Aim­mune's peanut al­ler­gy treat­ment could 'change prac­tice' — with safe­ty chal­lenges and a price any­thing but peanuts

Aim­mune Ther­a­peu­tics $AIMT has de­tailed the re­sults of its Phase III study of its peanut al­ler­gy ther­a­py known as AR101 in the New Eng­land Jour­nal of Med­i­cine in an ar­ti­cle — and in­de­pen­dent as­sess­ment — that will like­ly stoke its sup­port­ers as much as the skep­tics in the field. 

And once it is mar­ket­ed, if it gets that far, you can ex­pect a se­vere blow­back on the price, con­sid­er­ing this is a nat­ur­al byprod­uct that al­so has been used at the same dose that costs vir­tu­al­ly noth­ing to make — but wouldn’t have the same stamp of ap­proval that a prod­uct OK’d by the FDA would have.

On the bright side, the ar­ti­cle in the NE­JM un­der­scored that a dust­ing of care­ful­ly con­trolled 12% de­fat­ted peanut flour used in the treat­ment did help a broad swathe of 4- to 17-year-old al­ler­gic pa­tients in the study — two thirds to be ex­act — even­tu­al­ly tol­er­ate a dose of up to 4 peanuts with­out the se­vere and pos­si­bly life threat­en­ing re­ac­tion that they could nor­mal­ly ex­pect. That was true of on­ly 4% of place­bo group in the study.

A. Wes­ley Burks

A. Wes­ley Burks, the se­nior au­thor, said that the ther­a­py “could change prac­tice for peanut al­ler­gy.” And they’re just weeks away from fil­ing for an ap­proval at the FDA, with the EMA to fol­low next year.

Looked at in terms of ef­fi­ca­cy alone, their da­ta will get you through to an ap­proval and some high fives all around. But it’s not as sim­ple as that, with some big con­cerns about the na­ture of this prod­uct and the price tag that could make it a block­buster. Crit­ics didn’t over­look the fact that 11.6% of the pa­tients on AR101 dropped out of the study due to side ef­fects, com­pared to 2.4% in the place­bo arm.

Michael Perkin

“This is not some­thing to start at home,” notes Michael Perkin, one of the lead­ing spe­cial­ists in chil­dren’s al­ler­gies, in an in­de­pen­dent re­view of the NE­JM ar­ti­cle. “Ep­i­neph­rine was used by 14.0% of the par­tic­i­pants in the ac­tive-drug group as a re­sult of re­ac­tions to treat­ment. The longer-term side ef­fects of sus­tained con­sump­tion of an al­ler­gen to which the body has pro­duced IgE an­ti­bod­ies re­main un­known. Cur­rent think­ing has fo­cused on eosinophilic dis­ease, such as eosinophilic esophagi­tis, but sur­veil­lance and fol­low-up will be cru­cial.”

“The po­ten­tial mar­ket for these prod­ucts is be­lieved to be bil­lions of dol­lars,” adds Perkin. “It is per­haps salu­tary to con­sid­er that in the study con­duct­ed by the Cam­bridge group (which used a less pre­cise but equiv­a­lent 12% de­fat­ted peanut flour), chil­dren un­der­went de­sen­si­ti­za­tion with a bag of peanut flour cost­ing peanuts.”

The de­tails, and even the crit­i­cism, won’t help Paris-based DBV Tech­nolo­gies make its case for their ri­val al­ler­gy treat­ment, which failed a Phase III tri­al but is still bound to reg­u­la­tors.

Just days ago Nestlé Health Sci­ence upped its bet on Aim­mune Ther­a­peu­tics by $98 mil­lion, with its now $276 mil­lion stake in the com­pa­ny giv­ing it 19% of the biotech’s eq­ui­ty.

RWE chal­lenges for to­day's bio­phar­ma

The rapid development of technology — and the resulting avalanche of data — are catalysts for significant change in the biopharmaceutical industry. This translates into urgent pressures for today’s biopharma, including a need to quickly and affordably develop products with proven therapeutic efficacy and value. This urgency is expedited by the growth of value-based contracting, where access to reimbursement and profit depends on these abilities.

UP­DAT­ED: In a stun­ning turn­around, Bio­gen says that ad­u­canum­ab does work for Alzheimer's — but da­ta min­ing in­cites con­tro­ver­sy and ques­tions

Biogen has confounded the biotech world one more time.

In a stunning about-face, the company and its partners at Eisai say that a new analysis of a larger dataset on aducanumab has restored its faith in the drug as a game-changer for Alzheimer’s and, after talking it over with the FDA, they’ll now be filing for an approval of a drug that had been given up for dead.

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As shares suf­fer from a lin­ger­ing slump, a bruised Alk­er­mes slash­es 160 jobs in R&D re­struc­tur­ing

With its share price in a deep slump after suffering through a regulatory debacle over their depression drug ALKS 5461, Alkermes CEO Richard Pops is taking the ax to its R&D organization in a restructuring aimed at cutting costs ahead of its next attempt at a rollout in a tough field.

