Idenix Pharmaceuticals (IDIX)

[gofishmarko]

>> This IS for real money if you've got positions in the hep C marketplace! <<

dew ,

I should be hoping for a VX-950 failure since my only position in this space is IDIX ( though I might consider some mad-money option bets on the upcoming VRTX data release ).

Your points are all well-taken and my relatively optimistic outlook is driven mainly by a srong desire to see pegifn and/or riba relegated to the scrapheap ASAP. We need better tx. regimens for the patients' sake and Roche and SGP need an attitude adjustment.

The "accordian effect" in HCV treatment is well known and I think I've even heard VRTX use the term in their CCs. This effect being the success of short tx. regimens when HCV-negativity occurs early and is maintained for "X" period of time before stopping tx. , compared to HCV-negativity occuring later and maintained for ">>X" before stopping tx. , in order to achieve the same SVR rates. In terms of generation of resistant mutants, the strategy of hitting the virus hard and fast with multiple MOAs is the method of choice until proven otherwise with real data , IMO , based on general principles derived from other antiviral and antibacterial txs. I wince when I hear IDIX sing the praises of the 'slow but steady' effects of NM283 without any more justification than the story about " The Tortoise and The Hare".

The other thing VX-950 may have going for it , in terms of shorter tx. durations , is the corrective effect on ifn signalling of protease inhibition. This might result in a faster 'turnaround' of the immune response after HCV-negativity is attained , and more rapid achievement of a stable , serum-sterilizing immune response. No evidence for this yet , of course , just one possibility among many.