More three years af­ter Al­ler­gan $AGN dipped its toes in­to the world of CRISPR/Cas9 gene edit­ing by en­list­ing Ed­i­tas $ED­IT as a part­ner — the com­pa­nies are now off to the races with a tri­al in pa­tients with a rare eye dis­ease.

This tri­al marks the first in­stance of us­ing the tech­nol­o­gy to ed­it DNA with­in the body.

Mean­while, part­ners Ver­tex $VRTX and CRISPR Ther­a­peu­tics $CR­SP kick­start­ed a tri­al ear­li­er this year that em­ployed the tech­nol­o­gy to en­gi­neer a gene-edit­ed stem cell ther­a­py to treat pa­tients suf­fer­ing from se­vere he­mo­glo­binopathies, a group of blood dis­or­ders. Sang­amo Ther­a­peu­tics $SG­MO has test­ed its old­er zinc fin­ger tech­nol­o­gy in pa­tients with two lyso­so­mal stor­age dis­eases, but a set­back dif­fused en­thu­si­asm for the pro­gram — but the com­pa­ny bounced back with en­cour­ag­ing ear­ly da­ta on its he­mo­phil­ia pro­gram part­nered with Pfiz­er.

Al­ler­gan and Ed­i­tas had orig­i­nal­ly ex­pect­ed to file an ap­pli­ca­tion to test their ther­a­py in hu­mans by the end of 2017, but man­u­fac­tur­ing trou­ble pushed that time­line to Oc­to­ber 2018. To get the FDA en­dorse­ment, Ed­i­tas fought off a stiff patent chal­lenge — and like its peers — bat­ted back per­sis­tent ques­tions about off-tar­get ef­fects to ad­e­quate­ly con­vince the reg­u­la­tor it was armed and ready to make the jump from an­i­mal stud­ies to hu­mans.

The tri­al, chris­tened Bril­liance, will eval­u­ate their ex­per­i­men­tal ther­a­py AGN-151587 (ED­IT-101) for the treat­ment of Leber con­gen­i­tal amau­ro­sis 10 (LCA10), a rare, in­her­it­ed form of blind­ness caused by mu­ta­tions in the CEP290 gene.

LCA is a group of in­her­it­ed reti­nal de­gen­er­a­tive dis­or­ders caused by mu­ta­tions in at least 18 dif­fer­ent genes, and are con­sid­ered the most com­mon cause of in­her­it­ed child­hood blind­ness, oc­cur­ring in two to three per 100,000 live births glob­al­ly. The most com­mon form of the dis­ease, LCA10, ac­counts for ap­prox­i­mate­ly 20% to 30% of all LCA pa­tients.

Ka­trine Bosley Ed­i­tas

Spark Ther­a­peu­tics’ ap­proved gene ther­a­py Lux­tur­na, which de­liv­ered via a vi­ral vec­tor, is tai­lored to treat an­oth­er rare eye dis­ease due to mu­ta­tions in both copies of the RPE65 gene. The FDA nod sparked Roche’s $4.3 bil­lion takeover of the com­pa­ny, al­though the deal is yet to be con­sum­mat­ed.

The Bril­liance study is set to en­roll 18 pa­tients — and in­clude up to five co­horts and eval­u­ate three dos­es of the drug. Each pa­tient will re­ceive a sin­gle dose of AGN-151587 ad­min­is­tered via an eye in­jec­tion aimed at pho­tore­cep­tor cells in the reti­na.

Ed­i­tas’ se­nior team has seen up­heaval in the past year. In Jan­u­ary, CEO Ka­trine Bosley, who led the com­pa­ny for near­ly five years, an­nounced her ex­it and sev­ered ties with the board, with­out ex­pla­na­tion. Chief fi­nan­cial of­fi­cer An­drew Hack an­nounced his de­ci­sion to leave by March, back in De­cem­ber 2018, and chief med­ical of­fi­cer Ger­ald Cox jumped ship at the end of last year.

Be­set by set­backs, Al­ler­gan’s Brent Saun­ders made the best of a bad sit­u­a­tion by agree­ing to be swal­lowed by Ab­b­Vie $AB­BV in an eye-wa­ter­ing $63 bil­lion deal ear­li­er this year. The US drug­mak­er was swayed by the po­ten­tial of Al­ler­gan’s block­buster Botox fran­chise to sta­bi­lize its rev­enue as its $20 bil­lion cash cow Hu­mi­ra hur­tles to­wards a patent cliff in the Unit­ed States.

So­cial im­age: Shut­ter­stock

Hepatitis delta, also known as hepatitis D, is a liver infection caused by the hepatitis delta virus (HDV) that results in the most severe form of human viral hepatitis for which there is no approved therapy.

