Friday, October 23, 2009

Targacept - my favorite biotech idea into the new year

Oct 21, 2009

Having seen small biotech stocks (Dov Pharma and Interneuron to name two) that showed promising Phase 2 results in treatments for depression which ended up failing after the drugs advanced into phase 3, I was somewhat skeptical of Targacept's rapid rise from $4 to $20 over the summer cause by the company's announcement that it's Phase 2b results of TC-4214 showed highly significant results when combined with Celexa in treating depression.

My thought was that a two point or even a three point improvement in either the HAMD or MADRS depression rating scale over placebo might not look so impressive when the drug goes into much larger phase 3 studies and the results tend to be more modest .

However, last Thursday night the company presented data that were eye popping to say the least. TC-4214 showed a 6 point improvement in the HAM-D ratings scale and a 7.5 point improvement in the MADRS scale . To put that into perspective the current leading augmented depression drug Abifly showed only a 2.5 point or so improvement in the ratings scales. Another amazing data point from the presentation was that the drug more than doubled the remission rates compared to placebo (40% to 18%). Safety was also very clean as there was only one adverse event in the trial which most likely was not due to the drug, and overall adverse events were only slightly higher than placebo with the most frequent being headache and constipation.

The data is so spectacular that even if the Phase 3 trial data is only 3/4 as good as the Phase 2 were, the drug will still be a huge improvement over any available therapy.

To get a sense of how big the opportunity is we only need to look at Abifly, which despite only showing a 2.4 point improvement over placebo is growing very rapidly. Sales, which had been flat with it's original label of schizophrenia alone, have really taken off since the drug was approved for depression. Recent sales trends have grown 30% in the US since approval. A billion dollars in depression sales is possible for Abifly next year.

Considering that even with more moderate data in the phase 3 trials for TC-4214 the drug can be twice as effective as Abifly TC-4214 will easily be a billion dollar plus drug just in the US alone, if Targacept can find the right partner to market the drug.

Speaking of possible partners, the company has stated publicly that they intend to start phase 3 trials by next spring, and I believe the most likely scenario is that they sign a partnership with a major pharmaceutical company before then. The list of companies who have experience in the depression field is quite long and include the like of Pfizer,Eli Lilly, Forest labs, Glaxo among others. I think any one of them would be very interested in getting hold of a drug with over a billion dollars in peak revenue potential.

Another interesting aspect of the Targacept story is that they have other potential blockbusters in the pipeline as well. The company has a partnership with Astra Zeneca for two drugs one is in phase 2 for ADHD which could enter Phase 3 next year. The other is for Alzheimers and is in phase 1 trials. A partnership with Glaxo is in the pre clinical stage but a promising drug for smoking cessation could enter the clinic in the near future.

Despite the run up over the last few months, Targacept's market cap is only a little over $500 million. Considering that the company will probably be able to get somewhere around $200 million up front for a partnership, and the potential for TC-4214 to do well over $1 billion a year in sales(I'm guessing at a royalty rate somewhere between 20-25%), then the stock looks extremely cheap even at these levels.

The stock went up to $23 and change on Friday after the data as released and has now pulled back to $21 which is only a point over the price it was trading at before the release of the phase 2b data. This was somewhat bewildering, until I saw the filing last night that the company's largest holder BVF sold about 30% of their holdings after the data was released. The sale of about 600 thousand shares seems to have accounted for most of the selling over the last couple of days. The filing last night though ,means that BVF is done selling.

There is very solid support around the $20 level where it has sat for the last few weeks . I expect the stock to move nicely higher as we head towards the end of the year and closer to a potential partnership agreement with a major pharmaceutical company.

Long TRGT

Tuesday, October 20, 2009

2015年多动腿综合症药物市场将超过10亿美元

2006

日前,Decision Resources公司在其研究报告《多动腿综合症》中预计,多动腿综合症药物市场将从2005年的2000万美元增长到2015年超过10亿美元。

确诊人群增加以及Schwarz,XenoPort和Serono公司的3个新药上市将推动市场增长。Schwarz的 rotigotine CDS(Neupro)拥有透皮制剂;XenoPort的 XP-13512具有改良的药动学性质;Serono的safinamide提供新的作用机制,这3个新药都将凭借产品差异化而成功上市用于多动腿综合 症的治疗。

“Schwarz的rotigotine CDS和 XenoPort的XP-13512获准上市将促使2015年接受药物治疗人群增加4倍,整个市场销售额增加6倍。” Decision Resources的分析家Julie Kerner说,“rotigotine CDS将是多动腿综合症市场中最成功的新产品,2015年其销售额将占整个多动腿综合症市场增长的46%。”

Monday, October 19, 2009

XenoPort's Most Recent Data Points to Larger Opportunity

2009/09/18

XenoPort (XNPT) received a big boost yesterday from positive data on its lead drug, GSK1838262/XP13512 (gabapentin enacarbil), in a neuropathic pain trial, the second attempt by the company and its partner GlaxoSmithKline (GSK) to prove that this product has much larger potential than currently forecast.

