Gilead bol­sters its case for block­buster hope­ful fil­go­tinib as FDA pon­ders its de­ci­sion

Be­fore remde­sivir soaked up the spot­light amid the coro­n­avirus cri­sis, Gilead’s fil­go­tinib was the star ex­per­i­men­tal drug tapped to rake in bil­lions com­pet­ing with oth­er JAK in­hibitors made by ri­vals in­clud­ing Ab­b­Vie and Eli Lil­ly.

Now, long term da­ta on the drug — dis­cov­ered by Gilead’s part­ners at Gala­pa­gos and post­ed as part of a vir­tu­al med­ical con­fer­ence — have so­lid­i­fied the dura­bil­i­ty and safe­ty of fil­go­tinib in pa­tients with rheuma­toid arthri­tis, span­ning da­ta from three late-stage tri­als. An FDA de­ci­sion on the drug is ex­pect­ed this year.

Last Oc­to­ber, the com­pa­nies showed that the drug’s 52-week da­ta from the two main tri­als FINCH 1 and FINCH 3 were con­sis­tent with their 24-week re­sults. On Thurs­day, fur­ther analy­ses of the da­ta sug­gest­ed that pa­tients on the fil­go­tinib arm had a nu­mer­i­cal ad­van­tage in re­mis­sion rates.

At the 24-week cut­off, 48% of pa­tients en­rolled in the high­er 200 dose of fil­go­tinib arm were in re­mis­sion in the FINCH 1 tri­al that com­pared the drug to adal­i­mum­ab (Ab­b­Vie’s Hu­mi­ra). By the end of 52 weeks, that re­mis­sion rate rose to 52%. The per­cent­age in the Hu­mi­ra arm rose too, but the num­bers fa­vored fil­go­tinib across mul­ti­ple mea­sures of ef­fi­ca­cy. Da­ta from the FINCH 3 tri­al echoed that trend.

Fil­go­tinib’s biggest ri­val is Ab­b­Vie’s Rin­voq — the re­place­ment for its cash cow and world’s best sell­ing drug Hu­mi­ra. Rin­voq is slat­ed to be a block­buster, but car­ries the dread­ed black box warn­ing for throm­bo­sis, even though the event was rare in Ab­b­Vie’s de­vel­op­ment pro­gram.

The move by the FDA is more pre­cau­tion­ary giv­en that the JAK class of drugs has long been plagued by safe­ty con­cerns. Pfiz­er’s JAK1/JAK3 in­hibitor Xel­janz’s use has been blight­ed by reg­u­la­to­ry re­stric­tions af­ter the high­er dose of the block­buster drug was found to be as­so­ci­at­ed with the risk of blood clots and death. Eli Lil­ly’s JAK1/JAK2 Olu­mi­ant, mean­while, was ini­tial­ly re­ject­ed by the US agency due to safe­ty con­cerns — on­ly to even­tu­al­ly se­cure ap­proval for the low­er dose. Lil­ly’s part­ner, In­cyte, elect­ed to walk away from co-fund­ing the drug’s de­vel­op­ment as fears about the ben­e­fit-risk pro­file of the class of drugs ac­cu­mu­lat­ed.

Gala­pa­gos $GLPG, which once part­nered with Ab­b­Vie on fil­go­tinib, has pre­sent­ed it­self as a safer al­ter­na­tive to its ri­vals us­ing a pooled analy­sis of safe­ty da­ta com­piled from sev­en rheuma­toid arthri­tis tri­als. The analy­sis showed that the rate of ve­nous throm­boem­bolism, a key safe­ty con­cern, was low­er in pa­tients giv­en fil­go­tinib ver­sus those on place­bo.

“While filg’s pro­file has been quite clean so far, giv­en the his­to­ry of Jak in­hibitor ap­provals/re­jec­tions, we be­lieve the biggest risk to the pro­gram re­mains if any safe­ty im­bal­ances (even if seem­ing­ly mi­nor) emerge and de­rail ap­prov­abil­i­ty of the most ac­tive high dose (200mg) of the drug, or of the drug al­to­geth­er,” not­ed RBC Cap­i­tal Mar­kets an­a­lyst Bri­an Abra­hams in a note.

