Archive for December, 2009

Study Set To Provide Breakthrough In Treatment Of Alzheimer’s

Thursday, December 31st, 2009

A ground-breaking clinical trial which could help halt the onset of advanced Alzheimer’s and dramatically improve the quality of life for patients and carers has been launched in the UK.

Glasgow Memory Clinic is now enrolling patients in the CONCERT trial, a one-year international study set up to test the effectiveness of a unique investigational drug, dimebon (also known by its proposed generic name of latrepirdine), in patients currently taking Aricept (donepezil HCI tablets), the leading medication for Alzheimer’s disease worldwide.

More than 1,000 patients from across western Europe, the United States, Australia and New Zealand will take part in the CONCERT trial and it is hoped that the combined medication will help stabilise the condition of those with Alzheimer’s by safely improving cognition (thinking and awareness), memory, daily functioning, behaviour and the ability to care for oneself.

Glasgow Memory Clinic has already enrolled a number of patients onto the trial and still has spaces available for those who meet the eligibility criteria.

Dr Fraser Inglis, Consultant Physician and founder of the Glasgow Memory Clinic, is optimistic about the advances the trial may make in the treatment of Alzheimer’s disease.

“Alzheimer’s is a complex disease and while current medications may improve the symptoms for some patients for a time, often the disease continues to progress. Therefore, combination therapy may be the method to maximise clinical benefit,” said Dr Inglis.

“CONCERT is an important study because dimebon is thought to work differently to current medications and this study will evaluate whether adding it to one of the most commonly used Alzheimer’s medications will provide a more effective symptomatic treatment to patients, stabilising their condition and ultimately improving their quality of life.

“A cure for Alzheimer’s is still many years away, however treatments that provide lasting effects, more symptomatic benefits or slow disease progression would offer meaningful benefits for patients and their carers. For this reason, there is an urgent need for patients to participate in clinical trials such as CONCERT and help advance the understanding of how Alzheimer’s disease can be better treated.”

The Alzheimer’s Society estimates that as many as 417,000 people in the UK are living with  Alzheimer’s, a devastating disease that hinders the patient’s ability to remember, learn, perform daily activities and relate to others. As the baby boomer population ages, the incidence of Alzheimer’s is expected to increase dramatically.

Mrs Balneaves, wife of an Alzheimer’s sufferer adds: “As the wife and carer of an Alzheimer’s patient, I understand fully how debilitating this disease is and how, in the majority of cases, it leaves sufferers requiring round-the-clock care and unable to interact fully with society.

“It causes untold suffering not only to the person with the disease, but also to their family and friends, and I can only welcome any research that can provide renewed hope of an improved quality of life for anyone touched by Alzheimer’s.”

The Glasgow Memory Clinic is based in a new £4m facility within the West of Scotland Science Park and is internationally recognised as a leading independent research organisation dedicated to finding better treatments for those with Memory Impairment, Alzheimer’s disease and dementia.

Alzheimer’s Dimebolin

www.dimebonalzheimers.com

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Medivation Reports First Quarter 2009 Financial Results and Provides Corporate Update

Tuesday, December 22nd, 2009


“We continue to make significant progress with both of our product candidates — Dimebon in patients with Alzheimer’s and Huntington’s diseases and MDV3100 in patients with prostate cancer. Having received written permission from the FDA to initiate a pivotal Phase 3 trial of MDV3100 in castration-resistant prostate cancer, we are on track to be in Phase 3 testing in all of our clinical programs this year,” said David Hung, M.D., president and chief executive officer of Medivation. “We expect to achieve a significant milestone in June – completion of enrollment in our six-month, confirmatory, pivotal Phase 3 CONNECTION trial in mild-to-moderate Alzheimer’s disease. And as part of our plan to support a broad and differentiated label for Dimebon in Alzheimer’s disease, we are pleased to have initiated the Phase 3 CONCERT trial of Dimebon in combination with donepezil (Aricept(R)), and intend to begin two additional Phase 3 trials in moderate-to-severe Alzheimer’s disease patients this year.”

