Lit­tle vTv once again cir­cles sub­group num­ber, strug­gling to find some­thing good to say about failed Alzheimer's drug

The biotech vTv raised $117 mil­lion from their 2015 IPO $VTVT based on a pitch that they could take a failed Alzheimer’s drug from Pfiz­er and fol­low a trail of pos­i­tive sub­set da­ta to a big win. That didn’t work, with Phase A of the piv­otal pro­gram fail­ing both co-pri­ma­ry end­points re­cent­ly.

In fact, the drug arm once again did worse than a place­bo group.

Steve Hol­combe

But now they’ve had a chance to do some post hoc analy­sis of the first round of Phase III da­ta, and they’re back to spot­light­ing a pos­i­tive batch of da­ta for a sub­pop­u­la­tion.

So here it is. In a state­ment out Wednes­day night, vTv says that a group of pa­tients with a con­cen­tra­tion of the drug azeli­ragon un­der a bar of 7.5 ng/mL hit a sta­tis­ti­cal­ly sig­nif­i­cant score for ADAS-cog, p=0.02. It failed on an­oth­er score — CDR-sb — with a p-val­ue of 0.06. And they want to re­vise their sta­tis­ti­cal analy­sis plan for the FDA.

The sub­group in­clud­ed 48 of the 400 pa­tients in the study, which was di­vid­ed be­tween the drug and a place­bo. 

The biotech’s shares — which were crushed on the ini­tial Phase III fail­ure — bounced high­er in pre-mar­ket trad­ing Thurs­day. Whether they can sus­tain that with ad­di­tion­al sub­group analy­sis re­mains to be seen, but vTv is once again go­ing down a path that has led to the de­struc­tion of bil­lions of dol­lars of in­vestors’ cash on a wide range of drug stud­ies.

The com­pa­ny de­signed the 18-month Phase III pro­gram based on da­ta that the small 5 mg dose of the drug per­formed well in Pfiz­er’s study, where the 20 mg failed. And just like about every­thing else in the Alzheimer’s pipeline, that strat­e­gy has proved to be a re­peat los­er.

In­vestors in the field keep buy­ing in­to the idea that ac­quir­ing shares in an Alzheimer’s stock is just like buy­ing lot­tery tick­ets — ul­tra high risk with the pos­si­bil­i­ty of ul­tra high re­wards. But with no win­ners in more than a decade, that ar­gu­ment has been wear­ing thin.

This biotech, though, is still de­ter­mined to keep rolling the dice.

“We are en­cour­aged by the pos­i­tive im­prove­ments in cog­ni­tive and func­tion­al out­comes rel­a­tive to place­bo based up­on low azeli­ragon con­cen­tra­tion lev­els,” said vTv CEO Steve Hol­combe in a state­ment. “With this un­der­stand­ing, we are con­tin­u­ing to an­a­lyze the da­ta and then plan to ex­am­ine the rel­e­vant pop­u­la­tion prospec­tive­ly in the Part B study and an­nounce re­sults in June.”

Up­dat­ed: FDA re­mains silent on or­phan drug ex­clu­siv­i­ty af­ter last year's court loss

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.

Big week for Alzheimer’s da­ta; As­traZeneca buys cell ther­a­py start­up; Dig­i­tal ther­a­peu­tics hits a pay­er wall; and more

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Am­gen, years be­hind ri­vals, says PhI obe­si­ty drug shows dura­bil­i­ty signs

While NBC ran “The Biggest Loser” for 17 seasons, deemed toxic by critics for the reality show’s punishing exercise and diet upheavals, researchers in pharmaceutical labs have been attempting to create prescription drugs that induce weight loss — and one pharma betting it can require less frequent dosing is out with a new crop of data.

Amgen was relatively late to the game compared to its approved competitor Novo Nordisk and green light-approaching rival Eli Lilly. But early data suggested Amgen’s AMG 133 led to a 14.5% weight reduction in the first few months of dosing, buoying shares earlier this fall, and now the California pharma is out with its first batch of durability data showing that figure fell slightly to 11.2% about 150 days after the last dose. Amgen presented at the 20th World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease on Saturday afternoon.

