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Monday, October 3, 2022

Axsome: Sunosi Meets Primary Endpoint in Daytime Sleepiness Associated with Obstructive Sleep Apnea Trial

 Statistically significant improvement in cognitive function, as measured by the DSST RBANS compared to placebo (p=0.009, primary endpoint)

Statistically significant patient-reported improvement in cognitive function, as measured by the BC-CCI compared to placebo (p=0.002)

Reduced excessive daytime sleepiness compared to placebo (p=0.004 on ESS)

Activation of human TAAR1 by solriamfetol demonstrated in new pharmacology studies

https://www.marketscreener.com/quote/stock/AXSOME-THERAPEUTICS-INC-24949017/news/Axsome-Therapeutics-Announces-Sunosi-Solriamfetol-Meets-Primary-Endpoint-Demonstrating-Improvemen-41913289/

JJ Watt playing for Cardinals days after having ‘heart shocked back into rhythm’

 JJ Watt is set to play Sunday for the Cardinals just days after experiencing atrial fibrillation.

Watt, 33, announced the news of his irregular heartbeat on Twitter early Sunday afternoon before the 4:05 p.m. kickoff against the Panthers in Charlotte.

“I was just told somebody leaked some personal information about me and it’s going to be reported on today,” Watt wrote. “I went into A-Fib on Wednesday, had my heart shocked back into rhythm on Thursday and I’m playing today. That’s it.”

JJ Watt revealed Sunday he will play for the Cardinals days after experiencing atrial fibrillation.
JJ Watt revealed Sunday he will play for the Cardinals days after experiencing atrial fibrillation.

Watt, in his second season with the Cardinals, has two sacks in two games this year entering Sunday. He was limited to seven games last season due to a shoulder injury. Watt signed with the Cardinals after spending 10 seasons with the Texans.

https://nypost.com/2022/10/02/jj-watt-playing-for-cardinals-days-after-having-heart-shocked/

Sunday, October 2, 2022

Myovant Sciences rejects $2.5 bln takeover bid from Sumitovant, Sumitomo Pharma

  Myovant Sciences Ltd said on Sunday it rejected a $2.5 billion takeover offer from Sumitovant Biopharma and its parent group Sumitomo Pharma Co Ltd as the bid "significantly undervalues" the U.S. drugmaker.

Sumitovant, which currently holds approximately 52% of the outstanding shares in Myovant Sciences, and Sumitomo Pharma had submitted a proposal to acquire the remaining shares in the drugmaker for $22.75 per share in cash, according to a statement.

The special committee has carefully reviewed the proposal and determined that it significantly undervalues the company and is not in the best interests of the company or its minority shareholders, Myovant Sciences said, adding it remains open to considering any improved proposal that reflects the "full and fair value" of the firm.

The proposed acquisition consideration represents an equity value of $2.4 billion and an enterprise value of $2.5 billion, Sumitovant Biopharma said in a separate statement. 

https://finance.yahoo.com/news/1-myovant-sciences-rejects-2-004047768.html

Bubs Australia seeks permanent market access from U.S. FDA

 Baby formula maker Bubs Australia Ltd said on Monday it is seeking permanent access to the U.S. market after the Food and Drug Administration (FDA) spelled out how companies that have been filling a temporary shortage can become long-term suppliers.

Bubs said it had lodged a letter of intent with the U.S. FDA for permanent market access to October 2025 and beyond, adding that the FDA will issue a letter of acknowledgement in response.

Global infant formula manufacturers have been importing goods into the United States after the country's health regulator relaxed its import policy to address a nationwide shortage partly triggered by Abbott Laboratories' manufacturing plant in Michigan recalling some products in February.

The U.S. health regulator on Friday published guidance to help provide a pathway for infant formula manufacturers operating under enforcement discretion in the United States to remain in the market.

The FDA said manufacturers currently marketing their products in the country under enforcement discretion should send a letter to the FDA by Dec. 5, 2022, outlining their intent to pursue completion of all regulatory requirements.

"Some manufacturers may have most of the information needed to meet all U.S. requirements, and therefore, could achieve compliance fairly quickly, while others may need the full time frame being provided," the U.S. health regulator said.

https://sports.yahoo.com/bubs-australia-seeks-permanent-market-230144088.html

A lot of folks are running the White House. Joe Biden just isn't one of them

 Joe Biden isn’t as lively as he used to be. Not exactly breaking news, but it seems to be getting worse.

At 79, Biden is our oldest president. He consistently stumbles and misspeaks, forcing his beleaguered staff to retract his statements or pretend the lapse never happened.

Speaking at a White House conference on food, nutrition and health on Wednesday, Biden acknowledged the elected officials who helped organize the event.

“I want to thank all of you here for including bipartisan elected officials like Rep. (Jim) McGovern, Sen. (Mike) Braun, Sen. (Cory) Booker, Representative – Jackie, are you here?” Biden said, looking around the crowd. “Where’s Jackie? I think she wasn’t going to be here – to help make this a reality.”

