Category Archives: SGLT2i

Thoughts on Jardiance EMPERIAL 6MWT Full Results

Late last week, BI/Lilly announced full results from the EMPERIAL-Reduced and EMPERIAL-Preserved trials, evaluating Jardiance on exercise ability in patients with heart failure. Recall, in December 2019, BI/Lilly disclosed that both EMPERIAL trials failed to show a statistically significant improvement in the 6-minute walk test (previous FENIX insight). Full results of the studies were presented during the ESC HFA Discoveries program. Below, FENIX provides thoughts on the EMPERIAL trial results in the context of Novartis’s Entresto 6MWT study as well as potential readthrough to AstraZeneca’s DETERMINE studies.

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VERTIS-CV Questions Remain; Dexcom Partnered for COVID-19 Remote Monitoring; New Libre RWE; Nemaura Continues PR Blitz; ADA Key Press Releases (June 16)

On the final day of ADA 2020, four diabetes-related news items were observed: full results from the ertugliflozin VERTIS-CV study, Dexcom partnered with KORE for COVID-19 remote monitoring, additional Libre RWE, Nemaura continues on its ADA PR blitz. Below, FENIX provides context and analysis for the announcements.

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CREDENCE Receives Positive CHMP Opinion; Metformin ER Recalled Over NDMA Impurities

Two diabetes-related news items have been observed: according to the CHMP meeting highlights, Janssen’s Invokana/Vokanamet renal protection indication (CREDENCE) has received a positive CHMP opinion and FDA announced a voluntary recall for certain lots of metformin ER due to nitrosamine impurity N-Nitrosodimethylamine (NDMA) impurities. Of note, FDA indicated there are five firms who have been contacted about the recall but additional manufacturers remain unaffected. Below, FENIX provides brief thoughts on the the CREDENCE CHMP opinion and insight on a potential readthrough to branded OADs following the metformin recall.

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CREDENCE Once Again on the CHMP Agenda; CHMP Agenda May 25-28

The CHMP agenda for this month’s meeting (May 25-28) has been released, and it includes two notable items: the Invokana/Vokanamet renal protection indication (CREDENCE) and the Saxenda adolescent label extension. Of note, the May 2020 CHMP meeting agenda was just posted today despite the fact that the meeting started on May 25. Below, FENIX provides diabetes-related highlights and insights from the May 2020 CHMP agenda.

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New Jardiance Post-MI HF Trial (EMPACT-MI)

BI/Lilly announced plans to conduct a new pragmatic trial, called EMPACT-MI, to investigate the effect of Jardiance on heart failure patients ±T2DM who have been hospitalized with an acute MI. The trial is being conducted in collaboration with the Duke Clinical Research Institute, and is being led by Adrian Hernandez and Javed Butler. A preliminary search of CT.gov did not show any results for EMPACT-MI, and BI/Lilly did not provide a timeline of when it plans to initiate the study. Below, FENIX provides thoughts on EMPACT-MI, including BI/Lilly’s motivation to conduct such a trial as well as potential readthrough to Farxiga.

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Thoughts on DAPA-HF Approval; Farxiga HCP Website Updated

Yesterday, FDA approved Farxiga as the first SGLT2i for the treatment of HFrEF (NYHA class II-IV) in both T2DM and non-T2DM patients. The approval was based on results from the DAPA-HF study which demonstrated a 26% RRR in hospitalization for heart failure or CV death. Below, FENIX provides thoughts on the new Farxiga HF indication, including read-through to Jardiance and the SGLT2i class, and a brief overview of the updated Farxiga HCP website.

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Farxiga HF Indication Approved (DAPA-HF)

FDA has approved Farxiga to reduce the risk of CV death and hospitalization for heart failure in T2DM and non-T2DM patients based on results from the DAPA-HF outcomes trial (view FDA press release). The DAPA-HF approval comes just one day after FENIX’s estimated date of May 4, 2020. AstraZeneca has not issued a press release nor is the updated label available at the time of this publication. FENIX will be conducting an analysis of the new Farxiga HF indication once the updated label is available.

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Sanofi Bs-Aspart Receives Positive CHMP Opinion; No Update on CREDENCE

According to the CHMP meeting highlights, Sanofi’s bs-aspart has received a positive CHMP opinion. Of note, the Invokana/Vokanamet renal protection indication (CREDENCE) was not mentioned in the meeting highlights, suggesting additional questions were asked to the sponsor. Below, FENIX provides brief thoughts on the positive CHMP opinion for Sanofi’s bs-aspart.

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CREDENCE and Sanofi’s Bs-Aspart up for CHMP Opinion; CHMP Agenda April 28-30

The CHMP agenda for this month’s meeting (April 28-30) has been released, and it includes two notable items up for CHMP opinion: Invokana/Vokanamet renal protection indication (CREDENCE) and Sanofi’s bs-aspart initial application. Of note, the April 2020 CHMP meeting agenda was just posted today despite the fact that the meeting started yesterday. Below, FENIX provides diabetes-related highlights and insights from the April 2020 CHMP agenda.

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AZ CVRM Q1 ’20 Earnings Update

AstraZeneca hosted its Q1 ’20 earnings call and briefly discussed its diabetes business including the recent topline data readout from DAPA-CKD, which stopped early for overwhelming efficacy. Interestingly, AZ said it does not project DAPA-CKD filing acceptance until 2021. Below, FENIX provides highlights and insights from the call, including thoughts on why the DAPA-CKD submission is later than expected.

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