Moderna (NASDAQ:MRNA) and AstraZeneca (NASDAQ:AZN) compete against each other in some markets with their respective COVID-19 vaccines. However, the two companies are also partners. They recently reported results from a phase 2 study of a messenger RNA (mRNA) heart failure drug. In this Motley Fool Live video recorded on Nov. 16, 2021, Motley Fool contributors Keith Speights and Brian Orelli discuss whether or not Moderna's and AstraZeneca's mRNA candidate could be a winner.

Keith Speights: There's other news for Moderna. The company, along with its partner, AstraZeneca, reported some good news recently from a phase 2 study of a messenger RNA drug targeting heart failure.

Brian, what's your take on those results? Do you think these companies have a decent chance of going on to ultimately winning approval and achieving commercial success with this mRNA heart failure drug?

Brian Orelli: The drug goes by the name AZD-8601. As you can tell by the code name, it's fairly early in development. It's an mRNA that's injected into the myocardium, that's the muscle responsible for pumping the patient's heart. It was given while patients undergoing elective coronary bypass surgery.

The idea here is that you want to express this protein by three mRNA and then that's going to strengthen the pumping of the patient's heart. The clinical trial was mostly for safety, and so they showed that the procedure is safe, but it did measure some other secondary measurements.

They measured left ventricle ejection fraction, which is a measure of heart function. They looked at a bio-marker called an NT-proBNP, and that is a hormone. It's elevated in patients with heart failure. They were looking for that to go down. They saw trends that favored the drug, but they're only seven patients that got the drug and four that got a placebo, so it's hard to draw any conclusions.

The other issue here is that patients and their doctors and the FDA are going to care a lot more about outcomes like heart attacks, strokes, and death than they are about the heart pumping better or some bio-marker going down. Those clinical trials take a lot longer because you got to wait for somebody to get a heart attack, a stroke, or die.

I think investors, especially in Moderna, should expect this is going to be a long time frame, that their internal pipeline, I think AstraZeneca's in charge of over earning this drug through clinical development. I think Moderna's internal pipeline of vaccines is probably actually going to get through clinical development faster than AZD-8601 even though it might be a little bit further ahead, at this point, I think the clinical development timeline is going to be pretty long for this drug.

Speights: Yeah. Importantly, we are talking about a drug here, not a vaccine. Moderna has said all along that if its messenger RNA approach works in one disease, it really holds a lot of potential treating a lot of other diseases.

Do you think these results bolster that that Moderna's mRNA platform really could target a lot more diseases than just some of the viruses that are out there?

Orelli: Yeah. I think the issue is that it probably only is expressing for a short amount of time. That works fine when you're just trying to stimulate the immune system, start attacking things you don't need that much protein to be expressed. It might be difficult to do enzyme replacement therapy where you're putting the protein into the patient because you'd have to get it to be expressed constantly, you'd have to be constantly giving yourself injections.

That we'll have to wait and see how long it lasts between whether you're getting high enough expression that you would, and how long that expression lasts would be the keys there.

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