The results were from a trial in neuropathic pain associated with post-herpetic neuralgia (PHN); a previous trial in diabetic neuropathic pain failed to establish efficacy (Xenoport's bubble has burst but there is hope on the horizon, May 5, 2009). Whereas the first trip up caused the stock to drop to a two year low of $14, today’s results prompted the stock to surge almost 30% in early trade, to a seven-month high of $25.23. Should Glaxo chose to move into phase III in this indication, XenoPort shares should be able to at least maintain this level.

Drug effect

XP13512 is a prodrug of gabapentin, the former Pfizer (PFE) blockbuster Neurontin, which is now available generically. XenoPort has improved the pharmacokinetics of the drug, which it believes should boost effectiveness.

The 14-week study enrolled 376 patients who had been experiencing PHN for at least three months after recovering from a herpes zoster skin rash, also known as shingles. Three doses of GSK1838262 were tested, and all demonstrated significant improvements over placebo. The most common side effects were dizziness and somnolence, which increased with the dose, but most were mild to moderate in intensity.

The previous trial in diabetic patients was a big disappointment, but the outcome was blamed on a high placebo effect and the presence of an active drug arm, Pfizer’s Lyrica, which could have caused patients to believe they were receiving a proven medicine, the company believes.

The results announced yesterday, however, more convincingly point to a drug effect, although further results from the phase II programme will be watched with interest, to see if this will be replicated. Data are due from a trial in patients failed on gabapentin, if this succeeds the news will also be received very positively. A phase II study in migraine is also due to report fairly soon.

Brighter horizon

XenoPort and partner GlaxoSmithKline are waiting for news on approval in the US in the first indication, restless leg syndrome, by the PDUFA date of November 9. To be branded Solzira in this indication, analysts covering GlaxoSmithKline have pencilled in sales of $11m this year, climbing to $349m by 2014, according to consensus data from EvaluatePharma.

For XenoPort, consensus has alliance revenues of $218m by 2014, suggesting more optimistic biotechnology analysts may already be forecasting revenues from the neuropathic pain indications.

Glaxo still has to decide whether to push this drug into large, expensive neuropathic pain studies; until then a more cautious approach to the drug is probably wise. The regulator’s viewpoint on the Solzira data will be of interest, particularly the side effect profile, where events were similar to those seen in this PHN trial.

If the FDA baulks in the much more niche indication of RLS, Glaxo may decide pursuing trials in a much larger patient population is too much trouble.

However, compared to earlier this year when GSK1838262 looked like being a niche drug for niche indication, for XenoPort the situation is looking much brighter.

Targacept target raised to $34 from $26 at Oppenheimer

Oppenheimer raised its target on Targacept after the firm reported positive data for TC-5214, an adjunctive treatment for major depressive disorder. The firm thinks the drug's efficacy in multiple areas gives it the potential to become the top treatment for the disorder. Oppenheimer maintains an Outperform rating on the stock.

抑郁药TC-5214一项2b期试验获肯定结果

2009/07/17

  Targacept公司近日表示在研药物TC-5214的一项2b期试验获得了肯定性试验结果,试验表明该药与西酞普兰(citalopram)联用比西酞普兰单用相比能显著降低患者的抑郁水平、易怒、无能力能其它症状。

  研究者说道,虽然一例患者在试验中出现了癫痫,这可能与西酞普兰或TC-5214有关,但是患者对该药的总体耐受性还是良好的,最常见的副作用为头痛、头晕与便秘。

  公司表示将在随后的学术会议上公布该药的具体数据,并要与FDA讨论在2010年第二季度开始该药的3期试验。

Targacept:AZN计划进一步开发AZD3480

2009/07/09

Targacept宣布,大型药厂AstraZeneca (AZN)通知TRGT,AZN计划进一步开发AZD3480 (TC-1734),这种药物可能治疗注意力不足过动症(AD/HD),并同意支付1000万美元里程碑款项给TRGT。AZN也证实,计画继续开发AZD1446 (TC-6683),治疗老年失智症,AZD1446目前进行第一阶段实验,透过双方合作研究发现这种新药。

ADHD在研药AZD3480中期临床实验表现良好

2009/05/12

Targacept公司表示,其在研药物AZD3480在治疗成人注意力缺失/多动症(ADHD)的中期临床实验中达到了主要临床终点。这一喜讯使该公司的股票价格上涨了近40%。

在实验过程中,患者被随机分组,分别采用5毫克AZD3480,50毫克AZD3480和安慰剂进行治疗。实验结果显示,患者采用50毫克AZD3480 治疗之后,通过Conners成人ADHD测评表测评得出的总体症状分数证实,他们的症状得到显著缓解。数据还显示,AZD3480耐受性良好,在用药过程中未出现严重不良反应。

相关专家表示,虽然AZD3480在II期临床实验中获取的数据表明它的疗效达到统计性显著水平,但还需进行后续临床实验进一步评估药物疗效。

阿斯利康将在今年第二季度决定是否继续就AZD3480治疗ADHD或阿尔茨海默氏病进行后续的开发工作,它已获得这种药物的许可权和全球范围内的销售权。去年9月份,该药在中期临床实验中被证实治疗中-重度阿尔茨海默氏病的效果不理想,而这次新获取的数据有可能促使阿斯利康决定继续药物的研发工作。

