The Medicines Company has gained exclusive global licensing to Pfizer’s ApoA-I Milano, which is a naturally occurring variant of a protein found in high-density lipoprotein that has the potential to reverse atherosclerotic plaque development and reduce the risk of coronary events in patients with acute coronary syndrome.

Under the terms of the agreement, the New York City-based Pfizer will receive an up-front payment of $10 million for ApoA-I Milano and will receive additional payments upon the achievement of certain clinical, regulatory and sales milestones up to a total of $410 million. Pfizer will be eligible to receive single-digit royalty payments on worldwide net sales of ApoA-I Milano. Medicines will pay $7.5 million to third parties.

ApoA-I Milano is a naturally occurring variant of ApoA-I, the main protein component of the HDL lipoprotein particle, according to the Parsippany, N.J.-based Medicines. The variant has been found in approximately 45 individuals from Limone sul Garda, a small village in northern Italy. Carriers of this variant appear to have reduced risk of cardiovascular disease.

Patented by the University of Milan and Pharmacia, ApoA-I Milano was licensed to Esperion Therapeutics, which was subsequently acquired by Pfizer in 2004. Since that time, Pfizer has moved forward with the original manufacturing process.