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Illustration: Assistant Editor Kathy Wong for Endpoints News

As mon­ey pours in­to dig­i­tal ther­a­peu­tics, in­sur­ance cov­er­age crawls



Talk therapy didn’t help Lily with attention deficit hyperactivity disorder, or ADHD. But a video game did.

As the 10-year-old zooms through icy waters and targets flying creatures on the snow-capped planet Frigidus, she builds attention skills, thanks to Akili Interactive Labs’ video game EndeavorRx. She’s now less anxious and scattered, allowing her to stay on a low dose of ADHD medication, according to her mom Violet Vu.

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Eli Lil­ly’s Alzheimer’s drug clears more amy­loid ear­ly than Aduhelm in first-ever head-to-head. Will it mat­ter?

Ahead of the FDA’s decision on Eli Lilly’s Alzheimer’s drug donanemab in February, the Big Pharma is dropping a first cut of data from one of the more interesting trials — but less important in a regulatory sense — at an Alzheimer’s conference in San Francisco.

In the unblinded 148-person study, Eli Lilly pitted its drug against Aduhelm, Biogen’s drug that won FDA approval but lost Medicare coverage outside of clinical trials. Notably, the study didn’t look at clinical outcomes, but rather the clearance of amyloid, a protein whose buildup is associated with Alzheimer’s disease, in the brain.

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US month­ly costs for biosim­i­lars 'sub­stan­tial­ly high­er' than Ger­many or Switzer­land, JA­MA re­search finds

As the global biologics market is expected to hit nearly the half-trillion-dollar mark this year, new JAMA research points to the importance of timely biosimilar entry, particularly as fewer biosimilars are entering the US than in Europe, and as monthly treatment costs for biosimilars were “substantially higher” in the US compared with Germany and Switzerland.

Among the three countries, biosimilar market share at launch was highest in Germany, but increased at the fastest rate in the US, the authors from the University of Zurich’s Institute of Law wrote in JAMA Network Open today.

Kirk Myers is shown in a still image from a new film series showcasing the efforts of HIV advocates funded by Gilead.

Gilead spot­lights HIV projects and the com­mu­ni­ty lead­ers dri­ving them in new mi­ni-doc­u­men­tary films

Gilead is going behind the scenes of some of the HIV initiatives it funds through grants in a new film series narrated by the people helming the projects.

The first four films and leaders come from across the US — Arianna Lint in Florida and Puerto Rico, Cleve Jones in San Francisco, June Gipson in Mississippi and Kirk Myers in Texas. Their HIV-focused efforts range from addressing unmet needs of the transgender community to delivering social services and high-quality health care in underserved communities.

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EMA pulls an opi­oid from the 1950s used to treat dry cough

The European Medicines Agency said Friday that it’s pulling from all European markets pholcodine-containing medicines, which are an opioid used in adults and children for the treatment of dry cough and in combo with other drugs as a treatment for cold and flu.

The decision to pull the medicines comes as the EMA points to the results from the recent ALPHO study, which show that use of pholcodine during the 12 months preceding anesthesia is linked to a risk of an anaphylactic reaction related to the neuromuscular blocking agents (NMBAs) used (with an adjusted OR of 4.2, and a 95% confidence interval of 2.5 to 6.9).

David Arthur, Salarius Pharmaceuticals CEO

Salarius Phar­ma­ceu­ti­cals sees with­drawals, 3 of 13 pa­tient re­spon­ders in sar­co­ma tri­al

The Houston-based biotech Salarius Pharmaceuticals is lifting the cover on data from a Phase I/II trial for a drug currently on voluntary hold after a patient death, and the results appear to have underwhelmed investors.

Salarius’ candidate, dubbed seclidemstat, is an oral LSD1 inhibitor that is meant to treat Ewing sarcoma and FET-rearranged sarcomas in patients under 12 years old. The biotech had presented data with 13 patients with “first- and second-relapse Ewing sarcoma” who were treated in combination with topotecan and cyclophosphamide.