Sunday, October 18, 2009

不宁腿综合征药XP13512将在日本申请上市

2009/08/05

XenoPort公司计划于2009财年下半年在日本递交XP13512(ASP8825)的新药申请,该药用于治疗中-重度原发性不宁腿综合征(RLS)。

据报道,这次在日本递交新药申请的依据是该药较为成功一系列临床实验,其中包括Astellas公司在日本进行的针对RLS受试者的2期临床实验,以及由XenoPort公司在美国开展的其他临床实验。

XenoPort首席执行官罗纳德·巴雷特表示:“目前为止,尚未有任何RLS治疗药在日本获准,我们非常高兴看到Astellas努力将这种新药推向当地市场,为患者带来福音。”

他还补充道:“我们正与Astellas紧密合作,帮助后者在2010年3月底之前能够在日本递交这份新药申请。Astellas同仁的工作思路极富创造性,我们对此表示感谢。”

Xenoport:发表第二阶段临床实验结果为正面

2009/10/09

Xenoport与GLaxoSmithKline (GSK)公布第二阶段临床实验结果为正面,评估SK1838262/XP13512治疗带状疱疹後神经痛病人,这些病患先前对每天1800 mg或更高剂量gabapentin的反应不够。在这项研究当中,相较於1200 mg的GSK1838262,每天施以3600 mg的GSK1838262,统计数字显示疼痛大幅缓解,达到主要目标。

Helicos BioSciences接获NIH两年期合约

2009/10/10

Helicos BioSCiences宣布,接获美国国家卫生院(NIH)国家人类基因体研究院的合约,两年期合约金额为290万美元,属於序列技术开发计划的一部份。

诺华收购Vanda制药的精神分裂症药物的销售权

据悉,瑞士制药商诺华于周一表示,其将以2亿美元的价格收购Vanda制药公司新型神经分类症药Fanapt(iloperidone)在美国及加拿大境内的销售权。

诺化表示其将于明天年初开始在美国境内销售该药。

位于马里兰州罗克维尔市的Vanda表示,其将陆续收到额外的2.65亿美元作为获得一定的发展并商业化标志性成就的报偿。此外,其还将获得销售特许权使用费。

其将保留在美国与加拿大以外的对该药的市场推广权及销售权。根据协议,诺华仍然对该药在其他国家与之合作推广保持有限磋商的选择。

此外,诺华还对该药的长效注射剂型或口服剂型享有市场推广的权利。

Vanda的CEO Mihael Polymeropoulos在一份声明中表示:“根据协议,诺化协议允许我们利用当前并未来的口服剂或注射剂型的数据,申请美国及加拿大以外的药品监管机构的批准。”美国监管机构于五月批准该药用与治疗成人神经分裂症,是今年为制药行业带来的最大惊喜之一。

该公司于2008年七月收到美国FDA拒绝其抗精神病药的申请,这信意味着该药被扼杀在摇篮里。

但是这家小公司虽然没有足够资金进行昂贵的新一轮后期临床试验,但是其还是在四个月后重新申请与提交对现存数据进行的额外分析。

然后,监管部门最终批准了这化学名为iloperidone的药物,分析师们与投资者们都感到非常震惊,这使其股价大幅飙升。

Vanda股份,曾在2008年12月底狂跌至45美分,而本周一在纳斯达克行情中,其收于11.45美元。

Sunday, October 11, 2009

Nymox Announces New Pooled Analysis Confirms 12 Month Benefit of NX-1207 Treatment for BPH

NX-1207 Currently in Phase 3 U.S. Clinical Trials

Hasbrouck Heights, NJ (October 5, 2009) Nymox Pharmaceutical Corporation (NASDAQ:NYMX) is pleased to announce that a new formal statistical analysis of double-blind clinical trial data from pooled subjects in Phase 2 clinical trials for NX-1207, the Company's investigational treatment for BPH, confirmed that clinically significant benefits of a single NX-1207 treatment extend to 12 months or longer.

The new analysis pooled the results from double-blind follow-up studies involving 159 men treated with a single injection of either placebo or NX-1207. A statistically significant difference in standardized BPH symptom score improvement at mean 13.5 months after a single treatment was found between NX-1207 2.5 mg (the therapeutic dose of NX-1207) and placebo. The median improvement in BPH Symptom Score in subjects given a single injection of NX-1207 at 12 months was 9.0 points (p<.003).

NX-1207 is currently being tested in Phase 3 clinical trials in centers across the U.S. This new data provides solid evidence accompanying and confirming earlier reports of a significant proportion of patients who received a single dose of NX-1207 and maintained their improvement in BPH symptoms for up to 5 years.

Urologists in the U.S. have expressed very positive comments about the potential of NX-1207 to improve the care of millions of men with BPH.

