Novo Nordisk and Cardior Pharmaceuticals today announced that Novo Nordisk has agreed to acquire Cardior for up to 1.025 billion Euros, including an upfront payment and additional payments if certain development and commercial milestones are achieved.

Cardior is a leader in the discovery and development of therapies that target RNA as a means to prevent, repair and reverse diseases of the heart. The company’s therapeutic approach targets distinctive non-coding RNAs as a platform for addressing root causes of cardiac dysfunctions with an aim to achieve lasting patient impact.

The agreement includes Cardior’s lead compound CDR132L, currently in phase 2 clinical development for the treatment of heart failure.

The acquisition is an important step forward in Novo Nordisk’s strategy to establish a presence in cardiovascular disease. Novo Nordisk aims to build a focused, impactful portfolio of therapies through internal and external innovation to address the significant unmet needs that still exist within cardiovascular disease, the most common cause of death globally.

“By welcoming Cardior as a part of Novo Nordisk, we will strengthen our pipeline of projects in cardiovascular disease where we already have ongoing programmes across all phases of clinical development,” said Martin Holst Lange, executive vice president for Development at Novo Nordisk. “We have been impressed by the scientific work carried out by the Cardior team, especially on CDR132L, which has a distinctive mode of action and potential to become a first-inclass therapy designed to halt or partially reverse the course of disease for people living with heart failure.“

CDR132L is designed to halt and partially reverse cellular pathology by selectively blocking abnormal levels of the microRNA molecule miR-132, potentially leading to long-lasting improvement in heart function.

In a phase 1b trial published in the European Heart Journal(1) , CDR132L was reported to be safe and well tolerated and the results suggested cardiac functional improvements in people with heart failure compared to placebo. CDR132L is currently being investigated in the phase 2 trial HF-REVERT in 280 people with heart failure with reduced ejection fraction (HFrEF) who have previously suffered a heart attack (myocardial infarction). The first patient was dosed in the HFREVERT trial in July 2022.

Novo Nordisk plans to initiate a second phase 2 trial that will investigate CDR132L in a chronic heart failure population with cardiac hypertrophy – a condition that causes the walls of the heart muscle to become thick and stiff, affecting the heart’s ability to pump blood.

“This acquisition is a reflection of CDR132L’s transformative potential as a disease-modifying therapy for heart failure,” said Claudia Ulbrich, MD, CEO and co-founder of Cardior. “Novo Nordisk is the ideal partner based on its deep clinical and commercial expertise combined with its resources to accelerate our late-stage development programme, including through larger registrational studies. We look forward to advancing CDR132L towards market approval.”

The closing of the acquisition is subject to receipt of applicable regulatory approvals and other customary conditions and is expected to happen in the second quarter of 2024.

The transaction will not impact Novo Nordisk’s previously communicated operating profit outlook for 2024 or the ongoing share buy-back programme. Novo Nordisk will fund the acquisition from financial reserves.

Centerview Partners LLC is acting as exclusive financial advisor to Cardior. CMS Germany is acting as legal counsel to the sellers of Cardior and Latham & Watkins LLP is acting as legal counsel to Novo Nordisk in the transaction.

About heart failure Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen. The condition leads to frequent hospitalisations, and more than half of people diagnosed with heart failure die within five years(2) . Heart failure affects more than 65 million people globally and is most commonly caused by heart conditions such as ischaemic heart disease, cardiomyopathy or high blood pressure(3). The condition cannot be cured. Current therapies can slow but not halt disease progression(4) , and morbidity and mortality remain high(5).

About Cardior’s approach Cardior works to identify and counteract the molecular mechanisms of the broad area of ischaemic-induced heart failure as well as specific cardiac diseases such as hypertrophic and dilated cardiomyopathies. Cardior primarily seeks to advance a novel class of antisense oligonucleotides (ASOs) targeting so-called non-coding RNAs (ncRNAs) that are able to act on several key disease pathways simultaneously, triggering a concerted therapeutic effect against key hallmarks of heart disease, including cardiac hypertrophy, fibrosis, impaired contractility and reduced vascularization. Although ncRNAs are not translated into proteins, they are important for the regulation of critical cellular processes and their dysregulation is a hallmark of many diseases. With its deep knowledge in RNA biology, Cardior is developing a clinicallyoriented approach to restore normal levels and functions of these key players in the pathological processes of cardiac diseases.

About Novo Nordisk Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat serious chronic diseases, built upon our heritage in diabetes. We do so by pioneering scientific breakthroughs, expanding access to our medicines, and working to prevent and ultimately cure disease. Novo Nordisk employs about 63,400 people in 80 countries and markets its products in around 170 countries. For more information, visit novonordisk.com.

About Cardior Cardior Pharmaceuticals is a leading clinical-stage biopharmaceutical company pioneering the discovery and development of RNA-based therapeutics designed to prevent, repair and reverse diseases of the heart. Cardior’s therapeutic approach uses distinctive non-coding RNAs as an innovative platform for addressing the root causes of cardiac dysfunctions. The company aspires to bring transformative therapeutics and diagnostics to patients and thereby make a lasting impact on the treatment of cardiac diseases worldwide.

(1) Täubel J et al. European Heart Journal 2021 Jan 7;42(2):178-188 Novel antisense therapy targeting microRNA-132 in patients with heart failure: results of a first-in-human Phase 1b randomized, double-blind, placebo-controlled study - PubMed (nih.gov) (2) Jones NR et al. European Journal of Heart Failure 2019 Nov; 21(11): 1306–1325 Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis - PMC (nih.gov) (3) Bragazzi NL et al. Preventive Cardiology 2021;28(15):1682-1690 Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017 – PubMed (nih.gov) (4) McDonagh TA et al. European Heart Journal 2021 Sep 21;42(36):3599-3726 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure - PubMed (nih.gov) (5) Savarese G, Lund LH. Cardiac Failure Review. 2017;03(01):7-11 Global Public Health Burden of Heart Failure - PubMed (nih.gov)