Dew, you are right...the AGN technology review did have information relevant to the competitive position of the MRK/SRDX alliance.
The following points were of greatest interest to me:
1. AGN reiterates the critical role that local delivery will play in ocular medicines (i.e. to avoid ADMET, absorption, distribution, and metabolism problems).
2. AGN continues to pursue the use of Posurdex for diabetic macular edema, age related macular degeneration, and ocular uveitis. AGN reitierated that it is evaluating the efficacy of a Posurdex/Lucentis combination. These are not new initiatives (see Aslan’s #msg-12155548, Dew’s #msg-10941737, both written in 2006), but it is useful to have a status report.
I found the comments in the Q&A regarding Retisert of interest. Retisert, like Posurdex and Ivation-TA, is a steroid implant into the eye. Biowatch pointed out in Feb 2006 that Retisert was being evaluated for DME by Bausch & Lomb – #msg-9805220). Scot Whitcup (Head of R&D) felt that the limited acceptance of Retisert was the high rate of glaucoma that is a side effect (probably he was referring to the elevated intraocular pressure mentioned in Biowatch’s post). Whitcup claims that Posurdex does not raise the intra-ocular pressure as much as Retisert. However, I think this side effect remains a significant risk for this class of compounds. The I-vation TA has the advantage that it can be removed if a problem develops, not so for Posurdex or Retisert.
3. AGN is seemingly beating MRK/SRDX regarding the use of a sustained release implant of an anti-glaucoma medication, one of MRK’s areas of strength (see #msg-20910545). AGN is injecting LumiganX under the conjunctiva in the biodegradeble polymer used as the Posurdex platform. ... Scot Whitcup noted that 40%+ of the glaucoma patients must receive a combination of two or more drugs for glaucoma to see a positive outcome... AGN does not plan to develop combinations in a single implant, rather they plan to get approvals for different drug implants one at a time....
4. Scott Whitcomb was particularly excited about the use of BrimonidineDDS (an alpha adrenergic agonist) as a neuroenhancer that can reverse the degeneration found in glaucoma, retinitis pigmentosa, AMD, etc.... I came away skeptical of the claims, largely because I don’t know the mechanism of action and it bothers me that Brimonidine cures all the known retinal pathologies, even though they arise from a wide variety of causes and affect vastly different cell types. I tend to agree with one of the questioners that the effect looks like Brimonidine treats symptoms rather than underlying causes. I also wonder why AGN, a company known for its secrecy, is announcing this finding so early in the cycle (they have completed animal studies and have just begun to enter phase I status)... adrenergic agonists are widely available, I don’t see the basis for an exclusive franchise.
There were other insights that might interest some. In particular those interested in siRNA as an anti-VEGF therapy may be interested in the comments concerning AGN 745 (albeit they were characteristically brief).
For those interested, the relevant section of the webcast occurs during minutes 13 to 70 of part 2 (part 2 is accessed by going to the end of part 1 and letting the program roll over to part 2). The webcast is at:
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