Recent Highlights and Accomplishments

Dimebon

  • Expect to complete patient enrollment in CONNECTION, a confirmatory, pivotal Phase 3 trial in patients with mild-to-moderate Alzheimer’s disease, in June.
  • Initiated the Phase 3 CONCERT trial in patients with mild-to-moderate Alzheimer’s disease; the 12-month clinical trial is designed to evaluate the efficacy of Dimebon when added to ongoing treatment with donepezil (Aricept(R)), the leading Alzheimer’s disease medication worldwide, and builds on data from a small-scale safety and tolerability trial of Dimebon added to donepezil, which found the combination to be well tolerated.
  • Completed a multicenter, randomized, double-blind, placebo-controlled Phase 1 study to evaluate the safety and tolerability of Dimebon given to Alzheimer’s disease patients who currently are on a stable dose and regimen of memantine (Namenda(R)) or memantine plus donepezil. The study showed that these combinations were well tolerated.
  • In addition to the CONNECTION and CONCERT trials and a Phase 3 safety study already underway, we and Pfizer plan to initiate two additional Phase 3 studies in 2009 that will evaluate Dimebon in a total of approximately 1,100 patients with moderate-to-severe Alzheimer’s disease.
  • Expect to initiate a Phase 3 trial this year to evaluate Dimebon’s potential benefits on cognition in patients with mild-to-moderate Huntington’s disease.
  • Presented posters featuring Dimebon at the 61st American Academy of Neurology Annual Meeting in Seattle on April 29 and 30, including a poster entitled “Estimating Disease-Modifying Effects Using a Staggered Start Approach and a Natural History Staggered Start (NHSS) Approach: Preliminary Results from a 12-Month Study of Dimebon and a 6-Month Open-Label Period.”
  • Presented a poster at the American Geriatrics Society meeting in Chicago on May 1.

MDV3100

  • Received written permission from the U.S. Food and Drug Administration to initiate a pivotal Phase 3 trial of MDV3100 in castration-resistant prostate cancer in men who were previously treated with docetaxel-based chemotherapy; the primary endpoint of this randomized, placebo-controlled, double-blind, multinational trial will be overall survival.
  • Announced publication of an article in the May 8 issue of Science, presenting the discovery, novel mechanism of action and potent anti-androgen properties of MDV3100.
  • Conducted a podium presentation featuring MDV3100 at the 2009 American Urological Association Annual Meeting in Chicago on April 26.
  • Received acceptance by the American Society of Clinical Oncology (ASCO) of an abstract, entitled “Antitumor activity of MDV3100 in a Phase 1-2 study of castration-resistant prostate cancer (CRPC),” for oral presentation at the 2009 ASCO Annual Meeting on May 30 at 4:15 p.m. Eastern Time.
  • MDV3100 abstract selected by ASCO for inclusion in the Best of ASCO(R) program, an educational initiative covering highlights from the ASCO Annual Meeting to increase global access to cutting-edge science.

First Quarter 2009 Financial Results

Revenue for the first quarter of 2009 was $16.3 million, consisting of partial recognition of the non-refundable up-front payment of $225.0 million received from Pfizer in October 2008. The up-front payment was recorded as deferred revenue upon receipt and is being recognized on a straight-line basis over the estimated performance period of the Company’s obligations under its collaboration agreement with Pfizer, which the Company presently expects to complete in the first quarter of 2012.

For the three months ended March 31, 2009, total operating expenses were $22.1 million, compared with total operating expenses of $15.9 million for the same period in 2008. These figures include non-cash stock-based compensation expense of $2.6 million in the quarter ended March 31, 2009, compared with $2.1 million for the same period in 2008.

Beginning October 21, 2008, Pfizer became responsible for 60 percent of all Dimebon-related development and commercialization costs in the U.S., and 100 percent of such costs outside the U.S. The parties are making quarterly true-up payments as necessary to ensure that each bears its applicable share of costs. For the first quarter of 2009, the true-up payment payable to Medivation was $5.8 million. Medivation presents these cost-sharing true-up payments in the applicable expense line of its statement of operations.

Medivation reported a net loss for the quarter ended March 31, 2009, of $5.6 million, or $0.19 per share, compared with a net loss of $15.5 million, or $0.54 per share, for the same period in 2008.

Cash, cash equivalents and short-term investments at March 31, 2009, totaled $200.7 million, compared with $221.4 million at December 31, 2008.

Conference Call Information

To participate in today’s live call beginning at 4:30 p.m. Eastern Time by telephone, please call 877-681-3376 from the U.S. or +1-719-325-4757 internationally. In addition, the live conference call is being webcast and can be accessed on the “Events and Presentations” page of the “Investor Relations” section of the Company’s website at www.medivation.com. A replay also will be available for 30 days following the live call.

About Medivation

Medivation, Inc. is a biopharmaceutical company focused on the rapid development of novel small molecule drugs to treat serious diseases for which there are limited treatment options. Medivation aims to transform the treatment of these diseases and offer hope to critically ill patients and their caregivers. In September 2008, Medivation announced a global agreement with Pfizer Inc to develop and commercialize Dimebon for the treatment of Alzheimer’s and Huntington’s diseases. With Pfizer, the Company is conducting a broad Dimebon clinical development program, including a pivotal and confirmatory Phase 3 trial, known as the CONNECTION study, in patients with mild-to-moderate Alzheimer’s disease. The program also includes additional trials planned to begin this year in Alzheimer’s disease, as well as further development of Dimebon in patients with mild-to-moderate Huntington’s disease. In addition, a Phase 1-2 clinical trial of MDV3100 in patients with castration-resistant (also known as hormone-refractory) prostate cancer is ongoing. For more information, please visit us at http://www.medivation.com.

