Novartis has made a strategic move to strengthen its cardiovascular portfolio by announcing the acquisition of Anthos Therapeutics for $925 million upfront, with potential additional payments of up to $2.15 billion tied to regulatory and commercial milestones. The deal, expected to close in the first half of 2025, marks a full circle moment for abelacimab, a novel blood-thinning compound originally discovered by Novartis.
Strategic Acquisition Brings Promise of Safer Anticoagulation
The acquisition centers around abelacimab, a Factor XI inhibitor that represents a new class of anticoagulants designed to address the limitations of current blood thinners. Unlike widely used medications such as Xarelto and Eliquis, which carry significant bleeding risks, abelacimab's mechanism of action potentially offers a better safety profile while maintaining effective anticoagulation.
"We are proud that this medicine originated at Novartis and have been impressed with the Anthos Therapeutics team's expertise and dedication and with the great progress they have made on the program," said David Soergel, head of Novartis' cardiovascular, renal and metabolism development unit. "Now is the right time to bring abelacimab back into the Novartis CRM pipeline."
Development Journey and Clinical Progress
The drug's journey began in 2019 when Novartis licensed it to Anthos Therapeutics, a startup launched with $250 million from Blackstone Life Sciences. Novartis maintained a minority stake in the company as Anthos advanced the compound through clinical development.
Recent clinical data has shown promising results. In November 2023, Anthos presented findings from a large Phase 2 trial demonstrating abelacimab's superior safety profile compared to Xarelto. Currently, three Phase 3 studies are underway, focusing on high-risk populations including patients with atrial fibrillation and those with cancer-associated blood clotting. Results from these pivotal trials are expected next year.
Market Context and Competitive Landscape
The anticoagulant market presents both opportunities and challenges. While current market leaders Xarelto and Eliquis generate billions in annual sales, the approaching patent expiration of Eliquis in 2026 and the potential entry of generic alternatives will reshape the competitive landscape.
The Factor XI inhibitor class has faced mixed results in development. Bayer recently scaled back development of their Factor XI candidate following a failed Phase 3 trial in 2023, while Bristol Myers Squibb has advanced their compound to late-stage trials despite mixed early results.
Clinical Impact and Future Potential
The development of safer anticoagulants represents a significant unmet medical need. Current blood thinners, while effective, require careful management due to bleeding risks, which can complicate treatment regimens and impact patient outcomes. Abelacimab's potential to maintain anticoagulation efficacy while reducing bleeding risks could represent a meaningful advance in patient care.
The acquisition has been viewed positively by market analysts, with RBC Capital Markets noting that the deal "offers another validation for the Factor XI mechanism and its large market potential in the anticoagulant space."
