AstraZeneca announced the successful completion of its acquisition of CinCor Pharma, Inc., a US-based clinical-stage biopharmaceutical company focused on developing novel treatments for resistant and uncontrolled hypertension and chronic kidney disease. The acquisition was completed through a tender offer for approximately $1.3 billion upfront, with 86.3% of CinCor's outstanding shares tendered.
The deal centers on baxdrostat (CIN-107), a highly selective aldosterone synthase inhibitor that represents a potentially leading next-generation treatment for blood pressure lowering in treatment-resistant hypertension. The drug selectively targets aldosterone synthase while sparing the cortisol pathway in humans, addressing a critical mechanism in cardiovascular and renal diseases.
Clinical Development Progress
Baxdrostat has shown promising results in clinical trials for treatment-resistant hypertension. In the BrigHTN Phase II trial, the drug met its primary endpoint, demonstrating a statistically significant reduction in systolic blood pressure after a 12-week treatment period. However, baxdrostat did not meet the primary endpoint in the HALO Phase II trial, which evaluated systolic blood pressure reduction at eight weeks in patients with uncontrolled hypertension. The drug was well tolerated in both trials.
Two additional Phase II trials are currently ongoing: one in hypertensive patients with primary aldosteronism (Spark-PA) and another in chronic kidney disease. A Phase III trial for treatment-resistant hypertension is planned to begin during the first half of 2023.
Strategic Rationale
The acquisition bolsters AstraZeneca's cardiorenal pipeline and complements the company's strategy to provide added benefit across cardiorenal diseases, where there is high unmet medical need. The opportunity brings potential for combination with Farxiga (dapagliflozin), AstraZeneca's SGLT2 inhibitor that has shown efficacy in preventing and delaying cardiorenal disease.
"Acquiring CinCor supports our commitment to cardiorenal disease and further strengthens our pipeline with baxdrostat," said Mene Pangalos, Executive Vice President BioPharmaceuticals R&D at AstraZeneca. "Excess levels of aldosterone are associated with hypertension and several cardiorenal diseases, including chronic kidney disease and coronary artery disease and being able to effectively reduce this would offer a much-needed treatment option for these patients."
Financial Terms and Structure
Under the transaction terms, AstraZeneca acquired CinCor's outstanding shares for $26 per share in cash, representing a 121% premium over CinCor's closing market price on January 6, 2023. CinCor shareholders also received a non-tradable contingent value right of $10 per share, payable upon a specified regulatory submission of a baxdrostat product.
As part of the transaction, AstraZeneca acquired approximately $500 million in cash and marketable securities from CinCor's balance sheet as of closing. Combined, the upfront and contingent value payments represent a potential transaction value of approximately $1.8 billion if the regulatory milestone is achieved.
Mechanism of Action
Baxdrostat is an oral small molecule inhibitor of aldosterone synthase, the enzyme responsible for aldosterone synthesis in the adrenal gland. The drug selectively targets aldosterone synthase, encoded by the CYP11B2 gene, while having much lower affinity for 11β-hydroxylase, the enzyme responsible for cortisol synthesis encoded by the CYP11B1 gene.
In clinical trials, baxdrostat significantly lowered aldosterone levels without affecting cortisol levels across a wide range of doses. This selectivity profile represents a potential advantage over previous aldosterone synthase inhibitors that affected cortisol production.
Market Impact
Following completion of the acquisition, CinCor's shares will be delisted from the Nasdaq Stock Market, and the company will terminate its registration under the U.S. Securities Exchange Act. CinCor holds the exclusive, worldwide license to baxdrostat, which will remain in place following the transaction.
The acquisition aligns with AstraZeneca's broader cardiovascular, renal and metabolism strategy, which focuses on understanding the underlying links between the heart, kidneys and pancreas to develop medicines for organ protection and improved outcomes by slowing disease progression and reducing risks.
