Rac­ing af­ter the lead­ers, Eli Lil­ly's mi­graine drug clears an­oth­er piv­otal study

A month af­ter se­cur­ing ap­proval for clus­ter headaches, Lil­ly’s $LLY mi­graine drug Em­gal­i­ty has scored in a late-stage tri­al as a pre­ven­tive treat­ment for chron­ic and episod­ic mi­graines in pa­tients who have failed more than two stan­dard-of-care pro­phy­lac­tic treat­ments.

Em­gal­i­ty was the last in­jectable to win ap­proval for mi­graine pre­ven­tion last Sep­tem­ber, months af­ter Aimovig from Am­gen $AMGN  and No­var­tis $NVS, and Te­va’s $TE­VA Ajovy. Each has demon­strat­ed a re­duc­tion in mi­graine fre­quen­cy in about half of pa­tients when test­ed in clin­i­cal stud­ies and is priced at $6,900 a year, or $575 per month. Tiny Alder’s $AL­DR CGRP drug is un­der FDA re­view.

Em­gal­i­ty was test­ed against a place­bo in a 462-pa­tient study called CON­QUER. At base­line, pa­tients had on av­er­age 13.2 month­ly mi­graine headache days. Treat­ment with Em­gal­i­ty re­duced month­ly mi­graine headache days by 4.1 days (p<0.0001) com­pared with 1 day with place­bo.

Ac­cord­ing to the Mi­graine Re­search Foun­da­tion, mi­graines are the third most preva­lent ill­ness in the world, af­fect­ing about 39 mil­lion in the Unit­ed States and some 1 bil­lion world­wide. The mar­ket for mi­graine drugs is ex­pect­ed to hit $8.7 bil­lion by 2026, ac­cord­ing to Glob­al­da­ta.  Be­fore the slate of ap­provals this year, pa­tients were large­ly treat­ed with a host of drugs in­clud­ing an­ti­de­pres­sants, hy­per­ten­sion med­i­cines and a class of drugs called trip­tans.

Among users of pre­ven­tive mi­graine med­ica­tions, more than 40% have a his­to­ry of pre­vi­ous pre­ven­tive med­ica­tion fail­ure or of switch­ing treat­ments, Lil­ly not­ed on Mon­day.

This new class of bi­o­log­ics, known as CGRP (cal­ci­tonin gene-re­lat­ed pep­tide) in­hibitors, tar­get the CGRP pro­tein that trans­mits pain sig­nals in­to the brain and is be­lieved to be in­stru­men­tal in gen­er­at­ing and main­tain­ing headaches as­so­ci­at­ed with mi­graines.

Em­gal­i­ty gen­er­at­ed low­er-than-ex­pect­ed sec­ond-quar­ter sales of $34.3 mil­lion, while Aimovig raked in gen­er­al­ly in-line sales of $83 mil­lion. Te­va is set to re­port its quar­ter­ly re­sults on Wednes­day.

In April, Reuters re­port­ed that de­spite be­ing tout­ed as a rev­o­lu­tion­ary “break­through” class of new mi­graine med­i­cines, a small group of ex­ter­nal med­ical ex­perts who ad­vise US health in­sur­ers be­hind closed doors are not im­pressed. These ex­perts sug­gest­ed the trio of drugs of­fer no clear ben­e­fit over ex­ist­ing treat­ments and rec­om­mend­ed that in­sur­ers im­pose lim­its on their use.

So­cial im­age: Eli Lil­ly, AP Im­ages

Brian Kaspar. AveXis via Twitter

AveX­is sci­en­tif­ic founder fires back at No­var­tis CEO Vas Narasimhan, 'cat­e­gor­i­cal­ly de­nies any wrong­do­ing'

Brian Kaspar’s head was among the first to roll at Novartis after company execs became aware of the fact that manipulated data had been included in its application for Zolgensma, now the world’s most expensive therapy.

But in his first public response, the scientific founder at AveXis — acquired by Novartis for $8.7 billion — is firing back. And he says that not only was he not involved in any wrongdoing, he’s ready to defend his name as needed.

I reached out to Brian Kaspar after Novartis put out word that he and his brother Allen had been axed in mid-May, two months after the company became aware of the allegations related to manipulated data. His response came back through his attorneys.