Completed clinical trials to date have shown that men treated with NX-1207 reported statistically significant improvement in BPH symptoms 3 months after a single NX-1207 treatment with no reported serious drugrelated side effects, including no (0%) significant sexual side effects. In two multi-center Phase 2 U.S. prospective randomized blinded clinical trials, the aggregated mean improvement in the BPH symptom score for 2.5 mg NX-1207 was 10.3 points or a 44% improvement in BPH symptom score. By comparison, currently approved drugs for BPH provide on average 3 to 5 points improvement, must be taken daily to achieve or
maintain benefit, and often have unwanted side effects such as impotence, loss of libido, retrograde ejaculation, dizziness, and weakness.

NX-1207 involves a new targeted approach to the treatment of BPH. NX-1207 is injected by a urologist in an office setting directly into the zone of the prostate where the enlargement occurs. The entire procedure lasts on average 5-10 minutes, with the injection taking 1-2 minutes, does not require anesthesia or catheterization, and involves little or no pain or discomfort.

BPH treatment represents a growing market with more than 100 million men worldwide being estimated to suffer from BPH symptoms. The disorder is a common affliction of older men, affecting approximately half of men over age 50 and close to 90% of men by age 80, and is associated with growth in prostate size as men age. BPH causes difficulties with urination associated with aging, such as urination at night, urge to void frequently, hesitancy, weak stream, and other problems.

Friday, October 9, 2009

Halozyme Therapeutics, Inc.

Additional Data from Phase II Diabetes Study Demonstrates Advantages of rHuPH20

SUMMARY

On 10/1, HALO announced that additional data from a Phase II study of recombinant hyaluronidase enzyme (rHuPH20) co-administered with Humulin-R was presented at EASD. Importantly,
(1) consistent with data presented at ADA from the Humalog portion of the study, co-administration resulted in faster insulin absorption and higher peak insulin concentrations.
(2) We anticipate these advantages could lead to improved glycemic control and lower hypoglycemia and weight gain.
(3) A slightly higher number of injection site reactions (ISRs) were seen for rHuPH20+Humulin, but the study is too small to draw meaningful conclusions.
(4) With progress, we believe HALO's diabetes program will attract a partner, and believe chronic administration data (mid-2010, mid-2011) could catalyze partnership discussions.

KEY POINTS
Data Demonstrates Advantages of rHuPH20 Co-Administered With Humulin-R. Data presented at EASD (PK data from 12 patients, glucose data from 21pts) in Type I diabetics demonstrates rHuPH20+Humulin-R results in faster insulin absorption, increased insulin concentration and reduction in post-prandial glucose levels. This data is consistent with the Humalog portion of study in healthy volunteers.

Advantages of Co-Administration Could Result In Improved Treatment Outcomes. In our view, co-administration with rHuPH20 could lead to improved treatment outcomes for diabetic patients, including reduction in postprandial blood glucose levels and improved glycemic control, decreased incidence of hypoglycemia, and reduced weight gain through insulin dose-reduction.

Additional Humulin AEs But Study Too Small To Draw Conclusion.
Incidences of erythema and ecchymosis (types of ISRs) were higher in the Humulin arm (3) vs. Humalog arm (1). However, the study is too small to draw conclusions (n=22). Also ISRs for rHuPH20+Lispro were in-line with Lispro's alone, which is more important commercially vs. Humulin.

Continued Progress In HALO Diabetes Program Could Help Secure Partnership. We believe advantages of co-administration of insulin with rHuPH20 could attract a partner. Additional safety and chronic administration data (expected mid-2010, mid-2011) could accelerate partnership discussions.

Wednesday, October 7, 2009

90% 以上的精神分裂症患者毕生都会发生激越。发生激越的患者中,约有70%每年会发作1到6次。Alexza 公司注意到目前医生用侵入性的肌内注射、速溶片剂或标准片剂治疗急性激越,但都有缺点。肌内注射通常需要使用约束,需要 60 分钟才能奏效。口服片剂给药虽方便,但起效时间还要更慢。该公司认为医生会将起效速度作为影响治疗选择的一个重要因素。
为了解决这一问题,该公司正在研制ALXZ-004,这是使用自家 Staccato 系统给药的洛沙平吸入剂。这种单剂量的吸入剂,可通过肺快速吸收药物,使得起效速度与静脉给药相似,但使用更加简单方便。针对有急性激越的精神分裂症患者的III期试验开始于2008年2月,已经计划在今年第三季度针对双相疾病患者开展III b期试验。
若该试验获得成功,则 ALXZ-004 将会进入一个巨大的潜在市场。Eli Lilly 公司的肌内注射奥氮平(Zyprexa®)治疗居主导地位,2007年的销售额为47.6 亿美元。但该药有导致肥胖和糖尿病的风险,是医生开处方时的担心理由之一,他们可能会欢迎Alexza 公司的这一替代选择。
http://www.thomsonscientific.com.cn/files/q/2008-1.pdf

