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Wednesday, June 24, 2020

Rhythm Pharma announces positive setmelanotide data in obese volunteers

Rhythm Pharmaceuticals (NASDAQ:RYTM) announces positive preliminary data from a Phase 2 clinical trial evaluating once-weekly setmelanotide in healthy obese volunteers.
Participants who received weekly injections showed comparable weight loss to those who received daily treatment over a 12-week period.
Both formulations were safe and well-tolerated. All adverse events observed were considered mild by investigators.
On the pharmacokinetic front, mean plasma trough drug concentrations in patients receiving 20 mg and 30 mg each week were similar to 3 mg dosed daily, although the trough concentration for the 30 mg dose was actually greater.
The company plans to discuss next steps with the FDA.
The company completed its U.S. marketing application about three months ago seeking approval to use setmelanotide to treat pro-opiomelanocortin deficiency obesity and leptin receptor deficiency obesity.

Global Blood to file European application for Oxbryta for sickle cell anemia

June 24, 2020

Global Blood Therapeutics (NASDAQ:GBT) intends to submit a marketing application in Europe seeking approval to use Oxbryta (voxelotor) to treat hemolytic anemia in patients at least 12 years old with sickle cell disease (SCD). It expects to complete the filing by mid-2021.
Voxelotor inhibits hemoglobin polymerization, the root causes of the sickling and destruction of red blood cells in SCD.
The FDA approved Oxbryta in November 2019 for SCD.

Tuesday, June 23, 2020

Quest to expand footprint in Indiana with JV buyout

Quest Diagnostics (NYSE:DGX) has agreed to purchase its partners’ interests in Indianapolis-based joint venture Mid America Clinical Laboratories in an all-cash transaction.
The deal includes the main laboratory and 50 patient centers across the state.
As part of the agreement, Quest will provide hospital lab services for ~30 hospitals owned and operated by Ascension St. Vincent and Community Health Network.
The transaction should close next quarter. Financial terms are not disclosed.

Blocking sugar metabolism slows lung tumor growth

Blocking a pair of sugar-transporting proteins may be a useful treatment approach for lung cancer, suggests a new study in mice and human cells published today in eLife.
Cancer cells use a lot of sugar to fuel their rapid growth and spread. This has led scientists to consider cutting off their sugar supply as a way to treat cancer. The current study suggests this could be an effective approach but it will be necessary to block multiple pathways at once to be effective.
Proteins called glucose transporters supply sugar to cells making them an appealing target for therapies intended to starve cancer cells. But scientists don’t know the best ways to do this, or if cancer cells would just switch to alternative fuel sources if they are denied sugar.
“Inhibiting sugar use in lung tumours could be an efficient treatment strategy, but whether glucose transporters should be targeted and which ones to target remains unclear,” says lead author Caroline Contat, a PhD student and Doctoral Assistant at the Swiss Institute for Experimental Cancer Research, EPFL, Lausanne, Switzerland.
To find out, Contat and her colleagues genetically engineered mice with lung cancer that were missing a glucose transport protein called Glut1 or an alternate sugar transporter called Glut3. The team found that tumours grew just as fast in the mice lacking Glut1 or Glut3 as they did in mice with both transporters.
However, when they genetically engineered mice with lung cancer that lack both Glut1 and Glut3, they found that the animals grew fewer tumours and survived longer. By using an imaging technology called positron emission tomography (PET) and sugar labelled with radioactive tags, the team confirmed that the tumours used less sugar. The tumour cells also grew more slowly.
Finally, they deleted Glut1 and Glut3 in four different human lung cancer cell lines grown in the laboratory, which caused these cells to grow more slowly. “These experiments suggest Glut1 and Glut3 together are needed to fuel the growth of lung cancer,” Contat says.
Using nanoscale imaging studies, the team also found that most of the sugar-derived biomass in mouse lung tumour cells accumulates in cellular compartments called lamellar bodies and that Glut1 is necessary for this fuel storage.
“While more studies of these tumour fuel storage compartments are needed, our results suggest a new approach to lung cancer treatment that focuses on starving tumour cells of energy,” says senior author Etienne Meylan, Assistant Professor at the Swiss Institute for Experimental Cancer Research, EPFL. “In particular, treatments that block Glut1 and Glut3 simultaneously will be necessary to help stop lung tumour growth.”
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Reference
The paper ‘Combined deletion of Glut1 and Glut3 impairs lung adenocarcinoma growth’ can be freely accessed online at https://doi.org/10.7554/eLife.53618. Contents, including text, figures and data, are free to reuse under a CC BY 4.0 license.
https://www.eurekalert.org/pub_releases/2020-06/e-bsm062320.php