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Novartis CEO Vas Narasimhan [via Bloomberg/Getty]

I’m not per­fect: No­var­tis chief Vas Narasimhan al­most apol­o­gizes in the wake of a new cri­sis

Vas Narasimhan has warily stepped up with what might pass as something close to a borderline apology for the latest scandal to engulf Novartis.

But he couldn’t quite get there.

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FDA to Sarep­ta: Your wide­ly an­tic­i­pat­ed fol­lowup to Ex­ondys 51 is not get­ting an ac­cel­er­at­ed OK for Duchenne MD

In one of the least anticipated moves of the year, the FDA has rejected Sarepta’s application for an accelerated approval of its Duchenne MD drug golodirsen after fretting over safety issues.

In a statement that arrived after the bell on Monday, Sarepta explained the CRL, saying:

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Levi Garraway. Broad Institute via Youtube

Roche raids Eli Lil­ly for its next chief med­ical of­fi­cer as San­dra Horn­ing plans to step down

We found out Monday morning where Levi Garraway was headed after he left Eli Lilly as head of oncology R&D a few days ago. Roche named Garraway as their new chief medical officer, replacing Sandra Horning, who they say is retiring from the company.

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Af­ter a posse of Wall Street an­a­lysts pre­dict a like­ly new win for Sarep­ta, we're down to the wire on a crit­i­cal FDA de­ci­sion

As Bloomberg notes, most of the Wall Street analysts that cover Sarepta $SRPT are an upbeat bunch, ready to cheer on the team when it comes to their Duchenne MD drugs, or offer explanations when an odd setback occurs — as happened recently with a safety signal that was ‘erroneously’ reported last week.

Ritu Baral Cowen
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UP­DAT­ED: No­var­tis spin­off Nabri­va fi­nal­ly scores its first an­tibi­ot­ic ap­proval

In May, Nabriva Therapeutics suffered a setback after the FDA rejected its antibiotic for complicated urinary tract infections — the Novartis spinoff has now had some better luck with the US agency, which on Monday approved its other drug for community-acquired bacterial pneumonia.

The drug, lefamulin, has been developed as an intravenous and oral formulation and been tested in two late-stage clinical trials. The semi-synthetic compound, whose dosing can be switched between the two formulations, is engineered to inhibit the synthesis of bacterial protein by binding to a part of the bacterial ribosome.

Saqib Islam. CheckRare via YouTube

Spring­Works seeks $115M to push Pfiz­er drugs across fin­ish line while Sat­suma sells mi­graine play in $86M IPO

SpringWorks and Satsuma — both biotech spinouts that have closed B rounds in April — are loading up with IPO cash to boost their respective late-stage plans.
SpringWorks

Bain-backed SpringWorks is the better-known company of the two, and it’s gunning for a larger windfall of $115 million to add to $228 million from previous financings. In the process, the Stamford, CT-based team is also drawing the curtains on the partnerships it has in mind for the pair of assets it had initially licensed from Pfizer.

Mi­nor­i­ty racial groups con­tin­ue to be dis­mal­ly rep­re­sent­ed in can­cer tri­als — study

Data reveal that different racial and ethnic groups — by nature and/or nurture — can respond differently in terms of pharmacokinetics, efficacy, or safety to therapeutics, but this disparity is not necessarily accounted for in clinical trials. A fresh analysis of the last decade of US cancer drug approvals suggests the trend continues, cementing previous research that suggests oncology trials are woefully under-representative of the racial makeup of the real world.

Van­da shares slide af­ter FDA spurns their big end­point and re­jects a pitch on jet lag re­lief

Back in the spring of last year, Vanda Pharmaceuticals $VNDA served up a hot stew of mixed data for a slate of endpoints related to what they called clear evidence that their melatonin sleep drug Hetlioz (tasimelteon) could help millions of travelers suffering from jet lag.

Never mind that they couldn’t get a planned 90 people in the study, settling for 25 instead; Vanda CEO Mihael H. Polymeropoulos said they were building on a body of data to prove it would help jet-lagged patients looking for added sleep benefits. And that, they added, would be worth a major upgrade from the agency as they sought to tackle a big market.