Special Report: Dimerix is developing a potential treatment for constructive obstructive pulmonary disease (COPD), the fourth-leading cause of death worldwide.

Dimerix (ASX:DXB)’s drug candidate DMX-700 is less further developed than its pipeline companion DMX-200 for kidney diseases – but it has vast potential.

While still in pre-clinical development, DMX-700 is being investigated as a treatment for chronic obstructive pulmonary disease (COPD), which kills an estimated three million people worldwide each year – about five per cent of all deaths globally.

The progressive lung disease can be caused by tobacco smoke, asthma, air pollutants at home or the workplace and genetics. However, unlike most deadly diseases, mortality rates from COPD are actually increasing rather than falling.

In Australia COPD was the fifth-leading cause of death in 2018, killing 7,113 people and being associated with another 11,385 deaths, according to the Australian Institute of Health and Welfare. About 1 in 20 Australians aged 45 and over had it in 2017-18, according to survey data.


‘A huge unmet need’

Most drugs used to treat COPD patients only address the disease’s symptom, rather than its cause.

“There’s no way to slow it down, and there’s no way at all to cure it,” says Dimerix chief executive Dr Nina Webster.

“It is a huge unmet need, but there’s been no innovation at all in the space in 15 years.”

In 2018, the United States Food and Drug Administration changed its guidance to encourage the development of possible treatments by drugmakers. The agency said in evaluating drugs, clinical trials could use self-reported outcomes such as the St George’s Respiratory Questionnaire.

Still, Webster says there’s very little in development to treat the disease, with no late stage trials underway anywhere.


Lab tests show promise

At this point, Webster says she can’t disclose too many details of the DMX-700 candidate because the company is still taking steps to secure its intellectual property.

But earlier this month the company announced that in vitro (laboratory) research, conducted on behalf of Dimerix by the University of Western Australia and Excellerate Bioscience in the UK, which shows the drug candidate blocks the cell receptor pair implicated in the pathophysiology of COPD.

Clinical development by other companies had previously focused on blocking just one receptor, with disappointing results. But as previously reported, Dimerix has a platform called Receptor-HIT (heteromer investigation technology) that allows identification of different pairs of receptors that work together when ligands and small molecule drugs bind to them.

Dimerix is hopeful that by simultaneously blocking both receptors – which play a role in creating a type of white blood cell that causes damage to the lung tissue – DMX-700 could reduce the mucus production and inflammatory response seen in COPD.

“If this does hold down the inflammatory process, it can reduce the fibrosis or scarring and the fluid into the lungs, and you’re going to have a better outcome in patients,” Webster says. “Not just in mortality rates, but also in the quality of life for those patients.”

While there’s a lot of work to be done before this treatment could progress to a large-scale study – let alone commercialisation – and clinical trials are not always successful, it’s worth considering the potential impact of a successful treatment, given that there were estimated 251 million cases of COPD globally in 2016.

“It’s a big one,” Webster says. “Definitely not an orphan indication. We are excited by the data so far and we look forward to reporting on the development progress in due course.”


DMX-200 is further along

As previously reported, Dimerix has another drug candidate that’s closer to potential commercialisation.

The company has recently completed a phase 2 trial of its DMX-200 drug candidate to treat diabetic kidney disease, with positive outcomes reported. Also, in July, a positive phase 2a trial of DMX-200 to treat focal segmental glomerulosclerosis (FSGS) met all clinical endpoints, with 86 per cent of patients showing a response to the drug DMX-200 versus placebo.

FSGS is a rare kidney disorder for which there is no approved treatment and often leads to end-stage kidney failure. Dimerix has received Orphan Drug Designation for DMX-200 in both the US and Europe for the treatment of FSGS, and is currently planning for the proposed global Phase 3 pivotal program in FSGS, as well as for the COVID-19 study in ARDS.

This article was developed in collaboration with Dimerix, a Stockhead advertiser at the time of publishing.

This article does not constitute financial product advice. You should consider obtaining independent advice before making any financial decisions.