Replies to post #66467 on Biotech Values

[jbog]

FOLLOW-UP OF TYSABRI PATIENTS WITH PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY

Status update on the two patients who most recently developed PML after receiving Tysabri, marketed by Biogen Idec (BIIB, Market Perform): One, a German patient, is close to a coma and being fed through tubes, though he is breathing on his own. The other patient, a 37-year-old Swede, is in a rehabilitation center near Stockholm and suffering only from mild weakness on one side of his body.

The presenting physician, Dr. Ralf Gold, said the 52-year-old German patient continued to receive Tysabri two months after the presence of the JC virus, which causes PML, was detected in his system. He was diagnosed later than the Swedish patient and thus had a higher level of virus in his brain.

Both patients were subjected to plasmapheresis. Initially, the German patient responded well and showed significantly improved cognitive parameters within a week; however, he subsequently developed a condition known as immune reconstitution inflammatory syndrome, or IRIS. This occurs when the immune system, in eliminating an infection, produces an excessive inflammatory response that can worsen symptoms.

It is now most likely the patient will be permanently brain damaged, according to Dr. Gold. The only question is by how much. He was started on a course of corticosteroids on Friday, the standard treatment for IRIS.

In our view, the appearance of IRIS is likely to renew a certain level of caution. Furthermore, there may be some negative fallout if the German patient dies. Previously, it was stated that PML could be treated if caught early and that plasmapharesis could potentially represent a solution; the fates of these PML patients will be watched carefully to see whether plasmapharesis might, instead, exacerbate the problem under certain conditions.

[DewDiligence]

How big is the CIS market, IYHO?

p.s. Comments on #msg-32275994 (#msg-32241114)?

[DewDiligence]

Merck KGaA Starts Phase-3 Trial of Cladribine in CIS

http://www.reuters.com/article/marketsNews/idINLI33518120080918

›Sep 18, 2008

LONDON, Sept 18 (Reuters) - Germany's Merck KGaA (MRCG.DE) is launching a new late-stage Phase III clinical trial of its experimental multiple sclerosis pill cladribine, marking a step-up in investment for the product.

The latest study will evaluate the drug in patients at risk of developing multiple sclerosis (MS), after experiencing a first clinical event suggestive of MS, Merck said on Thursday.

Cladribine is already being tested in a fully enrolled Phase III pivotal trial for the treatment of relapsing forms of MS.

The new trial will look at the potential of the medicine in a wider group of patients at an earlier stage of disease.

Merck is racing other drugmakers, including Novartis to develop and launch the world's first MS drug that can be given by mouth, rather than injection.

Cladribine tablets have already been granted a fast track designation by the U.S. Food and Drug Administration.

Merck is an established leader in MS treatment through its existing Rebif medicine, which was acquired when the German drugmaker bought Swiss biotech firm Serono in 2006.‹

[DewDiligence]

Copaxone Approved in Europe for CIS

[The clinical data supporting the approval is in #msg-32316091. A similar sNDA is pending at the FDA.]

http://finance.yahoo.com/news/COPAXONEreg-is-Approved-for-bw-14249438.html

›COPAXONE is Approved for Treatment of Patients with a First Clinical Event Suggestive of Multiple Sclerosis

Wednesday February 4, 2009, 9:45 am EST

JERUSALEM--(BUSINESS WIRE)--Teva Pharmaceutical Industries Ltd. (NASDAQ: TEVA ) today announced that the Medicines and Healthcare products Regulatory Agency (MHRA) has approved an expanded label for COPAXONE® (glatiramer acetate injection) to include the treatment of patients with clinical isolated syndrome (CIS) suggestive of multiple sclerosis (MS). This approval includes 24 EU member countries that take part in the MHRA "mutual recognition procedure". A similar application for the expanded COPAXONE® label is currently under review by the U.S. Food and Drug Administration (FDA).

The PreCISe study, conducted in patients with CIS demonstrated that COPAXONE® significantly reduced the risk of developing clinically definite MS (CDMS) by 45 percent versus placebo and prolonged the quartile time to conversion to CDMS to 722 days, versus 336 days in those patients receiving placebo.

