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Wednesday, June 2, 2021

Chamath Palihapitiya Launches 4 New Biotech SPACs

 One of the most famous voices in the SPAC industry is launching four new SPACs and also making several changes to his existing lineup of SPACs and former SPACs.

What Happened: Chamath Palihapitiya is launching four new SPACs targeting the biotechnology sector. Each SPAC is seeking to raise $200 million and will not contain warrants.

The SPACs are Social Capital Suvretta Holdings Corp I NASDAQDNAASocial Capital Suvretta Holdings Corp II NASDAQDNAB, Social Capital Suvretta Holdings Corp III NASDAQDNAC and Social Capital Suvretta Holdings Corp IV NASDAQDNAD.

The SPACs break away from the traditionally named Social Capital Hedosophia line of SPACs from Palihapitiya’s Social Capital and Hedosophia. That line of SPACs also featured similarly-sequenced tickers, IPOA to IPOF.

Palihapitiya filed names for seven additional SPACs in the IPO line in February and had previously announced plans to launch SPACs IPOA to IPOZ.


The New SPACs: The four new SPACs are a partnership between Social Capital and Kishan Mehta, the portfolio manager of the Averill strategy at Suvretta. The new company will use “scientists, physicians, entrepreneurs and biotechnology-oriented investors around a shared vision of identifying and investing in innovative and agile biotechnology companies.”

Suvretta was founded in 2011 and has $4.5 billion in assets under management. The investment firm uses industry insights and fundamental-based stock selection according to the prospectus.

The Averill strategy is a “healthcare-oriented investment strategy that focuses on identifying companies that are disruptive to the healthcare industry.”

Palihapitiya will serve as the CEO and Chairman of all four SPACs, with Mehta serving as the President or Director of each SPAC.

Target Market: The SPACs are targeting the biotechnology sector, specifically companies that can improve quality of life. The filings cite new drugs that can treat Hepatitis C in weeks and new immunotherapies that are targeting fatal forms of cancer.

“Agile private biotechnology companies are uniquely positioned to embrace advances in drug development and rapidly innovate to develop life-changing therapies for patients.”

The filings highlight research and treatment options for the central nervous system and peripheral nervous system.

“Our management team will seek to capitalize on advances in nervous system therapeutic development by pursuing compelling investment opportunities in this space.”

Target areas could include CNS, neurodegenerative diseases, psychiatric diseases and addiction. The SPACs will target companies that have “multiple opportunities for success.”

Chamath’s SPACs: Palihapitiya has completed SPAC mergers for Virgin Galactic Holdings SPCE 7.75%Opendoor Technologies OPEN 7.35%, Clover Health Investments CLOV 13.07% and SoFi Technologies Inc SOFI 2.47%.

Palihapitiya’s Social Capital Hedosophia Holdings Corp IV IPOD 0.1% and Social Capital Hedosophia Holdings Corp VI IPOF 0.39% are both searching for targets with IPOF rumored to be bringing Equinox public.

Disclosure: Author has a long position in SPCE, IPOD and IPOF.

https://www.benzinga.com/general/biotech/21/06/21401280/chamath-palihapitiya-launches-4-new-biotech-spacs-what-investors-should-know

Lyell aims to follow Juno, Sana as Wall Street cools to biotech IPOs

 

  • Lyell Immunopharma, a well-funded cell therapy developer aligned with GlaxoSmithKline and co-founded by former National Cancer Institute director Rick Klausner, has outlined plans to go public with a group of experimental cancer treatments. 
  • The Californian biotech is one of a growing list of companies aiming to develop cell therapies for solid tumors, which have so far proven intractable targets for cell-based treatments but are among the most common cancer types. Lyell uses technologies meant to improve T cell function and durability, which the biotech claims could broaden the reach of treatment and prevent relapses. None of its programs will be in human testing until at least next year, however. 
  • Lyell could become the 10th cell or gene therapy maker to go public in 2021, which would far outpace any of the past four years, according to data compiled by BioPharma Dive. But the biotech is shooting for an IPO at a difficult time. Most members of the 2021 class trade below their offering price, and several have sat in the queue for more than a month.
Three years after Celgene paid $9 billion to buy Juno Therapeutics, two biotechs with strong ties to the pioneering cell therapy developer are testing the public markets. And as with Juno, both of them come with very high expectations.  

