Dimerix Limited

ASX:DXB

Dimerix Limited

ASX:DXB
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$0.345 (+6.2%)
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#129
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Pinned straw:
edgescape
Last edited 8 months ago

Although I have little medical background, I do know that Rituximab is one of the go-to drugs for Kidney disease, particularly FSGS which is the main focus for Dimerix's candiate DMX-200

What is Rituximab?

Rituximab is a cancer drug called a monoclonal antibody. Monoclonal antibodies target proteins on the surface of cancer cells. Rituximab targets a protein called CD20. (Cancer research UK)

The CD20 protein is also found on white blood B cells and is part of our immune system which is also where this gets interesting. When someone has kidney disease, the immune system come and fight the infection, but also may get too active and end up harming the kidney - similar to autoimmune disease. Rituximab is administered to reduce the number of B-cells and protect the kidney from further harm by the immune system.

So now Rituximab is not just used for cancer, but also treatment of Kidney disease due to the above characteristics.

Problems with Rituximab

By weakening the immune system, Rituximab can cause problems with other conditions and side-effects such as being more exposed to infections and viruses. Most critical one is the weakening of the Liver which is troublesome for people who had hepatitis B in the past. Weakening the immune system may activate hepatitis B lying dormant in the Liver. The obvious workaround is taking an antiviral such as Entecavir before taking Rituximab.

I've also been told that the Rituximab is not always successful in fighting kidney disease from one of the renal doctors. Usually there is 70-80% chance of treatment being effective

Opportunities/shortcomings for DMX-200

I haven't found much on how DMX-200 works. From the Dimerix website we know that DMX-200 is a chemokine receptor (CCR2) blocker taken in conjunction with Avapro/Irbesartan. But there could be lots of positives if DMX-200 can overcome the shortcomings of Rituximab.

We probably won't know too much until the Phase III trials are finished some time at the beginning of 2026 which is a long wait which I found when going to the clinical trials website.

Therefore much of the success in Dimerix hinges on license deals as well as any indication of the product being safer to use against the current treatments such as Rituximab

Anyway I thought I would share what is weighing on my mind while holding Dimerix.

[held]
edgescape
Added 8 months ago

This straw on Rituximab is mainly in response to this slide stating there are no approved treatments even if it is sometimes unsuccessful. Annoying when companies start being a bit selective about the information out in the real world but then it is always like that in small-cap land!

It would have been better to do the trial against Rituximab or any other corticosteroid so investors can compare the stats.

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On the flipside, Rituximab would be more appealing to China and South East Asia as this population has a a high proportion of patients with Hepatitis B carriers. So it is no surprise that the reference to China is in this slide.

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edgescape
Added 8 months ago

Meant "more" not "less" to Asia which I corrected.

I found a few interesting things about the failure of CCR inhibitors which I will add in another straw.

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edgescape
Added 6 months ago

While searching for some information about EGFR and DMX-200, I stumbled on this link from Newcastle University regarding current treatment options.

https://www.io.nihr.ac.uk/wp-content/uploads/2024/01/26875-DMX-200-for-Focal-Segmental-Glomerulosclerosis-V1.0-JAN2024-NON-CONF.pdf

13138c290821e02c4dff9faec3922d20d6a807.png

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Note 13 relates to this document about Rituximab and another drug Ciclosporin.

https://www.nice.org.uk/advice/es1/resources/minimal-change-disease-and-focal-segmental-glomerulosclerosis-in-adults-rituximab-pdf-32169639877#:~:text=Management of FSGS aims to,initial treatment is with corticosteroids

So it is not an outright decision of selecting DMX-200 if Rituximab fails as you can also take Ciclosporin and a few others too.

Think these treatment options would limit the market share and revenue of DMX-200.

Of course Dimerix and many of the broker reports I've found don't mention the above..

Still holding for now and really crossing my fingers the price action holds till July, but my revenue expectations is cautiously lowered from finding the above.

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