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New Ideas – New Medicines – New Hope




                                www.ithembapharma.com
iThemba – at a glance
    β€’ Mission: To become the premier medicinal
      chemistry driven drug discovery organization in
      Africa and to improve African healthcare
      through, novel, affordable small molecule drugs

    β€’ Strategy: leverage the expertise of founders and
      SAB, generate IP and partner projects with
      major pharmaceutical companies, offer world
      class chemistry services to offset drug discovery
      cash-burn with novel business model
2                                               www.ithembapharma.com
Business Model
    β€’ Offset discovery β€˜cash-burn’ by building world class
      collaborative service business
    β€’ Invest profits from above into in-house projects
    β€’ Identify, funded, IP generating collaborations
    β€’ License products at suitable point
    β€’ Retain marketing rights in Africa




3                                                www.ithembapharma.com
Board of Scientific Advisors
    β€’ Prof. Dennis Liotta
          - Emory University, Atlanta, USA
    β€’ Prof. James Bull
          - University of Cape Town, South Africa
    β€’ Prof. Anthony G. M. Barrett
          - Imperial College, London, United Kingdom
    β€’ Prof. Erick Carreira
          - ETH, Zurich
    β€’ Prof. Steven V. Ley
          - Cambridge University, England
    β€’ Dr. George R. Painter
          - Chimerix Inc., NC, USA

4                                                      www.ithembapharma.com
Drug Discovery




5                    www.ithembapharma.com
Disease Focus
                                                HIV
                                   6 million HIV+ in SA alone
                                   4 million new infections p.a.
                                   Over 30 million HIV+ in
                                   Africa



                                   Drug              Medicinal
                                 Discovery           Chemistry

                                                                                   TB
                                                                   8 million infections and 2
             Malaria                                               million deaths p.a.
300-500 million infected p.a.                                      Mortality growing at 20% p.a
1-2 million deaths p.a. mostly                                     Resistance
children



6                                                                             www.ithembapharma.com
Pipeline
                                                             Lead         Process
     Proposal      Screening             Hit to Lead
                                                         Optimisation   Optimisation




      Malaria        Set 1
                                           TB/ICL                         Abacavir
     proposals     (7k, TB)


                                           IF – TB
    TB selective                       Nitroimidazoles
    macrophage
    accumulation

                                        Malaria hits


                                          TB Hits
                                       (NIH/TB CoC)


                               Set 1
                          (12k, Malaria)




7                                                                          www.ithembapharma.com
Current Mtb Therapy Outdated
β€’ About 1/3 of the global population is infected
  with Mycobacterium tuberculosis (Mtb)
β€’ Annually, nearly 8 million of the infected people
  develop active TB
β€’ Current therapy takes too long to administer
β€’ Current regimen from 1960’s
β€’ 6 – 9 months to complete therapy
β€’ Non-compliance results in drug-resistant strains
β€’ Some resistant strains untreatable

                                          www.ithembapharma.com
TB adapts
    β€’ Like all pathogens TB adapts to its environment
    β€’ Mycobacteria mobilize the glyoxylate shunt for
      catabolism of fatty acids in order to sustain
      infection in an immune competent host
    β€’ The glyoxylate shunt is unique to bacteria and lower
      eukaryotes
    β€’ IsoCitrate Lyase (ICL) and Maleate Synthase (MS)
      are key enzymes in this process


9                                               www.ithembapharma.com
Isocitrate Lyase
     β€’ ICL (plus MS) allows MTB to bypass the CO2-
       generating steps of the tricarboxylic acid (TCA) cycle
        – The metabolic pathway by which acetate is oxidized to generate ATP.
     β€’ The shunt consumes two molecules of acetyl CoA to
       generate one molecule of succinate.
        – Lipids are a source of acetyl CoA, and succinate is a precursor for the
          synthesis of glucose.
     β€’ The net effect is that the glyoxylate shunt allows
       MTB to synthesize carbohydrates from fatty acids.
        – Thus, disruption of this pathway is a viable treatment for latent
          tuberculosis infections.