Richard Pops, Endpoints via Youtube

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Acor­da's Ron Co­hen brings the ax back out as new drug sales on­ly trick­le in while cash cow is led to the slaugh­ter

With its new drug earning meager sums and its one-time cash cow reduced to a bony shadow of its former self, Acorda Therapeutics today is rolling out a new restructuring aimed at slashing the staff and cutting costs to get through the hard times ahead.

The biotech is chopping a quarter of its staff today, carving back R&D as well as SG&A expenses. And CEO Ron Cohen is cutting deep.

Under the new austerity budget, Acorda’s R&D expenses for the full year 2019 are expected to be $55 – $60 million, reduced from $70 – $80 million. SG&A expenses for the full year 2019 are expected to be $185 – $190 million, reduced from $200 – $210 million. R&D expenses for the full year 2020 are expected to be $20 – $25 million and SG&A
expenses for the full year 2020 are expected to be $160 – $165 million.

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RAPT Ther­a­peu­tics re­turns to Wall Street to re­vive IPO bid

On May 24, FLX Bio, a small cancer and inflammation biotech with backing from GV, changed its name to RAPT Therapeutics and filed confidentially for an IPO. On July 5th, they filed to raise up to $86 million. On July 22, they announced the IPO with a $75 million goal.  And on August 1, they abruptly and without explanation called it all off.

Now, without explanation, they’re reviving the bid, filing again for a $75 million IPO, this time with a new bookrunner and a new drug candidate in the clinic. The terms will be the same: 5 million shares at $14-$16 per share. It would give them a diluted market value of $351 million.

EY vet set to re­place re­tir­ing Am­gen CFO Meline

Ahead of its third-quarter results next week, Amgen on Tuesday disclosed the planned retirement of David Meline, who has served as the company’s chief financial officer since 2014.

Meline will be replaced by Ernst & Young vet, Peter Griffith, as CFO come January 1, 2020 — but until then Griffith will serve as executive vice president, finance.

“Over the last 5 years at Amgen, Meline instituted many major changes that led to operational efficiencies and margin expansion while successfully returning cash to shareholders. Now that Amgen is on solid footing, it was a good time to step away,” Cowen’s Yaron Werber wrote in a note. “We do not anticipate any major changes to strategy or operations immediately due to this transition as Amgen is on solid footing.”

Eli Lil­ly’s USA, di­a­betes chief En­rique Con­ter­no is head­ing out af­ter 27 years, and he’s be­ing re­placed by a com­pa­ny in­sid­er

Close to 3 years after Eli Lilly CEO Dave Ricks added the title of president of the US operations to Enrique Conterno’s resume, which included his helmsmanship of the diabetes franchise, the Peruvian born exec is set to retire after a 27-year run at the pharma giant.

Lilly put out the news just as it was posting Q3 results, with a mix of upbeat and downbeat results in the latest set of numbers from Lilly.
Conterno — a grizzled, deeply experienced and sometimes gruff veteran of the pharma world — was a high-profile figure at Lilly, stepping up to expanded duties as the company was forced to deal with intense pricing pressure on the diabetes side of the business. He had replaced outgoing US president Alex Azar, who later popped up as head of Health and Human Services in the Trump administration.
As head of the diabetes unit, Conterno had to deal with an extraordinarily competitive field as payers demanded bigger discounts. Trulicity’s success helped generate new revenue for the company, but Q3’s miss on revenue had a lot to do with the need for discounting the drug ahead of Novo Nordisk’s rival therapy, Rybelsus, which was priced on the wholesale level at an almost identical rate.

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No­var­tis hands off $80M in cash to part­ner up with a top biotech play­er in the fi­bro­sis sec­tor

Never underestimate the power of a good showing at a scientific conference.
In a presentation late last year, the researchers at Pliant Therapeutics launched a series of discussions about the preclinical data they were pulling together around their work on their small-molecule integrin inhibitor aimed at transforming growth factor beta, or TGF-β, a key pathway involved in fibrosis.
And they got some serious attention for the work.
“We got interest from pharma partners and at the end Novartis basically made it,” says Pliant CEO Bernard Coulie.

Vas Narasimhan. Getty Images

UP­DAT­ED: Failed PhI­II fe­vip­iprant tri­als pour more cold wa­ter on No­var­tis' block­buster R&D en­gine — and briefly spread the chill to a high-pro­file biotech

Back in July, during an investor call where Novartis execs ran through an upbeat assessment of their Q2 performance, CEO Vas Narasimhan and development chief John Tsai were pressed to predict which of the two looming Phase III readouts — involving cardio drug Entresto and asthma therapy fevipiprant, respectively — had a higher likelihood of success. Tsai gave the PARAGON-HF study with Entresto minimally better odds, but Narasimhan emphasized that their strategy of giving fevipiprant to more severe patients gave them confidence.

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