Out to shake up PC­SK9 mar­ket, Med­i­cines Co boasts of piv­otal PhI­II win for in­clisir­an

The Med­i­cines Com­pa­ny’s first piv­otal Phase III re­sults for in­clisir­an are in, and the biotech can’t wait to high­light the cho­les­terol-low­er­ing po­ten­tial of its long-act­ing drug.

Mark Tim­ney

Ahead of a da­ta pre­sen­ta­tion of ORI­ON-11 at next week’s Eu­ro­pean So­ci­ety of Car­di­ol­o­gy, The Med­i­cines Com­pa­ny is putting out word that in­clisir­an — an RNAi ther­a­peu­tic li­censed from Al­ny­lam that works by pre­vent­ing PC­SK9 from be­ing syn­the­sized in the liv­er — met all pri­ma­ry and sec­ondary end­points. The ef­fi­ca­cy was “con­sis­tent with find­ings from Phase 1 and 2 stud­ies” and the safe­ty pro­file was “at least as fa­vor­able” as in pre­vi­ous Phase II stud­ies.

Baird’s Mad­hu Ku­mar added that in speak­ing with man­age­ment, the re­sults were “con­sis­tent with mod­el­ing work pre­vi­ous­ly de­scribed to rep­re­sent a 50%-55% re­duc­tion in LDL-C” — though he em­pha­sized da­ta at the ESC will be need­ed to con­firm a win here.

Mean­while, Umer Raf­fat of Ever­core ISI ze­roed in on the claim about a clean safe­ty pro­file, which was “by and far the biggest is­sue” head­ing in­to Phase III, call­ing the topline re­sults pos­si­bly “the sin­gle most im­por­tant piece of val­i­da­tion for RNAi safe­ty.”

Shares $MD­CO rose 12.79% to $38.03 pre-mar­ket.

Pa­tients who have com­plet­ed ORI­ON-11 will now join co­horts from ORI­ON-9 and -10 for ORI­ON-8, an open-la­bel ex­ten­sion study to eval­u­ate the dos­ing of in­clisir­an over three years.

ORI­ON-11 and -10 both en­rolled pa­tients with ath­er­o­scle­rot­ic car­dio­vas­cu­lar dis­ease and el­e­vat­ed LDL cho­les­terol de­spite statin ther­a­py; the for­mer was con­duct­ed in sev­en coun­tries ex-US while the lat­ter took place in the US. The re­sults for ORI­ON-10 as well as -9 — which tar­get pa­tients with het­erozy­gous fa­mil­ial hy­per­c­ho­les­terolemia — are ex­pect­ed lat­er this quar­ter.

That bulky da­ta pack­age — with each tri­al in­volv­ing more than a thou­sand pa­tients — will be sent to the FDA by the end of this year and to the EMA in Q1 2020.

The da­ta pre­sen­ta­tion at ESC can al­so bode well for Al­ny­lam $AL­NY, Mani Foroohar of SVB Leerink not­ed, es­pe­cial­ly with re­gards to ap­ply­ing its GalNAc-con­ju­gat­ed RNAi plat­form in large pop­u­la­tion, pri­ma­ry care in­di­ca­tions.

While mon­o­clon­al an­ti­bod­ies from Re­gen­eron/Sanofi and Am­gen have beat in­clisir­an to the mar­ket, Baird an­a­lysts have pre­dict­ed the drug will be “as­cend­ing the Iron Throne of PC­SK9 drugs” due most­ly to its dos­ing sched­ule. Un­like Pralu­ent and Repatha, which are ad­min­is­tered month­ly or twice-month­ly, in­clisir­an can be giv­en just twice a year af­ter an ini­tial in­ter­val of three months.

“We be­lieve this dos­ing sched­ule is at­trac­tive to pa­tients and can im­prove ad­her­ence, since cur­rent­ly on­ly 55-60% pa­tients are com­pli­ant on PC­SK9 Ab ther­a­py,” Jef­feries an­a­lysts have not­ed.

No­tably, ORI­ON-11 ex­clud­ed pa­tients with ac­tive liv­er dis­ease, which the com­pa­ny said is “not un­com­mon for stud­ies of dys­lipi­demia med­ica­tions.” While a case of liv­er en­zyme el­e­va­tion cropped up in Phase II, it was deemed un­re­lat­ed to the drug. Re­cent stud­ies com­pris­ing re­nal­ly im­paired pa­tients al­so sug­gest­ed in­clisir­an is safe for that group, and that they do not re­quire dose ad­just­ment.

“This is a mo­men­tous oc­ca­sion that fur­ther re­in­forces our con­fi­dence in the tremen­dous po­ten­tial of in­clisir­an to fun­da­men­tal­ly change the treat­ment of car­dio­vas­cu­lar dis­ease,” said CEO Mark Tim­ney, who suc­ceed­ed long­time chief Clive Mean­well in De­cem­ber 2018.

Hal Barron, GSK via YouTube

What does $29B buy you in Big Phar­ma? In Glax­o­SmithK­line’s case, a whole lot of un­com­fort­able ques­tions about the pipeline

Talk about your bad timing.

A little over a week ago, GSK R&D chief Hal Barron marked his third anniversary at the research helm by taking a turn at the virtual podium during JP Morgan to make the case that he and his team had built a valuable late-stage pipeline capable of churning out more than 10 blockbusters in the next 5 years.