Covid herd immunity threshold could be lower according to new study

Herd immunity to Covid-19 could be achieved with less people being infected than previously estimated according to new research.
Mathematicians from the University of Nottingham and University of Stockholm devised a simple model categorising people into groups reflecting age and social activity level. When differences in age and social activity are incorporated in the model, the herd immunity level reduces from 60% to 43%. The figure of 43% should be interpreted as an illustration rather than an exact value or even a best estimate. The research has been published today in Science.
Herd immunity happens when so many people in a community become immune to an infectious disease that is stops the disease from spreading. This happens by people contracting the disease and building up natural immunity and by people receiving a vaccine. When a large percentage of the population becomes immune to a disease, the spread of that disease slows down or stops and the chain of transmission is broken.
This research takes a new mathematical approach to estimating the herd immunity figure for a population to an infectious disease, such as the current COVID-19 pandemic. The herd immunity level is defined as the fraction of the population that must become immune for disease spreading to decline and stop when all preventive measures, such as social distancing, are lifted. For COVID-19 it is often stated that this is around 60%, a figure derived from the fraction of the population that must be vaccinated (in advance of an epidemic) to prevent a large outbreak.
The figure of 60% assumes that each individual in the population is equally likely to be vaccinated, and hence immune. However, that is not the case if immunity arises as a result of disease spreading in a population consisting of people with many different behaviours.
Professor Frank Ball from the University of Nottingham participated in the research and explains: “By taking this new mathematical approach to estimating the level for herd immunity to be achieved we found it could potentially be reduced to 43% and that this reduction is mainly due to activity level rather than age structure. The more socially active individuals are then the more likely they are to get infected than less socially active ones, and they are also more likely to infect people if they become infected. Consequently, the herd immunity level is lower when immunity is caused by disease spreading than when immunity comes from vaccination.
“Our findings have potential consequences for the current COVID-19 pandemic and the release of lockdown and suggests that individual variation (e.g. in activity level) is an important feature to include in models that guide policy.”
https://www.eurekalert.org/pub_releases/2020-06/uon-hit062320.php

