ACAD
En IV alguien ha colgado notas de la CC. Lo de Europa es negativo para mí porque creo que es en Ucrania donde había un buen número de pacientes y yo me fiaría menos de esos datos.
Lo más importante es que si no paran por eficacia el DRP antes de tiempo sacarán una nota. Esa es la ventana, de aquí a algún punto en 2H.
Conference Call Notes
1. Acadia is discontinuing its program in inadequate response/schizophrenia. CEO Davis: "Based upon today's topline results, we do not plan to initiate further clinical development for pimavanserin for inadequate response schizophrenia."
2. According to Davis, if the DRP interim does not lead to a study halt for reasons of efficacy, ACAD will let us know in a press release. The interim analysis is still slated for 2H of the year.
3. The background antipsychotic in the inadequate response trial had nothing to do with the outcome, according to Serge.
4. CEO Davis: "The ADVANCE trial [negative symptoms schizophrenia] is technically a phase 2 study; however, we sized this study and designed this study such that it can be considered a pivotal study if it's positive."
5. Most patients (over 80%) were enrolled in Europe. Just for this population, primary endpoint of study was met (PANSS; p value 0.0234). Key secondary endpoint was met (CGI; p value 0.0214).
6. Improvement was shown in the negative symptoms of patients.
7. Reduction of daytime sleepiness was observed. This finding mirrors what's been found in other studies, especially phase 3 PDP.
8. Safety profile was similar to placebo's. 88% of pimavanserin patients finished the study compared to 96% for placebo.
Conclusion
In time this will be seen as a minor setback.
The result is surely unexpected given a) proof-of-concept success of pimavanserin in schizophrenia; b) studies showing the anti-psychotic effect of pimavanserin to be superior to quetiapine (Seroquel), and one tiny study showing clozapine non-responders improving with pimavanserin; and c) the excellent sales of Nuplazid in the PDP population.
I expect strong earnings will mitigate the harsh reaction from the Street tomorrow.
It's possible, maybe even likely, that Acadia will file a supplemental NDA in negative symptoms/schizophrenia if the upcoming trial (slated for completion in Q4) succeeds. The sNDA will be based on pooled data from the successful phase 2 trial and supportive data from the recently completed trial.