An approval today would have been pretty unprecedented, so the drop can only be explained by concern about BMD at 2 years. However BMD was fine on the same regimen in women with fibroids. There should be no reason to think the endometriosis population is any different, so this reaction seems way off (even in a down market)
Data from the SPIRIT long-term extension study demonstrated clinically meaningful improvements in dysmenorrhea (84.8% of patients) and non-menstrual pain (75.8% of patients) over two years in women with endometriosis-associated pain. The safety profile during the second year of treatment, including bone mineral density, was consistent with that observed during the first year with no new safety signals identified.
The one year data release said BMD loss was minimal at 24 weeks and remained stable through one year
I posted a while ago that I bought MYOV bc of the promise of the drug in the endometriosis indication. It has the efficacy of the high dose Orlissa for endo with safety comparable to the (not so efficacious) low dose Orlissa. Endo patients are desperate for something for pain control aside from surgery that is more than a 6 month band aid (Lupron, Orlissa). I see these patients in my office. Myfembree if approved w 2 year label and good safety and tolerability should see very good uptake IMO. Right now with nothing more than a convenience advantage of one pill a day vs twice daily they are at 60% market share in the fibroid indication head to head w Orlissa - in endo if approved they will have meaningful clinical differentiation that opens up the market quite a bit IMO