FDA issued a warning for the risk of a rare genital infection (necrotizing fasciitis of the perineum aka Fournier’s gangrene) with the use of SGLT2 inhibitors. FDA is also requiring label updates for the class. According to the FDA’s warning letter, there have been 12 cases (7 males and 5 females) of Fournier’s gangrene from March 2013 to May 2018.
Based on the recent AZ announcement for the initiation of a Farxiga HFpEF Ph3b study, FENIX has updated its previous SGLT2i heart failure CVOT tale-of-the-tape analysis (published June 1, 2018) and projected timeline for filings and launches.
Late last week, AZ announced a new HF CVOT for Farxiga named DELIVER. Curiously enough, the news was not seen on any global newswires. Below, FENIX provides its thoughts on the trial, including the checkered past of Scott Solomon and the choice of him as PI on DELIVER.
According to court documents, AZ has dismissed its lawsuit against Zydus Pharmaceuticals over Zydus’ generic Farxiga filing in the US. The suit was initially filed with the US District Court, New Jersey on May 3, 2018 and claimed infringement on two AZ patents (6,414,126 and 6,515,117). Interestingly, the suit was dropped even though Zydus did not answer AZ’s complaint or filed a motion for summary judgment. It is unclear as to why AZ decided to withdraw its lawsuit vs. Zydus; however, AZ and Zydus may have come to an agreement outside of the courts. Below, FENIX provides an analysis based on the FDA Orange Book and Paragraph IV filings.
AZ hosted their Q2 ’18 earnings call and briefly discussed their diabetes portfolio, with particular focus on Farxiga and the upcoming DECLARE CVOT results.
Boehringer Ingelheim and Lilly have announced topline results from CARMELINA, the Tradjenta CVOT, which demonstrated no increased CV risk. BI/Lilly did not discuss whether or not CARMELINA met superiority, but it is assumed the trial was neutral given results from the other DPP-IVi CVOTs. Below, FENIX provides insight into the results including implications from the pre-specified superiority testing plan.
CREDENCE was recently stopped early, bringing a multitude of thoughts and potential implications to the diabetes market. Below, FENIX provides deep, rich analysis on the potential results of CREDENCE, the possibility for CREDENCE to be in a combined FDA review with CANVAS/R, market and label implications, read-through to DECLARE, and how ARB history seems to be repeating itself with SGLT2i.
Janssen announced FDA has extended the CANVAS/R sNDA review by 3 months with a new action date in October 2018. According to the press release, FDA requested the extension after receiving additional analyses from Janssen. Recall, BI/Lilly had a similar 3-month delay after FDA asked for additional data from the EMPA-REG OUTCOME study.
AZ presented 24-week data from the second Ph3 study (DEPICT-2) evaluating dapagliflozin in T1DM patients, showing an imbalance in DKA compared to placebo. Additionally, Lexicon presented 52-week data of the Ph3 inTandem1 study of sotagliflozin in T1DM.
In advance of ADA 2018 beginning June 21, FENIX has conducted a comprehensive analysis of new and recent promotional materials obtained at AACE 2018. Notably, this was the first major conference opportunity for Novo to promote both Ozempic and the Tresiba DEVOTE label update.