Ax­o­van­t's lead Alzheimer's drug flops in PhI­II, end­ing an un­like­ly quest

Vivek Ra­maswamy burst on­to the biotech scene a few years ago with a brash plan to grab a failed drug from Glax­o­SmithK­line and hus­tle it straight in­to a piv­otal Phase III study for Alzheimer’s — a dis­ease that has de­feat­ed every piv­otal shot tak­en at it over the past 15 years.

But in­tepir­dine, like every oth­er Phase III Alzheimer’s study, failed. And this fail­ure for Ra­maswamy’s Ax­o­vant will like­ly kill 5HT6 as a tar­get in Alzheimer’s af­ter sev­er­al oth­er stud­ies with the same tar­get al­so flopped over the past year.

The news quick­ly crushed Ax­o­vant’s share price, send­ing it down more than 70% and wip­ing out $1.8 bil­lion in mar­ket cap in sec­onds as in­vestors re­act­ed to one of the biggest cat­a­lysts of the month.

Re­searchers said that the drug failed both co-pri­ma­ry end­points, un­able to sig­nif­i­cant­ly im­prove cog­ni­tion or func­tion for pa­tients rel­a­tive to place­bo. The key num­bers: ADAS-Cog (0.36 points, p=0.22) and AD­CS-ADL (0.09, p=0.83).

The com­pa­ny is stick­ing with top-line da­ta for now, plan­ning to out­line more of the specifics at an up­com­ing con­fer­ence. But in a call with an­a­lysts Tues­day, Ax­o­vant CEO David Hung made it clear that the drug com­bined with donepezil failed bad­ly.

“There was no dif­fer­ence be­tween the in­tepir­dine and the place­bo arms,” said Hung, and the Alzheimer’s pro­gram is fin­ished — though the com­pa­ny plans to pur­sue its work on de­men­tia with Lewy bod­ies.

The fail­ure here will come as no sur­prise to long­time in­ves­ti­ga­tors in the field. Pfiz­er and Lund­beck had both tried and failed to amp up cog­ni­tion with a 5HT6 pro­gram, de­signed to spur re­lease of a neu­ro­trans­mit­ter, though Ax­o­vant in­sist­ed that it could beat the odds.

If it had, an­a­lysts agreed that a new drug now could be worth bil­lions in an­nu­al rev­enue. In­stead, the drug hasn’t proven it’s worth the $5 mil­lion Ra­maswamy paid for it.

“While we are deeply dis­ap­point­ed by these tri­al re­sults, we al­so are sad­dened for the mil­lions of pa­tients and fam­i­lies im­pact­ed by Alzheimer’s dis­ease. How­ev­er, we be­lieve that the fight against Alzheimer’s and oth­er im­por­tant ar­eas of un­met need in neu­rol­o­gy is too im­por­tant to be de­railed by this set­back,” said Hung in a state­ment.

While the drug cost on­ly a few mil­lion up front to li­cense, the 32-year-old Ra­maswamy quick­ly steered Ax­o­vant $AX­ON in­to a record-set­ting biotech IPO on this drug, on his way to gath­er­ing close to $2 bil­lion to back a mul­ti-faceted en­ter­prise that has grown rapid­ly. He was able to re­cruit CEO Hung to take the helm not long af­ter Hung com­plet­ed the deal of a life­time in sell­ing Medi­va­tion to Pfiz­er for $14 bil­lion.

For Hung, it was a chance to take an­oth­er shot at Alzheimer’s, a dis­ease that had de­feat­ed one of his can­di­dates at Medi­va­tion.

Ra­maswamy had in­sist­ed that this drug would prove dif­fer­ent, point­ing to tri­al da­ta that showed a path for­ward. In­tepir­dine was his first test of a busi­ness mod­el that de­pends on gain­ing ac­cess to drugs on the shelves at the world’s biggest phar­ma com­pa­nies. But that mod­el faces fresh ques­tions this morn­ing as Ax­o­vant and the par­ent com­pa­ny — Roivant — deal with a bit­ter set­back.

Roivant put out a state­ment this morn­ing point­ing to all the oth­er drugs now in its mul­ti­ple pipelines. Ax­o­vant, the com­pa­ny not­ed, will con­tin­ue to in­ves­ti­gate new drugs for the mem­o­ry wast­ing ail­ment, just as it will con­tin­ue to go af­ter oth­er drugs. And with­out at­tri­bu­tion, the com­pa­ny says it will per­se­vere.

Some of those ef­forts will suc­ceed. Oth­ers will fail. We owe it to pa­tients to take those risks, and we re­main un­de­terred in pur­su­ing our mis­sion.


Im­age: Vivek Ra­maswamy Get­ty, David Hung File Pho­to

Once fu­ri­ous over No­var­tis’ da­ta ma­nip­u­la­tion scan­dal, the FDA now says it’s noth­ing they need to take ac­tion on

Back in the BP era — Before Pandemic — the FDA ripped Novartis for its decision to keep the agency in the dark about manipulated data used in its application for Zolgensma while its marketing application for the gene therapy was under review.

Civil and criminal sanctions were being discussed, the agency noted in a rare broadside at one of the world’s largest pharma companies. Notable lawmakers cheered the angry regulators on, urging the FDA to make an example of Novartis, which fielded Zolgensma at $2.1 million — the current record for a one-off therapy.

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Covid-19 roundup: GSK, Am­gen tai­lor R&D work to fit the coro­n­avirus age; Doud­na's ge­nomics crew launch­es di­ag­nos­tic lab

You can add Amgen and GSK to the list of deep-pocket drug R&D players who are tailoring their pipeline work to fit a new age of coronavirus.

