Praxis Precision Medicines is making significant strides in its central nervous system (CNS) pipeline, highlighted by the advancement of ulixacaltamide, relutrigine, and vormatrigine (PRAX-628). The company's focus on genetically-informed therapies for CNS disorders is showing promise, with multiple clinical milestones anticipated in the near term.
Ulixacaltamide for Essential Tremor
The Phase 3 Essential3 program for ulixacaltamide in essential tremor (ET) is progressing, with an interim analysis of Study 1 expected in Q1 2025. Praxis anticipates submitting an NDA in 2025, pending positive outcomes. Recent surveys presented at the Movement Disorder Specialist Conference underscore the unmet need in ET, with neurologists reporting that 85% of patient visits are focused on finding effective treatment. A patient survey revealed that up to 80% adjust daily activities due to their condition.
Relutrigine for Developmental and Epileptic Encephalopathies (DEEs)
Relutrigine (PRAX-562) has shown promising results in the Phase 2 EMBOLD study for SCN2A and SCN8A developmental and epileptic encephalopathies (DEEs). Topline results from Cohort 1 demonstrated a 46% placebo-adjusted reduction in monthly motor seizures over 16 weeks. Furthermore, patients continuing onto the open-label extension (OLE) experienced a 75% reduction in motor seizures from baseline. Over 30% of patients achieved seizure freedom while on relutrigine, with improvements in alertness, communication, and seizure severity suggesting disease-modifying effects. Based on these positive results, Praxis has initiated a second cohort of the EMBOLD study, aiming to enroll 80 patients, with topline results expected in the first half of 2026. The company plans to initiate a registrational study (EMERALD) in all DEEs in the first half of 2025, pending regulatory alignment. Relutrigine has received Orphan Drug Designation (ODD) and Rare Pediatric Designation (RPD) from the FDA, and ODD from the European Medicines Agency (EMA) for the treatment of SCN2A-DEE and SCN8A-DEE.
Vormatrigine (PRAX-628) for Focal Onset Seizures and Generalized Epilepsy
The ENERGY program for vormatrigine (PRAX-628) in focal onset seizures (FOS) and generalized epilepsy is advancing, with the EMPOWER observational study already enrolling over 1,000 patients. Topline results from the RADIANT Phase 2 study are anticipated in the first half of 2025, while topline results from the POWER1 Phase 2/3 study are expected in the second half of 2025. Given vormatrigine's potency as a Nav 1.7 and 1.8 inhibitor, Praxis is evaluating its potential in pain indications.
Financial Update
As of September 30, 2024, Praxis had $411.2 million in cash, cash equivalents, and marketable securities, providing a runway into 2027. Research and development expenses were $41.9 million for the three months ended September 30, 2024, compared to $17.3 million for the same period in 2023. The company reported a net loss of $51.9 million for the three months ended September 30, 2024.
With a diversified portfolio and strong financial positioning, Praxis is poised to advance its clinical programs toward registrational readiness in 2025.