10                                                                 www.ithembapharma.com
Target Validation
     β€’ ICL promotes bacterial survival in infected
       macrophages
        – McKinney et al. Nature, 2000
     β€’ Gene deletion results in impaired growth
        – McKinney et al. Nat. Med, 2005
     β€’ Glyoxylate cycle is essential for TB growth and
       persistence in macrophages and mice

     οƒ˜ ICL Previously deemed β€˜un-druggable’
11                                             www.ithembapharma.com
Solution
     β€’ Screen a focused set of small molecules
       against ICL
       – 2 x small molecule inhibitors identified (IC50
         <50nM)
       – Program designed and initiated to address
         liabilities
       – Promising efficacy against Mtb


     οƒ˜Technology licensed from Emory University
12                                                www.ithembapharma.com
Isocitrate Lyase




     β€’ Isoniazid and Rifampin like activity

13                                            www.ithembapharma.com
Novel iThemba Nitroimidazoles
     β€’ In-house program to discover new nitroimidazoles
        β€’ Favourable IP position
        β€’ Short synthetic routes using readily available reagents,
          and established synthetic protocols
        β€’ No chiral centres

     β€’ Incorporate solubilizing groups, overcoming
       associated solubility and bioavailability problems
     β€’ No structural alerts
     β€’ Increased molecular flexibility
14                                                      www.ithembapharma.com
HIV Massive Problem in SA
     β€’ South Africa is currently experiencing one of the
       most severe AIDS epidemics in the world
     β€’ At the end of 2007, there were approximately
       5.7 million people living with HIV in South Africa,
       and almost 1,000 AIDS deaths occurring every
       day
     β€’ TB co-infection probably largest killer of HIV
       positive patients


15                                              www.ithembapharma.com
iThemba Solution
     β€’ Take existing drug and produce for less
     β€’ New process for anti-retroviral drug
       –   2007 global sales $220 million
       –   Off patent 2009
       –   Current synthetic route 15 steps, low yield
       –   iThemba has licensed technology from Emory
           university for 7 step process



16                                               www.ithembapharma.com
Short-circuiting Drug Discovery
     β€’ Traditional drug discovery approach not viable
       in South Africa
       – Cost and lack of infrastructure
       – Too many hurdles
     β€’ Solution to target whole organisms
       – Take away major hurdles
       – Identify efficacious hits immediately



17                                               www.ithembapharma.com
iThemba Approach
     β€’ Negotiate use of other companies screening
       collections
       – Requires no target/disease conflicts
     β€’ Leverage neglected disease angle
     β€’ Requires no capital investment in library
       purchase and storage



18                                              www.ithembapharma.com
iThemba Screening Solution

     β€’ Novel screening collaborations in place for
       Malaria (MMV sponsored)
     β€’ Medical Research Council Technology
          β€’ 45k compounds
          β€’ Constructed from commercial sources
          β€’ Historically good hit rate

     β€’ Chimerix compound collection
          β€’ 7k compounds
          β€’ Acquired from Dr Leroy Townsend (University of Michigan)
          β€’ Contains numerous unique nucleoside analogues as well as a
            diverse set of heterocycles
19                                                          www.ithembapharma.com
Screening Progress
     β€’ Chimerix collection of nucleoside analogues
        –   131 cpds with activity IC50<1Β΅M
        –   High toxicity attrition
        –   Mitochondrial toxicity flag
        –   Highly novel structures
     β€’ MRCT library diverse heterocyclic structures
        –   Low molecular weight (<300)
        –   No toxicophores or potential reactive functional groups
        –   30 cpds with activity IC50<1Β΅M
        –   MMV proposal submitted
        –   Solids re-ordered


20                                                                www.ithembapharma.com
Collaborations




21                    www.ithembapharma.com
Chemistry Services
     β€’ Services
       –   FTE contracts
       –   Custom Medicinal Chemistry
       –   Custom synthesis/arrays
       –   Individual compound synthesis
       –   Scale up
     β€’ Cost-effective and alternative synthetic routes
     β€’ Design and synthesis of molecules with drug-
       like properties
     β€’ Hit-to-lead optimization
22                                          www.ithembapharma.com
Capabilities
     β€’ Provide synthesis on milligram to 50+ gram scale on
       single or multistep routes
     β€’ Follow established synthetic routes, design new
       synthetic routes, or trouble-shoot existing synthetic
       routes
     β€’ Provide custom intermediate/template or
       monomer/reagent synthesis
     β€’ Prepare analog synthesis
     β€’ Produce synthesis of metabolites or standards