This press release contains forward-looking statements, including statements regarding the timing of clinical trial initiation and enrollment, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this press release that are not statements of historical fact may be deemed to be forward-looking statements. Forward-looking statements involve risks and uncertainties that could cause Medivation’s actual results to differ significantly from those projected, including, without limitation, risks related to progress, timing and results of Medivation’s clinical trials, difficulties or delays in obtaining regulatory approval, enrollment of patients in Medivation’s clinical trials, partnering of Medivation’s product candidates, manufacturing of Medivation’s product candidates, competition with Medivation’s product candidates should they receive marketing approval, the adequacy of Medivation’s financial resources, unanticipated expenditures or liabilities, intellectual property matters, and other risks detailed in Medivation’s filings with the Securities and Exchange Commission, including its quarterly report on Form 10-Q for the quarter ended March 31, 2009 filed today with the SEC. You are cautioned not to place undue reliance on the forward-looking statements, which speak only as of the date of this release. Medivation disclaims any obligation or undertaking to update or revise any forward-looking statements contained in this press release.

                                 MEDIVATION, INC.
                 CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
                      (In thousands, except per share data)
                                   (unaudited)

                                                       Three Months Ended
                                                            March 31,
                                                        2009            2008

    Collaboration revenue                            $16,340              $-

    Operating expenses:
       Research and development                       15,776          11,956
       Selling, General and administrative             6,305           3,953

              Total operating expenses                22,081          15,909

    Loss from operations                              (5,741)        (15,909)
    Other income (expense):
       Interest income, net                              509             382
      Other income (expense), net                         51              (1)
                Total other income (expense)             560             381
    Loss before provision for income
     taxes                                            (5,181)        (15,528)
    Provision for income taxes                           428               2
    Net loss                                         $(5,609)       $(15,530)

    Basic and diluted net loss per share              $(0.19)         $(0.54)

    Weighted average common shares used
     in the calculation of basic and
     diluted net loss per share                       30,105          28,847
                                MEDIVATION, INC.
                      CONDENSED CONSOLIDATED BALANCE SHEETS
                 (In thousands, except share and per share data)
                                   (unaudited)

                                                  March 31,      December 31,
                                                     2009           2008

    ASSETS
    Current assets:
      Cash and cash equivalents                     $50,718        $71,454
      Short-term investments                        149,970        149,968
      Receivable from collaboration partner           5,766          3,522
      Prepaid expenses and other
       current assets                                 3,127          1,957
              Total current assets                  209,581        226,901

    Property and equipment, net                         801            768
    Restricted cash                                     843            843
    Intellectual property, net                           53             54
    Other non-current assets                            664            706
    Total assets                                   $211,942       $229,272

    LIABILITIES AND STOCKHOLDERS' EQUITY

    Current liabilities:
      Accounts payable                               $5,044         $7,166
      Accrued expenses                               10,241          5,772
      Deferred revenue                               65,361         64,286
      Other current liabilities                         103             93
            Total current liabilities                80,749         77,317

    Deferred revenue, net of current                130,722        148,137
    Other non-current liabilities                       425            399
    Series A redeemable preferred stock                  11             11
            Total liabilities                       211,907        225,864

    Stockholders' equity:
      Preferred stock, $0.01 par value
       per share; 1,000,000 shares authorized;
       no shares issued and outstanding                   -              -
      Common stock, $0.01 par value per
       share;  50,000,000 shares authorized;
       issued and outstanding 30,125,556 shares
       at March 31, 2009 and 30,088,390
       at December 31, 2008                             301            301
      Additional paid-in capital                    127,800        125,074
      Accumulated other comprehensive income            203            693
      Accumulated deficit                          (128,269)      (122,660)
            Total stockholders' equity                   35          3,408

    Total liabilities and stockholders' equity     $211,942       $229,272

SOURCE Medivation, Inc.

http://au.sys-con.com/node/957830

Alzheimer’s Dimebolin

www.dimebonalzheimers.com

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Scottish clinic to test Dimebon

Monday, December 21st, 2009

Glasgow Memory Clinic (GMC) is enrolling patients to test Dimebon-a promising candidate to treat Alzheimer’s that might help improve a patient’s memory, cognition and the ability to care for him or herself, BBC News reports. More than 1,000 selected patients worldwide will take part in the CONCERT trial testing the drug, which is being evaluated in a joint effort between Medivation and Pfizer.

The two companies are studying Dimebon in patients who have been treated with Aricept (donepezil HCl), a leading treatment for Alzheimer’s marketed by Pfizer and Eisai. “Concert is an important study because Dimebon is thought to work differently to current medications and this study will evaluate whether adding it to [Aricept], one of the most commonly used Alzheimer’s medications[,] will provide a more effective symptomatic treatment to patients, stabilizing their condition and ultimately improving their quality of life,” the BBC quotes GMC founder Fraser Inglis as saying.

