Praxis Precision Medicines, Inc. (NASDAQ: PRAX) has outlined its corporate strategy and key business priorities for 2025, emphasizing its focus on developing therapies for central nervous system (CNS) disorders. The company anticipates significant milestones in its clinical programs, with potential for four commercial assets by 2028.
Ulixacaltamide for Essential Tremor
Praxis is advancing ulixacaltamide, a selective small molecule inhibitor of T-type calcium channels, for the treatment of essential tremor (ET). The Essential3 program, comprising two Phase 3 registrational studies, is underway. Study 1, a parallel design, placebo-controlled study (N=400), is on track for a pre-planned interim analysis in the first quarter of 2025. According to Praxis, over 100,000 patients have shown interest in participating in the study since recruitment began in November 2023. The company anticipates filing an NDA for ulixacaltamide in 2025.
ET affects an estimated seven million people in the U.S. and is characterized by tremor activity correlated with abnormal neuronal burst firing in the Cerebello-Thalamo-Cortical (CTC) circuit. Following positive results from Essential3, Praxis plans to re-initiate a study of ulixacaltamide in Parkinson’s disease, addressing the unmet need for non-dopaminergic treatment options.
Vormatrigine for Common Epilepsies
Vormatrigine (PRAX-628) is being developed as a once-daily, oral treatment for focal onset seizures (FOS) and generalized epilepsy. An estimated 3.5 million people in the U.S. suffer from common epilepsies. Vormatrigine is designed to target the hyperexcitable state of sodium channels in adult common epilepsies.
Praxis is conducting the ENERGY program to advance vormatrigine through efficacy and registrational trials. The RADIANT Phase 2 study for FOS and generalized epilepsy is currently enrolling patients, with topline results expected in the first half of 2025. RADIANT is an open-label study recruiting up to 50 patients with FOS or generalized epilepsy, who will be treated with a 30 mg dose over an 8-week period to evaluate the impact of vormatrigine on seizure burden. Enrollment for the POWER1 Phase 2/3 registrational study in patients with treatment resistant FOS is progressing as planned, with topline results anticipated in the second half of 2025. POWER1 is assessing adjunctive treatment, allowing dosing of vormatrigine on top of 1 to 3 antiseizure medications (ASMs), and aims to enroll approximately 250 patients in a parallel-arm study, comparing a treatment arm of 20 mg for 6 weeks followed by 30 mg for 6 weeks versus a placebo arm for 12 weeks.
Relutrigine for Developmental and Epileptic Encephalopathies
Relutrigine (PRAX-562) is under evaluation for developmental and epileptic encephalopathies (DEEs). DEEs encompass a range of genetically and phenotypically defined epileptic conditions, often characterized by seizure onset at or shortly after birth, affecting approximately 200,000 patients in the U.S. Relutrigine is a sodium channel modulator with therapeutic potential across developmental epilepsies.
In cohort 1 of the EMBOLD study, relutrigine demonstrated a 46% placebo-adjusted reduction in monthly motor seizures from baseline over a 16-week period in SCN2A gain-of-function (GoF) and SCN8A patients. Patients continuing into the ongoing open-label extension (OLE) (n=13) saw a 77% reduction in motor seizures from baseline through nine months of treatment. Over 30% of patients (n=5) achieved seizure freedom status while on relutrigine. EMBOLD is currently enrolling 80 patients with SCN2A and SCN8A DEEs in registrational cohort 2, with topline results anticipated in the first half of 2026, to be followed by an NDA filing later in 2026. In December 2024, Praxis received Rare Pediatric Disease Designation (RPDD) for relutrigine for Dravet Syndrome, adding to previous RPDDs for SCN2A and SCN8A DEEs.
Elsunersen for Early-Seizure-Onset SCN2A-DEE
Elsunersen (PRAX-222) is an antisense oligonucleotide (ASO) designed to selectively decrease SCN2A gene expression in early-seizure-onset SCN2A-DEE. In a Part 1 analysis of the EMBRAVE study, four patients receiving elsunersen over a four-month period achieved a 43% reduction in seizure burden compared to baseline. Praxis has completed discussions with global regulatory agencies to harmonize a registrational study design for elsunersen and will share the trial design and expected timelines in the first quarter of 2025.
Financial Position
Praxis Precision Medicines reported approximately $470 million in cash and investments at the end of 2024, which is expected to support operations into 2028. UCB exercised its option to in-license global development and commercialization rights for a KCNT1 small molecule development candidate, triggering an option exercise fee and potential future milestone payments totaling up to $100 million, plus tiered royalties on net sales.