First came Sana Biotechnology, whose $588 million IPO in February remains the sector's largest of the year and third-biggest since 2018, according to BioPharma Dive's database. Sana raised more than $700 million while privately held, was co-founded by Juno executives Steve Harr and Hans Bishop, and its top investor was Arch Venture Partners, the VC firm that originally backed Juno. 

Lyell now aims to follow in Sana's footsteps. Two Juno co-founders, Klausner and Stan Riddell, were both involved in Lyell's formation. Riddell's research contributed to the Juno cell therapy Breyanzi, now owned by Bristol Myers Squibb. The company raised even more than Sana — nearly $1 billion, according to its prospectus — before seeking an IPO. And Arch has reprised its role as top investor again, holding roughly 17% of the company. 

Both are part of a new wave of companies trying to advance the field of cell therapy beyond the blood cancers that Breyanzi and a handful of similar products are approved to treat. Sana, for instance, wants to tweak an array of different cell types to treat a range of diseases, not just genetically modify T cells for blood cancers, as Juno did. 

Lyell, by contrast, uses two complementary genetic reprogramming technologies to boost the function of T cells and thus, at least theoretically, make any type of T cell therapy more potent and broaden its reach. One of those technologies combats the T cell "exhaustion" that occurs, its founders discovered, more often in the solid tumors that cell therapies have struggled with. Another gives T-cells durable "stemness," or ability to self-renew and multiply. 

Lyell is using both to go after solid tumors — non-small cell lung cancer, triple-negative breast cancer and more — with multiple different types of cell therapies. One treatment, for example, is a CAR-T therapy in the mold of Breyanzi, Novartis' Kymriah and others. Another is a similar, but notably different form of cell therapy known as tumor-infiltrating lymphocyte, or TIL, being advanced by biotechs like Iovance Biotherapeutics.

Lyell is leaning on those technologies, its high-profile founders and Juno ties, and a wide-ranging alliance with GlaxoSmithKline — one of the firm's top investors — to fuel its push to Wall Street. That type of strategy worked for Sana, but Lyell is gunning for an IPO when the market has cooled to recent biotech offerings. 

On the positive side, 34 drug developers have raised at least $50 million in an IPO this year, more than doubling the pace of such offerings in any year since 2018. And as was the case in 2020, most of them are either in preclinical or early-stage testing, according to BioPharma Dive's database. That indicates investors "may still be enthusiastic over new technologies and ‘innovation,'" Jefferies analyst Michael Yee recently wrote in a research note. 

But only two biotechs have gone public in May after at least nine in each of the prior three months. (The tally for May could potentially rise to four by the end of the week.) Six have been in the IPO queue for at least a month without setting terms for their offerings, suggesting they won't get out for at least a while longer. And a majority of the biotechs in 2021's IPO class now trade below their offering price. That includes Sana, which was given one of the largest initial biotech valuations ever but whose shares have fallen roughly 20% below their $25 debut. 

Those results are a break from prior years and suggest "investors will be more valuation sensitive this year," Yee wrote. 

https://www.biopharmadive.com/news/lyell-ipo-cell-therapy-cancer/600847/

Biogen Alzheimer's med, if approved, may face extra hurdles, slow sales ramp: analysts

 Just a handful of days are left until patients, families, investors and Biogen executives will know the next chapter for the company’s controversial Alzheimer’s disease drug candidate aducanumab. But even if the drug scores its coveted FDA nod, a quick rollout is no sure thing, analysts say.

Confusion among physicians, resistance from payers and even the need for frequent follow-ups could slow the launch, pharma watchers said.

The FDA is slated to deliver a decision on aducanumab by June 7. If the agency approves the drug, physicians might still struggle with key questions such as who should get it and for how long. Payers might balk at its price and erect extra hurdles that could significantly limit its reimbursement, analysts warn. And a potential requirement for constant patient screening and monitoring may also stress the healthcare system.


