Aer­pio shares tum­ble as lead eye drug trips up in mid-stage di­a­bet­ic retinopa­thy study

Rough­ly two years af­ter rais­ing $40 mil­lion in a pri­vate place­ment, Aer­pio Phar­ma­ceu­ti­cals’ lead ex­per­i­men­tal eye drug has hit a road­block af­ter fail­ing a mid-stage study in pa­tients with non-pro­lif­er­a­tive di­a­bet­ic retinopa­thy (NPDR) — the ear­li­est stage of di­a­bet­ic eye dis­ease, which oc­curs when high blood sug­ar lev­els cause dam­age to blood ves­sels in the reti­na.

Stephen Hoff­man

These blood ves­sels can swell and leak, or close re­strict­ing blood flow and even­tu­al­ly cul­mi­nate in blind­ness. In the 167-pa­tient tri­al, called TIME-2b, pa­tients were giv­en the drug — AKB-9778 —  (once or twice dai­ly) or place­bo (once or twice dai­ly) for 48 weeks. The main goal was to im­prove the the study eye di­a­bet­ic retinopa­thy sever­i­ty score (DRSS) by two or more steps com­pared to the place­bo.

Ad­min­is­tra­tion of AKB-9778 twice dai­ly missed the study’s pri­ma­ry end­point, the com­pa­ny said on Mon­day. Shares of the Cincin­nati-based drug de­vel­op­er $AR­PO cratered more than 68% to $1.36 in pre-mar­ket trad­ing.

About 9.6% of pa­tients giv­en AKB-9779 twice dai­ly ex­pe­ri­enced such an im­prove­ment, ver­sus 3.8% on the place­bo — draw­ing a less than rosy p val­ue (p=0.270). The rates of pro­gres­sion to sight-threat­en­ing com­pli­ca­tions, in­clud­ing di­a­bet­ic mac­u­lar ede­ma (DME) and/or pro­lif­er­a­tive di­a­bet­ic retinopa­thy (PDR), dur­ing the treat­ment pe­ri­od were sim­i­lar be­tween treat­ment groups, Aer­pio not­ed, adding that the use of the ex­per­i­men­tal drug had an “en­cour­ag­ing” im­pact on key sec­ondary goals, in­clud­ing a mea­sure of kid­ney func­tion and in­traoc­u­lar pres­sure.

Un­like pa­tients with di­a­bet­ic eye dis­ease who are typ­i­cal­ly giv­en an­ti-VEGF in­jec­tions in­to the eye, AKB-9778 is self-ad­min­is­tered sub­cu­ta­neous­ly by the pa­tient, akin to in­sulin. The ex­per­i­men­tal drug is a small mol­e­cule in­hibitor of VE-PTP, the most crit­i­cal neg­a­tive reg­u­la­tor of Tie2 — a path­way be­lieved to sta­bi­lize vas­cu­la­ture — in dis­eased blood ves­sels. In a sep­a­rate study, called TIME-2, AKB-9778 im­proved un­der­ly­ing symp­toms by two or more steps on a di­a­bet­ic retinopa­thy sever­i­ty scale in both eyes.

Un­de­terred by the TIME-2b fail­ure, Aer­pio chief Stephen Hoff­man ex­pressed en­thu­si­asm for the to­tal­i­ty of da­ta on the drug. “(C)ol­lec­tive­ly these da­ta sup­port a po­ten­tial­ly im­por­tant role of the Tie2 path­way for the treat­ment of di­a­bet­ic com­pli­ca­tions, as well as for open an­gle glau­co­ma,” he said in a state­ment, adding that a Phase Ib study of a top­i­cal drop for­mu­la­tion of AKB-9778 is ex­pect­ed to com­mence in the sec­ond quar­ter.

Aer­pio al­so has an­oth­er ex­per­i­men­tal eye drug in de­vel­op­ment, in ad­di­tion to an in­ves­ti­ga­tion­al ther­a­py for in­flam­ma­to­ry bow­el dis­ease.

UP­DAT­ED: Mer­ck pulls Keytru­da in SCLC af­ter ac­cel­er­at­ed nod. Is the FDA get­ting tough on drug­mak­ers that don't hit their marks?

In what could be an early shot in the battle against drugmakers that whiff on confirmatory studies to support accelerated approvals, the FDA ordered Bristol Myers Squibb late last year to give up Opdivo’s approval in SCLC. Now, Merck is next on the firing line — are we seeing the FDA buckling down on post-marketing offenders?

Merck has withdrawn its marketing approval for PD-(L)1 inhibitor Keytruda in metastatic small cell lung cancer as part of what it describes as an “industry-wide evaluation” by the FDA of drugs that do not meet the post-marketing checkpoints on which their accelerated nods were based, the company said Monday.

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Paul Sekhri

The next big biotech su­per­star? Paul Sekhri has some thoughts on that

It occasionally occurs to Paul Sekhri that if they pull this off, his company will be on the front page of the New York Times and a lead story in just about every major news outlet on the planet. He tries not to dwell on it, though.

“I just want to be laser-focused on getting to that point,” Sekhri says, before acknowledging, “Yes, it absolutely crossed my mind.”

