Biotech Values

[DewDiligence]

Re: CP-690,550 mono vs combo data

…it's interesting that the ACR scores are higher across the board for the monotherapy treatment arm compared to the combination-therapy arm, which incorporated methotrexate.

The “placebo” arm in the combination study was methotrexate monotherapy.
Thus, although the magnitude of the ACR discrepancies between the mono study and the combo study is surprising, it’s not surprising, IMO, that the placebo-adjusted ACR scores were higher in the monotherapy study than in the combination study.

When one combines drugs that do not have a synergistic MoA, the Law of Diminishing Returns comes into play and the result is often less than additive efficacy.

p.s. The placebo-adjusted DAS28 Remission number for the 5mg dose was better in the combination study than in the monotherapy study, but this outcome was just statistical noise, IMO. Moreover, DAS28 Remission is a controversial metric that some clinicians think has little relevance in the real world.