Pfiz­er's JAK1 chal­lenger to Dupix­ent shines in an­oth­er PhI­II, but safe­ty is­sues still cast a shad­ow

Pfiz­er is rack­ing up am­mu­ni­tion for its full-on as­sault against Re­gen­eron and Sanofi’s Dupix­ent fran­chise, with the lat­est topline win for an oral atopic der­mati­tis drug that it’s steer­ing to the FDA lat­er this year. But the new da­ta cut is do­ing lit­tle to ease safe­ty con­cerns.

JADE COM­PARE is the third Phase III tri­al in the abroc­i­tinib eczema pro­gram. Un­like JADE MONO-1 and JADE MONO-2, which en­rolled pa­tients who ei­ther don’t re­spond well or can’t tol­er­ate top­i­cal treat­ment, this new tri­al ze­roed in on those al­so tak­ing top­i­cal ther­a­pies on back­ground.

Michael Cor­bo

This ap­proach helps “pro­vide da­ta rel­e­vant to the re­al-world set­ting,” Michael Cor­bo, Pfiz­er’s chief de­vel­op­ment of­fi­cer for in­flam­ma­tion and im­munol­o­gy, not­ed in a state­ment.

In this set­ting, abroc­i­tinib met the co-pri­ma­ry end­points at week 12, which cap­ture two of the most com­mon mea­sures of eczema. The one on IGA de­notes the in­ves­ti­ga­tor’s as­sess­ment of clear (0) or al­most clear and a 2+ point re­duc­tion on a 5-point scale from base­line. The oth­er, EASI-75, counts the pro­por­tion of pa­tients who achieve at least 75% change from base­line in their Eczema Area and Sever­i­ty In­dex.

While Dupix­ent was in­clud­ed as the ac­tive con­trol, it wasn’t for­mal­ly com­pared to abroc­i­tinib ex­cept on a mi­nor end­point on rel­a­tive pru­ri­tus re­lief at week 2. There, Pfiz­er’s ex­per­i­men­tal drug in­duced a sta­tis­ti­cal­ly su­pe­ri­or re­duc­tion in itch. Its ex­ecs have pre­vi­ous­ly tout­ed faster re­lief as a po­ten­tial ad­van­tage over Dupix­ent.

From the lim­it­ed da­ta, Bri­an Sko­r­ney of Baird reck­ons abroc­i­tinib has com­pa­ra­ble ef­fi­ca­cy, but Dupix­ent like­ly has a slight edge on safe­ty.

Pfiz­er said the safe­ty pro­file seen here was con­sis­tent with pre­vi­ous stud­ies, which could be a prob­lem. Among five treat­ment arms com­pris­ing vary­ing dos­es of abroc­i­tinib, Dupix­ent and place­bo, ad­verse events were most com­mon among the group re­ceiv­ing 200mg (61.9%). By com­par­i­son, 50% of the Dupix­ent group, 50.8% of those tak­ing abroc­i­tinib 100mg, and 53.4% among the two groups tak­ing place­bo ex­pe­ri­enced a side ef­fect.

JAK in­hibitors as a class have run in­to se­ri­ous safe­ty is­sues that forced reg­u­la­tors to lim­it dos­ing — some­thing Pfiz­er’s tra­vails with Xel­janz have un­der­scored. It ap­pears that abroc­i­tinib, which tar­gets the JAK1 sub­type, is still plagued with sim­i­lar prob­lems, with pre­vi­ous­ly re­port­ed in­stances of nau­sea and headache, as well as po­ten­tial in­creased risk of throm­bo­cy­tope­nia and meta­bol­ic dis­or­ders.

Ab­b­Vie’s FDA ap­proval for its oral JAK1 drug Rin­voq (for rheuma­toid arthri­tis no less) came with a black box warn­ing.

By block­ing the Janus ki­nase, abroc­i­tinib is thought to mod­u­late mul­ti­ple cy­tokines in­clud­ing IL-4, IL-13, IL-31, IL-22 and in­ter­fer­on gam­ma. Dupix­ent, on the oth­er hand, in­hibits IL-4 and IL-13 di­rect­ly.

If physi­cians and pa­tients can look be­yond the safe­ty con­cerns — a big if — one fi­nal fac­tor might be­come cru­cial in Pfiz­er’s fight: the con­ve­nience of dos­ing.

“While the ju­ry is still out with re­spect to the com­pa­ra­bil­i­ty of the clin­i­cal pro­files of Dupix­ent and abroc­i­tinib, we must note that if abroc­i­tinib pro­vides a sim­i­lar pro­file to Dupix­ent, but in a pill form, it could serve as a ma­jor threat to Re­gen­eron’s key sub­cu­ta­neous prod­uct (Dupix­ent),” Sko­r­ney wrote.

Tesla and SpaceX founder Elon Musk gestures to the audience after being recognized by President Trump following the successful launch of a Falcon 9 rocket at the Kennedy Space Center. (via Getty Images)

Tes­la chief Elon Musk teams up with Covid-19 play­er Cure­Vac to build 'R­NA mi­cro­fac­to­ries'

Elon Musk has joined the global tech crusade now underway to revolutionize vaccine manufacturing — now aimed at delivering billions of doses of a new mRNA vaccine to fight Covid-19. And he’s cutting right to the front.

In a late-night tweet Wednesday, the Tesla chief announced:

Tesla, as a side project, is building RNA microfactories for CureVac & possibly others.

That’s not a lot to go on. But the tweet comes a year after Tesla’s German division in Grohmann and CureVac filed a patent on a “bioreactor for RNA in vitro transcription, a method for RNA in vitro transcription, a module for transcribing DNA into RNA and an automated apparatus for RNA manufacturing.” CureVac, in the meantime, has discussed a variety of plans to build microfactories that can speed up the whole process for a global supply chain.

