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.

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.

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