Replies to post #86276 on Biotech Values

[biomaven0]

>>UFH already has a satisfactory reversing agent (protamine)<<

Protamine is of course routinely used for want of anything better, but I wouldn't characterize it as satisfactory. It has to be individually and carefully titrated, and not infrequently causes hemodynamic instability, usually minor but sometimes major or even fatal. I've seen in one article a figure of 2.6% for major adverse events from protamine in cardiac surgery. This paper also showed a significantly increased in-hospital mortality after even minor systemic hypotension or pulmonary hypertension within 30 minutes of protamine administration, but hard to know if that is correlative or causative. Protamine does activate the complement system, which is very likely a bad thing in a cardiac patient and maybe could explain the increased mortality after even minor reactions. (Of course it could be that patients that react poorly to protamine are simply sicker to begin with). Up to now there has really been no way to do a trial to figure this out because of the want of any alternative to protamine.

Peter

[mcbio]

Re: PYMX

In other words, there are a lot of ifs that have to work out for PYMX’s reversing agent to be a commercial success; if you decide to invest in PYMX, I think you should do it for the antibiotic program rather than the protamine-replacement program.

Thanks Dew, very informative response and makes a lot of sense. I'm not planning on investing or anything right now. I just always like to learn more about, and keep an eye on, these biotechs with sub-$100 million market caps and potentially novel programs.

[mcbio]

PYMX - correlation to MNTA's generic Lovenox

In thinking about this a bit more, I'm trying to correlate the potential success of MNTA's generic Lovenox with that of PYMX's PMX-60056. For the sake of this discussion, let's cast aside the use of PMX-60056 with UFH and just focus on its use with LMWHs such as Lovenox. Is it safe to assume that if MNTA is able to get its generic Lovenox approved and it is a success in the marketplace that would bode well for PMX-60056? I presume that PMX-60056 would be used in conjunction with generic Lovenox if it's successfully developed.

I know you've made the distinction between acute and chronic uses for Lovenox and how it is the chronic setting that is much more lucrative, but this is where the competition from the new oral anticoagulants could be a real concern. I think you said previously though that you thought the new oral anticoagulants would have more of an impact on warfarin than Lovenox in the chronic setting. I also think you indicated that generic Lovenox would obviously be able to compete with the new oral anticoagulants on a cost basis, which is something branded Lovenox obviously cannot do as well. Is there the potential that generic Lovenox combined with PMX-60056 could also be able to compete effectively with the new oral anticoagulants on a cost basis?

Are you still of the belief that the new oral anticoagulants will have more of an impact on warfarin than Lovenox in the chronic setting? And, even if branded Lovenox does take a market share hit, wouldn't it be possible that a PMX-60056 plus generic Lovenox combo could still compete with the new oral anticoagulants on a price standpoint in the chronic setting, which is the big opportunity here?