23                                                www.ithembapharma.com
Capabilities
     β€’ Pharmaceutical standard chemistry
         – Fully functional synthesis labs
         – ~750m2 of useable laboratory space
     β€’   Microwave synthesiser
     β€’   Automated prep and analytical HPLC
     β€’   Parallel sysnthesis and evaporation
     β€’   Pharma-standard analytical capability
         – State-of-the-art LC/MS and NMR (400MHz)
24                                              www.ithembapharma.com
Collaborations, example 1
     β€’ Brief: Synthesis of a number of functionalised
       steroid analogues as potential anti-cancer agents
     β€’ Solution: iThemba leveraged expertise on it’s SAB
       to devise novel routes to desired tool compounds
     β€’ Deliverables: 15 synthetic steps, 11 test
       compounds (>95% purity, β‰₯25mg) in 5 weeks
     β€’ Preliminary Results: 3 examples inhibit cell
       proliferation in the metaphase with <20nM EC50’s


25                                           www.ithembapharma.com
Collaborations, example 2
     β€’ Brief: Take computational derived fragments
       from marketed drugs and design library
     β€’ Solution: Using in-silico techniques and RO3
       100 component library deisgned
     β€’ Deliverables: 10, 10 component fragment sets
       with >95% purity and β‰₯100mg
     β€’ Time frame: 3 months from project initiation


26                                       www.ithembapharma.com
Why iThemba?
     β€’ Competitive cost base
     β€’ Strong IP laws in South Africa
     β€’ Access to superlative Scientific Advisory Board
     β€’ Good cultural fit
     β€’ Moral leverage – all profits re-invested into
       neglected disease research
     β€’ Governmental support


27                                             www.ithembapharma.com
Customer Needs!
     β€’ Communication
       – Dedicated and accessible project leader
     β€’ Confidentiality
       – Dedicated, backed up server , ELN,
     β€’ Quality
     β€’ Safety & Environment
       – Comply with global standards, PPE culture
     β€’ Competitive pricing with flexible terms

28                                             www.ithembapharma.com
Rates & Contact Information
     β€’ Competitive rates
     β€’ Flexible pricing model
        – Per FTE
        – Bid per project
        – Bid per compound
        – Bid per chemical step
     β€’ Contact: Dr. Chris Edlin
        – Tel (dir) +27 11 605 2635
        – Cell +27 82 350 4313
        – E-mail: cedlin@ithembapharma.com

29                                           www.ithembapharma.com
Improving healthcare in Africa and
           the developing world
30                                 www.ithembapharma.com

