Lilly completes $1.925 billion acquisition of Versanis and its muscle-preservation drug bimagrumab

Eli Lilly and Company agreed on July 14, 2023, to acquire Versanis Bio, a private clinical-stage company focused on cardiometabolic diseases, in a deal that gives Lilly control of the experimental drug bimagrumab ^[1]. The acquisition closed on August 14, 2023 ^[2].

Under the terms, Versanis shareholders could receive up to $1.925 billion in cash, made up of an upfront payment plus later payments if certain development and sales milestones are met ^[1][2]. That figure is a potential maximum, not a confirmed total, and the releases do not break out how much was paid upfront.

Bimagrumab is a monoclonal antibody that binds activin type II A and B receptors, blocking activin and myostatin signaling ^[1]. It is being tested in the BELIEVE Phase 2b study, both alone and in combination with semaglutide — the molecule sold as Ozempic, Wegovy and Rybelsus — in adults who are overweight or obese ^[1][2].

The rationale is that incretin drugs such as semaglutide and tirzepatide produce weight loss that includes fat and some lean mass. Lilly said combining incretins with bimagrumab "has the potential to further reduce fat mass while preserving muscle mass and may lead to better outcomes for people living with obesity and obesity-related complications" ^[1].

"Combining our current incretin portfolio, including tirzepatide, with activin receptor blockers such as bimagrumab, could be the next major step in innovative treatments for those living with cardiometabolic diseases, like obesity," said Ruth Gimeno, Ph.D., group vice president, diabetes, obesity and cardiometabolic research at Lilly ^[2]. In the July announcement, Gimeno described obesity as a chronic disease affecting more than 100 million Americans ^[1].

Mark Pruzanski, M.D., Versanis chairman and CEO, said Lilly is "ideally positioned to realize the potential of bimagrumab in combination with its incretin therapies to benefit people living with cardiometabolic diseases" ^[1]. Versanis was founded in 2021 by Aditum Bio ^[1].

Key details remain unreported. Neither announcement included results from BELIEVE, so it has not been reported whether bimagrumab preserves muscle or adds to fat loss in people, or how it compares with existing treatments. Lilly said it would determine the accounting treatment of the transaction, as a business combination or an asset acquisition, at closing ^[1]. No timeline for a regulatory filing, and no pricing information, has been disclosed ^[1][2].

Why it matters for patients

Weight loss with GLP-1 and dual GLP-1/GIP drugs often includes loss of lean mass along with fat, and how much that matters over the long term is still being studied. Bimagrumab is aimed at that question, but no data in people showing a muscle-preserving benefit when combined with an incretin has been reported yet ^[1].

Bimagrumab is not approved for weight loss, and an approval would depend on trial results that have not been reported. Anyone taking semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound) is not affected by this transaction in terms of what their prescription contains or covers ^[1][2].

One detail worth noting: the ongoing combination study pairs bimagrumab with semaglutide, a Novo Nordisk product, while Lilly's stated interest is in pairing activin blockers with its own incretin portfolio, including tirzepatide ^[1][2]. What that means for future trial designs has not been disclosed.

What happens next

The dated milestones so far are the July 14, 2023, announcement of the agreement and the August 14, 2023, completion of the acquisition ^[1][2]. The next expected step would be results from the BELIEVE Phase 2b study, but no date for reporting those results has been disclosed ^[1][2].