the time, Centrexion said that CNTX-0290 showed “very broad efficacy” in multiple animal models of chronic pain, adding that the candidate “has the potential to treat inflammatory, nociceptive, neuropathic, and mixed chronic pain states.”

Lilly agreed to pay Centrexion $47.5 million upfront, and up to $575 million in payments tied to achieving potential development and regulatory milestones. If CNTX-0290 is successfully commercialized, Centrexion would be eligible for up to $375 million in additional potential sales milestones, as well as tiered royalties ranging from the high-single to low-double digits.

Lilly also said it and Centrexion may also elect to co-promote CNTX-0290 in the U.S. at a later date.

“Lilly is committed to developing new medicines for people struggling with chronic pain,” Mark Mintun, MD, vice president of pain and neurodegeneration research at Lilly, said in a statement. “We are pleased to license this early-phase molecule from Centrexion, and look forward to developing it further as a potential non-opioid treatment option for multiple pain conditions.”

Lilly’s announcement of the licensing deal with Centrexion for CNTX-290 follows a series of setbacks that have included most recently the planned withdrawal from the market of the marketed advanced soft tissue sarcoma treatment Lartruvo® (olaratumab), and a halt to development of two Phase II cancer candidates, the cell cycle checkpoint kinase 1 and 2 inhibitor drug prexasertib (LY2606368) and the PI3k/mTOR inhibitor LY3023414.

In reporting first-quarter results for 2019 on April 30, Lilly cut its 2019 revenue forecast by $3 billion and now anticipates 2019 revenue between $22.0 billion and $22.5 billion. The pharma giant cited the planned Lartruvo withdrawal as well as lower revenue for Cialis and other products that have lost patent exclusivity; negative impact from foreign exchange rates; continued low- to mid-single digit price declines in the U.S. due mainly to patient affordability programs, rebates, and legislated increases to Medicare Part D cost sharing; and price declines in some international markets.

However, Lilly still saw year-over-year revenue growth during Q1 of 3%, for a total of $5.092 billion in revenue, driven by 7% growth in volume. And during the first quarter, Lilly signaled its intent to catch up in cancer drug development by completing its $8 billion acquisition of Loxo Oncology, announced during the JP Morgan 37th Healthcare Conference.

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