COPAXONE® now has evidence-based data for early treatment and, in addition, is the only relapsing-remitting MS (RRMS) treatment with prospective long-term data demonstrating that 8 out of 10 patients adhering to COPAXONE® therapy are still able to walk unassisted after a mean of 15 years of therapy and 22 years of disease duration.

“COPAXONE® provides clear benefits from early phase of the disease to patients presenting with a first clinical event suggestive of MS”, said Moshe Manor, Teva’s Group Vice President, Global Innovative Resources, “This significant effect that adds on to the robust efficacy and safety data demonstrated over the last 15 years position COPAXONE® as a cornerstone in MS therapy”.

Approval of an expanded label for COPAXONE® to include the treatment of CIS patients was also provided by the Australian Health Authority (Therapeutic Goods Administration, TGA).

About the PreCISe Study

The multinational, multi-center, prospective, double-blind, randomized, Phase III PreCISe study was conducted globally at 80 centers. It included a total of 481 patients presenting with a single clinical episode and magnetic resonance imaging (MRI) scans suggestive of MS. Patients included were those who had a unifocal disease manifestation (i.e., clinical evidence of a single lesion). Patients received either COPAXONE® 20mg/day or placebo as a subcutaneous injection and continued treatment for up to three years, unless a second attack was experienced and they were diagnosed with CDMS. Patients who converted to CDMS continued the trial on active treatment for an additional two years. The primary efficacy outcome was time to CDMS, based on a second clinical attack.

COPAXONE® (glatiramer acetate injection) was also shown to be very well tolerated in the PreCISe study, with 84 percent of patients completing the three-year study period; a rate similar to that observed in RRMS patients treated with COPAXONE®. All patients in the study participated in a follow-up study with COPAXONE® to prospectively assess the impact of early versus delayed treatment with COPAXONE® on the long-term course of the disease for a total observation time of up to five years.

A pre-planned interim analysis was performed on data accumulated from 81 percent of the three-year placebo-controlled study exposure. Results of the interim analysis, announced in December 2007, demonstrated the proportion of patients developing CDMS was reduced from 43 percent in the placebo group to only 25 percent in the COPAXONE® group (p< 0.0001). The PreCISe study also demonstrated that the 25th percentile of number of days to conversion to CDMS more than doubled by COPAXONE® from 336 days to 722 days (hazard ratio 0.55, p=0.0005) compared with placebo.

Moreover, there was a significant reduction in the number of new T2 lesions and in the number of T1-enhancing lesions in the COPAXONE® arm compared to the placebo arm, both at year one and year two magnetic resonance imaging (MRI) scans.

In September 2008, additional MRI data from the PreCISe study was presented at the World Congress on Treatment and Research in MS (WCTRIMS), in Montreal, Canada. The data demonstrated COPAXONE® significantly reduced MRI-disease activity and improved neuro-axonal integrity in patients presenting with a first clinical event suggestive of MS, versus patients who received placebo. These results provided the first evidence of neuro-axonal protection by a disease-modifying therapy in patients presenting with a first clinical event suggestive of MS.

About COPAXONE®

COPAXONE® is indicated for the reduction of the frequency of relapses in RRMS. The most common side effects of COPAXONE® are redness, pain, swelling, itching, a lump or an indentation at the site of injection, weakness, infection, pain, nausea, joint pain, anxiety, and muscle stiffness.

COPAXONE® is now approved in 51 countries worldwide, including the United States, Canada, Mexico, Australia, Israel, and all European countries. In North America, COPAXONE® is marketed by Teva Neuroscience, Inc., which is a subsidiary of Teva Pharmaceutical Industries Ltd. (NASDAQ:TEVA - News). In Europe, COPAXONE® is marketed by Teva Pharmaceutical Industries Ltd. and sanofi-aventis. COPAXONE® is a registered trademark of Teva Pharmaceutical Industries Ltd.

See additional important information at http://www.copaxone.com/pi/index.html or call 1-800-887-8100 for electronic releases. For hardcopy releases, please see enclosed full prescribing information.‹