Following in the footsteps of a lineup of big players like Eli Lilly — which has suspended patient recruitment for drug studies — Amgen and GSK have opted to take a more tailored approach. Amgen is intent on circling the wagons around key studies that are already fully enrolled, and GSK has the red light on new studies while the pandemic plays out.

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In a stun­ning set­back, Amarin los­es big patent fight over Vas­cepa IP. And its high-fly­ing stock crash­es to earth

Amarin’s shares $AMRN were blitzed Monday evening, losing billions in value as reports spread that the company had lost its high-profile effort to keep its Vascepa patents protected from generic drugmakers.

Amarin had been fighting to keep key patents under lock and key — and away from generic rivals — for another 10 years, but District Court Judge Miranda Du in Las Vegas ruled against the biotech. She ruled that:
(A)ll the Asserted Claims are invalid as obvious under 35 U.S.C.§ 103. Thus, the Court finds in favor of Defendants on Plaintiff’s remaining infringementclaim, and in their favor on their counterclaims asserting the invalidity of the AssertedClaims under 35 U.S.C. § 103.

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Covid-19 roundup: J&J, BAR­DA set ear­ly 2021 fin­ish line for $1B vac­cine race; FDA al­lows emer­gency drug use, ahead of piv­otal da­ta

J&J has zeroed in on a Covid-19 vaccine candidate that it hopes to begin testing in humans by September this year — with the extraordinary goal of getting it ready for emergency use in early 2021. And together with BARDA, it’s committing $1 billion to make it happen.

That kind of accelerated timeline would fall on the fast side of NIAID director Anthony Fauci’s well-publicized prediction that it would be another 12 to 18 months before a vaccine can be available for public use. A Phase I trial of Moderna’s mRNA vaccine began two weeks ago, and both the biotech and fellow mRNA player CureVac have discussed similar, if not even faster, timelines for emergency use among healthcare workers.

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As­traZeneca says its block­buster Farx­i­ga proved to be a game-chang­er in CKD — wrap­ping PhI­II ear­ly

If the FDA can still hold up its end of the bargain, AstraZeneca is already on a short path to scooping up a cutting-edge win with a likely approval for their SGLT2 drug Farxiga in cutting the risk of heart failure. Now the pharma giant says it can point to solid evidence that the drug — initially restricted to diabetes — also works for chronic kidney disease, potentially adding a blockbuster indication for the franchise.

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It is 'kind of a proven tech­nol­o­gy': Hep B vac­cine mak­er joins glob­al hunt for coro­n­avirus vac­cine

Using lab-grown proteins that are engineered to mimic the architecture of viruses to induce an immune response, VBI Vaccines is joining the hunt for a coronavirus vaccine — harnessing technology that has initially been proved safe in early trials as a prophylactic for cytomegalovirus (CMV) infection.

Unlike the raft of the companies in the Covid-19 vaccine race — including Moderna, CureVac and J&J — VBI is taking a pan-coronavirus approach, by developing a vaccine that will encompass Covid-19, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS).

Can a pair of top AveX­is alum­ni steer a new gene ther­a­py up­start to R&D glo­ry? 3 VCs bet $60M on it

VCs love few things more than a proven executive team when it comes to launching a new company. And now a group of A-listers has turned to a pair of top execs out of AveXis to steer the latest gene therapy player into the clinic.

The biotech is Waltham, MA-based Affinia and the two execs are Sean Nolan and Rick Modi — the former CEO and CBO respectively of AveXis, the gene therapy pioneer that fetched $8.7 billion in a sale to Novartis. Nolan has now taken the chairman’s role at Affinia while Modi moves up to the CEO post at the company.

Un­de­terred by a pan­dem­ic, Gilde Health­care rais­es their largest fund yet

When Pieter van der Meer started raising the capital for Gilde Healthcare’s fifth fund in the waning months of 2019, he had his eyes on a different chain of events that could change the healthcare system and perhaps even play to his firm’s advantage: The US presidential election.

Since raising their third fund in 2011, the 34-year-old Dutch firm had focused on value-based care. They chose late-stage biotechs that came up with new devices and delivery systems for de-risked established compounds, and when they chose preclinical biotechs, they spoke with potential pharma partners, payers and regulators to ask where and at what prices the drug made sense. As the Democratic primary became a contest over how to lower healthcare costs, it looked like a strategy that could pay off.

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Gilead CEO Dan O'­Day of­fers a de­tailed ex­pla­na­tion on remde­sivir ac­cess — re­as­sur­ing an­a­lysts that Covid-19 da­ta are com­ing fast

After coming under heavy fire from consumer groups ready to pummel them for grabbing the FDA’s orphan status for remdesivir — reserved to encourage the development of rare disease therapies — Gilead CEO Daniel O’Day had some explaining to do about the company’s approach to providing access to this drug to patients suffering from Covid-19. And he set aside time over the weekend to patiently explain how they are making their potential pandemic drug available in a new program — one he feels can better be used to address a growing pack of infected patients desperately seeking remdesivir under compassionate use provisions.

In addition to trying to reassure patients that they will once again have an avenue to pursue access, O’Day also reassured some analysts who had been fretting that China’s quick comeback from the coronavirus outbreak could derail its ultra-fast schedule for testing the drug in patients. The data are still expected in a few weeks, he says in the letter, putting the readout in April.

O’Day emphasizes that Gilead intends to pursue a pricing approach that will make this drug widely available — if it proves effective and safe. But no one is quite sure just what the longterm value would be, given the work being done on a variety of vaccines that may be rolled out as early as this fall — at least to the most heavily threatened groups.

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