Biotech Values

[biotech jim]

>CARA vs TRVN

OK, I will take a stab at this but was waiting for some other commentary. I did some DD on Trevena, TRVN, a while back and passed on the stock. I took a further look this morning as I thought I might have missed something.

TRVN's lead compound, TRV130, is an IV drug for acute post op pain. It is a so-called 'biased' ligand for the mu opioid receptor, and as such does not activate all potential signalling pathways for this Galphai coupled GPCR. Thus, it is advertised to offer pain relief via the mu receptor, but shows lesser activity on mechanistic events such as repiratory depression, nausea and constipation as some examples of the negative effects of morphine at this receptor. As such, one is playing the so-called therapeutic index or TI game. You hope that the differentiation on these side effects is complete. The below pdf is from a TRV130 clinical study wherein analgesia, respiratory depression and nausea are evaluated. You can see that there is a good signal for pain relief, but a modest signal for nausea with this lead compound. Thus, the TI may be there but may be too close for comfort in the real world of patient or hospital dosing.

http://www.trevenainc.com/pdf/Soergel_et_al_PAIN_2014.pdf

These TI approaches are a bit too tricky for me so I passed on the company.

They do have a good BOD with lots of experience and Bob Lefkowitz is a great scientist in my view. I do not like the heart failure drug TRV027 as a drug in this space needs to be 'as safe as mothers milk'. I would not place a bet on a nascent company to know and understand all the potential pitfalls a small molecule may have in terms of tox, but large companies do not either, for that matter. One needs long term treatment with the drug candidate with many patients to understand the potential safety issues.

As for their oral mu biased ligand, it is quite a ways off from clintrial results. I suspect also money will be an issue for the company as well, but I have not looked at the financials recently. So, my bet for the acute pain indication currently remains with CARA, and it sure looks like its follow on offering was successful, so I look for this stock to move up from here. Caveat emptor.

You did mention in your post, ompression, as in respiratory depression for TRV130?, I think was a Freudian slip. I think you meant comparison.