NGM Bio un­veils pos­i­tive PhII NASH re­sults to some unim­pressed in­vestors

NGM Bio got up ear­ly this morn­ing in South San Fran­cis­co ready to pro­claim an in­ter­im win of its lead NASH drug, aldafer­min, in the fourth and fi­nal leg of a lengthy Phase II pro­gram. The re­sults of com­par­ing drug to place­bo were pos­i­tive, the com­pa­ny said, set­ting up some ex­pec­ta­tions for a fi­nal read­out in ear­ly 2020.

But in­vestors weren’t quite buy­ing it. The stock $NGM has slid around 18%.

So what’s wrong?

It may be help­ful to re­mem­ber, first of all, that NASH is a block­buster sized mar­ket that’s en­ticed mul­ti­ple biotech play­ers from In­ter­cept and Madri­gal to Gen­fit and Viking, and any signs of ear­ly hope or doom — es­pe­cial­ly as com­pared to oth­er ri­vals, de­spite the dan­gers of cross-tri­al com­par­isons — could cast dif­fer­ent lights on the da­ta.

David Wood­house

With that, here’s what NGM has re­port­ed about the 38-pa­tient tri­al: A 24-week treat­ment with once-dai­ly 1 mg aldafer­min, or NGM282, met the pri­ma­ry end­point re­gard­ing changes in ab­solute liv­er fat con­tent achiev­ing a drop of 7.9% ver­sus 2.0% on place­bo as mea­sured by MRI-es­ti­mat­ed pro­ton den­si­ty fat frac­tion (p<0.05).The change in rel­a­tive LFC came in at a dra­mat­ic -39.6% over -5.9% in the place­bo arm.

The com­pa­ny al­so not­ed that 72% of the aldafer­min group achieved 5% or more ab­solute re­duc­tion in LFC, com­pared to 17% of those tak­ing place­bo.

That’s in­deed pos­i­tive, and rough­ly in line with the Phase II da­ta Madri­gal pre­vi­ous­ly re­port­ed for their MGL-3196 (-36.3% rel­a­tive re­duc­tion on drug vs 9.6% on place­bo). But it fell short of the 57-60% me­di­an rel­a­tive change and 77-91% re­spon­der rate that Viking post­ed last year, spark­ing a surge in share price.

Hsiao Lieu

Some­thing else might al­so be dri­ving the con­cern: a spike in cho­les­terol lev­els (LDL-C to be spe­cif­ic) at week 2 of treat­ment. While NGM con­tends it’s noth­ing they didn’t know from pre­vi­ous Phase II co­horts, that it’s a di­rect ef­fect of FGF19’s in­hi­bi­tion of the clas­si­cal bile acid syn­the­sis path­way and that it was quick­ly re­solved by statin treat­ment, a mean in­crease of 47.6 mg/dL in LDL-C rel­a­tive to a 103.5 mg/dL base­line could be alarm­ing to a pa­tient pop­u­la­tion that al­ready has height­ened car­dio­vas­cu­lar risks.

CEO David Wood­house main­tained they are pleased with the in­ter­im find­ings, part of an ex­pan­sive clin­i­cal cam­paign fund­ed by a $200 mil­lion-plus part­ner­ship with Mer­ck and a $107 mil­lion IPO a few months ago.

“Aldafer­min con­tin­ues to be dif­fer­en­ti­at­ed with what we be­lieve is an in­dus­try-lead­ing pro­file as a monother­a­py for the po­ten­tial treat­ment of NASH, as few drugs in de­vel­op­ment for this dis­ease have shown mean­ing­ful meta­bol­ic, an­ti-in­flam­ma­to­ry and an­ti-fi­brot­ic ac­tiv­i­ty,” CMO Hsiao Lieu added in a state­ment. “Through­out our Phase 2 pro­gram, we’ve seen a re­la­tion­ship be­tween aldafer­min’s im­pact on bio­mark­ers of dis­ease and sub­se­quent his­tol­ogy re­sults. To that end, we look for­ward to the biop­sy da­ta read­out for Co­hort 4, which will fur­ther in­form plan­ning ac­tiv­i­ties for our Phase 3 study.”

Tal Zaks, Moderna CMO (Moderna via YouTube)

UP­DAT­ED: NI­AID and Mod­er­na spell out a 'ro­bust' im­mune re­sponse in PhI coro­n­avirus vac­cine test — but big ques­tions re­main to be an­swered

The NIAID and Moderna have spelled out positive Phase I safety and efficacy data for their Covid-19 vaccine mRNA-1273 — highlighting the first full, clear sketch of evidence that back-to-back jabs at the dose selected for Phase III routinely produced a swarm of antibodies to the virus that exceeded levels seen in convalescent patients — typically in multiples indicating a protective response.

Moderna execs say plainly that this first stage of research produced exactly the kind of efficacy they hoped to see in humans, with a manageable safety profile.

