RVNC BAML commentary (they only cover AGN)
Botox competitor Phase 3 results; focus on label
Today, Botox competitor Revance reported positive Phase 3 topline results for its RT- 002, a long-acting facial injectable for temporary treatment of glabellar (frown) lines. Revance reported the Phase 3 results showed: 1) RT-002 definitively satisfies the primary (regulatory) endpoint evaluating the efficacy of the drug through a 4-week patient and investigator assessment. This does not come as a surprise based on supportive Phase 2 data which had previously shown; 2) duration of therapy: RT-002 response rates on secondary endpoint at week 24 (month 6) on investigator responder analysis (none to mild wrinkles) was on par with response rates with approved toxins which carry 3-4 month duration of use. Questions include 1) whether the RT-002 data will translate to label language calling for 6 month duration of use, since the regulatory development guidance changed (2014) post Botox approval (2002); 2) whether an incremental 1-2 months duration of benefit will meaningfully change prescribing patterns; 3) will RT-002 be brought to market by Revance which lacks aesthetics presence/portfolio or licensed to established medical aesthetics player. We are making no changes to our Botox forecasts for Allergan and maintain our Buy rating.
Duration label claim unclear given FDA’s vague guidance
How Revance’s secondary endpoint results will translate to product labeling remains a critical question. The FDA guidance states that the assessment measures for effect duration “should” be the same as for the primary efficacy endpoint. It remains unclear 1) what RT-002’s primary efficacy would be beyond Week 4; and 2) how the FDA will assess effect duration based on RT-002’s secondary efficacy. On its conference call this morning, Revance management commented their meeting with the FDA led them to focus on the secondary endpoint (% subjects with none or mild wrinkle severity) as key for duration claim (Botox label indicates 3-4 months duration in Section 2 of its label). Tolerability wise, Revance indicated RT-002 looks comparable to Botox. AGN derives ~$800m (5% topline) in US Botox cosmetic sales and the competitive impact of RT-002 on Allergan will depend largely on marketing strategy in our view.
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Path to regulatory filing: long term safety study remains
Revance anticipates its open-label (all subjects will be drug treated) long-term safety study to readout in 2H18E, and the company plans to file for FDA approval in late 2018E / early 2019E and suggested 2020E US launch.