Sage’s quick flip in­to PhI­II crash­es as lead drug fails bad­ly for rare type of seizures

Af­ter build­ing in­tense in­ter­est in its lead drug for su­per-re­frac­to­ry sta­tus epilep­ti­cus with da­ta from tiny stud­ies, Sage Ther­a­peu­tics $SAGE says the drug failed bad­ly in Phase III.

Com­par­ing brex­anolone (SAGE-547) with a place­bo, the drug act­ed just like a sug­ar pill, with a 43.9% re­sponse for the drug com­pared to 42.4% in the place­bo arm — and a mis­er­able p-val­ue of 0.8775.

Sage’s shares dropped more than 20% on the news. But by the af­ter­noon the biotech had trimmed its loss­es, with the stock down about 14% — a mod­est re­treat giv­en the bad judg­ment this biotech has shown.

Jeff Jonas, Sage

Sage cre­at­ed both fierce be­liev­ers as well as even fiercer crit­ics of its drug for rare cas­es of pro­tract­ed seizures as CEO Jeff Jonas con­fi­dent­ly pre­dict­ed suc­cess. More than a year ago Sahm Ad­ran­gi’s Ker­ris­dale Cap­i­tal ex­e­cut­ed a short at­tack on Sage, caus­ti­cal­ly sum­ma­riz­ing its move from a small Phase I/II to a piv­otal tri­al as a strat­e­gy doomed to fail­ure.

Ker­ris­dale’s re­port picked apart da­ta from a sin­gle-arm study with no com­par­i­son group of pa­tients, which they be­lieve set the stage for the biotech to claim a big win with­out ac­tu­al­ly putting the ther­a­py to the test. And they add that there are ex­ist­ing ther­a­pies that go af­ter the ex­act same tar­get with sim­i­lar out­comes.

The fail­ure here will al­so cast a cloud over Sage’s oth­er R&D work, in­clud­ing a new drug for post­par­tum de­pres­sion which was al­so tout­ed with small stud­ies il­lus­trat­ing pos­i­tive re­sults.

But not every­one thinks the ug­ly flop here reads through to the rest of the pipeline. Notes Paul Mat­teis at Leerink:

The in­vest­ment de­bate this morn­ing cen­ters around the de­gree to which SRSE reads neg­a­tive­ly on­to the clin­i­cal po­ten­tial of SAGE-547 in PPD (and by ex­ten­sion oth­er mood dis­or­ders); while we un­der­stand that the lack of sig­nal in SRSE has ren­dered some in­vestors more cau­tious in their in­ter­pre­ta­tion of SAGE‘s many small CNS da­ta sets, for us, it’s hard to see a tan­gi­ble readthrough on­to PPD, which has (1) place­bo-con­trolled da­ta, (2) bet­ter un­der­stood nat­ur­al his­to­ry/place­bo ef­fects, and (3) break­through ther­a­py des­ig­na­tion.

As for Jonas, he still found rea­sons to ap­plaud the work.

“I’m proud of the Sage team for the sig­nif­i­cant progress they have made in im­prov­ing our un­der­stand­ing of how to best treat these crit­i­cal­ly ill pa­tients,” he said. “SRSE is a com­pli­cat­ed con­di­tion that is poor­ly un­der­stood, and I want to thank the pa­tients, their fam­i­lies, and the in­ves­ti­ga­tors who par­tic­i­pat­ed in the STA­TUS Tri­al. Al­though we did not meet the pri­ma­ry end­point, this first-ever tri­al in a high­ly vari­able and com­plex pa­tient pop­u­la­tion con­firms that re­search in a crit­i­cal care unit is pos­si­ble and deep­ens our un­der­stand­ing of GA­BA mech­a­nisms and their ef­fect on brain cir­cuit­ry. As we con­tin­ue ex­am­in­ing da­ta from the STA­TUS Tri­al in the com­ing weeks, I’m hope­ful this in­for­ma­tion will in­form cur­rent treat­ments, and aid in the de­vel­op­ment of fu­ture treat­ments for pa­tients with SRSE.”

Biotech and Big Phar­ma: A blue­print for a suc­cess­ful part­ner­ship

Strategic partnerships have long been an important contributor to how drugs are discovered and developed. For decades, big pharma companies have been forming alliances with biotech innovators to increase R&D productivity, expand geographical reach and better manage late-stage commercialization costs.

Noël Brown, Managing Director and Head of Biotechnology Investment Banking, and Greg Wiederrecht, Ph.D., Managing Director in the Global Healthcare Investment Banking Group at RBC Capital Markets, are no strangers to the importance of these tie-ups. Noël has over 20 years of investment banking experience in the industry. Before moving to the banking world in 2015, Greg was the Vice President and Head of External Scientific Affairs (ESA) at Merck, where he was responsible for the scientific assessment of strategic partnership opportunities worldwide.