Back in November, a panel of independent FDA advisers voted overwhelmingly against aducanumab, arguing that existing conflicting clinical trial results don’t prove the drug is effective. The resounding snub reflects that some practicing doctors likely aren’t convinced of aducanumab’s efficacy and may be reluctant to prescribe it. 

If approved, aducanumab would be the first disease-modifying therapy for Alzheimer’s. The many unknowns behind that first have some physicians concerned, SVB Leerink analyst Marc Goodman said in an investor note ahead of the advisory committee meeting.

Biogen’s been positioning the anti-beta amyloid drug for early-stage symptomatic patients who test positive for beta-amyloid plaques. However, mixed results from the two phase 3 clinical trials have left many wondering whether the drug only works in a yet unidentified subgroup of patients—or at all.

An Alzheimer’s specialist Goodman interviewed at the time said that many of his colleagues are skeptical about aducanumab and would like to see more data from an additional phase 3 trial to confirm its effect.

Aside from that concern, patients in aducanumab’s clinical trials were only treated for 18 months, so questions remain as to how long patients should remain on treatment, as well as how often physicians should monitor for a side effect called amyloid-related imaging abnormalities (ARIA) that involves swelling in the brain. The Alzheimer’s expert Goodman spoke with believes it would be easy to have a symptom-based management program that tests patients when they have a headache, but he would find it more cumbersome to monitor for asymptomatic ARIA.

But reluctance from physicians may be the easiest hurdle to cross for a potential launch.

“Doctors will be under pressure from their patients and their patients’ families to use the drug because there’s really nowhere else to go,” Mizuho analyst Salim Syed said during a recent interview.


Payers could represent a bigger problem for Biogen’s rollout.

The FDA can give its green light, but payers will likely turn to their own experts to evaluate reimbursement dynamics, RBC Capital Markets analyst Brian Abrahams noted in a report in December. “If their own experts mirror AdComm panelists, access could be limited depending on the payer,” he said. It typically takes months after approval for payer committees to review drugs, and early payer feedback suggests that aducanumab would be no different, he added.


“We will be ready to support and prepare our clients to ensure appropriate and affordable access to this therapy if the FDA approves aducanumab,” Express Scripts said in a statement shared with Fierce Pharma. “As with all newly approved medications, the Express Scripts independent Pharmacy & Therapeutics Committee would review the clinical data for aducanumab and share a coverage recommendation in the coming months.”

It’s not unprecedented for insurers to push back at controversial new medicines. After Sarepta Therapeutics’ Duchenne muscular dystrophy drug Exondys 51 won its approval in 2016, some large plans initially rejected access and said the drug hadn’t proven its clinical benefit. Coverage improved after patient advocacy groups brought the restrictions to the public spotlight, but plans continue to deny access even today, Abrahams said.

While that’s just one “anecdotal example,” the Sarepta situation illustrates that payers need “demonstrated clinical rationale” and support from influential doctors to sign off on coverage, he added.

Mizuho’s Syed suggested that payers will “thread the needle” if aducanumab gets its go-ahead.

“I don’t think payers are going to … say 'absolutely not' because at the end of the day it’s an FDA-approved product,” he said in an interview. “But they will make it difficult.”

Payers could base their decision on the total healthcare spending burden associated with aducanumab, and they might also try to identify the patients with the best chances of responding, Syed said.


On the pricing front, the analyst suggested that Biogen should pay attention to recommendations from the Institute for Clinical and Economic Review. The U.S. drug cost watchdog recently said aducanumab’s list price should fall between $2,500 to $8,300 to be considered cost-effective. In reaching the numbers in a draft report, it also pointed to “insufficient” evidence on the drug’s benefits.

In the end, Abrahams believes initial coverage for aducanumab will be “highly fragmented.” The situation may improve as real-world experience accumulates and if, more importantly, organizations such as the American Academy of Neurology include the drug in their guidelines, which he said would be hard for payers to ignore.


Aside from doctor concerns and payer restrictions, patient selection and monitoring could prove to be another stumbling block.

