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.

An­drew Rit­ter

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).

The mea­sures were tak­en on day 61, well in­to the re­al world ev­i­dence phase of the study (in which pa­tients con­sumed their nor­mal di­ets plus di­ary prod­ucts) fol­low­ing a 30-day treat­ment pe­ri­od.

None of the sec­ondary end­points were met. On­ly 36.2% of the RP-G28 arm count­ed as re­spon­ders with a mean­ing­ful ben­e­fit com­pared to 34.1%, but the one-sided p-val­ue was an abysmal 0.284. The oth­er dif­fer­ences al­so missed sta­tis­ti­cal sig­nif­i­cance.

All of Rit­ter’s eggs were in this one bas­ket. Its al­ready ham­mered stock $RT­TR took a fur­ther 69% plunge to $0.32.

Founder and CEO An­drew Rit­ter, who has suf­fered from se­ri­ous lac­tose in­tol­er­ance since child­hood, was bet­ting that his com­pa­ny could bring the first treat­ment to the mar­ket. RP-G28 is a for­mu­la­tion of galac­to-oligosac­cha­ride, which is de­signed to stim­u­late growth lac­tose me­tab­o­liz­ing bac­te­ria in the gut, there­by al­le­vi­at­ing symp­toms.

The drug failed to elic­it a sta­tis­ti­cal­ly sig­nif­i­cant re­sponse rate com­pared to place­bo in its pre­vi­ous tri­al, but the com­pa­ny in­sist­ed that the pri­ma­ry end­point was ac­tu­al­ly met — once they elim­i­nat­ed a site with “sig­nif­i­cant ir­reg­u­lar­i­ties” and changed the pri­ma­ry end­point.

That study, pub­lished in 2017, had 368 pa­tients. The cur­rent Phase III en­rolled 557 in to­tal.

“We are deeply dis­ap­point­ed in the re­sults of the phase 3 clin­i­cal tri­al,” Rit­ter said in a state­ment. “We be­lieve the clin­i­cal tri­al was well-de­signed and ex­e­cut­ed. We are con­tin­u­ing to an­a­lyze the re­sults of the tri­al to bet­ter un­der­stand the da­ta and clin­i­cal out­comes to as­sess a path for­ward, which may in­clude al­ter­na­tive strate­gic op­tions for the Com­pa­ny.”

Any plans will have to come quick. As of June 30, Rit­ter had $4.4 mil­lion in cash and cash equiv­a­lents, with a work­ing cap­i­tal of on­ly $2 mil­lion.

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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Deb­o­rah Dun­sire is pay­ing $2B for a chance to leap di­rect­ly in­to a block­buster show­down with a few of the world's biggest phar­ma gi­ants

A year after taking the reins as CEO of Lundbeck, Deborah Dunsire is making a bold bid to beef up the Danish biotech’s portfolio of drugs in what will likely be a direct leap into an intense rivalry with a group of giants now carving up a growing market for new migraine drugs.

Bright and early European time the company announced that it will pay up to about $2 billion to buy Alder, a little biotech that is far along the path in developing a quarterly IV formulation for a CGRP drug aimed at cutting back the number of crippling migraines patients experience each month.

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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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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.