Credit: Shutterstock

How Chi­na turned the ta­bles on bio­phar­ma's glob­al deal­mak­ing

Fenlai Tan still gets chills thinking about the darkest day of his life.

Three out of eight lung cancer patients who received a tyrosine kinase inhibitor developed by his company, Betta Pharma, died in the span of a month. Tan, the chief medical officer, was summoned to Peking Union Medical College Hospital, where the head of the clinical trial department told him that the trial investigators would be conducting an autopsy to see if the patients had died of the disease — they were all very sick by the time they enrolled — or of interstitial lung disease, a deadly side effect tied to the TKI class that’s been reported in Japan.

An­gion's or­gan dam­age drug strikes out again, this time in high-risk kid­ney trans­plant pa­tients

After flopping a test in Covid-19 earlier this year, Angion’s lead organ damage drug has now hit the skids again in kidney transplant patients.

Angion and partner Vifor Pharma’s ANG-3777 failed to beat out placebo in terms of improving eGFR, a measure of kidney function, in patients who had received a deceased donor kidney transplant and were at high risk of developing what is known as delayed graft function, according to Phase III results released Tuesday.

An image of Alzheimer's brain tissue. The red show gingipains, a protein from P. gingivalis, intermixing with neurons (yellow) and glial cells (green)

An Alzheimer's dark­horse fails its first big tri­al, but of­fers hope for a long-over­looked hy­poth­e­sis

Three years ago, Cortexyme emerged out of obscurity with some big-name backers and an unorthodox approach to treating Alzheimer’s.

They moved their drug into a pivotal study the next year, offering one of the first major tests for a hypothesis that has fluttered on the outskirts of Alzheimer’s research for decades: that, in many cases, the disease is driven by infectious agents — the havoc they wreak in the brain and the inflammation the body uses to try to fend them off. And that quashing the infection could slow patients’ cognitive decline.

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No­var­tis dumps AveX­is pro­gram for Rett syn­drome af­ter fail­ing re­peat round of pre­clin­i­cal test­ing

Say goodbye to AVXS-201.

The Rett syndrome gene therapy drug made by AveXis — the biotech that was bought, kept separate, then renamed and finally absorbed by Novartis into its R&D division — has been dropped by the biopharma.

In Novartis’ third quarter financial report, the pharma had found that preclinical data did not support development of the gene therapy into IND-enabling trials and beyond. The announcement comes a year after Novartis told the Rett Society how excited it was by the drug — and its potential benefits and uses.

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Peter Nell, Mammoth Biosciences CBO

UP­DAT­ED: Jen­nifer Doud­na spin­out inks a Mam­moth CRISPR deal with Ver­tex worth near­ly $700M

When a company gets its start in gene editing pioneer Jennifer Doudna’s lab, it’s bound to make headlines. But three years in, the fanfare still hasn’t died down for Mammoth Biosciences. Now, the Brisbane, CA-based company is cheering on its first major R&D pact.

Mammoth unveiled a nearly $700 million deal with Vertex on Tuesday morning, good for the development of in vivo gene therapies for two mystery diseases. The stars of the show are Mammoth’s ultra-small CRISPR systems, including two Cas enzymes licensed from Doudna’s lab over the past couple years, Cas14 and Casɸ.

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FDA is much worse than its reg­u­la­to­ry peers at proac­tive­ly dis­clos­ing da­ta, re­searchers find

The European Medicines Agency and Health Canada continue to outpace the FDA when it comes to proactively releasing data on drugs and biologics the agency has reviewed, leading to further questions of why the American agency can’t be more transparent.

In a study published recently in the Journal of Law, Medicine, & Ethics, Yale and other academic lawyers and researchers found that between 2016 and April 2021, the EMA proactively released data for 123 unique medical products, while Health Canada proactively released data for 73 unique medical products between 2019 and April 2021. What’s more, the EMA and Health Canada didn’t proactively release the same data on the same drugs. In stark contrast, the FDA in 2018 only proactively disclosed data supporting one drug that was approved that year.

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No­var­tis' sec­ond at­tempt to repli­cate a stun­ning can­cer re­sult falls flat

Novartis’ hopes of turning one of the most surprising trial data points of the last decade into a lung cancer drug has taken another setback.

The Swiss pharma announced Monday that its IL-1 inhibitor canakinumab did not significantly extend the lives or slow the disease progression of patients with previously untreated locally advanced or metastatic non-small cell lung cancer when compared to standard of-care alone.

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NYU surgeon transplants an engineered pig kidney into the outside of a brain-dead patient (Joe Carrotta/NYU Langone Health)

No, sci­en­tists are not any clos­er to pig-to-hu­man trans­plants than they were last week

Steve Holtzman was awoken by a 1 a.m. call from a doctor at Duke University asking if he could put some pigs on a plane and fly them from Ohio to North Carolina that day. A motorcyclist had gotten into a horrific crash, the doctor explained. He believed the pigs’ livers, sutured onto the patient’s skin like an external filter, might be able to tide the young man over until a donor liver became available.