Researchers at the Mood and Memory Clinic in Ann Arbor, Michigan, also are evaluating Dimebon, according to the Detroit News.

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Medivation Cleared to Begin Pivotal Prostate Cancer Trial

Saturday, December 19th, 2009

Well under way with pivotal trials of Alzheimer’s disease drug Dimebon, Medivation Inc. is moving into late-stage development with another product, MDV3100, an androgen receptor antagonist, in prostate cancer.

The San Francisco-based firm recently gained FDA clearance to start a pivotal Phase III study of MDV3100, a small molecule that has shown signs of efficacy in earlier studies, including an ongoing Phase I/II study in which data indicated a significant reduction in prostate-specific antigen in both previously treated and chemotherapy-naïve patients.

“We’ve seen very promising antitumor activity across several endpoints,” said Lynn Seely, chief medical officer at Medivation.

Earlier this year, the company presented data from 114 patients who have been followed for 12 weeks or longer, which showed the drug’s positive effect on PSA levels and radiographic controls, as well as in circulating tumor cell count.

Data to date have shown that MDV3100 was “able to convert patients from unfavorable circulating tumor cell count to favorable circulating tumor cell count,” and those findings have correlated with overall survival data, Seely told BioWorld Today.

The upcoming Phase III trial, set to begin patient enrollment this year, will involve about 1,200 patients with metastatic castration-resistant prostate cancer who have failed docetaxel treatment. They will be randomized 2 to 1 to receive either MDV3100 or placebo. Overall survival will be the primary endpoint, with secondary endpoints to include progression-free survival and circulating tumor cell counts, Seely said.

Since the progression of prostate cancer is driven by the testosterone androgen, MDV3100 is designed to work by blocking the binding of testosterone to the androgen receptor and preventing the androgen receptor from invading the cell’s nucleus where it would spur further tumor growth, she said.

Prostate cancer affects about 1 million men in the U.S., and the castration-resistant form, also known as hormone-refractory prostate cancer, has few treatment options. Seely said the median survival for those patients is about 12 months.

Medivation has not provided a specific timeline for starting the concluding the Phase III study of MDV3100 – at this time, no interim analysis is planned – but the company should have enough cash in the bank to get started. As of Dec. 31, the firm had cash, equivalents and short-term investments totaling $221.4 million.

“We were very successful in signing a partner for Dimebon,” Seely said, referring to the company’s September deal with New York-based Pfizer Inc., in which Medivation scored a $225 million up-front payment in exchange for rights to the drug in Alzheimer’s disease and Huntington’s disease.

Under that deal, Medivation can earn up to $500 million in precommercial milestones, plus undisclosed commercial milestones if the product makes it to market. The two firms have agreed to share U.S. development and commercialization costs and U.S. profits on a 60/40 basis, with Pfizer holding the larger share. (See BioWorld Today, Sept. 4, 2008.)

If a similar collaboration opportunity for MDV3100 emerged, Medivation certainly would consider a deal, Seely said, but that drug’s advancement into Phase III is not dependent upon landing a big pharma partnership.

In its earnings earlier this week, the company said it is expecting 2009 revenue to include about $65 million, which will represent partial recognition of the up-front payment from Pfizer, though no milestone payments from Dimebon development are expected this year.

As published in The Lancet last year, Dimebon, a drug approved as an antihistamine in Russia, improved the cognitive symptoms and functioning of Alzheimer’s patients in a late-stage Russian study. It also is in a second study that is ongoing, and “we’re on track to complete enrollment this year,” Seely said. (See BioWorld Today, July 18, 2008.)

Three additional pivotal trials are expected to start this year, including the anticipated CONCERT study, expected to involve about 1,000 patients with mild to moderate Alzheimer’s disease who are taking Pfizer’s Aricept (donepezil).

Medivation reported in this week’s earnings call that, pending success, the firm anticipates a new drug application filing in 2011, though an NDA could come sooner than that if results from a recently started Phase III safety study support accelerated filing.

The Huntington’s disease program is slightly behind, though the companies recently received FDA approval to start a pivotal Phase III study of Dimebon in that indication, using the Mini Mental State Exam as the primary cognitive endpoint.

http://www.therapeuticsdaily.com/news/article.cfm?contentValue=1895290&contentType=sentryarticle&channelID=28

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Alzheimer’s study: Progress, but back of pack in funding

Friday, December 18th, 2009

Research cash for disease is short, says official at fundraiser

Dearborn — Alzheimer’s disease is the only major disease without a prevention or cure, and fatalities are on the rise. Yet it is a disease that gets a fraction of federal research dollars when compared to other ailments, said Harry Johns, president and CEO of the national office of the Alzheimer’s Association.

