Category Archives: SGLT2i

Farxiga DAPA-HF receives priority review; Fiasp pediatric approval in US; MannKind launching in Brazil

A series of diabetes-related news items were observed today from AstraZeneca, Novo Nordisk, and MannKind. AZ announced FDA filing acceptance and granting of priority review for the Farxiga DAPA-HF sNDA. According to AZ, the PDUFA date is in Q2 2020. Additionally, Novo announced US approval of Fiasp for pediatric populations. Further, MannKind announced that it has received approval of the proposed price of Afrezza in Brazil, and intends to commence marketing and distribution the week of January 13, 2020. Below, FENIX provides context and insights regarding these news items.

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Thoughts on ADA 2020 Standards of Care

ADA recently updated its Standards of Medical Care in Diabetes for 2020, which includes key additions across multiple drug classes. Of note, the standards now include a recommendation for initiating SGLT2i or GLP-1RA therapy in patients with ASCVD, HF, or CKD (SGLT2i only) who are already at their A1C goal. Interestingly, while the guidelines were updated to include discussion of the CANVAS/R, CREDENCE, DECLARE, REWIND, and CARMELINA trials, CAROLINA and DAPA-HF trials were not addressed. Below, FENIX provides thoughts and market implications for selected guideline updates.

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Medtronic Acquires Klue; New Tandem SGLT2i+Closed-loop Trial

Medtronic announced it has completed the acquisition of “Klue,” a company developing behavior tracking technology to “provide real-time insights into when a person is consuming food.” Additionally, a new CT.gov record has been observed for an investigator-initiated trial evaluating Tandem’s closed-loop systems (Basal IQ and Control IQ) in T1DM patients on an SGLT2i. Below, FENIX provides thoughts on the news items including how Klue may help to enhance Medtronic’s PCL while still leaving some potential hurdles.

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Tirzepatide CVOT vs. Trulicity; Lilly 2020 Guidance Summary

Today, Lilly hosted its 2020 Guidance and Investment Community Meeting and discussed potential key milestones for 2020. Importantly, Lilly disclosed that its tirzepatide CVOT will be conducted H2H vs. Trulicity. Below, FENIX provides highlights and insights from the call including thoughts on why a tirzepatide CVOT vs. Trulicity makes sense.

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AZ Updates Farxiga Heart Failure Promotion on Websites

AstraZeneca has recently updated its patient and HCP websites with new messaging for its heart failure indication based on the approval of the DECLARE CVOT. Recall, in November 2019, AZ also initiated an unbranded disease state education campaign called “Diabetes Can Break Your Heart.” Below, FENIX provides analysis of the new promotion in the context of the evolving SGLT2i HF story including the DAPA-HF indication.

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Jardiance EMPERIAL Studies Fail to Show HF Symptom Improvement

Boehringer Ingelheim and Lilly announced that the Jardiance EMPERIAL-Preserved and EMPERIAL-Reduced trials failed to meet the respective primary endpoints. Recall, these trials evaluated the impact of Jardiance on the 6-minute walk test in T2DM and non-T2DM patients with HFpEF and HFrEF. Below, FENIX provides thoughts on the failed EMPERIAL studies in the context of BI/Lilly’s ongoing EMPEROR HF outcomes studies as well as readthrough to AstraZeneca, Janssen, and Lexicon.

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Lexicon Loses Sota T1DM Formal Appeal

Lexicon Pharmaceuticals announced the FDA’s Office of New Drugs has denied Lexicon’s appeal of the CRL issued for sotagliflozin in T1DM. Lexicon’s stock fell ~15% in response to this news. In a conference call hosted shortly after the announcement, Lexicon outlined next-steps for sotagliflozin in T1DM and provided comments on additional indications and partnership opportunities. Below, FENIX provides highlights and insights from the call.

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Novo 2019 Capital Markets Day Highlights and Analysis

Novo hosted its 2019 Capital Markets Day and provided updates on the strategic direction of the company through 2025 including commercial activities and R&D strategy. Of note, Novo provided clarity on Rybelsus positioning vs. Ozempic and competitor products as well as details on novel drug delivery technologies, including two oral peptide delivery methods being developed at MIT and the semaglutide+AM833 injection device. Below, FENIX provides details and insights from the call.

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Lexicon @ Stifel; First Presentation Since Empa T1DM Adcom

Lexicon participated in the 2019 Stifel Healthcare conference and provided brief updates on the sotagliflozin regulatory situation including commentary regarding the recent BI/Lilly empa T1DM adcom. Recall, the empa T1DM adcom ended in a 2-14 vote not favoring approval. Below, FENIX provides highlights and insights from the Stifel event including potential readthrough to the ongoing sotagliflozin appeal with the Office of New Drugs.

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