Sobered by mount­ing costs, Dy­navax $DVAX last month made the de­ci­sion to fo­cus all its re­sources on its 2017-ap­proved he­pati­tis B vac­cine Hep­lisav-B, which ri­vals and su­per­sedes the ef­fi­ca­cy and con­ve­nience pro­file of GSK’s $GSK es­tab­lished En­ger­ix-B. The Cal­i­for­nia-based com­pa­ny will be on the look­out for an­oth­er com­peti­tor — VBI Vac­cines, which on Mon­day un­veiled late-stage da­ta on its hep B vac­cine: Sci-B-Vac.

Sci-B-Vac, which has al­ready se­cured ap­proval in Is­rael and 10 oth­er coun­tries, is in Phase III de­vel­op­ment in North Amer­i­ca and Eu­rope. It is en­gi­neered to mim­ic all three sur­face anti­gens of the hep B virus to in­duce a po­tent im­mune re­sponse and is be­ing de­vel­oped to work at low­er dos­es than ex­ist­ing hep B vac­cines.

VBI on Mon­day broke out da­ta from the PRO­TECT study, in which 1,607 sub­jects aged 18 years and old­er were ei­ther giv­en a three-dose course of Sci-B-Vac (10 µg) or a three-dose course of En­ger­ix-B (20 µg).

Sci-B-Vac failed to show that two dos­es of the drug were equal­ly ef­fec­tive as three dos­es of En­ger­ix-B in the study — a key sec­ondary end­point. In­vestors were not im­pressed, and the Cam­bridge, Mass­a­chu­setts-based com­pa­ny’s shares $VBIV cratered 58% tak­ing VBI in­to pen­ny stock ter­ri­to­ry at 81 cents be­fore the open­ing bell on Mon­day.

Mean­while, the VBI vac­cine was found to be as pro­tec­tive as En­ger­ix-B at the end of the third vac­ci­na­tion — meet­ing the main goal of the study. In fact, da­ta showed that the rate of sero­pro­tec­tion (an an­ti­body re­sponse ca­pa­ble of pre­vent­ing in­fec­tion) — was 91.4% for Sci-B-Vac-treat­ed sub­jects, ver­sus 76.5% for En­ger­ix-B — a sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­ence.

In ad­di­tion, the sero­pro­tec­tion rate (SPR) in sub­jects aged 45 and over was 89.4% for Sci-B-Vac, ver­sus 73.1% for En­ger­ix-B af­ter the third vac­ci­na­tion — meet­ing the co-pri­ma­ry end­point. It al­so cleared oth­er sec­ondary goals in sub-analy­ses strat­i­fied by age, gen­der, body mass in­dex, di­a­bet­ic sta­tus and smok­ing sta­tus.

Jeff Bax­ter VBI

Da­ta from an­oth­er late-stage tri­al, CON­STANT, com­par­ing Sci-B-Vac and En­ger­ix-B is ex­pect­ed by the end of 2019. Pend­ing the suc­cess­ful com­ple­tion of CON­STANT, VBI is on to sub­mit mar­ket­ing ap­pli­ca­tions in the U.S., Eu­rope, and Cana­da next year, com­pa­ny chief Jeff Bax­ter said on Mon­day.

Hep B is trans­mit­ted through con­tact with blood and bod­i­ly flu­ids of an in­fect­ed per­son and is a high­ly in­fec­tious virus, 50 to 100 times more in­fec­tious than HIV — even slight laps­es in in­fec­tion con­trol can re­sult in pa­tient-to-pa­tient trans­mis­sion. Since the ear­ly 1990’s the Unit­ed States has im­ple­ment­ed vac­ci­na­tion pro­grams in new­born chil­dren, but those born be­fore re­main sus­cep­ti­ble. CDC da­ta now sug­gests 95% per­cent of new hep B in­fec­tions in the Unit­ed States oc­cur in adults, as there is no stan­dard­ized sys­tem for vac­ci­nat­ing peo­ple af­ter school age, and par­tic­u­lar­ly since spikes in in­jec­tion drug use may be lead­ing to acute out­breaks.

Af­ter be­ing linked to a string of in­ex­plic­a­ble safe­ty is­sues, Hep­lisav-B was fi­nal­ly ap­proved in No­vem­ber 2017. De­spite its check­ered path to the fin­ish line, the vac­cine’s ef­fi­ca­cy and con­ve­nience pro­file su­per­sedes En­ger­ix-B.

So­cial im­age: Shut­ter­stock

Since losing a controversial court case over orphan drug exclusivity last year, the FDA’s Office of Orphan Products Development has remained entirely silent on orphan exclusivity for any product approved since last November, leaving many sponsors in limbo on what to expect.

That silence means that for more than 70 orphan-designated indications for more than 60 products, OOPD has issued no public determination on the seven-year orphan exclusivity in the Orange Book, and no new listings of orphan exclusivity appear in OOPD’s searchable database, as highlighted recently by George O’Brien, a partner in Mayer Brown’s Washington, DC office.

The Drugs for Neglected Diseases initiative (DNDi) and Sanofi today said that their potential sleeping sickness treatment saw success rates of up to 95% from a Phase II/III study investigating the safety and efficacy of single-dose acoziborole.

The potentially transformative treatment for sleeping sickness would mainly be targeted at African countries, according to data published today in The Lancet Infectious Diseases medical journal. The clinical trial was led by DNDi and its partners in the Democratic Republic of the Congo (DRC) and Guinea, with the authors noting: