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Rhythm Pharmaceuticals Reports Fourth Quarter and Full Year 2022 Financial Results -- IMCIVREE U.S. launch for Bardet-Biedl syndrome (BBS) reflects strong demand with more than 200 new prescriptions received since FDA ap

Key Takeaway: Rhythm Pharmaceuticals reported encouraging financial results for Q4 and full year 2022, highlighting the strong demand for its IMCIVREE treatment following FDA approval for Bardet-Biedl syndrome (BBS). The company has seen over 200 new prescriptions in the U.S. and is set to expand globally, including entering the German market in Q2 2023. Rhythm has also initiated a pivotal Phase 3 trial for hypothalamic obesity and acquired Xinvento B.V. to enhance its pipeline for congenital hyperinsulinism. Despite progress, the company faces challenges with reimbursement negotiations and rising R&D expenses.

Market Sentiment Analysis

POSITIVE FACTORS

  • Successful U.S. launch of IMCIVREE for Bardet-Biedl syndrome reflects strong market demand.
  • Expansion of IMCIVREE into eight international markets, increasing its global reach.
  • Initiation of pivotal Phase 3 trial for acquired hypothalamic obesity indicates robust ongoing clinical development.

CONCERNS & RISKS

  • Pending reimbursement negotiations for launching IMCIVREE in Germany may delay market access.
  • R&D expenses increased significantly, indicating ongoing financial pressures as the company expands.