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iThemba overview

  • 1. New Ideas – New Medicines – New Hope www.ithembapharma.com
  • 2. iThemba – at a glance β€’ Mission: To become the premier medicinal chemistry driven drug discovery organization in Africa and to improve African healthcare through, novel, affordable small molecule drugs β€’ Strategy: leverage the expertise of founders and SAB, generate IP and partner projects with major pharmaceutical companies, offer world class chemistry services to offset drug discovery cash-burn with novel business model 2 www.ithembapharma.com
  • 3. Business Model β€’ Offset discovery β€˜cash-burn’ by building world class collaborative service business β€’ Invest profits from above into in-house projects β€’ Identify, funded, IP generating collaborations β€’ License products at suitable point β€’ Retain marketing rights in Africa 3 www.ithembapharma.com
  • 4. Board of Scientific Advisors β€’ Prof. Dennis Liotta - Emory University, Atlanta, USA β€’ Prof. James Bull - University of Cape Town, South Africa β€’ Prof. Anthony G. M. Barrett - Imperial College, London, United Kingdom β€’ Prof. Erick Carreira - ETH, Zurich β€’ Prof. Steven V. Ley - Cambridge University, England β€’ Dr. George R. Painter - Chimerix Inc., NC, USA 4 www.ithembapharma.com
  • 5. Drug Discovery 5 www.ithembapharma.com
  • 6. Disease Focus HIV 6 million HIV+ in SA alone 4 million new infections p.a. Over 30 million HIV+ in Africa Drug Medicinal Discovery Chemistry TB 8 million infections and 2 Malaria million deaths p.a. 300-500 million infected p.a. Mortality growing at 20% p.a 1-2 million deaths p.a. mostly Resistance children 6 www.ithembapharma.com
  • 7. Pipeline Lead Process Proposal Screening Hit to Lead Optimisation Optimisation Malaria Set 1 TB/ICL Abacavir proposals (7k, TB) IF – TB TB selective Nitroimidazoles macrophage accumulation Malaria hits TB Hits (NIH/TB CoC) Set 1 (12k, Malaria) 7 www.ithembapharma.com
  • 8. Current Mtb Therapy Outdated β€’ About 1/3 of the global population is infected with Mycobacterium tuberculosis (Mtb) β€’ Annually, nearly 8 million of the infected people develop active TB β€’ Current therapy takes too long to administer β€’ Current regimen from 1960’s β€’ 6 – 9 months to complete therapy β€’ Non-compliance results in drug-resistant strains β€’ Some resistant strains untreatable www.ithembapharma.com
  • 9. TB adapts β€’ Like all pathogens TB adapts to its environment β€’ Mycobacteria mobilize the glyoxylate shunt for catabolism of fatty acids in order to sustain infection in an immune competent host β€’ The glyoxylate shunt is unique to bacteria and lower eukaryotes β€’ IsoCitrate Lyase (ICL) and Maleate Synthase (MS) are key enzymes in this process 9 www.ithembapharma.com
  • 10. Isocitrate Lyase β€’ ICL (plus MS) allows MTB to bypass the CO2- generating steps of the tricarboxylic acid (TCA) cycle – The metabolic pathway by which acetate is oxidized to generate ATP. β€’ The shunt consumes two molecules of acetyl CoA to generate one molecule of succinate. – Lipids are a source of acetyl CoA, and succinate is a precursor for the synthesis of glucose. β€’ The net effect is that the glyoxylate shunt allows MTB to synthesize carbohydrates from fatty acids. – Thus, disruption of this pathway is a viable treatment for latent tuberculosis infections. 10 www.ithembapharma.com
  • 11. Target Validation β€’ ICL promotes bacterial survival in infected macrophages – McKinney et al. Nature, 2000 β€’ Gene deletion results in impaired growth – McKinney et al. Nat. Med, 2005 β€’ Glyoxylate cycle is essential for TB growth and persistence in macrophages and mice οƒ˜ ICL Previously deemed β€˜un-druggable’ 11 www.ithembapharma.com
  • 12. Solution β€’ Screen a focused set of small molecules against ICL – 2 x small molecule inhibitors identified (IC50 <50nM) – Program designed and initiated to address liabilities – Promising efficacy against Mtb οƒ˜Technology licensed from Emory University 12 www.ithembapharma.com
  • 13. Isocitrate Lyase β€’ Isoniazid and Rifampin like activity 13 www.ithembapharma.com
  • 14. Novel iThemba Nitroimidazoles β€’ In-house program to discover new nitroimidazoles β€’ Favourable IP position β€’ Short synthetic routes using readily available reagents, and established synthetic protocols β€’ No chiral centres β€’ Incorporate solubilizing groups, overcoming associated solubility and bioavailability problems β€’ No structural alerts β€’ Increased molecular flexibility 14 www.ithembapharma.com
  • 15. HIV Massive Problem in SA β€’ South Africa is currently experiencing one of the most severe AIDS epidemics in the world β€’ At the end of 2007, there were approximately 5.7 million people living with HIV in South Africa, and almost 1,000 AIDS deaths occurring every day β€’ TB co-infection probably largest killer of HIV positive patients 15 www.ithembapharma.com
