Biotech Values

[biotech jim]

Evercore ISI recently published a series of reports on the mechanisms and manifestations of NASH in a deep biology/investment dive, encompassing 4 reports with a total of roughly 500 pages of print. In their 3rd report of this 4 part series, they had this to say:


“4. “Signaling” through bile receptors to modulate fat and cholesterol metabolism can lead to redistribution of
these components and increase circulating cholesterol. Again, care must be taken to target the patients in
most need of therapy since there could be offsetting safety considerations related to atherosclerosis

5. We prefer NASH approaches that target the underlying fat and cholesterol accumulation in the body,
by either decreasing absorption, increasing elimination or burning off fat/cholesterol. With that framework,
we find bile-targeting approaches that lead to increased excretion/elimination of bile (e.g. IBAT inhibitors) to
hold promise.

6. We are less enthusiastic for FXR targeting approaches given the need to balance CV safety due to cholesterol
redistribution with hepatoprotective effects. But we note that this benefit may still outweigh risks in some
patients.

Credit to Josh Schimmer et al,, from Step #3 For Understanding NASH: Bile