Iron­wood, Al­ler­gan add a slate of PhI­I­Ib da­ta to its Linzess pitch for physi­cians, pa­tients

With the dust set­tled on an R&D spin­out, the ful­ly com­mer­cial op­er­a­tions at Iron­wood have come up with some late-stage da­ta to up its Linzess mar­ket­ing game.

Mark Mal­lon As­traZeneca

Iron­wood, along with part­ner Al­ler­gan, set out to col­lect ev­i­dence that their drug can im­prove the over­all ab­dom­i­nal symp­toms of ir­ri­ta­ble bow­el syn­drome with con­sti­pa­tion (IBS-C), not just con­sti­pa­tion. And the com­pa­nies say that’s what they found in the Phase II­Ib: Pa­tients tak­ing Linzess for 12 weeks saw a 29.7% mean de­crease from base­line in a week­ly score that mea­sured bloat­ing, pain and dis­com­fort, com­pared to 18.3% for place­bo (p<0.0001).

The tri­al al­so hit its sec­ondary end­points, in­clud­ing 40.5% of the drug arm meet­ing the cri­te­ria of a re­spon­der ver­sus 23.4% in the place­bo co­hort (p<0.0001).

The new da­ta are meant to bol­ster Iron­wood sales reps as they com­mu­ni­cate with doc­tors and pa­tients, ide­al­ly grow­ing a 7-year-old drug that brought in $785 mil­lion in 2018.

Boris Peak­er Cowen

Cowen an­a­lyst Boris Peak­er ex­plained it this way:

Linzess’ cur­rent la­bel notes re­duc­tions in “ab­dom­i­nal pain,” but not “bloat­ing” or “dis­com­fort,”, which man­age­ment stat­ed are the terms most fre­quent­ly used by pa­tients to de­scribe their symp­toms. The goal of the pro­gram was to en­able the com­pa­ny to align its mar­ket­ing with the lan­guage that physi­cians and pa­tients use day-to-day in the clin­ic

Iron­wood CMO Mike Shet­z­line added that the ab­dom­i­nal symp­toms are typ­i­cal­ly iden­ti­fied by pa­tients as the “most both­er­some.”

While the da­ta are “in­cre­men­tal­ly pos­i­tive for Linzess,” though, Peak­er sees no im­pact on his sales pro­jec­tions.

Pe­ter Hecht Cy­cle­ri­on

Linzess is one of two ap­proved prod­ucts Pe­ter Hecht kept for Iron­wood while spin­ning out the rest of the R&D work to a new com­pa­ny called Cy­cle­ri­on — un­der in­vestor pres­sure. The co-founder and long­time CEO then de­camped for the new out­fit and passed the reins to Mark Mal­lon, an As­traZeneca vet with sig­nif­i­cant in­ter­na­tion­al ex­po­sure.

Aside from a much less suc­cess­ful Tru­lance, Linzess al­so faces some de­gree of com­pe­ti­tion from Motegri­ty, a con­sti­pa­tion drug Take­da now owns cour­tesy of its Shire buy­out.

Gener­ics for the drug could be­gin to emerge in 2030, Peak­er added, at which point Iron­wood’s cur­rent­ly ex­per­i­men­tal ther­a­pies — MD-7246 for IBS with di­ar­rhea and IW-3718 for gas­troe­sophageal re­flux dis­ease — are ex­pect­ed to fill the gap.

So­cial im­age: Richard Drew, Ap Im­ages

2019 Trin­i­ty Drug In­dex Eval­u­ates Ac­tu­al Com­mer­cial Per­for­mance of Nov­el Drugs Ap­proved in 2016

Fewer Approvals, but Neurology Rivals Oncology and Sees Major Innovations

This report, the fourth in our Trinity Drug Index series, outlines key themes and emerging trends in the industry as we progress towards a new world of targeted and innovative products. It provides a comprehensive evaluation of the performance of novel drugs approved by the FDA in 2016, scoring each on its commercial performance, therapeutic value, and R&D investment (Table 1: Drug ranking – Ratings on a 1-5 scale).