Insights from JMP Conference: Target: $7

Friday, October 2, 2009

Micromet

2008-8-15
Science:新抗体可帮助T 细胞剿灭癌症

据8月14日的《科学》杂志报道说,T 细胞是一种在与癌症肿瘤的斗争中有前途的特别的免疫细胞;但肿瘤细胞与正常的人类细胞很好地混合在一起,因此要找到一种使得这些T 细胞能够标靶肿瘤细胞的技术一直难以成功。但是现在研究人员说,他们已经研发出了一种抗体蛋白,它能够有效地将非何杰金氏淋巴瘤病人的T 细胞与肿瘤细胞结合起来,导致该癌症的可测出的或是完全的消退。

这种被称作blinatumomab 的抗体看来对恶性肿瘤会有重大的治疗潜力。Ralf Bargou 及其同僚在病人中尝试了不同剂量的blinatumomab,结果发现,在38 名病人中,在每天每平方米0.0005-0.006 毫克的剂量范围内,有11 名病人出现了明显的治疗反应和肿瘤的消退。然而,也有相关的不良反应出现。现在有一个正在进行的临床II 期试验在研究blinatumomab 在淋巴细胞性白血病患者中的活性。

2007-8-22
某些癌症的肿瘤干细胞表达CD326

生物谷:Micromet公司是一家致力于研发新的专利性抗体为基础的肿瘤、炎症、自身免疫病药品的生物技术公司。他们最近宣布,在《美国国家科学院新进展》杂志上发表的一项研究结果支持一些其它研究结果,即Micromet公司新药物MT201和MT110针对的靶分子CD326,可能是一个很好的根除所谓肿瘤干细胞的靶位。其它研究表明,结肠癌、乳腺癌、胰腺癌、前列腺癌的肿瘤干细胞都表达高水平CD326,根据这些研究,这些细胞特别容易引发肿瘤。

肿瘤干细胞在肿瘤细胞中所占比例较低,有自我更新和持续再生为新肿瘤的能力。肿瘤干细胞对多种化疗都耐药,这可能是为什么目前大多数治疗不能通过根除所有肿瘤细胞来根治肿瘤的主要原因之一。Micromet公司的科学家相信,许多癌症的肿瘤干细胞表达CD326,CD326是一个常见的高表达的肿瘤相关抗原,支持Micromet公司使用CD326作为抗体治疗的靶位。

CD326是Micromet公司的临床产品MT201和MT110的治疗靶位,MT201是与Merck Serono公司联合研发的一种全人源性单克隆抗体,MT110是一种抗CD326/CD3双特异性抗体结构药物,目前处于临床前研发后期。两种产品都识别表达CD326的肿瘤细胞,诱导免疫系统的细胞毒性细胞根除这些癌细胞。

Micromet公司的首席科学官员Patrick Baeuerle博士说,他们的针对CD326的药物具有寻找和杀伤机制,可能能够发现和根除不同适应症的肿瘤干细胞。此外,CD326还表达于癌症干细胞的后代细胞上,单独使用这类药物或者与标准治疗联合使用,能够使肿瘤团块缩小。
Smaller companies win in most valuable race June 18, 2009

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Human Genome, OncoGenex stand out small caps so far in 2009 October 01, 2009

全球最有药物价值排行榜

7月27日,安进公司宣布葛兰素史克成为denosumab的国际市场营销合作伙伴。按照协议,葛兰素史克将支付安进1.2亿美元,外加销售提成,并与安进在欧洲、澳洲、新西兰和墨西哥共同销售denosumab。此外,葛兰素史克将承担在安进未建立销售队伍和渠道的国家和地区的销售推广工作,其中包括新兴国家中国和印度。

denosumab究竟是何方神圣,值得安进和葛兰素史克投入巨资,最近的一份报告给出了答案。

在EvaluatePharma最近的一份根据净现值对在研药物进行分析的报告中,安进公司的Denosumab荣登最有价值的药物之首,该药物用于治疗骨质疏松症。该公司的分析师认为该药物的净现值达到了令人咂舌的地步,最高可达115亿美元。

在全球最有价值的十大在研药物中,有三只抗体药物和两只生物工程疫苗,这意味着在接下来的10年内,生物技术产品将成为全球制药业非常重要的增长驱动器。紧随其后的是维特制药公司的丙肝治疗药物VX-950,该药物表现也相当出色,净现值达到了85.5亿美元。

虽然骨质疏松治疗药物市场充斥着各种各样的仿制药,但分析师仍然认为denosumab会取得成功,主要是由于该药物的安全性高、疗效好、使用方便,一年仅需给药两次等。此外,Denosumab还有希望用于骨质疏松症的其他细分市场,诸如肿瘤患者在接受激素治疗后的骨质丢失等。这一切可以维持该药物的价格,从而确保在2014年达到36.5亿美元的销售额。

此前,安进公司希望在今年年末决定denosumab在欧洲、甚至在美国的合作伙伴。但是分析师认为虽然合适的合作伙伴是安进公司挖掘 denosumab在欧洲市场最大潜力的好机会,但是在欧洲签订的授权协议将有损denosumab的价值。最终,安进公司还是选择了葛兰素史克作为合作伙伴。

