Lexicon/Sanofi's Zynquista outlook suffers from lack of direct comparison to SGLT2 inhibitors in type 2 diabetes; CKD results too short-term to determine Phase III outcomes

28 Aug 2019

Lexicon Pharmaceuticals (NASDAQ:LXRX) and Sanofi’s (EPA:SAN) Zynquista (sotagliflozin) has experts reserving judgement on the drug’s value without a direct comparison to SGLT2 inhibitors following topline data in type 2 diabetes (T2D) patients with chronic kidney disease (CKD).

Zynquista is a dual SGLT1/SGLT2 inhibitor. Experts said they are hesitant to consider the presumed added efficacy benefit of SGLT1 inhibition without a head-to-head comparison to existing drugs, which one of the experts said will be unlikely without Sanofi’s participation. Lexicon’s shares plummeted by 70% on 29 July after the company announced on 26 July after the market closed that Sanofi issued a partnership termination notice.

Sanofi said it was terminating the collaboration for Zynquista in ongoing type 1 diabetes (T1D) and T2D programs, but current studies will continue with no immediate changes. However, Lexicon contends this termination is invalid and states it is a breach of contract, and that even in case of a valid termination, Sanofi is obligated to fund ongoing trials for a specific period of time.

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