  • 16. iThemba Solution β€’ Take existing drug and produce for less β€’ New process for anti-retroviral drug – 2007 global sales $220 million – Off patent 2009 – Current synthetic route 15 steps, low yield – iThemba has licensed technology from Emory university for 7 step process 16 www.ithembapharma.com
  • 17. Short-circuiting Drug Discovery β€’ Traditional drug discovery approach not viable in South Africa – Cost and lack of infrastructure – Too many hurdles β€’ Solution to target whole organisms – Take away major hurdles – Identify efficacious hits immediately 17 www.ithembapharma.com
  • 18. iThemba Approach β€’ Negotiate use of other companies screening collections – Requires no target/disease conflicts β€’ Leverage neglected disease angle β€’ Requires no capital investment in library purchase and storage 18 www.ithembapharma.com
  • 19. iThemba Screening Solution β€’ Novel screening collaborations in place for Malaria (MMV sponsored) β€’ Medical Research Council Technology β€’ 45k compounds β€’ Constructed from commercial sources β€’ Historically good hit rate β€’ Chimerix compound collection β€’ 7k compounds β€’ Acquired from Dr Leroy Townsend (University of Michigan) β€’ Contains numerous unique nucleoside analogues as well as a diverse set of heterocycles 19 www.ithembapharma.com
  • 20. Screening Progress β€’ Chimerix collection of nucleoside analogues – 131 cpds with activity IC50<1Β΅M – High toxicity attrition – Mitochondrial toxicity flag – Highly novel structures β€’ MRCT library diverse heterocyclic structures – Low molecular weight (<300) – No toxicophores or potential reactive functional groups – 30 cpds with activity IC50<1Β΅M – MMV proposal submitted – Solids re-ordered 20 www.ithembapharma.com
  • 21. Collaborations 21 www.ithembapharma.com
  • 22. Chemistry Services β€’ Services – FTE contracts – Custom Medicinal Chemistry – Custom synthesis/arrays – Individual compound synthesis – Scale up β€’ Cost-effective and alternative synthetic routes β€’ Design and synthesis of molecules with drug- like properties β€’ Hit-to-lead optimization 22 www.ithembapharma.com
  • 23. Capabilities β€’ Provide synthesis on milligram to 50+ gram scale on single or multistep routes β€’ Follow established synthetic routes, design new synthetic routes, or trouble-shoot existing synthetic routes β€’ Provide custom intermediate/template or monomer/reagent synthesis β€’ Prepare analog synthesis β€’ Produce synthesis of metabolites or standards 23 www.ithembapharma.com
  • 24. Capabilities β€’ Pharmaceutical standard chemistry – Fully functional synthesis labs – ~750m2 of useable laboratory space β€’ Microwave synthesiser β€’ Automated prep and analytical HPLC β€’ Parallel sysnthesis and evaporation β€’ Pharma-standard analytical capability – State-of-the-art LC/MS and NMR (400MHz) 24 www.ithembapharma.com
  • 25. Collaborations, example 1 β€’ Brief: Synthesis of a number of functionalised steroid analogues as potential anti-cancer agents β€’ Solution: iThemba leveraged expertise on it’s SAB to devise novel routes to desired tool compounds β€’ Deliverables: 15 synthetic steps, 11 test compounds (>95% purity, β‰₯25mg) in 5 weeks β€’ Preliminary Results: 3 examples inhibit cell proliferation in the metaphase with <20nM EC50’s 25 www.ithembapharma.com
  • 26. Collaborations, example 2 β€’ Brief: Take computational derived fragments from marketed drugs and design library β€’ Solution: Using in-silico techniques and RO3 100 component library deisgned β€’ Deliverables: 10, 10 component fragment sets with >95% purity and β‰₯100mg β€’ Time frame: 3 months from project initiation 26 www.ithembapharma.com
  • 27. Why iThemba? β€’ Competitive cost base β€’ Strong IP laws in South Africa β€’ Access to superlative Scientific Advisory Board β€’ Good cultural fit β€’ Moral leverage – all profits re-invested into neglected disease research β€’ Governmental support 27 www.ithembapharma.com
  • 28. Customer Needs! β€’ Communication – Dedicated and accessible project leader β€’ Confidentiality – Dedicated, backed up server , ELN, β€’ Quality β€’ Safety & Environment – Comply with global standards, PPE culture β€’ Competitive pricing with flexible terms 28 www.ithembapharma.com
  • 29. Rates & Contact Information β€’ Competitive rates β€’ Flexible pricing model – Per FTE – Bid per project – Bid per compound – Bid per chemical step β€’ Contact: Dr. Chris Edlin – Tel (dir) +27 11 605 2635 – Cell +27 82 350 4313 – E-mail: cedlin@ithembapharma.com 29 www.ithembapharma.com
  • 30. Improving healthcare in Africa and the developing world 30 www.ithembapharma.com