As Biogen’s head of neurodegeneration development, Samantha Budd Haeberlein, explained during the advisory committee discussion, aducanumab’s filing included language that amyloid testing such as a PET scan should be used before starting treatment. But as Biogen CEO Michel Vounatsos noted during an investors conference call in April, neither PET nor an alternative cerebrospinal fluid amyloid testing are currently covered by payers.


Biomarker screening is already popular in cancer treatment, so as Vounatsos put it, “there is a path forward” for reimbursement for amyloid diagnostics. The problem with aducanumab, though, is that it may require regular doctor visits and testing to ensure that patients remain mild to be eligible to stay on the treatment. That tracking of disease development, plus the ARIA monitoring, could further overwhelm the current system.

A 2017 study (PDF) by the Rand Corporation predicts that patients would have to wait an average of 18.6 months for Alzheimer’s treatment in 2020—assuming a disease-modifying therapy reaches the market that year—thanks to limited capacity of dementia specialists, access to imaging testing and to infusion centers. Biogen sponsored the study.

“We know that the availability of specialist and diagnosis capabilities are a bottleneck,” Vounatsos said during the call. About 600 care facilities will be able to treat patients with aducanumab upon a potential approval, Biogen figures.

In all, the expert Goodman interviewed projected a slow sales ramp for aducanumab given the multiple barriers ahead. The specialist thinks it “may take a while to establish the infrastructure and capability for using adu in practice,” Goodman wrote.

https://www.fiercepharma.com/marketing/biogen-s-alzheimer-s-drug-aducanumab-if-approved-may-face-extra-hurdles-slow-sales-ramp

Biogen, up for aducanuamb decision, could be ripe for activist incursion if it's rejected: report

 All eyes are on Biogen as it approaches its date with destiny.

By June 7, the FDA is set to rule on Biogen’s aducanumab. If approved, it would become the first treatment for Alzheimer’s disease to hit the market in more than two decades.     

But if it is rejected, the verdict could have far-reaching implications for the Massachusetts-based company. In fact, it could hasten an activist incursion, according to a report from Insightia.

In its Activitst Insight Vulnerability study, Insightia placed Biogen in the 93rd percentile in a ranking of companies most vulnerable to activist investor pressure over the next nine months. Compared to its peers, Biogen's stock has underperformed, the firm says.

Analyst Iuri Struta contends in the study that Biogen’s lack of preparation for a patent cliff for three key multiple sclerosis drugs—Tysabri, Tecfidera, and Vumerity—has left it exposed.

“Uncertainty over what will be the company’s next revenue driver has dented investor confidence,” Struta wrote.


The numbers Struta cites as reflective of a drop in investor confidence are Biogen's market capitalization trading at just 11 times its profits and 7.7 times its EBITDA (earnings before interest, taxes, depreciation and amortization). The median figures for Biogen’s industry peers are 22.2 and 15.8 respectively. 

Meanwhile, sales figures show a company in free fall. For the first time in decades, Biogen’s annual revenue fell in 2020 and did so in precipitous fashion, dropping from $14.4 billion in 2019 to $13.4 billion. The trend accelerated in the first quarter of this year, with revenue decreasing by 24%, much of it chalked up to a 26% drop in sales of MS drugs, which had begun to decline even before the coronavirus pandemic.

According to Struta, aducanumab is the “only real hope of avoiding a plunge over the patent cliff.”

The drug is designed to break down amyloid plaque buildup that is thought to worsen Alzheimer’s disease. Aside from aducanumab, Biogen and its development partner Eisai are working on another Alzheimer’s treatment, which has finished enrolling patients in a late-stage trial.

Beside these efforts, Insightia says, Biogen hasn’t done enough to sustain sales until 2024, the year CEO Michel Vounatsos targets for Biogen’s early-stage assets to reach the market. 

“An activist investor could question whether the management team is executing poorly or following the wrong strategy,” Struta writes.

Further, an activist could “demand the company spend more money on late-stage assets that could help smooth the upcoming loss of revenues," he added.


Since Vounatsos took over in 2017, Biogen has made just one acquisition, an $800 million purchase of Nightstar Therapeutics, which has brought promising drugs but nothing to address the immediate future, Insightia points out.

