An­oth­er old drug looks for a sec­ond com­ing at the FDA, this time for Duchenne MD

So far, drugs that try to ad­dress the root cause of Duchenne mus­cu­lar dy­s­tro­phy have had to trav­el a rocky road at the FDA. But reg­u­la­tors are now hus­tling up a re­view of a new treat­ment — new to the US at least— that will try to do what a line­up of well fi­nanced biotechs and phar­ma com­pa­nies have failed at.

Marathon Phar­ma­ceu­ti­cals put their DMD can­di­date de­flaza­cort through a Phase III study, and it says the drug pro­vid­ed ev­i­dence of im­prov­ing the mus­cle strength of boys, let­ting them do bet­ter at a va­ri­ety of phys­i­cal tasks, like sit­ting up or walk­ing. On Wednes­day, the FDA pro­vid­ed pri­or­i­ty re­view sta­tus for the drug when it ac­cept­ed the ap­pli­ca­tion for re­view, set­ting up an ac­cel­er­at­ed Feb­ru­ary PDU­FA dead­line on whether it should be used to treat DMD boys with the lethal dis­ease.

Un­like the ex­on-skip­ping tech­nol­o­gy that Bio­Marin tried, and failed, to get ap­proved in the US — and Sarep­ta con­tin­ues to push hard on — de­flaza­cort is a sim­ple sys­temic steroid used for decades out­side the US.

It’s sold by Shire in the UK, for ex­am­ple, as Cal­cort in 6 mg tablets and used to treat a va­ri­ety of chron­ic au­toim­mune con­di­tions like rheuma­toid arthri­tis. You can buy it in Cana­da or an on­line phar­ma­cy for about a buck a pill. But be­cause it’s nev­er been ap­proved in Amer­i­ca, where oth­er steroids have been avail­able for those same con­di­tions, it gets the full reg­u­la­to­ry treat­ment.

The FDA has played its part. Aside from giv­ing de­flaza­cort pri­or­i­ty re­view sta­tus, cut­ting 4 months off the usu­al 10-month process, the agency has pro­vid­ed fast track sta­tus, an or­phan drug des­ig­na­tion and rare pe­di­atric dis­ease sta­tus for the drug to hus­tle it along and ex­tend mar­ket pro­tec­tion to Marathon. Rare pe­di­atric dis­ease ap­provals have been used to gain pri­or­i­ty re­view vouch­ers un­der a spe­cial FDA pro­gram de­signed to spur the de­vel­op­ment of im­por­tant new drugs. And they have fetched hun­dreds of mil­lions of dol­lars.

De­flaza­cort has won some key sup­port from pa­tient ad­vo­ca­cy groups, who al­so ap­plaud­ed Marathon’s de­ci­sion to pro­vide the steroid for free in an open ac­cess pro­gram. Va­lerie A. Cwik, MD, Ex­ec­u­tive Vice Pres­i­dent and Chief Med­ical and Sci­en­tif­ic Of­fi­cer for the Mus­cu­lar Dy­s­tro­phy As­so­ci­a­tion, had this to say for the treat­ment:

The Duchenne com­mu­ni­ty would great­ly ben­e­fit from wide­spread and re­li­able ac­cess to a treat­ment op­tion with the po­ten­tial to de­lay dis­ease pro­gres­sion. We are all too fa­mil­iar with the chal­lenges that chil­dren and adults with Duchenne and their fam­i­lies face, and we’re hope­ful that an FDA ap­proval of de­flaza­cort would be one of the first of many treat­ments for Duchenne.

Marathon’s Phase III tri­al didn’t use de­flaza­cort alone. It added a low dose of the glu­co­cor­ti­coid to pred­nisone, look­ing to bal­ance a bet­ter im­pact on strength that de­flaza­cort of­fered with the im­muno­sup­pres­sant.

So now the FDA can have a look at a com­bi­na­tion of two well known an­ti-in­flam­ma­to­ries. It can ap­prove de­flaza­cort/pred­nisone as a new drug for DMD, open­ing up a mar­ket of des­per­ate pa­tients. And it will like­ly spur a fresh out­burst over what pa­tients pay for old drugs that can be pur­chased for a frac­tion of the price in an­oth­er coun­try.

Hal Barron, GSK

Break­ing the death spi­ral: Hal Bar­ron talks about trans­form­ing the mori­bund R&D cul­ture at GSK in a crit­i­cal year for the late-stage pipeline

Just ahead of GlaxoSmithKline’s Q2 update on Wednesday, science chief Hal Barron is making the rounds to talk up the pharma giant’s late-stage strategy as the top execs continue to woo back a deeply skeptical investor group while pushing through a whole new R&D culture.

And that’s not easy, Barron is quick to note. He told the Financial Times:

I think that culture, to some extent, is as hard, in fact even harder, than doing the science.

