Re­gen­eron, Sanofi win a de­layed OK for rheuma­toid arthri­tis IL-6 heavy­weight sar­ilum­ab

It took more than six months and like­ly caused more than a few red faces, but Sanofi has dealt with the FDA’s is­sues with its man­u­fac­tur­ing ops and won a green light to start mar­ket­ing the like­ly block­buster sar­ilum­ab along­side its part­ners at Re­gen­eron.

Con­sen­sus peak sales fore­casts on the drug — to be mar­ket­ed as Kevzara — top the $1 bil­lion block­buster mark, mak­ing it a big ad­di­tion for both com­pa­nies.

George Yan­copou­los, Re­gen­eron (Get­ty/Bloomberg)

The part­ners say they set the WAC at $39,000/year for the 200 mg and 150 mg dos­es, which is ap­prox­i­mate­ly “30 per­cent low­er than the WAC for the two most wide­ly used TNF-al­pha in­hibitors.” Those two are Hu­mi­ra – which earned $16 bil­lion last year – and En­brel.

The IL-6 drug whet­ted an­a­lysts’ ex­pec­ta­tions last March when it beat out Ab­b­Vie’s Hu­mi­ra in a head-to-head show­down for rheuma­toid arthri­tis. The Hu­mi­ra da­ta weren’t in reg­u­la­tors’ pack­age for the ap­proval, but you can be sure that pay­ers will give it a good look over once the sales team hits the streets. On the down­side, sar­ilum­ab was linked to a sig­nif­i­cant­ly high­er rate of neu­trope­nia.

Leerink high­light­ed the price com­pe­ti­tion with a nod to the low­er price mod­el.

As im­por­tant­ly, Kevzara is al­so ap­prox­i­mate­ly 15% be­low the price of Actem­ra at the high­est dose and, with dis­counts, should of­fer a cost ef­fec­tive treat­ment op­tion for pay­ers in this set­ting. In a re­cent In­sti­tute for Clin­i­cal and Eco­nom­ic Re­view (ICER) analy­sis, Kevzara did not reach a typ­i­cal $100,000 per qual­i­ty-ad­just­ed life year (QALY) cost ef­fec­tive­ness thresh­old at this lev­el, but nei­ther did any of the oth­er wide­ly pre­scribed bi­o­log­i­cals for this dis­ease, in­clud­ing En­brel, Hu­mi­ra, Cimzia, Oren­cia, Actem­ra and Xel­janz.

Sar­ilum­ab now be­comes the third an­ti­body to win ap­proval from a Re­gen­eron/Sanofi part­ner­ship. The first was the PC­SK9 drug Pralu­ent, which has trig­gered a bruis­ing le­gal bat­tle with Am­gen and has yet to find any re­al trac­tion in the mar­ket, de­spite its dra­mat­ic im­pact on cho­les­terol. The part­ners are now lin­ing up car­dio out­comes da­ta from a big Phase III, hop­ing to push that out front of the com­pe­ti­tion. Then there was an OK ear­li­er this year for Dupix­ent, which a num­ber of fore­casts have pegged as a po­ten­tial megablock­buster.

Rheuma­toid arthri­tis is a tough dis­ease to beat, es­pe­cial­ly when you have to line up against some big ri­vals that are al­ready well en­trenched in the field. J&J and Glax­o­SmithK­line demon­strat­ed that when they came up with mixed re­sults in their head-to-head with sirukum­ab vs. Hu­mi­ra. But it was Eli Lil­ly that turned in the big nasty sur­prise, with the FDA stun­ning an­a­lysts with their re­jec­tion of baric­i­tinib, a drug li­censed from In­cyte.

“In the clin­i­cal tri­al pro­gram, sar­ilum­ab demon­strat­ed sta­tis­ti­cal­ly sig­nif­i­cant, clin­i­cal­ly-mean­ing­ful im­prove­ments in adult pa­tients with rheuma­toid arthri­tis by re­duc­ing signs and symp­toms and im­prov­ing phys­i­cal func­tion, re­sult­ing in sig­nif­i­cant­ly less ra­di­ograph­ic pro­gres­sion of struc­tur­al dam­age of RA,” said Alan Kivitz, an in­ves­ti­ga­tor in the glob­al SAR­IL-RA clin­i­cal pro­gram for sar­ilum­ab. “This is im­por­tant be­cause not all cur­rent­ly avail­able treat­ments work in all pa­tients, and some pa­tients may spend years cy­cling through dif­fer­ent treat­ments with­out achiev­ing their treat­ment goals. Sar­ilum­ab works dif­fer­ent­ly from the most com­mon­ly used bi­o­log­ics, such as those in the an­ti-TNF class, and is a wel­come new op­tion for pa­tients and their physi­cians.”

It’s fi­nal­ly over: Bio­gen, Ei­sai scrap big Alzheimer’s PhI­I­Is af­ter a pre­dictable BACE cat­a­stro­phe rais­es safe­ty fears

Months after analysts and investors called on Biogen and Eisai to scrap their BACE drug for Alzheimer’s and move on in the wake of a string of late-stage failures and rising safety fears, the partners have called it quits. And they said they were dropping the drug — elenbecestat — after the independent monitoring board raised concerns about…safety.

We don’t know exactly what researchers found in this latest catastrophe, but the companies noted in their release that investigators had determined that the drug was flunking the risk/benefit analysis.