失踪的失败者

今年的排名中有些药物的缺席值得注意,大部分未出现在此次名单中的药物主要是由于研发过程中遇到了问题。

其中最大的变故是武田公司的二肽基肽酶Ⅳ(DPP-Ⅳ)抑制剂SYR-322,直到几个月前,该药物还占据第三把交椅。但是今年3月份FDA宣布该药需要根据新的2型糖尿病指导原则进行审评,给了武田公司沉重一击,因为新的指导原则重点在于糖尿病治疗药物在心血管病发作风险的评价上。武田本来希望今年该药能上市,但是考虑到可能需要进行额外的临床试验,分析师们认为该药将于2011年上市。因此,该药销售预期下调毫不奇怪。在过去的6个月内,分析师们一致将该药2012年的销售预期从15.9亿美元下调至3.33亿美元。

另外一个从名单中消失的药物是糖尿病治疗药物利拉鲁肽(liraglutide),商品名为Victoza,FDA顾问委员会担心该药具有引发淋巴肿瘤的风险。分析师们认为,即使该药获得批准,用药时也需要进行监测,这意味着该药将失去创造高销售额的机会,当出现比现有药物安全性更好的药物时,患者将不愿意使用它。

甜蜜的成功者

但是,也有两个糖尿病治疗药物成功跻身榜单,分别是Mannkind公司的吸入胰岛素Afresa和Amylin公司的艾塞那肽聚合物微球包裹的长效释放制剂(ByettaLAR),每周给药一次。这两只药物也有其自身的问题:ByettaLAR将面临监管机构的审批延迟,同时还存在Amylin和其合作伙伴 Alkermes之间的生产差异问题。

Thursday, October 1, 2009

B细胞药物:靶向系统性红斑狼疮

2009-3-23

近10年来,没有一只用于治疗系统性红斑狼疮的药物获得美国FDA批准,甚至目前正在使用的治疗药物疗效并不确切,且还有比较严重的副作用。由此看来,此病的诊断和治疗药物都存在巨大的需求

系统性红斑狼疮(SLE) 是一种复杂的慢性免疫系统疾病,这种疾病能累及包括皮肤、关节、心脏、肺、血液系统和肾脏在内的系统,最严重的时候还能累及脑。这种疾病在加勒比黑人、亚洲或西班牙裔妇女中的发病率比较高,在白种人中的发病率稍微低一点。由于病情反复,且易与其他疾病的症状混淆,因此,给SLE诊断带来了不小的困难。而且更重要的是,目前还缺乏能确切诊断SLE的检测手段。

由于SLE的确定和诊断存在着一定的难度,同时还缺乏适当的流行病学研究,造成了对患病人群的估计比较困难。如据美国狼疮基金会(Lupus Foundation of America)统计,美国有150万~200万狼疮患者;但有更为严格的流行病学统计称这一数字为30万人,甚至有保守估计为24万人。而在法国、德国、意大利、西班牙、日本和美国这七大全球最主要的医药市场共有40万的SLE患者。

无论是从诊断还是从治疗方面来说,SLE治疗药物都存在着巨大的需求。近10年来,美国FDA还没有批准过一只用于治疗SLE的药物,甚至目前正在使用的治疗药物疗效并不确切,且还有比较严重的副作用。由于SLE具有多样性和渐进性的特质,使得对临床试验药物的疗效判断比较困难,同时,药品监管机构也缺乏明确的态度,这两方面因素导致过去SLE药物的开发处于停滞状态。但是,最近人们开始从生物学的角度来了解免疫系统疾病,这当然也包括了SLE。同时,由于对SLE的发病机理了解得更多,让人们重新树立了对这一疾病进行研究的信心。正在研发中的产品针对不同的SLE疾病,其中就包括了由严重SLE引发的一种肾脏疾病狼疮性肾炎(LN),还包括了影响皮肤和临床表现多样化的皮肤红斑狼疮(CLE)。

药物治疗:个性化成趋势

目前SLE治疗的药物比较个性化,医生主要是通过患者所患疾病的类型和严重程度选择用药。

类固醇类药物:尤其是仿制药泛滥的泼尼松对控制SLE的症状十分重要。这一类药物经常作为一种拯救疗法或作为短期内的维持用药,且对SLE的症状控制十分有效。但是,长时间使用类固醇类药物将会引起严重的副作用,这就迫使医生使用不同类型的具有不同作用机制的药物。

抗疟药:诸如赛诺菲-安万特公司的羟氯喹(hydroxychloroquine、Plaquenil)是目前普遍用来治疗SLE的药物。据估计,SLE累及多器官的患者中,44%的患者使用的是这类药物。而且更重要的是,尽管绝大多数治疗SLE的免疫抑制剂是受限制的标签外用药,但是至少有一半的患者使用了此类药物,尤其是那些狼疮性肾炎患者。硫唑嘌呤、甲氨喋呤和环磷酰胺是普遍使用的免疫抑制剂。安斯泰来制药公司的普乐可复 (Tacrolimus、Prograf)对狼疮性肾炎具有特别的疗效,2007年1月日本批准该药用于治疗狼疮性肾炎(LN)。