He was looking for Rep. Jackie Walorski, R-Ind., who was killed in a tragic car accident in early August. A death he commemorated at the time in a solemn White House statement.

Where's Biden? Not often in the White House

White House press secretary Karine Jean-Pierre refused to acknowledge any mistake was made, despite repeated questions from the gathered reporters.

Add in Biden’s early “lids,” four-day weekends and frequent vacations, and he doesn’t seem to be running things. About 40% of his days have been away from the White House, including two-thirds of August.

I’ve known several older folks who were sharper at 80 than I was at 40. Joe Biden is not one of them. This isn’t about his age as much as his competence. To blame his behavior on a childhood stutter – a favorite excuse in 2020 – insults all Americans.

Perhaps we should be thankful. Considering inflation, energy shortages and a world teetering on the brink, maybe the less Biden is involved, the better.

Regents often ruled in place of the king

To understand what’s happening, it’s best not to think of this as a Biden Presidency, but a Biden Regency.

The term was regularly used in the age of kings and empires. If an 8-year-old princess was placed on the throne or an incapable king couldn’t perform his duties, one or several regents would handle the day-to-day operations.

Many a royal adviser would ignore a capable successor, instead crowning a child so the courtiers could run things behind the scenes.

One regency served during the reign of King George III, most famous for losing the Revolutionary War. After several concerning incidents, his mental health collapsed. George remained king on paper, but the Parliament appointed his heir as Prince Regent.

The dissolute prince decided he would rather party than rule, so he happily let the advisers run the show. The regency ran the empire for the next decade.

Whoever's running things, they aren't doing it well

In like manner, Biden is surrounded with longtime D.C. power players, such as Ron Klain, Susan Rice, Anita Dunn, John Podesta, Gene Sperling – a veritable “who’s who” of Beltway knife fights and insider skullduggery. Throughout their long careers, they’ve never sought credit or voter approval. Just power.

And the less Joe is around, the more their regency can accomplish.

Not that these new courtiers always agree. Journalists spend their days trying to determine which of them is rising and who is falling – D.C.’s version of Cold War “Kremlinology.”

These competing power centers explain the contradictory policies coming out of the Oval Office these days. Aggressively pushing a new Iran Nuclear Deal while Russia buys Iranian drones to fight Ukrainians. When there’s no one to say “the buck stops here,” the bucks turn up in pretty strange places.

It reminds me of the confusing end of Woodrow Wilson’s presidency. For his last 18 months in office, he was incapacitated with a stroke. First lady Edith Wilson and a handful of confidantes covered it up and ran the country themselves.

As with Wilson, historians will one day explain the Biden Regency more fully. But someone is running the country, and not very well.

Jon Gabriel, a Mesa resident, is editor-in-chief of Ricochet.com and a contributor to The Republic and azcentral.com.

https://www.azcentral.com/story/opinion/op-ed/2022/10/01/joe-biden-absent-minded-president-who-runs-white-house/10460695002/

NFLPA fires doctor, agrees to change concussion protocols after Tagovailoa injury

 The NFL’s player’s union has fired a doctor and agreed with the league on changes to the league’s concussion protocols amid backlash over a concussion suffered by Miami Dolphins quarterback Tua Tagovalioa.

Tagovalioa appeared to suffer a head injury last weekend, but was allowed to continue playing. He then started for the Dolphins just four days later, and suffered a chilling concussion in a game against the Cincinnati Bengals that caused his hands to seize up

The third-year quarterback was carted off the field and admitted to a nearby medical facility before being discharged later that night. 

“The NFL and the NFLPA agree that modifications to the Concussion Protocol are needed to enhance player safety,” the NFL and its players’ union, the NFLPA, said in a joint statement on Sunday.

“The NFLPA’s Mackey-White Health & Safety Committee and the NFL’s Head Neck and Spine Committee have already begun conversations around the use of the term ‘Gross Motor Instability’ and we anticipate changes to the protocol being made in the coming days based on what has been learned thus far in the review process.” 

The statement follows the NFLPA dismissing a neurotrauma consultant on Friday who was involved in the concussion protocol check of Tagovalioa after his first injury during a game against the Buffalo Bills, according to NFL.com. 

The reasons for the dismissal reportedly included failure to understand his role and hostility during the investigation into the injuries, which remains ongoing.

The 2018 Heisman Trophy winner returned to the Bills game and led his team to victory, with the team saying it was actually his back that bad been injured and that he cleared concussion protocols to return.

ut when he suffered another injury days later, fans and pundits erupted in criticism of the Dolphins organization and concern about the impact on Tagovalioa’s future.

In a statement on Friday, Tagovalioa thanked fans for the good wishes and added he’s feeling much better and is focused on returning to the field soon.

https://thehill.com/blogs/blog-briefing-room/3671327-nflpa-fires-doctor-changes-concussion-protocols-after-tagovailoa-injury/

ADC Offers Promising Results in Relapsed or Refractory Hodgkin Lymphoma

 Investigational camidanlumab tesirine led to a high response rate in heavily pretreated patients with relapsed or refractory classical Hodgkin lymphoma (HL), according to results from a phase II trial.

