To­bi­ra crushed af­ter NASH drug flunks a PhI­Ib, but slice of da­ta dri­ves PhI­II plans

To­bi­ra Ther­a­peu­tics’ $TBRA lead drug ceni­crivi­roc flunked a Phase IIb study for NASH, but the South San Fran­cis­co-based biotech says it got enough pos­i­tive da­ta on a sec­ondary end­point to war­rant a move in­to a piv­otal Phase III pro­gram,.

To­bi­ra’s shares were crushed by the news, plung­ing 64% in pre­mar­ket trad­ing.

The pri­ma­ry end­point in the study, which reg­is­tered 289 pa­tients, was a drop in a score for dis­ease ac­tiv­i­ty in NASH, a fat­ty liv­er ail­ment that has been grow­ing at an epi­dem­ic pace around the world. On that point, the drug flopped. It al­so failed a sec­ondary end­point for com­plete res­o­lu­tion of steato­hep­ati­tis.

But To­bi­ra vowed that it had a good rea­son to launch a late-stage pro­gram, look­ing for an im­prove­ment in fi­bro­sis with­out any wors­en­ing of steato­hep­ati­tis. The da­ta for the in­tent-to-treat pop­u­la­tion in Phase IIb was 20% for the drug vs 10% for place­bo af­ter a year of treat­ment, p=0.02; in oth­er words, twice as many pa­tients on drug had a marked im­prove­ment for fi­bro­sis, but it was a small group.

“The CEN­TAUR pa­tient pop­u­la­tion is sim­i­lar to the an­tic­i­pat­ed Phase III pop­u­la­tion, and we ex­pect to ini­ti­ate a glob­al piv­otal study in 2017 to con­firm CVC’s an­ti-fi­brot­ic ac­tiv­i­ty to ad­dress this high un­met med­ical need,” said CEO Lau­rent Fis­ch­er in a state­ment. Talk­ing to an­a­lysts, Fis­ch­er ham­mered on his point that this is the first such study that had seen a pos­i­tive im­pact on NASH.

In­vestors weren’t stick­ing around, though, re­act­ing quick­ly to the key fail­ure on NASH ac­tiv­i­ty.

Com­pa­ny ex­ecs said this morn­ing that they could de­tect no dif­fer­ence be­tween the drug and a place­bo in the study da­ta for NASH.

“They (the drug arm and place­bo group) were equal with no sta­tis­ti­cal­ly sign dif­fer­ence be­tween the two,” Chief Med­ical Of­fi­cer Er­ic Lefebre told an­a­lysts in a call this morn­ing.

NASH has been a prime tar­get in the bio­phar­ma world. Just a few months ago Gilead paid a whop­ping $400 mil­lion up­front to land rights to a NASH drug from Nim­bus. In­ter­cept gained an ap­proval for its drug OCA for pri­ma­ry bil­iary cir­rho­sis, and is now seek­ing to prove that it can work against NASH. And a large num­ber of oth­er drugs for NASH are in the clin­ic.

“Liv­er fi­bro­sis is the most im­por­tant fea­ture of NASH and is in­de­pen­dent­ly as­so­ci­at­ed with key out­comes in­clud­ing long-term over­all mor­tal­i­ty, liv­er trans­plan­ta­tion, and liv­er-re­lat­ed events,” said Scott L. Fried­man, M.D., chief, Di­vi­sion of Liv­er Dis­eases, Ic­ahn School of Med­i­cine at Mount Sinai and CEN­TAUR study chair­man. “The very fa­vor­able safe­ty pro­file of CVC com­bined with the ef­fi­ca­cy da­ta un­der­score the po­ten­tial of CVC to emerge as a treat­ment of fi­bro­sis as­so­ci­at­ed with NASH, at a time when there are no ap­proved ther­a­pies yet for this grow­ing epi­dem­ic.”

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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