Trimetazidine Hydrochloride

A biotech incubated by RA Capital has secured a $57.5 million Series B to begin a mid-stage trial for its cardio drug this quarter and get to a readout in late 2026. Imbria Pharmaceuticals has now raised a total of about $150 million in equity financing, CEO Alvin Shih exclusively told Endpoints News . The Boston startup, which has eight employees, has not previously disclosed its fundraising. Imbria’s financial backers include RA, SV Health Investors, Deep Track Capital, AN Ventures and Catalio Capital Management. The money is expected to help the company prove whether its oral medicine, code-named ninerafaxstat , can treat patients with non-obstructive hypertrophic cardiomyopathy, or HCM, in a Phase 2b study. The biotech now has a runway into the second half of 2027, according to Shih, who joined Imbria as a board member last year and is now CEO. Anne Prener, a former partner at SV Health, was president and CEO of Imbria from 2020 until September, according to her LinkedIn. Shih has spent the past few quarters trying to secure funding in a challenging market. “It has not been easy. The environment is very difficult, but I would say raising money for my previous company — Catamaran [Bio] in the cell therapy space — was impossible,” he said, referring to the CAR-NK cell therapy biotech that closed last year . “This was just difficult.” Imbria will also benefit from the expertise of Cytokinetics, which chipped into the startup’s Series B. “Their involvement validates our approach,” Shih said. The California drug developer’s aficamten is in late-stage development in similar cardio fields as Imbria’s ninerafaxstat; however, Cytokinetics doesn’t have any operational control over ninerafaxstat, Shih confirmed. Eventually, and maybe with the help of a partner, Imbria plans to continue testing the twice-daily drug in other cardio indications like heart failure with preserved ejection fraction, or HFpEF. The drug has already gone through a Phase 2a in HFpEF. Imbria said the drug met the trial’s primary endpoint in a presentation at last month’s annual American College of Cardiology conference. “It’s become an epidemic,” Shih said. “HFpEF is the fastest-growing segment of heart failure, and it’s clear that even with GLP-1s, you haven’t totally fixed the problem, and so patients are going to need additional therapeutics.” Ninerafaxstat is a partial fatty acid oxidation (pFOX) inhibitor. Shih said the goal is to make the heart less reliant on fatty acids, which is common in heart failure patients, and more reliant on glucose, which could boost metabolism and make for a more well-oiled mitochondrial engine. With better energy generation, cardiac function should improve. Shih said the experimental oral drug has demonstrated improvement in “cardiac energetics,” key functional outcomes and quality of life outcomes, including on the Kansas City Cardiomyopathy Questionnaire, a self-administered survey for heart failure patients. “That is what is going to be the approvable endpoint in both HCM and HFpEF,” Shih said. RA Capital got the idea from a decades-old drug called trimetazidine , which has been commercialized in Europe to treat angina but is not approved by the FDA. “It’s known to have some activity in the cardiac mitochondria, but what they wanted to do was to optimize the molecule and they ended up creating a new molecule that results in trimetazidine as one of its metabolites, but also has other active metabolites,” Shih said. It’s “sort of getting more bang for the buck on the mechanism, which is in the mitochondria.”