Full Press Release Details

Rhythm Pharmaceuticals Reports Fourth Quarter
and Full Year 2022 Financial Results
U.S. launch for Bardet-Biedl syndrome (BBS) reflects strong demand with more than 200 new prescriptions received
since FDA approval --
-- IMCIVREE now available in eight ex-U.S.
markets; first commercial sales for BBS expected in Germany in 2Q 2023 --
-- Pivotal Phase 3 trial evaluating setmelanotide
in acquired hypothalamic obesity initiated --
-- Acquired Xinvento B.V., a rare disease company
in preclinical development for congenital hyperinsulinism --
-- Management to host conference call today
BOSTON, March 1, 2023 -
Rhythm Pharmaceuticals, Inc. (Nasdaq: RYTM), a global commercial-stage biopharmaceutical company focused on transforming
the lives of patients and their families living with hyperphagia and severe obesity caused by rare melanocortin-4 receptor (MC4R) pathway
diseases, today reported financial results and provided a business update for the fourth quarter and full year ended December 31,
"Rhythm had a very strong 2022. Following U.S. Food and Drug
Administration (FDA) approval in June, we successfully launched IMCIVREE (setmelanotide) for Bardet-Biedl syndrome (BBS)
in the United States, and we've continued to extend our reach globally, with IMCIVREE now available in eight international markets,"
said David Meeker, M.D., Chair, President and Chief Executive Officer of Rhythm. "With compelling Phase 2 data in hypothalamic obesity
and FDA alignment on our pivotal trial design, we recently began screening patients for our Phase 3 study. We look forward to working
toward the achievement of several additional clinical milestones in 2023 as we aim to expand the reach of setmelanotide as the first and
only precision medicine to address the needs of patients and families living with hyperphagia and severe obesity caused by rare MC4R pathway
Dr. Meeker continued, "With the acquisition of Xinvento,
we are excited to expand our pipeline into congenital hyperinsulinism (CHI), a rare disease that is well aligned with our corporate strategy
and broadens our focus into an adjacent endocrine indication with a high unmet need."
Fourth Quarter and Recent
Bardet-Biedl Syndrome
- Today, Rhythm announced that it received more than 200 new prescriptions for IMCIVREE for BBS from more than 125 physicians in the United States with reimbursement approvals for more than 100 of those prescriptions from FDA approval on June 16, 2022 to December 31, 2022.
- In November 2022, Rhythm announced that Great Britain's Medicines & Healthcare products Regulatory Agency (MHRA) expanded the marketing authorization for IMCIVREE to include the treatment of obesity and control of hunger associated with genetically confirmed BBS in adult and pediatric patients 6 years of age and older. The Company is working closely with the National Health Service (NHS) to finalize guidance for coverage of IMCIVREE for BBS.
- Also in November 2022, Rhythm announced that Health Canada accepted for review its New Drug Submission (NDS) with Priority Review for setmelanotide, indicated in adults and pediatric patients 6 years of age and older with impairments in the MC4R pathway due to genetic diseases, for the treatment of obesity and control of hunger in BBS and POMC, PCSK1, or LEPR deficiencies.
POMC, PCSK1 and LEPR Deficiency Obesities
Clinical Development Updates
- Today Rhythm announced that its pivotal Phase 3 trial evaluating setmelanotide in patients with acquired hypothalamic obesity has been initiated, with patient screening underway.
- In January 2023, Rhythm announced that certain patients with BBS and obesity who participated in the Company's global Phase 3 clinical trial of setmelanotide reported clinically meaningful improvements across multiple health-related quality of life (HRQOL) measures, based on an analysis which was published in the peer-reviewed Orphanet Journal of Rare Diseases .
- In November 2022, Rhythm announced the publication of previously disclosed results from its Phase 3 clinical trial in patients with BBS in the peer-reviewed journal The Lancet Diabetes and Endocrinology .
Key Upcoming 2023 Milestones
Rhythm expects to achieve the following near-term milestones:
- Secure market access and launch IMCIVREE in Germany for BBS in the second quarter of 2023, pending reimbursement negotiations with German authorities; Rhythm also anticipates launching IMCIVREE for BBS in The Netherlands in the second half of 2023, pending local negotiations;
- Complete regulatory review by Health Canada and, pending approval, make IMCIVREE commercially available in Canada for the treatment of BBS, or POMC, PCSK1 or LEPR deficiencies in the second half of 2023;
- Initiate a Phase 3, randomized, double-blind trial in patients na ve to setmelanotide therapy ("de novo study") to evaluate the weekly formulation of setmelanotide in patients with BBS in the second half of 2023;
- Announce preliminary data from the open-label part of the Phase 2 DAYBREAK trial from one or more genetically defined cohorts in the second half of 2023;
- Announce topline data from the ongoing Phase 3, open-label pediatrics trial evaluating one year of setmelanotide therapy in patients with MC4R pathway deficiencies between the ages of 2 and 6 years old in the second half of 2023; and
- Announce topline data from the ongoing Phase 3 switch trial evaluating a weekly formulation of setmelanotide in the second half of 2023.
Fourth Quarter and Full Year 2022 Financial
- Cash Position: As of December 31, 2022, cash, cash equivalents and short-term investments were approximately $333.3 million, as compared to $294.9 million as of December 31, 2021.
