Mesoblast is preparing for a potential FDA approval of its lead product, Ryoncil (remestemcel-L), for the treatment of steroid-refractory acute graft versus host disease (SR-aGvHD) in children. The FDA decision is expected by January 7, 2025, marking a significant milestone for the company and potentially providing the first FDA-approved treatment specifically for children under 12 with this serious condition.
SR-aGvHD is a severe complication following stem cell or bone marrow transplantation, where donor immune cells attack the recipient's tissues. This immune response primarily affects organs such as the skin, liver, and digestive system, leading to symptoms like skin rashes, jaundice, and gastrointestinal distress. The condition poses a significant threat, especially in pediatric patients, where treatment options are limited.
Manufacturing and Distribution Readiness
According to CEO Silviu Itescu, Mesoblast has established robust manufacturing and distribution channels to ensure rapid deployment of Ryoncil upon approval. A Pre-License Inspection by the FDA in May found no significant regulatory issues, further solidifying the company's readiness. To support the commercial launch, Mesoblast has arranged a convertible note financing with its largest shareholder, providing access to US$50 million following FDA approval.
Progress in Other Programs
Mesoblast's pipeline extends beyond Ryoncil, with Revascor (rexlemestrocel-L) showing promise in treating paediatric congenital heart disease. Revascor has been granted Rare Pediatric Disease and Orphan-Drug Designation, potentially unlocking additional FDA incentives. Another Revascor variant is currently in Phase 3 trials for chronic low back pain, offering a potential solution for patients with degenerative disc disease and aiming to reduce opioid dependence.
Financial Strategy
Mesoblast has strategically managed its finances, reducing Q1 net operating cash outflows by 26% compared to the previous year, to US$10.5m. The company reported a cash balance of US$51.1m at the end of the quarter, supplemented by US$60m in available financing facilities contingent on Ryoncil's approval. Leadership has also deferred portions of their compensation in exchange for equity-based incentives, demonstrating a commitment to fiscal responsibility.