移植排斥抑制剂:罗氏和Aspreva公司的骁悉(mycophenolate mofetil、CellCept)同样对SLE有效,尤其是狼疮性肾炎。但由于在Ⅲ期临床试验中,该药物的疗效没能超过另一只标签外用药的免疫抑制剂环磷酰胺,因此该研究被迫终止。但是无论如何,现有数据显示,医生从安全性的角度考虑时,更加愿意使用骁悉,而不是环磷酰胺。

针对B细胞:今后研究方向

目前新的SLE治疗药物是一些针对细胞因子、B细胞和T细胞的靶向治疗药物。由于自身抗体经常被认为是SLE的病因,因此,B细胞特别引人注意。目前有6只专门针对B细胞的新药处于SLE的研究末期(表2)。

Biogen Idec、基因泰克和罗氏公司的美罗华(Rituximab、MabThera)是一种嵌合性抗CD20单克隆抗体。该药物本来很有希望成为10年来第一只获准用于治疗SLE的一线治疗药物,但是2008年4月的SLE的EXPLORER临床试验中,该药物未能达到最主要的和二期临床试验终点。但是正在进行的狼疮性肾炎的研究给美罗华带来希望。尽管2006年12月FDA发布了SLE患者使用美罗华后诱发了进行性多灶白质脑病(PML),但是该药物的标签外用药还在继续。

其他与美罗华竞争针对B细胞的处于Ⅲ期临床的药物有:Human Genome Sciences和葛兰素史克的单克隆药物belimumab,该药物的靶标为B淋巴细胞刺激因子(BLyS);UCB公司的epratuzumab,该药物的靶标为B细胞表面受体 CD22。在美罗华SLE临床试验失败之后,belimumab将是有望最快获批的SLE适应症药物,到2008年8月,2项Ⅲ期临床的患者入组和初始剂量试验已经完成。Belimumab具有超过美罗华成为第一个用于治疗SLE的生物药。Atacicept是一种水溶性的融合蛋白,该药物能抑制B细胞的活性,从而被开发用来治疗SLE和狼疮性肾炎。默克雪兰诺最近已经从ZymoGenetics公司手中获得了该药的独家开发权,后者将为该产品的商业化预测提供支持。基因泰克公司和Biogen Idec公司是免疫性疾病领域的重要参与者,他们正在寻找美罗华、Ocrelizumab的下一代产品——人源化的以CD20为靶标的单克隆抗体药物。

市场展望:开发潜力巨大

由于10年前,SLE的研发线就近乎停止,因此,针对新靶标的药物将具有改变现有治疗药物的潜力。处于研发末期的药物已经展现了希望,SLE市场未来10年增长可期。但是,由于美罗华SLE临床试验和马替麦考酚酯狼疮性肾炎的临床试验都以失败告终,因此,如何继续向药品监管机构证实这些药物的疗效将是最大的阻碍。

据Datamonitor统计,2007年,法国、德国、意大利、西班牙、日本和美国七大主要医药市场中狼疮治疗药物的销售额最少已经达到3.3亿美元。尽管美罗华SLE试验的Ⅲ期临床试验以失败告终,但是2007年,美罗华在狼疮用药方面的销售额却高达1.25亿美元,美罗华将继续作为治疗狼疮的标签外用药,一旦该药物获准用于治疗狼疮性肾炎,销售额将会进一步升高。

价格昂贵的靶向治疗药物获得批准将是推动SLE市场增长的关键。目前有许多公司正在开发治疗狼疮性疾病的靶向治疗药物。而且更重要的是,由于SLE 疾病的流行性存在不同人种差异,因此,巴西、俄罗斯、中国、印度、韩国、墨西哥、土耳其等新兴医药市场将具有巨大的潜在患者群。据Datamonitor 分析,仅中国、印度和墨西哥三国的SLE患者就超过了220万人。但是新兴医药市场中仅有极少部分的SLE患者能负担得起昂贵的生物治疗药物,因此,这些市场对那些价格低廉的小分子治疗药物来说确实存在着机会。

BENLYSTA (belimumab)
epratuzumab
Atacicept

美国审批速度加快 专利药断层期有望平稳度过

颗粒无收之後,近期一系列药品获得批准,同时一些临床试验结果出乎意料之好,不禁令人冀望,医药行业在度过药品专利大量到期的"大限"之後,能够重获成长。

“无疑取得了许多成功,”Axa Framlington健康保障基金经理Andy Smith说,“这能够弥补专利药品断层期导致的损失吗?现在还不能,但这是一个好的迹象.”