And then, just days later, one of the cancer drugs he bet big on as a top prospect — bintrafusp, partnered with Merck KGaA — failed its first pivotal test in non-small cell lung cancer.

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5AM Ven­tures: Fu­el­ing the Next Gen­er­a­tion of In­no­va­tors

By RBC Capital Markets
With Andy Schwab, Co-Founder and Managing Partner at 5AM Ventures

Key Points

Prescription Digital Therapeutics, cell therapy technologies, and in silico medicines will be a vital part of future treatment modalities.
Unlocking the potential of the microbiome could be the missing link to better disease diagnosis.
Growing links between academia, industry, and venture capital are spinning out more innovative biotech companies.
Biotech is now seen by investors as a growth space as well as a safe haven, fuelling the recent IPO boom.

Janet Woodcock (AP Images)

End­points poll: Janet Wood­cock takes the (in­ter­im) helm at the FDA. And a large ma­jor­i­ty of our read­ers want her to stay there

It’s official: Janet Woodcock is now the acting chief of the FDA.

And — according to an Endpoints poll — most industry readers would like her to stay there, although a significant minority is strongly opposed.

To recap: Joe Biden is reportedly choosing between Woodcock and former deputy FDA commissioner Joshua Sharfstein as his nominee for the permanent position. Given their respective track records, the decision is set to determine the agency’s lodestar for years to come.

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What’s next for End­points — and how to sup­port our in­de­pen­dent bio­phar­ma news mis­sion

The firehose of biopharma news is gushing these days.

That’s why broader and deeper is the theme for 2021 at Endpoints. You can expect new coverage outside our core R&D focus, with deeper reporting in some key areas. When John Carroll and I launched Endpoints nearly five years ago, we were wading in waist-high waters. Now we’re a team of 25 full-time staffers (and growing) with plans to cover the flood of biopharma news, Endpoints-style.

Fast on Glax­o­SmithK­line's heels, Au­rinia wins OK to steer a sec­ond lu­pus nephri­tis drug straight to the mar­ket

GlaxoSmithKline’s Benlysta isn’t alone in the small circle of approved lupus nephritis drugs anymore.

Little Aurinia Pharmaceuticals has gotten the green light from the FDA to start marketing its first and only program, voclosporin, under the brand name Lupkynis — something CEO Peter Greenleaf says it’s been ready to do since December.

Regulators went right down to the wire on the decision, keeping the company and the entire salesforce it’s already assembled on its toes.

Eli Lil­ly's an­ti­body cuts risk of Covid-19 by up to 80% among the most vul­ner­a­ble — but will it have a place next to vac­cines?

Eli Lilly says bamlanivimab lowered the risk of contracting symptomatic Covid-19 in a first-of-its-kind trial involving nursing home residents and staff, paving the way for a new option to protect against the virus.

But how big of an impact it might have, and what role it will play, at a time vaccines are being rolled out to the exact population it is targeting still remains unclear.

Among 965 participants in the study — all of whom tested negative for the coronavirus at baseline — the number of symptomatic cases reported in the bamlanivimab arm was 57% lower than that in the placebo arm (odds ratio 0.43, p=0.00021). In addition to that primary endpoint, all secondary endpoints reached statistical significance.

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Charlie Fuchs, Roche and Genentech global head of product development for oncology and hematology (Yale Cancer Center)

Yale can­cer spe­cial­ist Char­lie Fuchs tapped as new glob­al de­vel­op­ment chief for Roche/Genen­tech

Roche and their big sub Genentech have just recruited a top cancer specialist at Yale to head up global product development in oncology and hematology.

I just got word that the pharma giant, which leads one of the most active cancer research operations in the world, recruited Charlie Fuchs, director of the Yale Cancer Center and physician-in-chief of Smilow Cancer Hospital. He’ll join the global operation March 1 and will be based in South San Francisco, where Genentech is based.

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Jonathan Weissman (MIT)

Can a new CRISPR tech­nique un­lock the se­crets of how can­cer spreads?

Jonathan Weissman’s team watched the cancer cells spread across the doomed mouse. Engineered with a bioluminescent enzyme, they appeared in scans first as a small navy blue diamond lodged near the heart; a week later, as a triangle splayed across the mouse’s upper body, with streaks of green and two distinct bright red hubs of activity. By day 54, the mouse resembled a lava lamp.

The images would have been familiar to any cancer biologist, but they didn’t actually tell you much about what was going on: why the cancer was metastasizing or which cells were responsible. For that, Weissman’s team had designed a new tool. Inside the original navy blue diamond, they had engineered the microbiological equivalent of an airplane’s black box — a “molecular recorder” that, after the mouse’s death, could allow them to extract the cells and wind back intimate footage of a single cancer’s ascent.

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Glax­o­SmithK­line scraps a LAG3 study, mark­ing an­oth­er fail­ure for the pipeline af­ter a crit­i­cal set­back

Another gap has appeared in GlaxoSmithKline’s pipeline.

Friday morning the Australian biotech Immutep put out word that Hal Barron’s R&D group at GSK had decided to scrap a Phase II proof-of-concept study in ulcerative colitis for their anti-LAG3 therapy GSK2831781. According to the biotech, the program didn’t survive an interim review.

The trial was stopped by GSK based on the assessment of clinical data as part of a planned interim analysis conducted in consultation with the trial’s Data Review Committee. GSK is conducting further reporting, assessment and analyses of the efficacy and safety data and evaluating the biology to determine next steps for the GSK2831781 development program.

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