Sanofi Sets Its Sights On RIPK1 in ALS

A new partnership paves the way to evaluate an emerging neuroprotectant in the ALS clinic. The milestone-based deal, which could reach an estimated $1.02 billion USD, will include support from French drug maker Sanofi for the clinical testing of inhibitors of RIPK1 kinase in ALS. The inhibitors are being developed by Denali Therapeutics in San Francisco, California. RIPK1 is increasingly implicated in the destruction of motor neurons in the disease (July 2018 news; for review, see Yuan et al., 2018).

Double Trouble. Activation of RIPK1 may contribute to inflammation and motor neuron loss in ALS. [Courtesy of Yuan et al., 2018, Nature Reviews Neuroscience.]

One of these inhibitors, DNL747, is currently being developed as a potential treatment for ALS, Alzheimer’s disease and multiple sclerosis. The approach is emerging as a key alternative to GlaxoSmithKline’s GSK2982772, due to its ability, according to Denali Therapeutics, to be delivered to the brain (see Harris et al., 2017).

Sanofi announced the partnership with Denali Therapeutics on November 1.

RIPK1 kinase may contribute to ALS by promoting inflammation and axonal loss (see September 2016 news; Ito et al., 2016). The strategy, originally introduced at Harvard Medical School by Junying Yuan and Alexei Degeterev, now at Tufts University School of Medicine, aims in part to block necroptosis, a programmed form of necrosis, which may destroy motor neurons in the disease (see Feb 2014 news; Re et al., 2014Degterev et al., 2008).

The results of a phase 1 safety study of DNL747 in healthy volunteers will be presented by Denali Therapeutics in New York on December 10, 2018.


Ito Y, Ofengeim D, Najafov A, Das S, Saberi S, Li Y, Hitomi J, Zhu H, Chen H, Mayo L, Geng J, Amin P, DeWitt JP, Mookhtiar AK, Florez M, Ouchida AT, Fan JB, Pasparakis M, Kelliher MA, Ravits J, Yuan J. RIPK1 mediates axonal degeneration by promoting inflammation and necroptosis in ALS. Science. 2016 Aug 5;353(6299):603-8.[PubMed].

Re DB, Le Verche V, Yu C, Amoroso MW, Politi KA, Phani S, Ikiz B, Hoffmann L, Koolen M, Nagata T, Papadimitriou D, Nagy P, Mitsumoto H, Kariya S, Wichterle H, Henderson CE, Przedborski S. Necroptosis drives motor neuron death in models of both sporadic and familial ALS. Neuron. 2014 Mar 5;81(5):1001-8. [PubMed].

Degterev A, Hitomi J, Germscheid M, Ch’en IL, Korkina O, Teng X, Abbott D, Cuny GD, Yuan C, Wagner G, Hedrick SM, Gerber SA, Lugovskoy A, Yuan J. Identification of RIP1 kinase as a specific cellular target of necrostatins. Nat Chem Biol. 2008 May;4(5):313-21. [PubMed].

Sanofi and Denali Therapeutics to develop treatments for neurological and inflammatory diseases. Globe Newswire. 1 Nov 2018.

Denali Therapeutics Announces Positive Clinical Results With Its Lead RIPK1 Inhibitor Molecule and Intention to Initiate Patient Studies in Multiple Indications in Collaboration With Sanofi. Globe Newswire. 19 Nov 2018.

Further Reading

Yuan J, Amin P, Ofengeim D. Necroptosis and RIPK1-mediated neuroinflammation in CNS diseases. Nat Rev Neurosci. 2018 Nov 22. [PubMed].

disease-als disease-ftd inflammation necroptosis neuroinflammation RIPK1
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