Tag Archives: Farxiga

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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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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AZ Initiates Unbranded HF Education Campaign

AstraZeneca announced the initiation of a new unbranded disease state education (DSE) campaign called “Diabetes Can Break Your Heart,” which focuses on heart failure (HF) risk in patients with T2DM. The DSE includes a new website as well as a national bus tour that will stop at select cities throughout 2020 but starts in Philadelphia at the upcoming AHA conference (November 16-18). Below, FENIX provides insights about the new AZ HF campaign including a comparison to BI/Lilly’s initial Jardiance DSE for its CV death risk reduction indication.

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Thoughts on DECLARE FDA Approval

AstraZeneca announced FDA approved a Farxiga heart failure indication in T2DM patients based on results from the DECLARE CVOT. Below, FENIX provides a DECLARE label analysis as well as potential market implications to the SGLT2i class particularly ahead of the DAPA-HF FDA filing/approval.

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DAPA-HF is a Home Run, But Results Remain Unpublished

Full results from AstraZeneca’s Farxiga DAPA-HF trial were presented at ESC 2019. Data from the trial showed an impressive 26% RRR (p<0.0001) in the primary composite endpoint (CV death or worsening of heart failure) with both components contributing to the highly statistically significant result. Additionally, Novartis presented results from the Entresto PARAGON-HF trial (patients with HFpEF) which narrowly missed statistical significance on the primary endpoint but showed benefit in key subpopulations. Of note, it appears that DAPA-HF has not yet been published in any scientific journal, and the p-value in the AZ press release did not exactly match what was presented during ESC 2019. Below, FENIX provides thoughts on the DAPA-HF and PARAGON-HF results in the context of the evolving HF market.

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DAPA-HF @ ESC 2019 on Sunday Sept 1

AstraZeneca announced that the Farxiga DAPA-HF study will be presented on Sunday, September 1, 2019 the European Society of Cardiology (ESC) congress in Paris. Of note, DAPA-HF will be presented during the same session as THEMIS (Brilinta in patients with established CAD and T2DM) and PARAGON-HF (Entresto in patients with HFpEF). On August 20, AZ announced positive topline results from the trial. FENIX will be providing an in-depth analysis of the data following the ESC presentation.

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AZ’s Farxiga CKD Development Receives Fast Track Designation

AstraZeneca announced FDA granted Fast Track designation to Farxiga for the prevention of renal failure and CV/renal death in patients with CKD. Recall, AZ recently announced positive topline results for DAPA-HF and subsequently purchased a priority review voucher (PRV) which FENIX believes could be used for the Farxiga HF filing. Below, FENIX provides thoughts on the Farxiga Fast Track designation in the context of Janssen’s CREDENCE FDA filing which received FDA priority review.

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Thoughts on AZ PRV Purchase and Potential Uses

AstraZeneca announced it purchased a priority review voucher (PRV) for $95M from Sobi, a subsidiary of Swedish Orphan Biovitrum AB. Below, FENIX provides thoughts on the PRV including potential scenarios for which AZ could use the PRV for either Farxiga (DAPA-HF), roxadustat (CKD anemia), or for part of its oncology franchise (trastuzumab deruxtecan), and why AZ is unlikely to use the PRV for the Epanova STRENGTH CVOT.

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Farxiga Positive Topline DAPA-HF Results

AstraZeneca announced positive topline results from the DAPA-HF trial which evaluated the effect of dapagliflozin on the composite of CV death or worsening heart failure (HF). AZ did not provide any details (e.g. hazard ratios) for DAPA-HF; however, the company is likely looking to present the trial at the 2019 AHA conference (November 16-18). Below, FENIX provides insight into the positive DAPA-HF results including potential readthrough to BI/Lilly, Janssen, and Lexicon.

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