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Lisa M. DeAngelis, MSKCC

MSK picks brain can­cer ex­pert Lisa DeAn­ge­lis as its next CMO — fol­low­ing José Basel­ga’s con­tro­ver­sial ex­it

It’s official. Memorial Sloan Kettering has picked a brain cancer expert as its new physician-in-chief and CMO, replacing José Baselga, who left under a cloud after being singled out by The New York Times and ProPublica for failing to properly air his lucrative industry ties.

His replacement, who now will be in charge of MSK’s cutting-edge research work as well as the cancer care delivered by hundreds of practitioners, is Lisa M. DeAngelis. DeAngelis had been chair of the neurology department and co-founder of MSK’s brain tumor center and was moved in to the acting CMO role in the wake of Baselga’s departure.

Penn team adapts CAR-T tech, reengi­neer­ing mouse cells to treat car­diac fi­bro­sis

After establishing itself as one of the pioneer research centers in the world for CAR-T cancer therapies, creating new attack vehicles to eradicate cancer cells, a team at Penn Medicine has begun the tricky transition of using the basic technology for heart repair work.

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Tal Zaks. Moderna

The mR­NA uni­corn Mod­er­na has more ear­ly-stage hu­man da­ta it wants to show off — reach­ing new peaks in prov­ing the po­ten­tial

The whole messenger RNA field has attracted billions of dollars in public and private investor cash gambled on the prospect of getting in on the ground floor. And this morning Boston-based Moderna, one of the leaders in the field, wants to show off a few more of the cards it has to play to prove to you that they’re really in the game.

The whole hand, of course, has yet to be dealt. And there’s no telling who gets to walk with a share of the pot. But any cards on display at this point — especially after being accused of keeping its deck under lock and key — will attract plenty of attention from some very wary, and wired, observers.

“In terms of the complexity and unmet need,” says Tal Zaks, the chief medical officer, “this is peak for what we’ve accomplished.”

Moderna has two Phase I studies it wants to talk about now.

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It's not per­fect, but it's a good start: FDA pan­elists large­ly en­dorse Aim­mune's peanut al­ler­gy ther­a­py

Two days after a fairly benign review from FDA staff, an independent panel of experts largely endorsed the efficacy and safety of Aimmune’s peanut allergy therapy, laying the groundwork for approval with a risk evaluation and mitigation strategy (REMS).

Traditionally, peanut allergies are managed by avoidance, but the threat of accidental exposure cannot be nullified. Some allergists have devised a way to dose patients off-label with peanut protein derived from supermarket products to wean them off their allergies. But the idea behind Aimmune’s product was to standardize the peanut protein, and track the process of desensitization — so when accidental exposure in the real world invariably occurs, patients are less likely to experience a life-threatening allergic reaction.

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Rit­ter bombs fi­nal PhI­II for sole lac­tose in­tol­er­ance drug — shares plum­met

More than two years ago Ritter Pharmaceuticals managed to find enough silver lining in its Phase IIb/III study — after missing the top-line mark — to propel its lactose intolerance toward a confirmatory trial. But as it turned out, the enthusiasm only set the biotech and its investors up to be sorely disappointed.

This time around there’s little left to salvage. Not only did RP-G28 fail to beat placebo in reducing lactose intolerance symptoms, patients in the treatment group actually averaged a smaller improvement. On a composite score measuring symptoms like abdominal pain, cramping, bloating and gas, patients given the drug had a mean reduction of 3.159 while the placebo cohort saw a 3.420 drop on average (one-sided p-value = 0.0106).

Ear­ly snap­shot of Ad­verum's eye gene ther­a­py sparks con­cern about vi­sion loss

An early-stage update on Adverum Biotechnologies’ intravitreal gene therapy has triggered investor concern, after patients with wet age-related macular degeneration (AMD) saw their vision deteriorate, despite signs that the treatment is improving retinal anatomy.

Adverum, on Wednesday, unveiled 24-week data from the OPTIC trial of its experimental therapy, ADVM-022, in six patients who have been administered with one dose of the therapy. On average, patients in the trial had severe disease with an average of 6.2 anti-VEGF injections in the eight months prior to screening and an average annualized injection frequency of 9.3 injections.

Alex Ar­faei trades his an­a­lyst's post for a new role as biotech VC; Sanofi vet heads to Vi­for

Too often, Alex Arfaei arrived too late. 

An analyst at BMO Capital Markets, he’d meet with biotech or pharmaceutical heads for their IPO or secondary funding and his brain, trained on a biology degree and six years at Merck and Endo, would spring with questions: Why this biomarker? Why this design? Why not this endpoint? Not that he could do anything about it. These execs were coming for clinical money; their decisions had been made and finalized long ago.

Arde­lyx bags its first FDA OK for IBS, set­ting up a show­down with Al­ler­gan, Iron­wood

In the first of what it hopes will be a couple of major regulatory milestones for its new drug, Ardelyx has bagged an FDA approval to market Ibsrela (tenapanor) for irritable bowel syndrome.

The drug’s first application will be for IBS with constipation (IBS-C), inhibiting sodium-hydrogen exchanger NHE3 in the GI tract in such a way as to increase bowel movements and decrease abdominal pain. This comes on the heels of two successful Phase III trials.