Johns, who spoke Sunday at a fundraiser for the Alzheimer’s Association, Greater Michigan Chapter, said the National Institutes of Health last year awarded billions of dollars in research funding, including $6 billion for cancer, $4 billion for cardiovascular disease and $3 billion for HIV/AIDS.

But NIH funds for Alzheimer research reached $428 million — a threshold that needs to increase, he said.

“We’ve made excellent progress, despite underfunding,” said Johns. “But there are still many unknowns. We’ll get to the answers. The question is, will we get to the answers soon enough.”

More than 5.3 million Americans are succumbing to Alzheimer’s, an incurable, degenerative disease. With the aging of baby boomers, the disease is expected to explode to 16 million Americans who slowly lose bodily functions and the ability to recognize loved ones and perform daily tasks.

And the toll won’t be just on individuals. The federal Alzheimer’s Study Group, co-chaired by former House Speaker Newt Gingrich and former Sen. Bob Kerrey, released a report in May projecting Alzheimer’s-related costs to Medicare and Medicaid alone to reach $20 trillion over the next 40 years.

“If we do nothing, this disease is going to bankrupt our health care system,” said Stephen Aronson, a clinical professor at the University of Michigan Medical School.

Current Alzheimer’s research is attempting to identify biomarkers to help diagnose the disease in individuals before symptoms appear.

Aronson is enrolling patients in the third phase of a clinical trial investigating a new drug, Dimebon, at the Mood and Memory Clinic in Ann Arbor, one of several sites across the United States and in Europe, Australia and New Zealand.

No data are available on the third stage, but Aronson is hopeful that Dimebon will win approval from the U.S. Food and Drug Administration within the next few years.

Mary Ellen Geist, a New York broadcast journalist who left her career in 2005 and came home to northern Michigan to help her mother care for her father, has hope for Dimebon and more research for the disease. The burden, she said, isn’t just on individuals or the nation’s economy.

“Some people think that Alzheimer’s Alzehimer’s only affects one person,” said Geist, who wrote a memoir, “Measure of the Heart.” “But it takes a whole family. All of us are suffering from the disease.”

www.detnews.com/article/

Dimebon Over Counter Treatment

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Il Lancet pubblica due studi che hanno valutato due approcci terapeutici diversi per il morbo di Alzheimer.

Thursday, December 17th, 2009

Nel primo studio [1] sono stati reclutati 183 pazienti affetti da malattia di Alzheimer lieve-moderata (score di 10-24 al MMSE), randomizzati a dimebon (20 mg x 3/die) oppure plecebo. Non era permesso usare altri farmaci approvati per il trattamento della demenza. L’end-point primario era la variazione della funzione cognitiva a sei mesi rispetto al baseline, valutata mediante la scala ADAS-cog. Lo studio era in doppio cieco e l’analisi dei dati è stata effettuata secondo l’intenzione a trattare. Hanno completato lo studio 78 pazienti (88%) nel gruppo dimebon e 77 (82%) nel gruppo placebo. Al termine dello studio i pazienti del gruppo dimebon mostravano un miglioramento del punteggio alla scala ADAS-cog significativo rispetto a quello basale (differenza mediana – 1,9, da – 2,92 a – 0,85; p = 0,0005). Si è visto che questo trend continuava in una estesnione dello studio (sempre in cieco) durata altri sei mesi. I più comuni effetti avversi associati al trattamento (secchezza della mucosa orale e depressione dell’umore) si verificarono nel 14% dei pazienti. La percentuale di pazienti che ebbero effetti avversi nei due gruppi non differiva. Gli autori concludono che dimebon è sicuro, ben tollerato e migliora il decorso clinico dei pazienti con Alzheimer lieve-moderato.
Il secondo studio [2] voleva valutare se l’immunizzazione con amiloide beta peptide (Aβ42) è in grado di ridurre la deposizione di amiloide nel cervello. Pertanto nel settembre 2000 sono stati arruolati 80 pazienti in uno studio di fase I. I pazienti sono stati immunizzati con Aβ42. Il follow-up era completo al settembre 2006. La valutazione delle placche di sostanza amiloide nel cervello è stata effettuata sia in termini di percentuale dell’area corticale interessata sia in termini di caratteristiche istologiche. La sopravvivenza dei pazienti è stata valutata con il modello di Cox fino a che non si era sviluppata una grave demenza oppure non si era verificato il decesso. Morirono 20 pazienti (15 nel gruppo trattato e 5 nel gruppo placebo) prima che iniziasse il follow-up. Ulteriori 22 pazienti morirono (19 nel gruppo trattato e 3 nel gruppo placebo) durante il follow-up. Diedero il consenso all’esame autoptico 9 pazienti, tutti nel gruppo trattato. Uno di essi venne escluso perchè morì senza essere affetto da demenza di Alzheimer. Negli 8 pazienti rimasti il carico di Aβ era più basso che in soggetti di controllo non immunizzati che erano deceduti ad un’età analoga. In tutta la coorte studiata tuttavia non c’era un miglioramento della sopravvivenza o del tempo di comparsa di demenza grave nel gruppo immunizzato rispetto al gruppo controllo. Gli autori concludono che l’immunizzazione con Aβ42 aumenta la rimozione dei depositi di amiloide dal cervello ma questo non previene la progressiva degenerazione neurologica.