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Elias Zerhouni (Photo by Vincent Isore/IP3/Getty Images)

Elias Zer­houni dis­cuss­es ‘am­a­teur hour’ in DC, the de­struc­tion of in­fec­tious dis­ease R&D and how we need to prep for the next time

Elias Zerhouni favors blunt talk, and in a recent discussion with NPR, the ex-Sanofi R&D and ex-NIH chief had some tough points to make regarding the pandemic response.

Rather than interpret them, I thought it would be best to provide snippets straight from the interview.

On the Trump administration response:

It was basically amateur hour. There is no central concept of operations for preparedness, for pandemics, period. This administration doesn’t want to or has no concept of what it takes to protect the American people and the world because it is codependent. You can’t close your borders and say, “OK, we’re going to be safe.” You’re not going to be able to do that in this world. So it’s a lack of vision, basically just a lack of understanding, of what it takes to protect the American people.

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Sec­ond death trig­gers hold on Astel­las' $3B gene ther­a­py biotech's lead pro­gram, rais­ing fresh con­cerns about AAV

Seven months after Astellas shelled out $3 billion to acquire the gene therapy player Audentes, the biotech company’s lead program has been put on hold following the death of 2 patients taking a high dose of their treatment. And there was another serious adverse event recorded in the study as well, with a total of 3 “older” patients in the study affected.

The incidents are derailing plans to file for a near-term approval, which had been expected right about now.

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George Yancopoulos (Regeneron)

UP­DAT­ED: Re­gen­eron co-founder George Yan­copou­los of­fers a com­bat­ive de­fense of the po­lice at a high school com­mence­ment. It didn’t go well

Typically, the commencement speech at Yorktown Central School District in Westchester — like most high schools — is an opportunity to encourage students to face the future with confidence and hope. Regeneron president and co-founder George Yancopoulos, though, went a different route.

In a fiery speech, the outspoken billionaire defended the police against the “prejudice and bias against law enforcement” that has erupted around the country in street protests from coast to coast. And for many who attended the commencement, Yancopoulos struck the wrong note at the wrong time, especially when he combatively challenged someone for interrupting his speech with a honk for “another act of cowardness.”

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Dan Gold, MEI Pharma CEO

De­vel­op­ment part­ners at MEI, Helsinn dump a high-risk PhI­II AML study af­ter con­clud­ing it would fail sur­vival goal

Four years after Switzerland’s Helsinn put $25 million of cash on the table for an upfront and near-term milestone to take MEI Pharma’s drug pracinostat into a long-running Phase III trial for acute myeloid leukemia, the partners are walking away from a clinical pileup.

The drug — an HDAC inhibitor — failed to pass muster during a futility analysis, as researchers concluded that pracinostat combined with azacitidine wasn’t going to outperform the control group in the pivotal.

Pfiz­er shares surge on pos­i­tive im­pact of their mR­NA Covid-19 vac­cine — part­nered with BioN­Tech — in an ear­ly-stage study

Pfizer and their partners at the mRNA specialist BioNTech have published the first glimpse of biomarker data from an early-stage study spotlighting the “robust immunogenicity” triggered by their Covid-19 vaccine, which is one of the leaders in the race to vanquish the global pandemic.

Researchers selected 45 healthy volunteers 18-55 years of age for the study. They were randomized to receive 2 doses, separated by 21 days, of 10 µg, 30 µg, or 100 µg of BNT162b1, “a lipid nanoparticle-formulated, nucleoside-modified, mRNA vaccine that encodes trimerized SARS-CoV-2 spike glycoprotein RBD.” Their responses were compared against the effect of a natural, presumably protective defense offered by a regular infection.

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An ex­pe­ri­enced biotech is stitched to­geth­er from transpa­cif­ic parts, with 265 staffers and a fo­cus on ‘new bi­ol­o­gy’

Over the past few years, different teams at a pair of US-based biotechs and in labs in Japan have labored to piece together a group of cancer drug programs, sharing a single corporate umbrella with research colleagues in Japan. But now their far-flung operations have been knit together into a single unit, creating a pipeline with 10 cancer drug development programs — going from early-stage right into Phase III — and a host of discovery projects managed by a collective staff of some 265 people.

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Joseph Kim, Inovio CEO (Andrew Harnik, AP Images)

Pos­i­tive Covid-19 vac­cine da­ta? New mouse study? OWS in­clu­sion? Yep, but some­how, the usu­al tid­bits from In­ovio back­fire

You don’t go more than 40 years in biotech without ever getting a product to market unless you can learn the art of writing a promotional press release. And Inovio captures the prize in baiting the hook.

Tuesday morning Inovio, which has been struggling to get its Covid-19 vaccine lined up for mass manufacturing, put out a release that touched on virtually every hot button in pandemic PR.

There was, first and foremost, an interim snapshot of efficacy from their Phase I program for INO-4800.

Jan van de Winkel, Genmab CEO

Seat­tle Ge­net­ics, Gen­mab turn on TV for a high­light reel in cer­vi­cal can­cer — but a ri­val biotech promis­es a bet­ter show

Seattle Genetics $SGEN and their partners at Genmab $GMAB polished up some positive Phase II numbers for their antibody drug conjugate tisotumab vedotin — you can call it TV — for recurrent cervical cancer. And while they mapped out a shortcut to a potential quick approval, the big challenge for this team is being presented by a rival biotech which muscled its way into the spotlight for the same indication a year ago.

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