UP­DAT­ED: FDA’s golodirsen CRL: Sarep­ta’s Duchenne drugs are dan­ger­ous to pa­tients, of­fer­ing on­ly a small ben­e­fit. And where's that con­fir­ma­to­ry tri­al?

Back last summer, Sarepta CEO Doug Ingram told Duchenne MD families and investors that the FDA’s shock rejection of their second Duchenne MD drug golodirsen was due to some concerns regulators raised about the risk of infection and the possibility of kidney toxicity. But when pressed to release the letter for all to see, he declined, according to a report from BioPharmaDive, saying that kind of move “might not look like we’re being as respectful as we’d like to be.”

He went on to assure everyone that he hadn’t misrepresented the CRL.

But Ingram’s public remarks didn’t include everything in the letter, which — following the FDA’s surprise about-face and unexplained approval — has now been posted on the FDA’s website and broadly circulated on Twitter early Wednesday.

The CRL raises plenty of fresh questions about why the FDA abruptly decided to reverse itself and hand out an OK for a drug a senior regulator at the FDA believed — 5 months ago, when he wrote the letter — is dangerous to patients. It also puts the spotlight back on Sarepta $SRPT, which failed to launch a confirmatory study of eteplirsen, which was only approved after a heated internal controversy at the FDA. Ellis Unger, director of CDER’s Office of Drug Evaluation I, notes that study could have clarified quite a lot about the benefit and risks associated with their drugs — which can cost as much as a million dollars per patient per year, depending on weight.

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FH: We started working on the product at Phase II and now we’re going into Phase III trials. There is a significant unmet need in this disease area, and everyone is excited about the launch. However, the organisation is still evolving and the team is quite small – naturally this causes a little turbulence.

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Things are no different, as the coronavirus outbreak in Wuhan, China takes hold. There have been close to 300 confirmed human infections in China, and at least four deaths. Coronaviruses are a large family of viruses, which include MERS and SARS. On Tuesday, the CDC reported the virus was detected in a US traveler returning from Wuhan.

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Who are the young bio­phar­ma lead­ers shap­ing the in­dus­try? Nom­i­nate them for End­points' spe­cial re­port

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BeiGene lines up its first shot at crack­ing the megablock­buster PD-1 mar­ket for lung can­cer. But can they over­come un­der­dog sta­tus?

BeiGene took another big step towards challenging Merck, Bristol-Myers Squibb, AstraZeneca and some other Big Pharma heavyweights for a share of the lucrative lung cancer market for the PD-(L)1s racking up billions in annual revenue.

The China-based biotech $BGNE run by CEO John Oyler posted positive top-line progression-free survival results for their pivotal Chinese study on their PD-1 antibody tislelizumab combined with chemo for squamous non-small cell lung cancer in frontline cases. Squamous NSCLC accounts for about 30% of the overall lung cancer market.

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Brex­it fears, Wood­ford woes over­shad­owed UK biotech and cut 2019 fi­nanc­ing by al­most half

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Overall investment in UK biotech last year fell from the record-breaking £2.2 billion levels of 2018 to £1.3 billion — including £679 million in venture capital, a meager £64 million in IPOs plus £596 million when you add up all public financings, according to a new report from the BIA.

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→ Blueprint Medicines filed an amendment to its application to get the gastrointestinal stromal tumor (GIST) drug Ayvakit approved in fourth-line GIST, the company disclosed in the prospectus for a new $325 million public offering.  Blueprint got a big accelerated OK on the drug this month in a particular mutation, but because the FDA decided to split their review in two, they didn’t hear on fourth-line GIST. They were supposed to hear before February 14, but this amendment could push that date back by 3 months. Blueprint wrote that the amendment is designed to allow the company to comply with the FDA’s request for data from the Phase III VOYAGER before they give a judgment.