Fonte:

1. Doody RS et al. on behalf of the dimebon investigators.Effect of dimebon on cognition, activities of daily living, behaviour, and global function in patients with mild-to-moderate Alzheimer’s disease: a randomised, double-blind, placebo-controlled study. Lancet 2008 Jul 19; 372:207-215
2. Holmes C et al. Long-term effects of Aβ42 immunisation in Alzheimer’s disease: follow-up of a randomised, placebo-controlled phase I trial. Lancet 2008 Jul 19; 372:216-223

Commento di Renato Rossi

I due studi del Lancet illustrano nuove strade che la ricerca sta intraprendendo nella lotta alla demenza di Alzheimer.
Il secondo studio parte dal presupposto che l’immunizzazione con amiloide beta peptide sia in grado di rimuovere i depositi di amiloide dal cervello che si riscontrano nella demenza di Alzheimer e quindi di combattere la progressione della degenerazione neuronale. Purtroppo, anche se l’immunizzazione sembra esercitare un effetto di pulizia sulla sostanza amiloide, non ci sono stati benefici clinicamente apprezzabili.
Il primo studio invece è più promettente. Dimebon è un vecchio antistaminico non selettivo che viene usato da circa vent’anni in Russia. E’ stato visto però che il farmaco possiede la capacità di interagire sulla funzione mitocondriale dei neuroni, funzione che è compromessa in malattie come l’Alzheimer e la malattia di Huntington. Lo studio di Doody e collaboratori suggerisce, in effetti, che il dimebon può essere in grado di migliorare le funzioni cognitive, il livello di attività e il comportamento dei pazienti con forme lievi-moderate di demenza di Alzheimer. Ovviamente siamo ancora in una fase iniziale e bisognerà vedere se questi risultati saranno confermati da altri studi a più lungo termine e con più ampia casistica. Inoltre sarà importante valutare se il dimebon sia in grado di rallentare la progressione della malattia, ridurre la disabilità e la dipendenza che sono caratteristiche della fasi avanzate della demenza. Sarà interessante anche confrontare il farmaco con i trattamenti finora approvati per la demenza ed eventulamente stabilire se si possano avere benefici maggiori con una terapia combinata. E’ attualmente in corso uno studio di fase III (studio CONNECTION) che potrà portare ulteriori elementi di conoscenza. Un punto a favore del dimebon potrebbe essere il costo particolarmemte vantaggioso.

http://www.pillole.org/public/aspnuke/news.asp?id=4135

Alzheimer’s Dimebon

www.dimebonalzheimers.com

Dimebolin Improves Cognition in Patients With Huntington’s Disease:

Wednesday, December 16th, 2009

Dimebolin is safe and well tolerated, and provides significant improvements in cognition for patients with mild to moderate Huntington’s disease, according to research presented here at the 9th International Conference on Alzheimer’s and Parkinson’s Diseases (ADPD). Karl Kieburtz, MD, Department of Neurology, University of Rochester, Rochester, New York, presented this multicentre, randomised, placebo-controlled, phase 2 trial on March 12 on behalf of the Dimebon in Mild-to-Moderate Huntington’s Disease (DIMOND) investigators. He indicated, “[Dimebolin] was developed originally as an antihistamine … and then studied in Alzheimer’s disease,” where it was shown to improve patient cognition, behaviour, and overall function. Huntington’s disease is a neurodegenerative disease of midlife that is also characterised by cognitive impairment and behavioural changes. Dr. Kieburtz and colleagues conducted their study to evaluate the safety and tolerability of dimebolin, and to explore its effects on symptoms of Huntington’s disease. They enrolled 91 patients with mild to moderate Huntington’s disease and total functional capacity of 5 or greater. Of these patients, 45 were randomised to placebo (mean age, 52.7 years; male, 40.0%) and 46 to dimebolin 20 mg TID (mean age, 53.7 years; male, 6.5%), all receiving treatment for 90 days. The primary outcome was completion of treatment period at the target dimebolin dose; secondary outcomes included mean changes from baseline to day 90 for the Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale (ADAS-cog), and Unified Huntington’s Disease Rating Scale ‘99 (UHDRS). Clinical characteristics were similar in the 2 treatment groups at baseline for MMSE (25.6 vs[ 25.1) and ADAS-cog (19.9 vs 20.3), and for the full range of psychometric assessments of the UHDRS.

