Lexicon Pharma: Blockbuster Potential From A Diabetes Drug

NEW YORK (TheStreet) -- Two of my closest friends, including my college roommate, were diagnosed with diabetes recently. I was taken aback when they told me because both my friends are fit and not even close to being overweight. This got me thinking that diabetes is not just a problem for the obese but it's probably the largest health concern facing our country.

The grim statistics bear this out: At current growth rates, one out of every three adults in this country will have diabetes by the year 2050, according to the CDC.

Biotech investors who want to take advantage of this unfortunate demographic trend should take a look at Lexicon Pharmaceuticals (LXRX).

Lexicon's LX4211 is a once-daily pill belonging to a novel class of diabetes drugs known as sodium-dependent glucose transporter (SGLT) inhibitors that work by blocking the reabsorption of glucose into the bloodstream. Instead, patients on SGLT inhibitors excrete glucose in their urine.

LX4211 inhibits SGLT-1, which is the primary transporter of glucose from the gastrointestinal tract and SGLT-2, the mechanism by which glucose is transported from kidneys back into the bloodstream.

As a "dual" SGLT inhibitor, LX4211 stands apart from Bristol-Myers Squibb (BMY) and AstraZeneca's (AZN) dapaglifozin and Johnson & Johnson's (JNJ) canaglifozin, both of which inhibit SGLT-2 only. In January, FDA rejected dapaglifozin and asked for more clinical date to assuage concerns about higher rates of bladder and breast cancer reported in the treatment arms of phase III studies. J&J submitted canaglifozin to FDA in June.

By stopping glucose reabsorption in the gut, LX4211 could have more of a beneficial effect after a meal and may also help release beneficial peptides such as GLP-1 that help glucose secretion.

LX4211 also has the potential to be safer than the other drugs in the SGLT inhibitor class because blocking glucose reabsorption in the gut first followed by the kidneys may translate into less glucose secreted in urine. [Glucose-rich urine stored in a patients' bladder might be associated with the higher rates of bladder infections and bladder cancer seen with dapaglifozin.]

Lexicon's LX4211 phase IIb trial results have been outstanding. LX4211 at the highest 400 mg dose combined with metformin demonstrated a reduction of 0.86% in hemoglobin a1c (HbA1c), a standard measure of blood-sugar control. This reduction compares favorably with both dapaglifozin (0.67% HbA1c reduction) and canaglifozin (0.7% HbA1c reduction) in their respective phase III trials.

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