But rather than being an acquirer, Insightia sees a potential alternative for Biogen: It could sell itself or merge with a rival. Recent megadeals such as AbbVie’s acquisition of Allergan, Bristol Myers Squibb’s merger with Celgene and AstraZeneca’s buyout of Alexion are examples of the industry’s shifting landscape, the report says.

If an activist stare-down comes about, it won’t be the first time for Biogen. More than a decade ago, billionaire investor Carl Icahn sparred with the company over the same issues, claiming poor management and underperformance relative to peers. 

Icahn first urged Biogen to sell, then argued that it would be better off split in two, with one firm focused on oncology, the other on neurology. Icahn maneuvered to place three of his nominees on the board before abandoning a proxy fight in a 2010 settlement. 

Soon after, Biogen’s fortunes rose with approvals for MS drugs Tecfidera and Vumerity. But 2015 brought a reversal in the momentum, according to Insightia, and Biogen’s failure to respond has again left the company exposed. Tecfidera has now succumbed to U.S. generics, denting sales.


Ahead of the FDA's decision on aducanuamb, Brian Abrahams of RBC Capital Markets has warned investors to be ready, not only for a dramatic move in Biogen stock, but also for moves in the stock of other companies that sell Alzheimer’s treatments and even companies that may be takeover targets for Biogen, including Eisai.

“The FDA’s upcoming decision on aducanumab is not only binary for Biogen but also likely to reverberate throughout the biopharma sector, influencing overall sentiment on the space, perceptions on regulatory flexibility and business development dynamics,” Abrahams wrote. “With sector sentiment negative, the adu decision has potential to rapidly turn perceptions around or conversely, to double down on recent apathy.”

https://www.fiercepharma.com/pharma/aducanumab-biogen-s-future-balance-if-rejected-company-could-be-ripe-for-activist-incursion

Radiation Speeds Up Biological Aging in Head and Neck Cancer

 Patients who underwent radiotherapy for head and neck cancer experienced accelerated biological aging, which contributed to fatigue and inflammation, a prospective longitudinal study found.

Changes in epigenetic age acceleration (EAA) were significant over time, with the biggest increase -- 4.9 years -- seen immediately after the completion of radiotherapy (P<0.001), reported Canhua Xiao, RN, PhD, of Emory University School of Nursing in Atlanta, and colleagues.

The study also demonstrated that EAA was associated with greater inflammation and fatigue, even up to a year after treatment, they noted in Cancer.

While chronological age is a strong risk factor for chronic health problems, Xiao and colleagues said that it often differs from epigenetic age and may be a limited predictor of age-associated disorders. On the other hand, they noted that epigenetic clocks, based on blood DNA methylation measures, have become reliable aging biomarkers.

"Importantly, acceleration of epigenetic age, which is the discordance between epigenetic and chronological age, can be used to quantify the age acceleration process, which most current age markers or chronological age cannot," they wrote.

Xiao's group evaluated EAA in patients with head and neck cancer who underwent radiotherapy with or without chemotherapy, as well as the relationship of EAA with fatigue and inflammation before radiotherapy and up to 1 year after radiotherapy.

The study included 133 patients enrolled at oncology clinics at Emory University's Winship Cancer Institute. Most patients were men (72%) and white (82%), with a mean age of 59 years. Fifty-four percent were diagnosed with oropharyngeal cancer; of these, 90% were human papillomavirus (HPV)-related cancers. All had advanced disease and underwent radiotherapy; 80% underwent concurrent chemotherapy.

Data were collected at four time points -- before radiotherapy, immediately after completing radiotherapy, 6 months after radiotherapy, and 12 months after radiotherapy.

EAA was calculated using the Levine epigenetic clock (DNAm PhenoAge), adjusted for chronological age, while fatigue was measured with the Multidimensional Fatigue Inventory-20 questionnaire. Inflammation was measured using standard laboratory techniques.

