Cabbage anyone? (Not cribbage--CABG)
The CABG (coronary artery bypass grafting) indication for Atryn hasn't been discussed much lately but GTC specifically mentioned this area when talking about their partnering discussions. I put below ( as best as I am able) a small section from a book on Cardiac Anesthesia. (ACT=activated clotting time)
"4. Heparin resistance is present when a heparin dose of 5 mg/kg fails to raise the
ACT to an adequate level (>400 seconds). This is an unpredictable occurrence
but is more commonly noted in patients on preoperative heparin, IV nitroglycerin,
an IABP, and in patients with infective endocarditis. It is usually related to
antithrombin III deficiency. If additional heparin does not elevate the ACT,
antithrombin III must be given, either in fresh frozen plasma or in a commercially
available pooled product (Thrombate III), which provides 500 units per vial.
Bojar_CH04.qxd 18/10/2004 10:18 AM Page 153
154 Cardiac Anesthesia"
I have been told that this is routinely done for CABG procedures and in my view this really lowers the risk for a partner. If Atryn is approved for HD, then perhaps only one study might be sufficient to request a label expansion from the FDA. If the market for CABG is $100 million+ then this may well define the low end--and high probability--market for a partner. Interesting opportunity...on the low end you've got a good chance at some revenues while the high end could be a multi-billion dollar product.
Also, in my view, this area represents the quickest way for GTC to get to profitably or a self-financing status. After all, who would use plasma when you've got a safe recombinant product? Isn't that right MTB?
