No­var­tis builds block­buster case for En­tresto, beat­ing out a cheap ACE in­hibitor — or not

No­var­tis ex­ecs got the pos­i­tive da­ta they were look­ing for from their PI­O­NEER-HF study of En­tresto to back ac­cel­er­at­ing sales of the heart med­ica­tion.

Ini­tial­ly a slow mov­ing prod­uct ham­pered by physi­cians re­luc­tant to adopt a new med and pay­ers who were none too hap­py with the price, En­tresto is now com­fort­ably hit­ting its block­buster stride. In the third quar­ter the drug earned $271 mil­lion. And now they’ll be look­ing for con­tin­ued ac­cel­er­a­tion af­ter the drug scored the pri­ma­ry end­point and key sur­vival and re-hos­pi­tal­iza­tion num­bers in a head-to-head study with the cheap ACE in­hibitor enalapril.

Shree­r­am Arad­hye

Re­searchers com­pared the two drugs among pa­tients suf­fer­ing from heart fail­ure with re­duced ejec­tion frac­tion. And they came away with sig­nif­i­cant­ly bet­ter re­sults for a key bio­mark­er — NT-proB­NP — at weeks 4 and 8. There was al­so a “46% re­duc­tion in the risk of a com­pos­ite of death, heart fail­ure re-hos­pi­tal­iza­tion (hos­pi­tal stay >24 hours), re­quire­ment for left ven­tric­u­lar as­sist de­vice (LVAD) in­ser­tion or list­ing for car­diac trans­plan­ta­tion com­pared to enalapril over 8 weeks.”

But the tri­al re­sults al­so spurred some Twit­ter dis­cus­sion about the dos­es used in the tri­al.

That point was over­looked by the in­ves­ti­ga­tors in­volved.

Er­ic Ve­lazquez

“With the PI­O­NEER-HF tri­al re­sults — once acute heart fail­ure is di­ag­nosed, pa­tients are he­mo­dy­nam­i­cal­ly sta­bi­lized, and a low ejec­tion frac­tion is con­firmed — sacu­bi­tril/val­sar­tan should be start­ed prompt­ly to re­duce neu­ro­hor­mon­al ac­ti­va­tion and re­duce the risk of post-dis­charge heart fail­ure hos­pi­tal­iza­tion,” not­ed Yale’s Er­ic Ve­lazquez.

The tri­al al­so builds on No­var­tis’ am­bi­tious tri­al strat­e­gy, aim­ing to build their ar­gu­ment to get this drug to pa­tients at an ear­li­er point.

No­var­tis CMO Shree­r­am Arad­hye put it this way:

To­geth­er with da­ta from the PAR­A­DIGM-HF study, which demon­strat­ed the su­pe­ri­or ben­e­fit of En­tresto com­pared to an ACEi on car­dio­vas­cu­lar mor­tal­i­ty and HF hos­pi­tal­iza­tions in am­bu­la­to­ry pa­tients, there is now con­sis­tent ev­i­dence in the in- and out­pa­tient set­tings sup­port­ing the use of En­tresto.

Grow­ing ac­cep­tance of ac­cel­er­at­ed path­ways for nov­el treat­ments: but does reg­u­la­to­ry ap­proval lead to com­mer­cial suc­cess?

By Mwango Kashoki, MD, MPH, Vice President-Technical, and Richard Macaulay, Senior Director, of Parexel Regulatory & Access

In recent years, we’ve seen a significant uptake in the use of regulatory options by companies looking to accelerate the journey of life-saving drugs to market. In 2018, 73% of the novel drugs approved by the U.S. Federal Drug Administration (FDA) were designated under one or more expedited development program categories (Fast Track, Breakthrough Therapy, Priority Review, and Accelerated Approval).ᶦ

Sanofi out­lines big API plans as coro­n­avirus out­break re­port­ed­ly threat­ens short­age of 150 drugs

As the world becomes increasingly dependant on Asia for the ingredients of its medicines, Sanofi sees business to be done in Europe.

The French drugmaker said it’s creating the world’s second largest active pharmaceutical ingredients (API) manufacturer by spinning out its six current sites into a standalone company: Brindisi (Italy), Frankfurt Chemistry (Germany), Haverhill (UK), St Aubin les Elbeuf (France), Újpest (Hungary) and Vertolaye (France). They have mapped out €1 billion in expected sales by 2022 and 3,100 employees for the new operations headquartered in France.

