Category Archives: SGLT2i

AZ Triple Combo Approved as Qternmet XR; Qtern Label Update

AstraZeneca announced FDA approval for its triple combination, Qternmet XR (dapagliflozin+saxagliptin+metformin XR), for improvement of glycemic control in patients with T2DM (Qternmet XR FDA label). Additionally, the Qtern label (dapagliflozin+saxagliptin) was updated with 3 notable changes: 1) eGFR cutoff lowered to 45ml/min/1.73m2 which is now consistent with Farxiga, 2) a new 5mg dapa/5mg saxa strength is now available, and 3) the indication no longer requires dapa failure or concurrent use of dapa and saxa. Below, FENIX provides thoughts on the new triple combination FDC and Qtern label updates.

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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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Zynquista Approved in EU for T1DM

Sanofi and Lexicon announced they received EU marketing authorization for the commercialization of Zynquista (sotagliflozin) in T1DM (200mg and 400mg doses). Recall, on February 28, 2019, CHMP adopted a positive opinion. Zynquista is now the second SGLTi to be approved by EU regulatory authorities. On March 25, 2019, Forxiga was granted approval. Below, FENIX provides brief thoughts on the approval.

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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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JnJ Q1 ’19 Earnings Update

JnJ hosted its Q1 ’19 earnings call and provided a brief update to its diabetes business including the recent sNDA filing of the CREDENCE data for Invokana. Recall, the full CREDENCE results were presented at the World Congress of Nephrology on April 14, 2019. Below, FENIX provides a summary and insights from the call.

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CREDENCE Demonstrates 30% RRR in Renal Outcomes; Nephros Likely New Priority Prescribers For Invokana

Yesterday, Janssen presented full results from the Invokana renal outcomes study, CREDENCE, at the World Congress of Nephrology and simultaneously published the results in the NEJM. The CREDENCE study demonstrated a 30% RRR in the primary composite endpoint (progression to end-stage kidney disease (ESKD), doubling of serum creatinine, and renal or CV death) and met all key secondary endpoints. Recall, in July 2018, CREDENCE was stopped early and Janssen subsequently announced it submitted an sNDA in late March 2019. Below, FENIX provides an overview of the full CREDENCE results, market implications, and the potential impact on ADA and AACE guidelines.

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CREDENCE sNDA Filed; Priority Review Unclear

Janssen announced it has filed an sNDA for the Invokana renal outcomes study, CREDENCE. Full results from CREDENCE are scheduled to be presented on April 14 at the World Congress of Nephrology meeting. Recall, on July 16, 2018, Janssen announced that CREDENCE stopped early for positive efficacy findings. Of note, Janssen’s press release did not state whether the company requested a priority review by FDA. Below, FENIX provides thoughts on the CREDENCE filing and potential approval timelines based on whether or not FDA grants priority review.

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Forxiga T1DM Approved in Europe; Sota EU T1DM Approval Imminent

AstraZeneca announced the European Commission (EC) approved Forxiga in T1DM. The news follows the positive CHMP opinion on February 1, 2019. Recall, Lexicon/Sanofi’s sotagliflozin also received a positive CHMP opinion on March 1, 2019 followed by a CRL from FDA on March 22, 2019. Below, FENIX provides thoughts on the Forxiga EU approval and readthrough to sotagliflozin and Jardiance.

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