Dimebolin was as well tolerated as placebo among patients who completed the treatment course at the target dose (87% vs 82%, respectively), with fewer patients reporting adverse events (70% vs 80%).

The most common adverse event in the 2 groups was falling (9% vs 16%); the incidence of headache was higher in the dimebolin group than in the placebo group (15% vs 7%).

Mean MMSE scores showed significant improvement with dimebolin treatment (0.9) while the placebo group's mean score remained unchanged over the full 90-day treatment period (1-point treatment effects: P = .03).

Dr. Kieburtz noted that in a post hoc subgroup analysis, patients with a greater degree of cognitive impairment at baseline (MMSE >27) showed a significantly increased magnitude of treatment benefit (MMSE, 1.9 vs 0.3; P = .008).

However, for the mean ADAS-cog, there was no significant difference for dimebolin versus placebo (adjusted mean changes, approximately -1.0 for each), as seen for the full range of UHDRS behavioural and cognitive scores.

Dr. Kieburtz concluded, "[Dimebolin] is safe and well tolerated, at least over this 3-month period of observation, … and if you sort out the people who actually had cognitive impairment at baseline, it is the MMSE that shows a significant change.”

He also noted the lack of effects in the other measures, “because really these cognitive measures are intended to track long-term deterioration rather than short-term improvement, with the ADAS-cog measuring aspects of cognition that aren’t key to Huntington’s disease.”

Funding for this study was provided by Medivation, Inc.

[Presentation title: The Safety and Efficacy of Dimebon in Mild-to-Moderate Huntington's Disease: A Multicentre, Phase 2, Randomised, Placebo-Controlled Trial (DIMOND). Abstract P1-455]

http://www.docguide.com/news/content.nsf/NewsPrint/852571020057CCF6852575770072EDE0

Dimebon Alzheimers

http://www.dimebonalzheimers.com

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Medivation, Inc. Q4 2008 Earnings Call Transcript

Wednesday, December 16th, 2009

Medivation, Inc. Q4 2008 Earnings Call Transcript
March 16, 2009 | about: MDVN

*

Medivation, Inc. (MDVN)

Q4 2008 Earnings Call Transcript

March 16, 2009 4:30 pm ET

Executives

Nicole Forterrero [ph] – IR

David Hung – President & CEO

Patrick Machado – SVP & CFO

Lynn Seely – Chief Medical Officer

Rohan Palekar – Chief Commercial Officer

Analysts

Kim Lee [ph] – Wedbush Morgan

Michael Yee – RBC Capital Markets

Corey Davis – Natixis

Bill Tanner – Leerink Swann

Raghuram Selvaraju – Hapoalim Securities

Elemer Piros – Rodman & Renshaw

Raymond Myers – Emerging Growth Equities

Presentation

Operator

Good day, everyone and welcome to the Medivation fourth quarter and year end 2008 financial results conference call. This call is being recorded. At the end of the company’s prepared remarks we will open the call for questions and we will provide specific instructions at that point.

I now would like to turn the call over to Nicole Forterrero [ph]. Please go ahead, ma’am.

Nicole Forterrero

Thank you, and welcome to Medivation’s fourth quarter 2008 financial results conference call. On the call today from Medivation are Dr. David Hung, President and CEO, Patrick Machado, Chief Financial Officer, Dr. Lynn Seely, Chief Medical Officer, and Rohan Palekar, Chief Commercial Officer.

We issued a press release earlier today, a copy of which can be found at www.medivation.com in the news section.

Before we begin I’d like to remind you that various remarks that we make on this call contain forward-looking statements including statements regarding the timing of, initiation of clinical studies, filing of an NDA for Dimebon, seeking approvals or commence a Phase 3 trial of MDV3100, the presentation of data with respect to Dimebon and MDV3100 and the receipt of milestone payments as well the expanded future expected financial results which are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995.

Any statements contained in this call that are not statements of historical fact may be deemed to be forward-looking statements. Forward-looking statements involve risks and uncertainties that could cause Medivation’s actual results to differ significantly from those projected including without limitation to risks related to progress, timing and results and Medivation’s clinical trial, difficulties or delays in obtaining regulatory approval, enrolment of patients in Medivation’s clinical trials, partnering of Medivation’s product candidates, manufacturing of Medivation product candidates, competition with Medivation’s product candidates should they receive marketing approval, the adequacy of Medivation’s financial resources, unanticipated expenditures or liabilities, intellectual property matters and other risks detailed in Medivation’s filings with the Securities and Exchange Commission, including its annual report on Form 10-K for the year ended December 31, 2008, filed today with the SEC.

You are cautioned not to place undue reliance on the forward-looking statements but speak only as of the date of this call. Medivation disclaims any obligation or undertaking to update or revise any forward-looking statements contained in this conference call.

With that I will turn the call over to Dr. David Hung, President and CEO of Medivation.