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Trans­port Sim­u­la­tion Test­ing for Your Ther­a­py is the Best Way to As­sure FDA Ex­pe­dit­ed Pro­gram Ap­proval

Modality Solutions is an ISO:9001-registered biopharmaceutical cold chain engineering firm with unique transport simulation capabilities that support accelerated regulatory approval for biologics and advanced therapeutic medicinal products (ATMP). Our expertise combines traditional validation engineering approaches with regulatory knowledge into a methodology tailored for the life sciences industry. We provide insight and execution for the challenges faced in your cold chain logistics network.

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Who are the women blaz­ing trails in bio­phar­ma R&D and lead­ing the fight against Covid-19? Nom­i­nate them for End­points' spe­cial re­port

One of the many inequalities the pandemic has laid bare is the gender imbalance in biomedical research. A paper examining Covid-19 research authorship wondered out loud: Where are the women?

It’s a question that echoes beyond our current times. In the biopharma world, not only are women under-represented in R&D roles (particularly at higher levels), their achievements and talents could also be undermined by stereotypes and norms of leadership styles. The problem is even more dire for women of color.

Jeff Albers, Blueprint CEO

Di­ag­nos­tic champ Roche buys its way in­to the RET ti­tle fight with Eli Lil­ly, pay­ing $775M in cash to Blue­print

When Roche spelled out its original $1 billion deal — $45 million of that upfront — with Blueprint to discover targeted therapies against immunokinases, the biotech partner’s RET program was still preclinical. Four years later, pralsetinib is on the cusp of potential approval and the Swiss pharma giant is putting in much more to get in on the commercial game.

Roche gains rights to co-develop and co-commercialize the drug, with sole marketing responsibility for places outside the US and China (where CStone has staked its claim).

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Mene Pangalos, AstraZeneca R&D chief (AstraZeneca via YouTube)

A day af­ter Mod­er­na vac­cine re­sults, ru­mors swirl of pend­ing As­traZeneca da­ta

A day after Moderna and the NIH published much-anticipated data from their Phase I Covid-19 vaccine trial, attention is turning to AstraZeneca which, according to a UK report, is expected to publish its own early data tomorrow.

ITV’s Robert Peston reported that AstraZeneca will publish the Phase I data in The Lancet. 

AstraZeneca and Moderna represent the two most ambitious Covid-19 vaccine efforts, having set the quickest timelines for approval (though they were recently joined in that regard by the Pfizer-BioNTech partnership) and some of the loftiest goals in total doses. Yet there is even less known about AstraZeneca’s vaccine’s effect on humans than there was about Moderna’s before yesterday. Although, in a controversial move, Moderna released some statistics from its Phase I in May, AstraZeneca has yet to say anything about what it saw in its Phase I trial — a move consistent with the scientific convention to withhold data until it can be published in a peer-reviewed journal.

Ludwig Hantson, Alexion CEO

Why pay $4B for a steady di­et of dis­ap­point­ment? Porges turns thumbs down on Alex­ion’s M&A strat­e­gy, of­fers some point­ers

When Alexion announced recently that it was paying $1.4 billion to bag Portola and its underperforming Factor Xa inhibitor reversal agent, you could hear the head-scratching going on around virtual Wall Street.

Why was Alexion going down the discount lane for new products? And why something like this? Analysts have been urging Alexion to get serious about M&A for years if it was serious about diversifying the company beyond Soliris and its successor drug. But this wasn’t the kind of heavy-impact deal they were looking for.

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Mil­li­pore­Sig­ma to build new $20 mil­lion, 12,000-square-foot lab in Switzer­land

On the heels of opening a new laboratory in Shanghai last week, MilliporeSigma is continuing its construction push.

The Merck KGgA life science subsidiary announced Wednesday its intentions to build a new $20 million lab in Buchs, Switzerland to support its reference materials business. It’s estimated that the new facility will be completed in December 2021 and open in early 2022 and is expected to be 12,000 square feet.

Stéphane Bancel, Moderna CEO (Steven Ferdman/Getty Images)

‘Plan­ning to vac­ci­nate every­one in the US,’ Mod­er­na out­lines ef­forts to sup­ply their Covid-19 vac­cine as man­u­fac­tur­ing ramps up ahead of PhI­II

Twelve days from the planned start of their Phase III pivotal trial, the executive crew at Moderna has set up the manufacturing base needed to begin production of the first 500,000 doses of their Covid-19 vaccine with plans to feed it into a global supply chain. But the initial batches will likely be ready in the US first, where company CEO Stéphane Bancel plans to be able to vaccinate everyone.

“We have started making commercial product at-risk, and will continue to do so every day and every week of the month,” Bancel told analysts during their morning call on the Phase I data just published in the New England Journal of Medicine.

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Covid-19 roundup: Vac­cine by end of 2020? Ken Fra­zier warns hype do­ing 'grave dis­ser­vice'

When it comes to setting expectations about a Covid-19 vaccine, Ken Frazier does not mince words.

Over a month after first casting doubts on the aggressive 12- to 18-month timeframe championed by the US government and his biopharma peers, the Merck CEO again cautioned against any hype around a quick vaccine approval.

In a wide-ranging interview with Harvard Business School professor Tsedal Neeley that touched other big topics such as race, Frazier emphasized that vaccines take a long time to develop. He would know: Out of the seven new vaccines introduced around the world in the past 25 years, four came from Merck.

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