There seems a completely plausible reason for the PII study disapointment.  COVID is a rapidly changing illness, and RVX is extremely late to the game.

Of course there is no way of knowing for sure, but I think there would have been a decent shot at a positive trial outcome had apabetalone been studied during the earlier, more severe strains of COVID. They seem to be victim to the transformation of COVID from a more serious illness to a less serious but outrageously more contageous illness.  I'm not a virologist, but it seems completely plausible to me that by the time RVX showed up for testing, they really couldn't find 100 people to give the drug to (matching the trial requirements, people actually seriously ill enough to want the drug...) or the results were inconclusive (how many people in the control group ended up just fine? In 100 people, how many people with omicron would have ended up seriously ill in a timely, measurable way?).

There wasn't really a way of reliably predicting any of this when they actually had to get the trial designed.

At least with the new focus (long term adverse outcomes, emphasis on cardio problems) they seem to have a more stable target, and are bringing it into a realm they already know they have a possitive impact on.  Hindsight may suggest this was the better target all along.  The worldwide hysteria about COVID continuing to be an immediate, serious threat for years to come got DM seeing "emergency use" dollar signs for wide numbers of dosable populations.  That thought, in my opinion, was always a long shot.

For what it's worth, I have every confidence that the team is right about the PIII.  Too many confirming factors to ignore: good scientific studies to indicate apabetalone's impact on Covid and cardiovascular outcomes, Eversana staying onboard (its not cheap for them to build out a dedicated team, and to keep persuing this), and major investors are not bailing.  

After BOM, and the rise of Covid, RVX had somewhat of a forced hand.  They couldn't possibly ignore the science suggesting they had a good shot at becoming a therapeutic for COVID, and couldn't really do much with BOMII while the world was hunkered down.  However, RVX is a tiny player in the biotech world, and as soon as BP got their clutches on even remotely promising treatments...well, he who pays the piper calls the tune.  We were underfunded, and in a ridiculous line trying to get started.  By the time we were ready, the disease had drastically changed.

BOMII is by far the more promising program for this drug long term, and it is a shame that we don't have a clear understanding of that program going forward.  Hepa surely had all of this COVID info when they extended the debenture, so you have to believe the promise is still there for apabetalone.  But the financing for BOMII is not going to be pretty without better COVID news.  Given the track record, that PIII trial is unlikely to get off the ground before next Spring.

I, for one, would much prefer to take the dillusion pain and get BOMII going.  It's way overdue, and surely they have to have been laying the groundwork for that trial while waiting on COVID...right? Please?