Xiao and colleagues found that the magnitude of age acceleration gradually decreased after radiotherapy, with a nonsignificant increase of 0.3 years in EAA persisting 1 year after the completion of treatment (P=0.61) compared with baseline. Post-hoc analyses showed a significant increase in EAA -- 4.7 years -- at the end of radiotherapy among those who also received chemotherapy, but not those who did not receive chemotherapy (P=0.001).

In addition, fatigue scores increased from baseline to the end of radiotherapy, and then gradually decreased over time. Over the course of the study, patients with severe fatigue experienced 3.1 years higher EAA compared with those who reported low fatigue (P<0.001).

EAA was most prominent in patients with HPV-unrelated disease at 12 months after treatment, the authors noted; those with HPV-unrelated tumors who experienced severe fatigue showed an increase of 5.63 years in EAA compared with those who reported low fatigue (P=0.018).

The study also showed that EAA was positively associated with several inflammatory markers over time. For example, patients who had high C-reactive protein levels had an EAA increase of 4.6 years, while those with high levels of interleukin-6 had an increase of 5.9 years, compared with patients who had low levels. Further analysis showed that inflammatory markers significantly mediated the relationship between EAA and fatigue.

The findings "add to the body of evidence suggesting that long-term toxicity and possibly increased mortality incurred from chemoradiation for patients with [head and neck cancer] may be related to increased EAA and its association with inflammation," the authors concluded. "Interventional studies to reduce inflammation, including before chemoradiation, might significantly benefit patients who have cancer in decelerating the aging process and subsequently reducing age-related chronic health problems such as fatigue."

In an accompanying editorial, Kord Kober, PhD, and Sue Yom, MD, PhD, both of the University of California San Francisco, noted that cancer-related fatigue may not be just an ancillary symptom, "but a meaningful physiological phenomenon reflecting a dangerous biology at work in these patients." They further speculated that a chronic inflammatory state that predisposes patients to fatigue and premature aging could be a contributing factor to poor outcomes.

"If there are possibilities that we might be able to combine advances in oncologic aims with improving the overall health and quality of life of our patients who are at highest risk in all of these domains, these deserve concentrated and serious exploration," they wrote.


Disclosures

The study was supported by grants from the National Institute of Nursing Research and the National Cancer Institute .

Xiao reported no disclosures. Co-authors reported relationships with industry.

Kober reported no disclosures.

Yom reported institutional research funding from Genentech, Bristol Myers Squibb, Merck, and BioMimetix; royalties or licenses from Springer and UpToDate; and honoraria from the American Society for Radiation Oncology, all outside the submitted work. She is president of the American Radium Society.

Parkinson's: How Long Do Deep Brain Stimulation Benefits Last?

 Deep brain stimulation remained effective in Parkinson's disease patients more than 15 years after the device was implanted, and patients continued to demonstrate significant improvement in motor symptoms, a retrospective study showed.

Parkinson's patients who had bilateral subthalamic nucleus deep brain stimulation for 15 years or longer spent 75% less time with dyskinesia and 58.7% less time in the off state than pre-surgery baseline (both P<0.001), reported Elena Moro, MD, PhD, of Grenoble Alpes University in France, and co-authors.

These patients also reduced their dopaminergic drugs by 50.6% (P<0.001), they wrote in Neurology. The Parkinson's Disease Quality of Life (PDQL) questionnaire total score, emotional function domain score, and social function domain score improved by 13.8% (P=0.005), 13.6% (P=0.01) and 29.9% (P<0.001), respectively.

"Deep brain stimulation benefits seem to last for several years but not enough data have been available to show that these effects are still present more than 15 years after surgery," Moro said in a statement.

"Our study found that, despite the natural progression of Parkinson's disease and the worsening of some symptoms that become resistant to medications over the years, participants still maintained an overall improvement in quality of life," she added.

"These results (better motor outcomes with less medication) reinforce why subthalamic nucleus deep brain stimulation has revolutionized treatment for advanced Parkinson's disease," observed Kelvin Chou, MD, of the University of Michigan in Ann Arbor, and David Charles, MD, of Vanderbilt University in Nashville, in an accompanying editorial.