Sekhri, a longtime biopharma executive with tenures at Sanofi and Novartis, is now entering year three as CEO of eGenesis, the biotech that George Church protégé Luhan Yang founded to genetically alter pigs so that they can be used for organ transplants. He led them through one megaround and has just closed another, raising $125 million from 17 different investors to push the first-ever (humanized) pig to human transplants into the clinic.

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Amit Munshi, Arena

One of Are­na's top drugs flops in a PhI­Ib study for IBS pain. But re­searchers tease out a pos­si­ble path for­ward as CEO ex­plores 's­trate­gic op­tion­s'

Four years ago, when Arena CEO Amit Munshi cut its ties to a troubled weight drug and doubled down on the pipeline, a cannabinoid receptor 2 agonist figured prominently in the biotech’s future. On Tuesday evening, however, Munshi’s high hopes for the drug took a nasty hit after it failed a Phase IIb study for patients with irritable bowel syndrome pain.

Put through a randomized pace with 273 patients, researchers said it flat failed the primary endpoint among the large group with abdominal pain. But they quickly went on to highlight subgroup data, always a tricky and controversial ploy, where they spotlighted a positive p value for patients with moderate to severe pain who received the high dose of the drug — one of 3 provided in the study.

Bob Nelsen (Photo by Michael Kovac/Getty Images)

With stars aligned and cash in re­serve, Bob Nelsen's Re­silience plans a makeover at 2 new fa­cil­i­ty ad­di­tions to its drug man­u­fac­tur­ing up­start

Bob Nelsen’s new, state-of-the-art drug manufacturing initiative is taking shape.

Just 3 months after gathering $800 million of launch money, a dream team board and a plan to shake up a field where he found too many bottlenecks and inefficiencies for the era of Covid-19, Resilience has snapped up a pair of facilities now in line for a retooling.

The company has acquired a 310,000-square-foot plant in Boston from Sanofi along with a 136,000-square-foot plant in Ontario to add to a network which CEO Rahul Singhvi says is just getting started on building his company’s operations up. The Sanofi deal comes with a contract to continue manufacturing one of its drugs.

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CEO Marco Taglietti (Scynexis)

'N­ev­er been more ur­gent:' Scynex­is looks to tack­le su­per­bug cri­sis with late-stage read­out for an­ti­fun­gal hope­ful

As the superbug crisis heats up around the world, Scynexis says it has new data from two interim analyses that prove its antifungal has the potential to treat a broad range of infections.

“The need for new anti-infectives capable of fighting the most resistant pathogens has never been more urgent as we confront the ongoing COVID-19 global pandemic,” CEO Marco Taglietti said in a statement.

A spot­light schiz­o­phre­nia drug in Neu­ro­crine's $2B Take­da deal flunks its first ma­jor test. But it's not giv­ing up yet

When Takeda spun out a pipeline of experimental psychiatry drugs to Neurocrine in a $2 billion deal amid a post-merger shakeout, R&D chief Andy Plump described the therapies as “very interesting but still difficult.”

On Tuesday, we got some idea of how difficult.

San Diego-based Neurocrine revealed that one of the three spotlight clinical programs they’d acquired failed the primary endpoint in a Phase II trial for schizophrenia, registering a negative outcome on the change from baseline in the positive and negative syndrome scale/negative symptom factor score (PANSS NSFS).

Af­ter bail­ing on Covid-19 vac­cines, Mer­ck will team up with J&J to pro­duce its shot as part of un­usu­al Big Phar­ma pact

Merck took a big gamble when it opted to jump into the Covid-19 vaccine race late, and made an equally momentous decision to back out in late January. Now, looking to chip in on the effort, Merck reportedly agreed to team up with one of the companies that has already crossed the finish line.

President Joe Biden on Tuesday is expected to announce a partnership between drugmakers Merck and Johnson & Johnson to jointly produce J&J’s recombinant protein Covid-19 vaccine that received the FDA’s emergency use authorization Saturday, the Washington Post reported.

Ab­b­Vie tees up a biotech buy­out af­ter siz­ing up their Parkin­son's drug spun out of Ke­van Shokat's lab

AbbVie has teed up a small but intriguing biotech buyout after looking over the preclinical work it’s been doing in Parkinson’s disease.

The company is called Mitokinin, a Bay Area biotech spun out of the lab of UCSF’s Kevan Shokat, whose scientific explorations have formed the academic basis of a slew of startups in the biotech hub. One of Shokat’s PhD students in the lab, Nicholas Hertz, co-founded Mitokinin using their lab work on PINK1 suggesting that amping up its activity could play an important role in regulating the mitochondrial dysfunction contributing to Parkinson’s disease pathogenesis and progression.

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Fi­bro­Gen shares skid low­er as a sur­prise ad­comm rais­es risks on roxa OK

FibroGen will likely have to delay its US rollout for roxadustat once again.

In an unexpected move, the FDA is convening its Cardiovascular and Renal Drugs Advisory Committee to review the NDA in an advisory committee meeting. The date is yet to be confirmed.

Just a few weeks ago, SVB Leerink analyst Geoffrey Porges predicted that the roxa approval could come ahead of the PDUFA date on March 20 — effusive despite already being let down once by the FDA’s extension of its review back in December. AstraZeneca, which is partnered with FibroGen on the chronic kidney disease-related anemia drug, disclosed regulators had requested further clarifying analyses of clinical data.