#022: A Map of Mitochondria Longevity Companies (PART 2)

*This is PART 2 of Newsletter #022: A Map of Mitochondria Longevity Companies (PART 1)

Peroxidation / Oxidation

Stealth BioTherapeutics (NASDAQ:MITO)

• Market cap: $94 M

• Enterprise Value: $54 M

• Cash: $40 M 

• Founded: 2006

• Modality: peptide, injection

• Founders: Hazel Szeto

• Partnership: Alexion (NASDAQ:ALXN)

• Notable Investors: 

• Pipeline:

  • Elamipretide // Barth Syndrome (rare mitochondrial disease) // Phase 2/3 (active)

  • Elamipretide // Geographic Atrophy (Dry AMD) // Phase 2 (recruiting)

  • Elamipretide // Duchenne cardiomyopathy // Phase 2 (planned 2021) 

  • Elamipretide // Freidreich’s Ataxia // Phase 2 (planned 2021)

  • Elamipretide // Leber Hereditary Optic Neuropathy (LHON) // Phase 2 complete

  • 2nd generation peptides & mimetics // Neurodegenerative diseases // Preclinical

• Links

  • Slide deck Jan 2021

  • Q3 Report

General Notes

• Stealth BioTherapeutics is a clinical-stage company developing peptides and peptide mimetics to treat diseases linked to mitochondrial dysfunction.

• Their main asset is a four-amino acid peptide called elamipretide. Elamipretide is believed to permeate the outer mitochondrial membrane where it helps reduce the production of Reactive Oxygen Species and stabilize cardiolipin, a phospholipid foundin the inner mitochondrial membrane.

• Stealth had a high-profile failure of a Phase 3 trial for elamipretide to treat Primary Mitochondrial Myopathy in December 2019. The stock fell ~66% on the news and down as much as 90% in subsequent months.

• Stealth’s lead clinical program is targeting Barth Syndrome, a rare mitochondrial disease. Some early Phase 2 data has shown elamipretide improves 6-minute walking test, cardiac function biomarkers, and Barth Syndrome Scale scores. 

• Stealth is also developing 2nd generation peptides or peptide mimetics (SBT-272, SBT-550). 

Origins & Funding

• Hazel Szeto accidentally discovered peptides that act on mitochondria as a researcher at Weill Cornell Medical College studying opioid receptors. 

• Stealth was eventually spawned out of Morningside Ventures, a venture capital firm founded by a wealthy Hong Kong family. Rennie McCarthy, a lawyer, and Principal at Morningside would eventually be placed as CEO of Stealth. 

• Morningside is the majority investor in the company and has also injected cash into the company post-IPO. 

Pipeline Details

• Stealth has two active clinical trials with elamipretide. Most of their planned clinical trials involve elamipretide, with a couple of newer 2nd generation peptides/mimetics being tested for neurological indications

• Elamipretide (also known as MTP-131, SS-31, Bendavia) is a four-amino acid peptide. ~0.68 kDa weight. Stealth believes it can permeate the mitochondrial membrane, reduce the levels of Reactive Oxygen Species, and stabilize cardiolipin