Grenoble researchers were the first to report the therapeutic effects of bilateral subthalamic nucleus deep brain stimulation on bradykinesia and rigidity in patients with Parkinson's disease, Chou and Charles noted. The Grenoble group now has the largest number of patients who have lived with deep brain stimulation for 15 years or more.

When patients ask how long benefits of deep brain stimulation last, "we can now reassure them that, at least for subthalamic nucleus deep brain stimulation, improvement in motor complications lasts beyond 15 years and is often accompanied by improvement in quality of life," the editorialists wrote.

In their study, Moro and colleagues evaluated 51 patients with a mean of about 17 years followup after surgery. At surgery, all patients had idiopathic Parkinson's disease, disabling motor complications (motor fluctuations or levodopa-induced dyskinesia), and levodopa responsiveness in all Parkinson's cardinal motor symptoms, including tremor. On average, the group -- 33 men and 18 women -- was about 51 years old at baseline and had Parkinson's disease for 11.35 years.

In 39 patients with complete long-term data, subthalamic nucleus deep brain stimulation improved motor fluctuations and dyskinesia scores on the Unified Parkinson's Disease Rating Scale (UPDRS). Compared with baseline, the time spent with dyskinesia was reduced by 75% (1.64 vs 0.41, P<0.001), and the time spent in the off state diminished by 58.7% (1.85 vs 0.74, P<0.001).

In 27 patients with full long-term followup data, both short-term and long-term PDQL scores improved. Total PDQL score improved by 26.7% at 1 year, while emotional function domain scores rose 21.7%, and social function domain scores increased 33.3%.

In the long-term, 19 patients (37.3%) were completely independent in their activities of daily living, 27 patients (52.9%) needed some help, and five (9.8%) were institutionalized. A total of 18 of 51 patients (35.3%) had dementia.

In contrast to medically managed Parkinson's patients who often lose weight, people in this study gained an average of 9 kg in the first year after surgery, which remained stable during the entire followup period. During long-term followup, five patients needed lead reimplantation due to intracranial infections, lead malfunctions, or lead suboptimal placement.

The study had several limitations, the researchers acknowledged. A high percentage of patients who received deep brain stimulation more than 15 years ago were lost at long-term followup, and the sample presented here may not be representative. Some people in the study did not have long-term motor or quality of life scores.

The editorialists also pointed out that the results are from a highly selected cohort that has been managed by experts in the field of movement disorders and deep brain stimulation. The average age at surgery was 51 and, as a group, these patients already had lived with Parkinson's for 11 years. In contrast, "the average age of onset for Parkinson's disease is between 65-70 years of age," Chou and Charles noted.


Disclosures

The study had no targeted funding.

Researchers reported relationships with Medtronic, Boston Scientific, St Jude, Abbott, and Newronika.

Editorialists reported relationships with NIH, Parkinson Study Group, Michael J. Fox Foundation, Eli Lilly, Voyager Therapeutics, Neuraly, Abbott, Watermark Research Partners, Accordant, CNS Ratings, UpToDate Springer Publishing, Alliance for Patient Access, Newronika, Revance, and US WorldMeds.

AmerisourceBergen Boosts Fiscal Year Earnings Forecast

 AmerisourceBergen Corp. on Wednesday raised its annual earnings forecast following the completion of its purchase of the majority of Walgreens Boots Alliance Inc.'s Alliance Healthcare businesses for $6.275 billion in cash and two million shares.

The drug distributor said it now expects adjusted earnings of between $8.90 and $9.10 a share for fiscal 2021, where it previously anticipated $8.45 to $8.60.

Revenue for the year is expected to be at least $210 billion, compared with earlier guidance for growth in the high-single-digits percent range, AmerisourceBergen said. The company logged revenue of $189.9 billion in fiscal 2020.

AmerisourceBergen said it continues to have a strong performance across its businesses.

With the completion of the sale of its Alliance Healthcare businesses, Walgreens Boots said it would use the proceeds to reduce debt and accelerate growth of its core retail pharmacy and healthcare businesses.

https://www.marketscreener.com/quote/stock/AMERISOURCEBERGEN-CORPORA-9428091/news/AmerisourceBergen-Boosts-Fiscal-Year-Earnings-Forecast-35499215/