UP­DAT­ED: NGM Bio takes leap for­ward in crowd­ed NASH field

South San Francisco-based NGM Bio may have underwhelmed with its interim analysis of a key cohort from a mid-stage NASH study last fall — but stellar topline data unveiled on Monday showed the compound induced significant signs of antifibrotic activity, NASH resolution and liver fat reduction, sending the company’s stock soaring.

There are an estimated 50+ companies focused on developing drugs for non-alcoholic steatohepatitis, or NASH, a common liver disease that has long flummoxed researchers. The first wave of NASH drug developers struggled with efficacy as well as safety — and companies big and small have crashed and burned.

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Mickey Kertesz, KidsandArtOrg via YouTube

Soft­Bank's newest, $165M biotech in­vest­ment looks for in­fec­tious traces in the blood

SoftBank has found its newest biotech investment.

The Japanese bank has invested $165 million into Karius, a company that uses blood tests to diagnose infectious diseases, as part of its new Vision Fund 2. The full scope of the new fund has yet to be announced, but the first and newly-beleaguered Vision Fund poured $100 billion into technology companies, including the biotechs Vir Biotechnology and Roivant and the sequencing company 10x Genomics.

Methicillin-resistant Staph aureus (Shutterstock)

FDA grants ‘break­through’ sta­tus to an­tibi­ot­ic al­ter­na­tive as Con­tra­Fect rush­es to join fight against su­per­bug

An experimental drug that promises to be the first anti-infective agent to prove superior to vancomycin — an antibiotic approved in 1958 — has notched the FDA’s “breakthrough” status.

ContraFect said the designation was based on Phase II data in which exebacase was tested against a superbug known as methicillin-resistant Staph aureus, or MRSA. In a subgroup analysis, the clinical responder rate at day 14 was 42.8% higher than that among those treated with standard of care, the company said (p=0.010).

Zhong Nanshan, CGTN via YouTube

Har­vard joins coro­n­avirus fight with $115 mil­lion and a high-pro­file Chi­nese part­ner

For two months, as the novel coronavirus swelled from a few early cases tied to a Wuhan market to a global epidemic, most of the world’s focus and dollars have flowed toward emergency initiatives: building vaccines at a record pace, plucking experimental antivirals out of freezers to see what sticks and immunizing mice for new antibodies.

Now a new and well-funded collaboration between Harvard and a top Chinese research institute will play the long game. In a 5-year, $115 million initiative backed by China Evergrande Group, researchers from the Harvard Medical School, Harvard T.H. Chan School of Public Health and Guangzhou Institute for Respiratory Health will study the virus in an effort to develop therapies against infections by the novel coronavirus, known as SARS–CoV-2, and to prevent new ones.

No­var­tis gets a boost in block­buster mul­ti­ple scle­ro­sis race with Roche

In the first step of what’s likely to be a long and uphill battle for the drugmaker, the FDA has accepted Novartis’s BLA submission for a new multiple sclerosis drug and given it priority review. The PDUFA date for the potential blockbuster drug is in June.

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Juergen Horn

An­i­mal health vet Juer­gen Horn makes new an­ti­body play for pets, rak­ing $15M in Se­ries A haul

Zoetis forked over $85 million in 2017 to acquire Nexvet Biopharma and its pipeline of monoclonal antibodies. Juergen Horn, Nexvet’s former chief product development officer, has now secured $15 million for his own biologic company for animals: Invetx.

Buoyed by emerging advances in gene therapies for humans, scientists have started looking at harnessing the technology for animals setting up companies such as Penn-partnered Scout Bio and George Church-founded Rejuvenate Bio. But akin to Nexvet, Invetx is working on leveraging the time-tested science of monoclonal antibodies to treat chronic diseases that afflict man’s best friend.

As coro­n­avirus out­break reach­es 'tip­ping point,' GSK lends ad­ju­vant tech to Chi­nese part­ner armed with pre­clin­i­cal vac­cine

As the coronavirus originating out of Wuhan spreads to South Korea, Italy and Iran, stoking already intense fears of a pandemic, GlaxoSmithKline has found another pair of trusted hands to place its adjuvant system. China’s Clover Biopharmaceuticals will add the adjuvant to its preclinical, protein-based vaccine candidate against SARS-CoV-2.

Clover, which is based in the inland city of Chengdu, boasts of a platform dubbed Trimer-Tag that produces covalently-trimerized fusion proteins. Its candidate, COVID-19 S-Trimer, resembles the viral spike (S)-protein found in the virus.