Replies to post #76535 on Biotech Values

[iwfal]

It does come back to the idea that Rib's synergistic effect is mainly due to shifting Th2 to Th1. Indeed, given Lambda itself can shift the axis towards Th1, Rib might be redundant in reducing viral load. I do agree monotherapy will likely get beaten by relapse,

Confused. If Rib's primary benefit does come from shifting towards Th1, and Ifn-L does the same thing why wouldn't that also benefit decreased relapses?

I truly do think it likely that the ph ii is going to have to have three arms: standard treatment, a monotherapy lambda arm and a rib/lambda combo - to assess precisely such things as relapse rate.

[dewophile]

"Rib should add much to early viral load declines"

tony - can you provide data to back this assertion. my understanding is that ribavirin contribues way more to decreasing relapse than knocking down virus. i saw data showing it can decrease rebound during interferon-free days prior to introduction of pegylated interferon, but given it was already soc before pegylated interferon was introduced it's going to be tough to dig up data on viral kinetics with and without rib using a potent interferon. perhaps data on daily vs 3x/week standard interferon with or without rib might give a clue. regardless, i think with a very potent agent like lambda the contribution of rib to further suppressing virus is likely to be masked - just as it seems to be in the non-rib containing arms in studies using direct antivirals where viral kinetic data without rib was superb but svr suffered due to relapse

[DewDiligence]

Re: Lambda in HBV

I think Lambda should now focus on HBV rather than HCV given Ribavirin doesn't add anything to HBV seroconversion.

Inasmuch as the partnership agreement between ZGEN and BMY has $287M of potential milestone payments for non-HCV indications (#msg-34768182), ZGEN has considerable upside if BMY should decide to pursue a Lambda program in HBV. On the other hand, BMY might be reluctant to move aggressively in HBV due to fear of cannibalizing sales of Baraclude.