- Revenue: Product revenue, net relating to global sales of IMCIVREE was $8.8 million for the fourth quarter of 2022 and $16.9 million for the year ended December 31, 2022, as compared to $1.8 million for the fourth quarter of 2021 and $3.2 million for the year ended December 31, 2021. For the years ended December 31, 2022, and 2021, 85% and 100%, respectively, of the Company's product revenue was generated in the United States.
- License Revenue: License revenue was $6.8 million in 2022 and was entirely related to the RareStone license agreement. Rhythm, entered into a license agreement with RareStone in December 2021 and completed activities required to transfer the license to RareStone during the second quarter of 2022, which resulted in the recognition of the license revenue.
- R&D Expenses: R&D expenses were $23.5 million in the fourth quarter of 2022 and $108.6 million for the year ended December 31, 2022, as compared to $31.6 million in the fourth quarter of 2021 and $104.1 million for the year ended December 31, 2021. The year-over-year increase was due to:
an increase of $2.9 million for purchases of clinical supply material;
an increase of $2.8 million in gene sequencing costs to support expanded clinical programs; an increase of $2.4 million in clinical trial costs associated with new and planned clinical trials, including Phase 2 DAYBREAK and Phase 3 EMANATE trials, Phase 3 pediatrics trial, Phase 2 hypothalamic obesity trial, Phase 3 hypothalamic obesity trial and increased enrollment in the long-term extension and weekly switch trials. These increases were partially offset by reduced activity due to the completion and winding down of the Phase 3 POMC and LEPR trials, QTc trial, BBS trial, Phase 2 Basket trial and renal study. These increases were further offset by a $2.3 million refund due upon the close out and reconciliation of the GO-ID study, all of which resulted in an insignificant change in clinical trial expense;
an increase of $2.1 million in salaries, benefits and stock-based compensation related to the hiring of additional full-time employees in order to support the growth of research and development programs;
an increase of $1.0 million in development milestones earned by Camurus AB, related to development milestone achieved related to our weekly formulation; and
an increase of $0.9 million related to IP and patent related filing activities.
The above increases were partially offset by a decrease of $4.0 million in costs associated with medical affairs; and a decrease of $0.9 million in costs associated with next generation research and development activities.
an increase of $9.6 million due to increased compensation and benefits related costs associated with additional headcount to support expanding business operations as well as to establish commercial operations in the United States and internationally;
an increase of $8.6 million related to increased costs associated with commercial operations, sales and marketing activities for IMCIVREE in connection with preparing for the U.S. approval for BBS obtained in June 2022 and EC approval in September 2022;
an increase of $5.0 million due to increased costs associated with information technology, international office space, sponsorships and general corporate travel related expenses for an expanding workforce.
- Other (expense) income, net: Other (expense) income, net decreased by $102.4 million to ($2.0) million in 2022, a decrease of 102%. The decrease was primarily due to the sale of Rhythm's Priority Review Voucher (PRV) in February 2021. The sale of the PRV in the prior year was a non-recurring transaction. Other (expense) income, net consists of $5.2 million of interest expense related to Royalty Interest Financing Agreement (RIFA) with HealthCare Royalty Partners (including amortization of debt discount and deferred financing fees) and a $1.0 million other than temporary impairment of RareStone equity, partially offset by $4.0 million of interest income and $0.3 million of other income resulting from the remeasurement of the embedded derivative related to the RIFA.
- Provision/(Benefit) for income taxes: There was no provision (benefit) for income taxes during for the three months and year ended December 31, 2022, respectively. During the three months ended December 31, 2021, we recorded a benefit for income taxes of $8.0 million related to the unwinding of the tax provision recorded earlier in the year as a result of the sale of the PRV upon generating sufficient losses from operations to offset the tax provision.
- Net Loss: Net loss was $42.5 million for the fourth quarter of 2022 and $181.1 million for the year ended December 31, 2022, or a net loss per basic and diluted share of ($0.75) and ($3.47), respectively, as compared to a net loss of $42.9 million for the fourth quarter of 2021 and $69.6 million for the year ended December 31, 2021, or a net loss per basic and diluted share of $0.85 and $1.40, respectively.
Financial Guidance: Rhythm today
announced that, for the year ending December 31, 2023, it currently anticipates approximately $200 million to $220 million in Non-GAAP
Operating Expenses (see below under "Non-GAAP Financial Measures" for more details), comprised of $120 million to $130 million
from R&D expenses and $80 million to $90 million from S,G&A expenses.
Based on its current operating plans, Rhythm
expects that its existing cash, cash equivalents and short-term investments as of December 31, 2022 will be sufficient to fund
its operating expenses and capital expenditure requirements into 2025.
Rhythm Pharmaceuticals will host a live conference
call and webcast at 8:00 a.m. ET today to review its fourth quarter and full year 2022 financial results and recent business activities.
