Biotech Values

[iwfal]

XOMA and Canakinumab and Serious Infection risk:

If increased infection rate was a problem with anti IL-1beta I doubt Novartis would have started CANTOS.

FWIW there is no question whatsoever that Cana does create excess serious infection risk. It showed up both in the gout trial and in the RA trial. And it showed up at every dose level - even ones with very small cohorts on a single dose. And that elevation in serious infection risks was one of the primary causes of rejection in the gout indication.

So Novartis' hope (reasonable IMO) is undoubtedly that in a population at risk of death (vs "just pain") that the severe infection risk will be given less importance. And that rationale seems valid in uveitis as well - but riskier in osteo and really risky in acne. Even with a smaller rate of serious infection such an issue would (IMO) cause significant complications in the pursuit of the acne indication.

Note that, like Gev, Cana blocks only IL-1b and does not block IL-1a. Beyond that there are differences in affinity etc, but off hand I do not remember them.