With a median follow-up of 10.7 months, the drug demonstrated an overall response rate (ORR) of 70.1% among 117 patients who were refractory or had relapsed after a a median of six prior treatments, including brentuximab vedotin (Adcetris) and PD-1 blockade, reported Alex F. Herrera, MD, of City of Hope Comprehensive Cancer Center in Duarte, California.

A complete response (CR) was achieved in one-third of patients, while the partial response (PR) rate was 36.8%, and 17.9% of patients achieved stable disease, he said in a presentation at the Society of Hematologic Oncology (SOHO) annual meeting.

Camidanlumab tesirine is an antibody drug conjugate comprising a human IgG1 anti-CD25 monoclonal antibody conjugated to a pyrrolobenzodiazepine (PBD) dimer.

"Several patients experienced a long-lasting treatment effect. Most responses were observed after two cycles and 15 patients who initially had a partial response ultimately had a complete response," Herrera stated.

But adverse events (AEs) were an issue. Almost every (99%) patient in the study had a treatment-emergent AE, with skin rash the most common. The most common grade ≥3 treatment-emergent AEs were cytopenias. All-grade treatment-emergent AEs related to the PBD dimer included skin and nail reactions (74.4% of patients), hepatobiliary test abnormalities (29.1%), and edema/effusion (17.1%).

Over half of patients (56.4%) had treatment-emergent AEs leading to dose delays or reductions, while 27.4% had treatment-emergent AEs leading to discontinuation. Four patients had treatment-emergent AEs leading to death, none of which were deemed related to camidanlumab tesirine, according to Herrera and colleagues.

Immune-related AEs occurred in 32.5% of patients, with grade ≥3 AEs occurring in 10 patients. These came on after a median of about 3.5 cycles of camidanlumab tesirine, and half emerged more than 30 days after last dose, Herrera said.

Eight patients developed Guillain-Barré syndrome (GBS) or polyradiculopathy. Herrera pointed out that "there was not a clear signal for baseline characteristics that were associated with Guillain-Barré." However, he noted that with prompt management, such as IV immunoglobulin, plasma exchange, and/or high-dose steroids, GBS resolved in four of eight patients, and decreased in severity to grade 1 in three.

Still, SOHO session moderator Alison J. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center in New York City, commented that the agent's activity is "quite high, and its frustrating that we see the toxicity associated with it, and its seems to be pretty unpredictable."

"Where do you see this drug as far as in the treatment course for Hodgkin in the future?" she said.

Herrera responded that "the toxicities are real. It's an active drug and we have a lot of patients in a tough spot, so I think [the agent] has a role -- it will have to be a role that is maybe a bridge to something else, or a palliative bridge if there's not an intention for transplant."

"Patients will just have to be monitored carefully," he added. "As we learn more about how to use this agent, we'll be able to stop therapy earlier, especially since most of the responses have been early."

Herrera explained that all but one patient in the trial had previously received brentuximab vedotin and a checkpoint inhibitor. Of the 73 patients who previously received brentuximab vedotin and checkpoint inhibition with prior haematopoietic stem cell transplant (HSCT), 74.0% achieved a response with camidanlumab tesirine (95% CI 62.4%-83.5%). This included a CR rate of 41.1%, a PR rate of 32.9%, and a stable disease rate of 17.8%.

In the 43 patients who previously got brentuximab and checkpoint inhibition without prior HSCT, the ORR with camidanlumab tesirine was 62.8% (95% CI 46.7%-77.0%), which included an 18.6% CR rate, a 44.2% PR rate, and a 18.6% stable disease rate.

Herrera also reported that the median duration of response (DOR) was 13.7 months and median PFS was 9.1 months. Patients who achieved a CR had a median DOR 14.5 months and a median PFS 15.9 months.

Fourteen patients discontinued treatment to proceed to transplant. Of the patients who received a transplant, 11 received allogeneic transplants. Of the latter, three progressed 2-5 months after transplant. Four received autologous transplants, with one progression 2 months after transplant.

The single-arm, multicenter, open-label trial enrolled patients with a pathologic diagnosis of classical HL who had relapsed disease. Patients were required to have received at least three previous lines of systemic therapy, or two or more lines of prior therapy if ineligible for HSCT. Patients had a median age 37, 62.4% were male, and 95% had an ECOG score of 0 or 1.

Camidanlumab tesirine was administered at a dose of 45 μg/kg via a 30-minute IV infusion on day 1 of each 3-week cycle for cycles 1 and 2. For cycles 3 and on, patients received the agent at a dose of 30 μg/kg for up to 1 year.


Disclosures

The study was funded by ADC Therapeutics SA.

Herrera dislcosed relationships with, and/or support from, AbbVie, Adicet Bio, AstraZeneca, ADC Therapeutics, BMS, Caribour, Genentech/Roche, Genmab, Karyopharm, Merck, Pfizer, Seattle Genetics, Takeda, Tubulis, Bristol Myers Squibb, Gilead, and KiTE Pharma.