Tourmaline Bio (TRML) Guggenheim Inaugural Global Healthcare Innovation Conference summary

Company overview and strategy

• Focuses on immunology, aiming to develop medicines that can set new standards of care in areas of high unmet need.

• Lead asset is pacibucutog, an anti-IL-6 antibody licensed from Pfizer, with a long half-life and low immunogenicity.

• Pursuing two main indications: atherosclerotic cardiovascular disease (ASCVD) and thyroid eye disease (TED).

• Well-capitalized with over $300 million in cash, providing runway into 2027.

Clinical development and trial updates

• Running two trials: Tranquility (ASCVD) and Spirited (TED), with data expected in 2025.

• Tranquility is a PK/PD study in CKD patients with elevated CRP, primary endpoint is change in hsCRP at day 90.

• Tranquility trial includes 120 patients, testing quarterly and monthly dosing versus placebo.

• Spirited is a phase IIb trial in TED, designed as one of two pivotal studies, with phase III to start by end of 2024.

Scientific rationale and competitive landscape

• IL-6 pathway validated by genetic, epidemiologic, and clinical trial data as causally linked to cardiovascular outcomes.

• CRP is a strong risk marker for cardiovascular events, outperforming LDL and Lp(a) in long-term studies.

• CANTOS trial showed anti-inflammatory therapy reduces CV risk, with deeper CRP/IL-6 reductions yielding greater benefit.

• Novo Nordisk is running large phase III trials with ziltivekimab, but Tourmaline aims to differentiate with less frequent dosing and new indications.