“In an­a­lyz­ing the de­tailed da­ta, we do not see any ma­jor new con­cerns and con­tin­ue to see a good like­li­hood of ap­proval, with a low se­ri­ous in­fec­tion rate pro­vid­ing a po­ten­tial safe­ty ad­van­tage vs. com­peti­tors. How­ev­er, we do see a slight im­bal­ance in over­all deaths for high­er vs. low­er dose fil­go­tinib that could be scru­ti­nized by the agency and may be a small risk to keep an eye on.”

Gilead paid $750 mil­lion up­front to part­ner with Gala­pa­gos years ago, ex­pand­ing the col­lab­o­ra­tion to an up-to $5.1 bil­lion deal last year. Fil­go­tinib, which is at the heart of the deal, is al­so be­ing test­ed for oth­er au­toim­mune con­di­tions such as Crohn’s dis­ease, ul­cer­a­tive col­i­tis and pso­ri­at­ic arthri­tis. Last Oc­to­ber it was re­vealed the drug failed mid-stage stud­ies in lu­pus and Sjö­gren’s dis­ease.

Janus ki­nase (JAK) in­hibitors are named af­ter the two-faced Ro­man god Janus and the fam­i­ly con­sists of four en­zymes: JAK1, JAK2, JAK3 and TYK2, which are as­so­ci­at­ed with cy­tokine re­cep­tors on the sur­face of cells and form part of a path­way in­volved in in­flam­ma­to­ry and im­mune re­spons­es.

Biotech and Big Phar­ma: A blue­print for a suc­cess­ful part­ner­ship

Strategic partnerships have long been an important contributor to how drugs are discovered and developed. For decades, big pharma companies have been forming alliances with biotech innovators to increase R&D productivity, expand geographical reach and better manage late-stage commercialization costs.

Noël Brown, Managing Director and Head of Biotechnology Investment Banking, and Greg Wiederrecht, Ph.D., Managing Director in the Global Healthcare Investment Banking Group at RBC Capital Markets, are no strangers to the importance of these tie-ups. Noël has over 20 years of investment banking experience in the industry. Before moving to the banking world in 2015, Greg was the Vice President and Head of External Scientific Affairs (ESA) at Merck, where he was responsible for the scientific assessment of strategic partnership opportunities worldwide.

No­var­tis' sec­ond at­tempt to repli­cate a stun­ning can­cer re­sult falls flat

Novartis’ hopes of turning one of the most surprising trial data points of the last decade into a lung cancer drug has taken another setback.

The Swiss pharma announced Monday that its IL-1 inhibitor canakinumab did not significantly extend the lives or slow the disease progression of patients with previously untreated locally advanced or metastatic non-small cell lung cancer when compared to standard of-care alone.

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How Chi­na turned the ta­bles on bio­phar­ma's glob­al deal­mak­ing

Fenlai Tan still gets chills thinking about the darkest day of his life.

Three out of eight lung cancer patients who received a tyrosine kinase inhibitor developed by his company, Betta Pharma, died in the span of a month. Tan, the chief medical officer, was summoned to Peking Union Medical College Hospital, where the head of the clinical trial department told him that the trial investigators would be conducting an autopsy to see if the patients had died of the disease — they were all very sick by the time they enrolled — or of interstitial lung disease, a deadly side effect tied to the TKI class that’s been reported in Japan.

No­var­tis dumps AveX­is pro­gram for Rett syn­drome af­ter fail­ing re­peat round of pre­clin­i­cal test­ing

Say goodbye to AVXS-201.

The Rett syndrome gene therapy drug made by AveXis — the biotech that was bought, kept separate, then renamed and finally absorbed by Novartis into its R&D division — has been dropped by the biopharma.

