Category Archives: GLP-1RA

Tresiba Hypo Benefit Over Toujeo; Novo Q1 ’19 Earnings Update

Novo Nordisk hosted its Q1 ’19 earnings call (press release) and provided updates to its diabetes business including the recent oral semaglutide and Ozempic regulatory filings. Of note, Novo reported topline results from the Tresiba vs. Toujeo H2H trial. Below, FENIX provides highlights and insights from the call including thoughts on how the Tresiba vs. Toujeo H2H trial may impact the basal insulin market.

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Merck and Pfizer Q1 ’19 Earnings Updates

Merck and Pfizer hosted their respective Q1 ’19 earnings calls. Both companies only briefly discussed their diabetes-related businesses. Below, FENIX provides highlights from the calls.

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REWIND Filed; Empa T1DM, Nasal Glucagon Delayed; Lilly Q1 ’19 Earnings Update

Lilly hosted its Q1 ’19 earnings call and provided updates to its diabetes business. Of note, Lilly disclosed that it submitted REWIND (US and EU), URLi (EU, Japan, and maybe the US), a connected prefilled pen (US), and the empa+lina+metXR triple combination (US). Furthermore, Lilly also disclosed two regulatory delays. FDA refused to accept the sNDA for Jardiance in T1DM for “technical reasons,” and the review for Lilly’s nasal glucagon rescue product was extended by 3 months after FDA requested additional data. Below, FENIX provides thoughts and context to the significant Q1 ’19 regulatory events in diabetes.

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Victoza Pediatric Trial (ELLIPSE) Results and Regulatory Filings

Yesterday, Novo Nordisk presented results from the Victoza T2DM pediatric trial (ELLIPSE) at the Pediatric Endocrine Society/Pediatric Academic Societies annual meeting. Importantly, the results were published in the NEJM, which may be a testament to the growing attention on childhood T2DM/obesity. Additionally, Novo disclosed that it has submitted the data to US and EU regulators, although it did not specify the timing. Below, FENIX provides an overview of the ELLIPSE results – including the non-significant weight loss findings, and thoughts on the study in the context of Victoza’s impending LOE and recent settlement with Teva.

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No Sotagliflozin CRL Clarity; Sanofi Q1 ’19 Earnings Update

Sanofi hosted its Q1 ’19 earnings call but only briefly discussed its diabetes business including the recent sotagliflozin T1DM CRL. Below, FENIX provides highlights and insights from the call.

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DECLARE Filing Accepted; AZ Q1 ’19 Earnings Update

AstraZeneca hosted its Q1 ’19 earnings call and provided updates to its diabetes business. Of note, senior management disclosed that its Farxiga CVOT (DECLARE) filings have been accepted by US and EU regulatory authorities with approvals projected in 2020. Additionally, AZ said its Farxiga HF study (Dapa-HF) is projected to read out ahead of schedule (now in H2 ’19; previously 2020). Below, FENIX provides highlights and insights from the Q1 ’19 earnings call.

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Novo Oral Sema CVOT Initiated (SOUL)

A CT.gov record for Novo’s oral semaglutide CVOT, SOUL, has been observed. Novo recently announced the simultaneous filings for oral semaglutide T2DM glycemic control, oral semaglutide CV risk reduction, and Ozempic CV risk reduction. Below, FENIX provides a comparative GLP-1RA CVOT analysis as well as key considerations for the SOUL trial.

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New US Ozempic 3mL Pen Offering for Maintenance Dosing

According to Drugs@FDA, the Ozempic US label has been updated to reflect a new 3mL pen offering for a maintenance dose of 1mg. The new pen has a different NDC (0169-4130-13) and dials 4 doses of 1mg each. The new pen represents a total strength of 4 mg/3 mL and harmonizes the maximum pen strength offered in Europe. Below, FENIX provides thoughts on this new pen offering including potential reasons around manufacturing efficiencies.

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Sanofi To Layoff Diabetes Sales Reps; Details Remain Scarce

Sanofi is reportedly set to lay off an undisclosed number of diabetes US sales reps starting in June 2019. Below, FENIX provides thoughts on the new layoffs in the context of increasing US pricing pressures on Sanofi’s insulin franchise as well as the recent sotagliflozin CRL.

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Thoughts on Oral Sema and Ozempic Filings; 3 NDAs to De-risk Regulatory Uncertainty

In what is believed to be a first, Novo Nordisk simultaneously filed three NDAs for oral semaglutide T2DM glycemic control, oral semaglutide CV risk reduction, and Ozempic CV risk reduction. The timings for the filings, including the use of the priority review voucher (PRV) for oral semaglutide, are in line with Novo’s previous guidance (by the end of Q1 ’19). Novo’s decision to simultaneously file oral semaglutide and the Ozempic CV indication ahead of REWIND data at ADA confirms FENIX’s previous insight. Below, FENIX provides thoughts and insights into Novo’s probable reasoning behind three separate filings as a means to de-risk the submissions, insight into potential approval timings for all 3 products, and an updated REWIND filing scenario that could result in a Q4 2019 2-day FDA adcom discussing GLP-1RA CVOTs.

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