Participants may register for the conference call here. While not required, it is recommended that participants join the call
ten minutes prior to the scheduled start.
A live webcast of the call will also
be available under "Events and Presentations" in the Investor Relations section of the Rhythm Pharmaceuticals website at https://ir.rhythmtx.com/.
The archived webcast will be available on Rhythm Pharmaceuticals' website approximately two hours after the conference call and
will be available for 30 days following the call.
About Rhythm Pharmaceuticals
is a commercial-stage biopharmaceutical company committed to transforming the lives of patients and their families living with hyperphagia
and severe obesity caused by rare melanocortin-4 receptor (MC4R) diseases. Rhythm's lead asset, IMCIVREE (setmelanotide),
an MC4R agonist designed to treat hyperphagia and severe obesity caused by rare MC4R pathway diseases, is approved by the U.S. Food
and Drug Administration (FDA) for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic
or syndromic obesity due to pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1) or leptin receptor (LEPR)
deficiency confirmed by genetic testing, or patients with a clinical diagnosis of Bardet-Biedl syndrome (BBS). Both the European
Commission (EC) and the UK's Medicines & Healthcare Products Regulatory Agency (MHRA) have authorized setmelanotide
for the treatment of obesity and the control of hunger associated with genetically confirmed BBS or genetically confirmed loss-of-function
biallelic POMC, including PCSK1, deficiency or biallelic LEPR deficiency in adults and children 6 years of age and above. Additionally,
Rhythm is advancing a broad clinical development program for setmelanotide in other rare MC4R pathway diseases, as well as a preclinical
suite of small molecules for the treatment of congenital hyperinsulinism. Rhythm's headquarters is in Boston, MA.
Setmelanotide Indication
States, setmelanotide is indicated for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic
or syndromic obesity due to POMC, PCSK1 or LEPR deficiency as determined by an FDA-approved test demonstrating variants in POMC, PCSK1
or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS) or BBS.
In the European Union, setmelanotide is indicated for the treatment
of obesity and the control of hunger associated with genetically confirmed Bardet-Biedl syndrome (BBS) or genetically confirmed loss-of-function
biallelic proopiomelanocortin (POMC), including PCSK1, deficiency or biallelic leptin receptor (LEPR) deficiency in adults and children
6 years of age and above.
United States and Europe, Setmelanotide should be prescribed and supervised by a physician with expertise in obesity with underlying
Setmelanotide is not indicated for the treatment of patients with the
following conditions as setmelanotide would not be expected to be effective:
- Obesity due to suspected POMC, PCSK1 or LEPR deficiency with POMC , PCSK1 or LEPR variants classified as benign or likely benign
- Other types of obesity not related to POMC, PCSK1 or LEPR deficiency, or BBS, including obesity associated with other genetic syndromes and general (polygenic) obesity.
WARNINGS AND PRECAUTIONS
Skin Monitoring: Setmelanotide
may lead to generalized increased skin pigmentation and darkening of pre-existing naevi because of its pharmacologic effect. Full body
skin examinations should be conducted annually to monitor pre-existing and new skin pigmentary lesions before and during treatment with
Heart rate and blood pressure monitoring: Heart
rate and blood pressure should be monitored as part of standard clinical practice at each medical visit (at least every 6 months) for
patients treated with setmelanotide.
Prolonged penile erection: Spontaneous
penile erections have been reported in clinical trials with setmelanotide. Patients who have a penile erection lasting longer than 4 hours
should be instructed to seek emergency medical attention for potential treatment of priapism.
Depression: In clinical
trials, depression has been reported in patients treated with setmelanotide. Patients with depression should be monitored at each medical
visit during treatment with setmelanotide. Consideration should be given to discontinuing setmelanotide if patients experience suicidal
thoughts or behaviors.
Pediatric Population: The
prescribing physician should periodically assess response to setmelanotide therapy. In growing children, the impact of weight loss on
growth and maturation should be evaluated. The prescribing physician should monitor growth (height and weight) using age- and sex-appropriate
Excipients: This medicinal
product contains 10 mg benzyl alcohol in each ml. Benzyl alcohol may cause allergic reactions. Patients who are pregnant or breastfeeding
should be advised of the potential risk from the excipient benzyl alcohol, which might accumulate over time and cause metabolic acidosis.
This medicinal product should be used with caution in patients with hepatic or renal impairment, because of the potential risk from the

Frequently Asked Questions

What is IMCIVREE used for?

IMCIVREE (setmelanotide) is used to treat Bardet-Biedl syndrome (BBS) and other obesity-related conditions.

How many new prescriptions were received for IMCIVREE?

Rhythm Pharmaceuticals received over 200 new prescriptions for IMCIVREE since its launch.

When did Rhythm launch IMCIVREE in the U.S.?

IMCIVREE was launched in the U.S. after FDA approval on June 16, 2022.

What clinical trial has Rhythm initiated recently?

Rhythm initiated a pivotal Phase 3 trial for setmelanotide in acquired hypothalamic obesity.

What company did Rhythm Pharmaceuticals acquire?

Rhythm Pharmaceuticals acquired Xinvento B.V., focusing on congenital hyperinsulinism.

Last updated: Mar 1, 2023