未来四年药品行业由于专利药品到期带来的损失将为历来最严重,许多公司难以填补由此导致的销售和利润真空。

直到最近,投资者对于即将推出的新药还预期不高,因为他们怀疑这些药品能否在安全意识日益强烈的监管机构那里获得通过。

不过事情也许出现了转机.今年第二季美国食品药物管理局(FDA)批准了13种分子药物,而之前四个季度平均每季度仅有六种药物获批。

摩根士丹利分析师相信,今年3月美国最高法院的判决,如果一项药品在FDA批准後造成了伤害,可追究药厂的责任,这让FDA在审批时胆子大了许多。

3月以来许多批准出售的药品中很多都让人大为意外,比如Vanda Pharmaceuticals的精神分裂症药物Fanapt,以及先前被延迟批准的礼来(Eli Lilly)与第一三共推出的心脏药物Effient,还有赛诺菲安万特的Multaq。

同时,生物药物也带来一些令人叹服的正面临床试验结果--最有名的是Human Genome Sciences的狼疮药物Benlysta,Amgen的骨科药物denosumab以及Dendreon的抗癌药物Provenge。

葛兰素史克美占参与了Benlysta和denomsumab两项药品的研制.Dendrenon现正在寻找合作者。

瑞士信贷私人银行部门的买方投资机构分析师Thomas Kaufmann认为,最近的消息可能引发对药品行业的重新思考,投资者正再度审视这些大幅下跌过的股价。

“从股票估值角度而言,这可能成为该类股的转折点,医药类股股价受打压的程度为历来最严重,因为投资者原本预期近期将没有或几乎没有新药推出。”他说。

不过,并非所有制药公司都顺风顺水.比如,丹麦制药商诺和诺德仍在等待美国当局对其药物Victoza的批准.该药物用于治疗糖尿病,已经在欧洲市面上销售。

下一步的关注点将转向秋季医药会议高峰季,届时许多新药的临床试验数据将会展示。

一开始的亮点之一将会是制药商阿斯利康(AstraZeneca)的抗凝血新药Brilinta,有关该药品的数据将于本月稍後在巴塞罗那一个心脏病学会议上公布。

药品行业无疑需要得到振奋.尽管今年因为流感疫情大赚一笔,且第二季业绩良好,突显该行业的抗风险性,但制药公司还是面临一个痛楚的调整时期。

辉瑞和赛诺菲安万特是受到冲击最大的两家公司,因其胆固醇药物Lipitor和Plavix的专利到期,两家公司因而发布了直至2012和2013年的财测,希望以此缓和专利药品断层期带来的冲击。

不过,其他制药公司不大可能仿效,发布这麽长期的财测,尤其是美国医保改革增加了不确定性。

汤森路透数据显示,根据直至2013年的销售和利润预估结果,瑞士制药巨擘罗氏大药厂ROCZg.S和诺华制药应对此次专利药断层期的前景最为看好。

最大的不确定性在于,制药公司对于未来药品的大举押注,结局究竟会超过预期还是不及预期.

瑞士信贷的Kaufmann对此充满希望,“制药公司早晚都要推出新药,新药将会面市,也会像以前的药那样赚钱。”

Lupus 狼疮

HGSI phase III
IMMU phase IIb
ZGEN phase III


来源 生物谷
2009-8-28 9:48:20
分析家提醒人们谨慎HGS股价过热
因葛兰素可能收购人类基因科学(HGS)的传言,HGS股票飙升,昨日每股突破了22美元,这是一个月前的6倍多。一些生物科技领域的分析学家提醒人们警惕这整个事件。

Monness,Crespi,Hardt&Co.的分析家AvikRoy告诉道琼斯,在HGS预计于11月进行狼疮药物Benlysta 下一轮实验以前,葛兰素是不太可能提出收购的。一些分析家认为Benlysta是一个每年将赚取40亿美元的潜在重磅药物。但是该药物许可证尚未发放,葛兰素完全可以等到一个理想的机会再收购。

这并不是说分析学家们不懂得收购的意义,而是葛兰素史克公司手上有90亿美元的现金,完全可以找到一个保险的收购对象。
一则散发着乡土气息的幽默药品广告案例

Halozyme治疗公司推出了一个重组酶制剂(商品名为cumulase),用于不孕症患者体外受精时卵子的准备过程。这种酶作为透明质酸酶的替代物,完全取代了牛或羊等动物来源的体内提取物,这个新产品具有安全性更好、纯度更高、疗效更加可靠的特点。Halozyme公司认为,快捷是产品的优势,于是他们针对医生推出了很简单的广告词:“更纯、更安全,不是牛的!”(实际在英文中,犯傻和牛是同一个单词),表面意思是指所宣传的产品不是来源于牛体的提取物,实际是劝说医生不要固执使用原来产品,医生看到这句广告词时,一下子就能明白隐藏在其中的双关含义,同时忍俊不止。
Halozyme公司很聪明,他们没有就此停步,紧接着又向社会推出了可爱的卡通牛形象作为公司产品的吉祥物。他们使用了各种手段宣传他们的卡通牛形象,不仅邮寄、医生诊室张贴、街边电话亭或摊点派送,还在各种会议上大量赠送身穿印有Cumulase商品名T恤的卡通牛饰品。这头“牛”一下就让公众接受了Halozyme公司,迅速地认可了Cumulase这个品牌。当然,这家公司的产品宣传不会仅限于幽默的层次,他们也会在各种场合陈述真正支持自己产品的临床数据。
From The Garage To The Biotech Fast Track