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Human genetics doesn't just provide a drug target; it often specifies the therapeutic approach required. Discovering a protective loss-of-function mutation immediately tells researchers to develop an inhibitor (like an antibody or siRNA), accelerating the path from target discovery to molecule design.

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A new class of drug called siRNA, a cousin of mRNA, can enter cells and stop a specific gene from producing a harmful protein. This enables highly targeted treatments, such as new drugs that reduce a type of cholesterol by over 95% with a single, long-lasting injection.

Instead of only seeking disease-causing genes, Regeneron's primary strategy is to find rare protective mutations in individuals they call "superhumans." These people, naturally protected from diseases like heart attacks, provide a validated blueprint for new drugs. The company has already found over 50 such protective factors.

The next wave of neuroscience therapeutics is shifting from managing broad symptoms (e.g., in autism) to precision therapies. By identifying genetic underpinnings of a disease, developers can create drugs that target the specific biology of patient subpopulations, aiming for disease modification rather than just symptomatic relief.

The initial success of pan-RAS inhibitors stemmed from a deliberate development strategy. By designing a drug that blocks all RAS variants, not just a specific mutation, developers could efficiently test their compound in the largest possible patient pool, accelerating clinical validation in a disease highly dependent on RAS signaling.

Regeneron identified the main constraint in drug discovery as a lack of validated targets, not a shortage of advanced therapeutic tools. Their genetics engine was created to explore the 90% of the human genome that was untargeted by existing or experimental medicines, aiming to solve this core problem.

Regeneron's Genetics Center is a key competitive advantage, functioning as a discovery engine for new drug targets. By sequencing millions of patient genomes and linking them to health records, it allows Regeneron to identify novel genetic variants associated with diseases, feeding its antibody development pipeline with proprietary targets.

Instead of traditional methods, Regeneron sequences millions of people to find "superhumans"—those with rare genetic mutations that protect them from diseases. By studying these individuals, they identify high-confidence drug targets that mimic these natural protections, aiming for a higher probability of success in development.

Regeneron systematically expands the market for its drugs through "indication expansion." By identifying people in its database with a natural loss-of-function variant for a drug's target, they can scan thousands of diseases to see what other conditions these people are protected from, revealing new therapeutic opportunities.

The primary bottleneck in drug development isn't creating therapies but identifying the right targets. Regeneron built its massive genetics database to find rare, protective genetic mutations in humans, effectively de-risking the target identification process and aiming to improve the industry's low success rate.

Step Pharma's confidence in their drug's clean safety profile originated from studying a human population with a natural mutation in the CTPS1 gene. This real-world genetic data de-risked their therapeutic approach from the outset, guiding development towards a highly selective and safe inhibitor.

Genetic Discoveries Dictate a Drug's Modality, Accelerating Development from the Start | RiffOn