In Novartis’ third quarter financial report, the pharma had found that preclinical data did not support development of the gene therapy into IND-enabling trials and beyond. The announcement comes a year after Novartis told the Rett Society how excited it was by the drug — and its potential benefits and uses.

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FDA is much worse than its reg­u­la­to­ry peers at proac­tive­ly dis­clos­ing da­ta, re­searchers find

The European Medicines Agency and Health Canada continue to outpace the FDA when it comes to proactively releasing data on drugs and biologics the agency has reviewed, leading to further questions of why the American agency can’t be more transparent.

In a study published recently in the Journal of Law, Medicine, & Ethics, Yale and other academic lawyers and researchers found that between 2016 and April 2021, the EMA proactively released data for 123 unique medical products, while Health Canada proactively released data for 73 unique medical products between 2019 and April 2021. What’s more, the EMA and Health Canada didn’t proactively release the same data on the same drugs. In stark contrast, the FDA in 2018 only proactively disclosed data supporting one drug that was approved that year.

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As pres­sure to share tech­nol­o­gy mounts, BioN­Tech se­lects Rwan­da for lat­est vac­cine site

BioNTech’s first mRNA-based vaccine site in Africa will call Rwanda home, and construction is set to start in mid-2022, the company announced Tuesday at a public health forum.

The German company signed a memorandum of understanding, after a meeting between Rwanda’s Minister of Health, Daniel Ngamije, Senegal’s Minister of Foreign Affairs Aïssata Tall Sall, and senior BioNTech officials. Construction plans have been finalized, and assets have been ordered. The agreement will help bring end-to-end manufacturing to Africa, and as many as several hundred million doses of vaccines per year, though initial production will be more modest.

UP­DAT­ED: Eli Lil­ly toss­es a mar­quee pain drug and hits the gas on Alzheimer’s — as Bio­gen’s suf­fer­ing opens mar­ket to ri­vals

The furious chorus of critics that brought sales of Biogen’s ultra controversial Alzheimer’s drug aducanumab (sold as Aduhelm) to a near halt is opening up some big opportunities for a major league rival that has long sought the lead role in this largely untapped megamarket.

In its Q3 update today, Eli Lilly — noted for its dogged persistence in attempting for years to get solanezumab across the FDA finish line — said that it has begun a rolling submission of its rival Alzheimer’s drug donanemab in search of an accelerated approval. Anne White, senior VP of Lilly’s neuroscience unit, acknowledged during the investor call the challenges Biogen has faced with uptake and noted Lilly may face similar hurdles.

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Vas Narasimhan, Novartis CEO (Simon Dawson/Bloomberg via Getty Images)

With San­doz con­tin­u­ing to drag on No­var­tis, Vas Narasimhan says he may fi­nal­ly be ready for a sale or spin­off

After years of rehab work aimed at getting Sandoz in fighting trim to compete in a market overshadowed by declining prices, CEO Vas Narasimhan took a big step toward possibly selling or spinning off the giant generic drug player.

The pharma giant flagged plans to launch a strategic review of the business in its Q3 update, noting that “options range from retaining the business to separation.”

Analysts have been poking and prodding Novartis execs for years now as Narasimhan attempted to remodel a business that has been a drag on its performance during most of his reign in the CEO suite. The former R&D chief has made it well known that he’s devoted to the innovative meds side of the business, where they see the greatest potential for growth.

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James Peyer, Cambrian CEO

Brent Saun­ders joins $100M Se­ries C for a com­pa­ny out to be the Bridge­Bio of ag­ing

About a year ago, James Peyer, a CEO and co-founder of the little known longevity biotech Cambrian Biopharma, was trying to find some R&D talent last year when he met with more than a bit of experience in that department: David Nicholson, the former R&D chief of the erstwhile pharma giant Allergan.

It turned out Nicholson already had an interest in Peyer’s field. In their Allergan days, he and COO Brent Saunders held weekly meetups where they tried to figure out how to take the company’s dominance in aesthetics — which, until recently, was often what people meant by anti-aging science — and expertise with more traditional drug development, and use it to make drugs that extend people’s lifespan.

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