Forbion and Sanofi drive $75M investment in COPD biotech Altesa

Dutch venture capital fund Forbion joined with other European investors to support the US-based Altesa. Sanofi participated in the round alongside investors including London-based Medicxi and Israeli VC fund Pitango. Medicxi and Pitango were early investors in Altesa, which disclosed $4 million in seed funding and plans to develop antiviral drugs against common respiratory viruses in 2022.

Altesa will use the $75 million (€64 million) series B financing to run a placebo-controlled phase IIb study in 900 people with COPD in the US and UK. The trial will track patients until they become infected with a rhinovirus, the most frequent cause of the common cold and respiratory exacerbations in COPD patients. Once a patient has an infection, Altesa will randomize them to receive vapendavir or placebo.

Vapendavir is an oral capsid inhibitor that is active against more than 97% of rhinovirus strains. Altesa tested the candidate in a phase IIa trial that infected 40 COPD patients with RV-A16, a rhinovirus used to study respiratory infections. After the onset of clinical illness, participants were randomized to receive vapendavir or placebo for seven days.

Altesa linked vapendavir to statistically significant improvements on measures of COPD exacerbations and upper respiratory symptoms. The median time to the resolution of infection also favored vapendavir.

The data led Altesa to commit to further development of a candidate it licensed from Vaxart in 2021 in a deal worth up to $130 million in milestones. Vaxart acquired vapendavir in 2018 as part of its merger with Aviragen Therapeutics, which reported the failure of the drug candidate to improve outcomes in moderate-to-severe asthmatics with rhinovirus infections in 2017.

Finding a niche

Altesa’s focus on treating rhinovirus infections positions the biotech to enter an unoccupied niche of the otherwise competitive COPD market. There are no directly targeted therapies for rhinovirus infections, leaving patients reliant on supportive care to manage viruses implicated in 45% of acute exacerbations of COPD. Exacerbations can hospitalize patients, drive declines in lung function and harm quality of life.

Patients have remained exposed to those risks as companies have brought COPD drugs to market. Sanofi won European Union approval for Dupixent as an add-on maintenance treatment for adults with COPD in 2024. The EU approved GSK’s Nucala in a similar patient population last month. London-based Verona filed for EU approval of Ohtuvayre, only to withdraw the submission after being acquired by Merck & Co.

Katharine Knobil, the former chief medical officer of GSK, is part of the team overseeing Altesa’s efforts to enter the COPD market. Knobil joined Altesa as chief medical officer last year. Altesa’s CEO, Brett Giroir, is the former acting commissioner of the US Food and Drug Administration.

Led by Giroir, Altesa has identified rhinovirus infections in COPD patients as vapendavir’s lead indication, but the drug candidate could be effective in additional indications. Rhinovirus infections are a threat to patients with multiple high-risk respiratory conditions, including asthma.