HDV is a single-stranded, circular RNA virus that requires the envelope protein (HBsAg) of the hepatitis B virus (HBV) for its own assembly. As a result, hepatitis delta virus (HDV) infection occurs only as a co-infection in individuals infected with HBV. However, HDV/HBV co-infections lead to more serious liver disease than HBV infection alone. HDV is associated with faster progression to liver fibrosis (progressing to cirrhosis in about 80% of individuals in 5-10 years), increased risk of liver cancer, and early decompensated cirrhosis and liver failure.
HDV is the most severe form of viral hepatitis with no approved treatment.
Approved nucleos(t)ide treatments for HBV only suppress HBV DNA, do not appreciably impact HBsAg and have no impact on HDV. Investigational agents in development for HBV target multiple new mechanisms. Aspirations are high, but a functional cure for HBV has not been achieved nor is one anticipated in the forseeable future. Without clearance of HBsAg, anti-HBV investigational treatments are not expected to impact the deadly course of HDV infection anytime soon.

More than 3 years after Merck stepped up and paid $1 billion in cold, hard cash to gain the US commercial rights to Bayer’s high-risk heart drug vericiguat in a broad-ranging cardio alliance, the partners say their Phase III study has come through with promising data and a date with regulators.
We don’t have the data, and won’t until they put it out at an upcoming scientific session, but Merck touted the results, saying that their big Phase III VICTORIA study hit the primary endpoint  — with vericiguat combined with available therapies reducing “the risk of the composite endpoint of heart failure hospitalization or cardiovascular death in patients with worsening chronic heart failure with reduced ejection fraction (HFrEF) compared to placebo when given in combination with available heart failure therapies.”
Depending on the hard data, and how it breaks out with the combinations used, this drug could pose a threat to Novartis’ blockbuster drug Entresto, currently at $1.6 billion while analysts expect peak sales to hit $4 billion.
The drug is a soluble guanylate cyclase (sGC) stimulator, which Bayer and Merck have had high hopes for. Evidently, so did cardiologists. Cowen’s last analysis set potential sales at $400 million in 2024, but that number could go up significantly now.
Cowen’s Steve Scala noted this morning:
Vericiguat could be a lucrative product for Merck, and one with potentially under-appreciated value. At Cowen’s Therapeutics Conference in September 2019, 80% of specialists anticipated a positive result from VICTORIA whereas only 51% of investors shared this optimism.
Investigators recruited more than 5,000 patients at more than 600 centers in 42 countries for this study — one of the most expensive propositions in R&D. Millions of people in the US suffer from heart failure with reduced ejection fraction when the failing heart fails to contract properly to eject blood into the system. Bayer holds ex-US rights to the drug and also stands to earn cash from the $1.1 billion in milestones Merck agreed on for their collaboration.
Remarkably, the drug was pushed into Phase III despite failing the mid-stage trial — though investigators flagged a success at the high dose of 10 mg. In VICTORIA, researchers started patients at 2.5 mg and then titrated up to 5 and then 10 mg.

Thirteen of the top biotech venture capitalists in the country wrote a letter last week warning lawmakers that if Congress passes a drug pricing bill House Speaker Nancy Pelosi has put before lawmakers, they won’t be able to invest in biomedical research at their current rate, and patients will suffer.

“If policies such as those included within H.R. 3, the Lower Drug Costs Now Act, are passed, our ability to continue to invest in future biomedical innovation will be severely constrained, thus crushing the hopes of millions of patient waiting for the next breakthroughs to treat or cure their cancers, rare genetic diseases, Alzheimer’s, or other serious and life-threatening conditions,” they wrote in a letter addressed to the highest-ranking Democrats and Republicans in the House and Senate and acquired by Endpoints News. 

Turns out Dicerna wasn’t done with deals yet after locking in $200 million upfront from Roche for a hepatitis B cocktail two weeks ago.

Novo Nordisk has signed on as the latest partner to its GalXC RNAi platform, handing over $175 million in cash to claim any and all targets of interest in liver-related cardio-metabolic diseases that are not already reserved in previous pacts. The Danish drugmaker — which has signaled its interest to expand considerably beyond its core diabetes franchise into areas like NASH — is also purchasing $50 million worth of Dicerna’s equity at a 25% premium of $21.93 per share. More research payments and milestones extending to the billions are on the line.

→ Gene therapy maker Orchard Therapeutics has been granted an accelerated assessment for OTL-200 by the EMA’s Committee for Medicinal Products for Human Use (CHMP). The gene therapy — in development in partnership with the San Raffaele-Telethon Institute for Gene Therapy (SR-Tiget) in Milan, Italy — being used towards the treatment of metachromatic leukodystrophy.

→ Pharmaceutical Product Development has announced that its parent company, PPD, Inc has submitted a draft to the SEC relating to the proposal of an IPO of the parent company’s common stock. Number of shares and price range have not yet been determined.