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Aca­dia is mak­ing the best of it, but their lat­est PhI­II Nu­plazid study is a bust

Acadia’s late-stage program to widen the commercial prospects for Nuplazid has hit a wall. The biotech reported that their Phase III ENHANCE trial flat failed. And while they $ACAD did their best to cherry pick positive data wherever they can be found, this is a clear setback for the biotech.

With close to 400 patients enrolled, researchers said the drug flunked the primary endpoint as an adjunctive therapy for patients with an inadequate response to antipsychotic therapy. The p-value was an ugly 0.0940 on the Positive and Negative Syndrome Scale, which the company called out as a positive trend.

Their shares slid 12% on the news, good for a $426 million hit on a $3.7 billion market cap at close.

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Some Big Phar­mas stepped up their game on da­ta trans­paren­cy — but which flunked the test?

The nonprofit Bioethics International has come out with their latest scorecard on data transparency among the big biopharmas in the industry — flagging a few standouts while spotlighting some laggards who are continuing to underperform.

Now in its third year, the nonprofit created a new set of standards with Yale School of Medicine and Stanford Law School to evaluate the track record on trial registration, results reporting, publication and data-sharing practice.

Busy Gilead crew throws strug­gling biotech a life­line, with some cash up­front and hun­dreds of mil­lions in biobucks for HIV deal

Durect $DRRX got a badly needed shot in the arm Monday morning as Gilead’s busy BD team lined up access to its extended-release platform tech for HIV and hepatitis B.

Gilead, a leader in the HIV sector, is paying a modest $25 million in cash for the right to jump on the platform at Durect, which has been using its technology to come up with an extended-release version of bupivacaine. The FDA rejected that in 2014, but Durect has been working on a comeback.

In­tec blitzed by PhI­II flop as lead pro­gram fails to beat Mer­ck­'s stan­dard com­bo for Parkin­son’s

Intec Pharma’s $NTEC lead drug slammed into a brick wall Monday morning. The small-cap Israeli biotech reported that its lead program — coming off a platform designed to produce a safer, more effective oral drug for Parkinson’s — failed the Phase III at the primary endpoint.

Researchers at Intec, which has already seen its share price collapse over the past few months, says that its Accordion Pill-Carbidopa/Levodopa failed to prove superior to Sinemet in reducing daily ‘off’ time. 

Cel­gene racks up third Ote­zla ap­proval, heat­ing up talks about who Bris­tol-My­ers will sell to

Whoever is taking Otezla off Bristol-Myers Squibb’s hands will have one more revenue stream to boast.

The drug — a rising star in Celgene’s pipeline that generated global sales of $1.6 billion last year — is now OK’d to treat oral ulcers associated with Behçet’s disease, a common symptom for a rare inflammatory disorder. This marks the third FDA approval for the PDE4 inhibitor since 2014, when it was greenlighted for plaque psoriasis and psoriatic arthritis.

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Francesco De Rubertis

Medicxi is rolling out its biggest fund ever to back Eu­rope's top 'sci­en­tists with strange ideas'

Francesco De Rubertis built Medicxi to be the kind of biotech venture player he would have liked to have known back when he was a full time scientist.

“When I was a scientist 20 years ago I would have loved Medicxi,’ the co-founder tells me. It’s the kind of place run by and for investigators, what the Medicxi partner calls “scientists with strange ideas — a platform for the drug hunter and scientific entrepreneur. That’s what I wanted when I was a scientist.”

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Af­ter a decade, Vi­iV CSO John Pot­tage says it's time to step down — and he's hand­ing the job to long­time col­league Kim Smith

ViiV Healthcare has always been something unique in the global drug industry.

Owned by GlaxoSmithKline and Pfizer — with GSK in the lead as majority owner — it was created 10 years ago in a time of deep turmoil for the field as something independent of the pharma giants, but with access to lots of infrastructural support on demand. While R&D at the mother ship inside GSK was souring, a razor-focused ViiV provided a rare bright spot, challenging Gilead on a lucrative front in delivering new combinations that require fewer therapies with a more easily tolerated regimen.

They kept a massive number of people alive who would otherwise have been facing a death sentence. And they made money.

And throughout, John Pottage has been the chief scientific and chief medical officer.

Until now.

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Vlad Coric (Biohaven)

In an­oth­er dis­ap­point­ment for in­vestors, FDA slaps down Bio­haven’s re­vised ver­sion of an old ALS drug

Biohaven is at risk of making a habit of disappointing its investors.

Late Friday the biotech $BHVN reported that the FDA had rejected its application for riluzole, an old drug that they had made over into a sublingual formulation that dissolves under the tongue. According to Biohaven, the FDA had a problem with the active ingredient used in a bioequivalence study back in 2017, which they got from the Canadian drugmaker Apotex.

Apotex, though, has been a disaster ground. The manufacturer voluntarily yanked the ANDAs on 31 drugs — in late 2017 — after the FDA came across serious manufacturing deficiencies at their plants in India. A few days ago, the FDA made it official.

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