When the Food and Drug Administration expanded approval of Novo Nordisk’s weight loss medicine Wegovy to also protect heart health, the Danish drug giant had already made a pipeline commitment to developing new cardiovascular treatments.

The March 8 approval was followed by news this week that Novo plans to buy German cardiovascular specialist Cardior Pharmaceuticals for north of $1 billion. “The heart is back,” Cardior CEO and co-founder Claudia Ulbrich told PharmaVoice. “It’s back for venture capital, and it’s back for the pharma industry.”

As revenue from Wegovy sales pour in, Novo Nordisk is in position to bolster its pipeline further. The deal to buy Cardior, whose lead candidate CDR132L is a RNA-based treatment for heart failure, serves that purpose.

Cardior is a 2016 spinout from Germany’s Hannover Medical School, building on the work of Professor Thomas Thum, now the company’s chief scientific and medical officer. Rather than turning to messenger RNA, Cardior’s approach makes use of non-coding RNAs that aren’t translated into proteins, but regulate processes like cardiovascular function, Ulbrich said. CDR132L is an antisense oligonucleotide.

“Overall, the compound targets heart failure, and under this joint collaboration, we can address a large patient population,” Ulbrich said.

The cardiovascular drug field hasn’t advanced as quickly in recent decades as has oncology and immunology. “Over the last 20 years, we haven't really seen innovation in the cardiovascular space — we had only symptomatic treatments [like] ACE inhibitors, beta blockers or diuretics,” Ulbrich said.

GLP-1 drugs like Wegovy, and their ability to reduce cardiovascular risk, give physicians new options for certain people and could lay the foundation for new combinations.

“It's too early to state whether there is potential for our drug to be a combination product because we have a unique and completely different mode of action,” Ulbrich said. “But Novo is clearly striving to strengthen its pipeline in cardiovascular disease coming from diabetes and obesity.”

Novo said in a statement that the acquisition is “an important step forward” for the company to “establish a presence in cardiovascular disease.” The biotech has invested in other pipeline assets as well, including a $1.3 billion dollar investment for a hypertension drug developed by KBP Biosciences last October. Across Novo’s pipeline, the company is developing cardiovascular treatments that range from monoclonal antibodies to immunotherapies to cell therapy.

For Cardior, the deal provides a way to reach more patients, Ulbrich said.

“Our first trial was in post-myocardial heart failure, and this is a niche gap where there aren’t any causal treatments — where patients would clearly fit our treatment,” Ulbrich said. “But now, we will pursue development in a chronic situation, which is a large patient population.”

Cardior expects results from a Phase 2 trial by the end of the year or the beginning of 2025, Ulbrich said.

While the success of mRNA vaccines for COVID-19 didn’t directly influence Cardior, Ulbrich said companies like Germany’s BioNTech improved the industry’s understanding of RNA technology, particularly among large pharmaceutical companies.

Although not all the details of the transaction are set in stone, Cardior “will stay as is” for the moment, Ulbrich said.

“I want to oversee the transition and the next development steps because, having worked seven years for this company and for this program, it affects me personally,” Ulbrich said. “Overall, this looks like the right partnership and the right deal at the right point in time.”