Steps to expand and improve antibody tests in COVID-19 response

More than 300 scientists and clinicians from the federal government, industry and academia published a report of their conclusions and recommendations on COVID-19 serology studies online in Immunity. The group gathered for an online workshop in May to discuss the role of serology testing in understanding and responding to the COVID-19 public health crisis and to explore strategies to address key scientific knowledge opportunities and gaps in the emerging field. Serology tests for COVID-19 are designed to detect antibodies against SARS-CoV-2, the virus that causes COVID-19. While such tests do not diagnose active infection, they can indicate prior infection with SARS-CoV-2 that may have been missed because a person did not experience significant symptoms or access testing while infected.
The COVID-19 Serology Studies workshop was convened by an interagency working group comprised of experts from the U.S. Department of Health and Human Services–including scientists at the National Institute of Allergy and Infectious Diseases (NIAID), the National Cancer Institute (NCI), and the National Heart, Lung and Blood Institute (NHLBI), parts of the National Institutes of Health, as well as the Centers for Disease Control and Prevention and the Biomedical Advanced Research and Development Authority–and the Department of Defense. Attendees assessed efforts to better understand the implications of serology test results, to produce and validate test kits, and to quantify undetected cases of SARS-CoV-2 infection.
Attendees recommended that additional research is needed to determine if and to what extent a positive antibody test means a person may be protected from reinfection with SARS-CoV-2. Attendees emphasized that until such data is available, serology tests should not be used as a stand-alone tool to make decisions about personal safety related to SARS-CoV-2 exposure. Researchers are now pursuing studies in humans and in animal models to better understand SARS-CoV-2 immunity. Attendees noted that such understanding could help identify optimal donors of convalescent plasma that potentially could be used to help treat those with severe COVID-19.
Researchers from NCI reviewed progress in their effort to independently validate SARS-CoV-2 serology tests on behalf of the U.S. Food and Drug Administration. Attendees also proposed strategies to expand the accuracy and capacity of these tests to distinguish between naturally acquired and vaccine-induced antibodies, which will be critical to evaluating COVID-19 vaccine candidates.
Both community-based and large-scale serology surveillance efforts–such as the RESPONSE study sponsored by NIAID and NHLBI–are collecting critical data to improve epidemiological models and inform public health decision-making. Ideally, attendees noted, federal partners will expand this activity to establish an interactive serological database that will help public health officials monitor and quickly respond to changes in SARS-CoV-2 infection patterns.
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ARTICLE:
A Lerner et al. COVID-19 Serology Studies Workshop: Meeting Report. Immunity DOI: 10.1016/j.immuni.2020.06.012 (2020).
https://www.eurekalert.org/pub_releases/2020-06/nioa-eis062320.php

New dexamethasone stats suggest lifesaving potential in severe COVID-19

The medical community expressed caution when researchers in England said the widely used steroid dexamethasone could save the lives of seriously ill COVID-19 patients. Health experts demanded a full report to be convinced. Now, they have more data to consider, though not yet from a peer-reviewed journal.
According to results published on the preprint site medRxiv, use of 6mg dexamethasone for up to 10 days indeed led to a 35% reduction in death rate among patients on invasive mechanical ventilation after 28 days of treatment.
That said, the 29% death rate for these critically ill patients is still not low, though significantly lower than 40.7% with usual care.
In patients receiving oxygen without invasive ventilation, the drug cut the 28-day death rate by 20%. But among patients who weren’t on oxygen or ventilation, the death rate was 22% higher with dexamethasone.
The data invited comparisons to Gilead Sciences’ on its antiviral remdesivir, but at least one analyst cautioned against drawing conclusions until after the two drugs are pitted against each other—and perhaps against a combination of the two—in a clinical trial.
There is an argument for dexamethasone performing better at least in ventilated patients. Dexamethasone’s benefit started showing after seven days of treatment in the U.K. trial dubbed Recovery, “when inflammatory lung damage is likely to have been more common,” the researchers noted. Besides, the greater effect in more serious patients later in their illness “suggests that at this stage the disease is dominated by immunopathology, with active virus replication playing a secondary role.”
Regulators in the U.K. have already granted dexamethasone an approval in hospitalized patients requiring oxygen.

In a large study run by the National Institutes of Health, remdesivir showed it could cut the time to recovery by 47% compared with placebo in patients who required oxygen support but were not mechanically ventilated. However, it didn’t shorten recovery time for patients receiving mechanical ventilation.
As for mortality rates among patients categorized as severe, there were 31 deaths (7.7%) by day 14 in the remdesivir arm, versus 53 cases (13.0%) for placebo. That translated into a 29% reduction, a difference that was not statistically significant.
By comparing the death and hospital discharge ratios in Gilead’s own Simple trial with a known baseline patient study, Bernstein analyst Ronny Gal recently estimated that remdesivir offered around 30% benefit to COVID-19 patients. More in line with the Recovery researchers’ observation, Gal did estimate that dexamethasone works “possibly a bit better in ventilated patients where the response to antivirals is somewhat lower.”
Will dexamethasone replace remdesivir as a new standard treatment? That would depend on a combination trial comparing solo dexa, remdesivir and a pairing of the two, Gal said in a Monday note. Such a study isn’t yet planned, but he expects something along those lines from the NIH in the coming months.
https://www.fiercepharma.com/pharma/preprint-dexamethasone-data-suggest-life-saving-potential-for-severe-covid-19-patients