David Hung

Thank you all for joining us today. I apologize if there is a bit of an echo on my speaker phone, but I’m calling in from an international number and I will try to do my best to speak as clearly as possible and defer as many answers or questions as possible to my U.S. based colleagues.

We had a very successful 2008 and are looking forward to an equally exciting 2009. I will begin the call with a corporate overview of our accomplishments in the fourth quarter last year as well as new progress so far this year. Pat will then provide an overview of guidance for 2009. I will conclude with a summary of progress to date and important upcoming milestones for the company.

Let’s begin with Dimebon, our lead investigational drug candidate for the treatment of neurodegenerative diseases. We and our partner Pfizer continue to make excellent progress as we work closely together to initiate new trials in both Alzheimer’s and Huntington’s diseases which I may refer to as AD and HD respectively.

In Alzheimer’s we put together a comprehensive Phase 3 development program which will allow us to pursue a broad label for Dimebon that includes treatments of all patients with Alzheimer’s disease, those mild, moderate and severe disease.

This comprehensive program is comprised of five pivotal studies which include the already completed pivotal trial that was published in the Lancet in 2008 and the connection study which is slated to finish enrolment this year. Next month, we will initiate the Concert Study; a 12 month placebo controlled the Phase 3 safety and efficacy study of Dimebon in patients already treated with Donepezil, also known as Aricept. In addition, two moderate to severe studies will also start this year.

As we have previously guided if we use all five of these studies to register for drug approval our NDA or application for marketing approval should be filed in 2011. However, we and Pfizer have recently initiated an additional new Phase 3 safety study to provide us with the added potential flexibility to file earlier than previously guided using just the Lancet trial, the Connection trial and the safety study.

Let me go into more detail on the status of each of these trials. Enrolment in connection are confirmatory in Phase 3 trial in mild to moderate Alzheimer’s patients continues to be on track. We have 66 clinical trial sites open both in the U.S. and ex U.S. and we remain on target to complete enrolment in this study in 2009.

We are also on track to begin enrolment in April in CONCERT, a Phase 3 safety and efficacy study. CONCERT is an international multicenter randomized placebo controlled double blind 12 month study evaluating Dimebon in approximately 1,000 patients with mild to moderate AD. We are currently taking to Donepezil or Aricept.

The co-primary objectives of the study are to evaluate the efficacy of Dimebon compared with placebo on, number one, the Alzheimer’s disease of asset scale, (inaudible) as the primary measure of memory in cognition and two, the Alzheimer’s disease cooperative study, activities of daily living skill or the ADCS-ADL as a measure of function.

As I mentioned we also recently initiated a placebo controlled Phase 3 safety study of 750 Alzheimer’s disease patients on a variety of background anti-dementia drugs. The purpose of this study is to generate a sufficient safety database required by the regulatory authorities to give us and (inaudible) the option to accelerate the filing for approval of Dimebon to treat Alzheimer’s patients. The results of the connection trial confirm those of our Lancet trial. This new safety study could provide us with the ability for an earlier than previously guided filing of our initial marketing application should we and Pfizer elect to pursue that option.

To round out our Phase 3 program we also plan to initiate two additional Phase 3 studies that will evaluate Dimebon in a total of approximately 1,100 patients with moderate to severe Alzheimer’s disease. These trials are on schedule to start this year.

Prior to our collaboration with Pfizer our resources allowed us to pursue labeling claims for Dimebon used as a monotherapy to treat mild to moderate AD based on six month data. We will continue to aggressively pursue this option.

In addition the comprehensive set of trials we are pursuing with Pfizer allows us to further expand Dimebon commercial opportunities through achievement of broader and more differentiated labeling claims including claims supporting the full spectrum of mild, moderate and severe AD. The safety and efficacy of Dimebon when used in combination with Aricept the current gold standard AD medicine and Dimebon safety and efficacy when used for a full year of treatment.

In addition we and Pfizer are actively exploring the potential of our planned studies to support a claim of delay and disability in Europe which would further differentiate Dimebon from all the currently approved AD drugs.

I am also trying to report that we have made significant advances in our Huntington’s disease program. We completed our end of Phase 2 meeting at which the FDA informed us that we could begin our pivotal Phase 3 HD trial using the MMSE as the primary cognitive end point. Dimebon has previously demonstrated benefit on the MMSE in both AD and HD patients.

The co-primary end point will be the civic plus. This development plan gives us another opportunity to bring this drug to market. We also are currently in discussion with European regulators and our Phase 3 study of Dimebon in patients with clinical disease is expected to begin this year.

At last week of 9th International Conference on Alzheimer’s and Parkinson’s disease that’s held in Prague, also known as ADPD we presented data from our Phase 2 trial of Dimebon in patients with Huntington’s. This three month trial that validate naïve patients with mild to moderate disease. These data showed Dimebon to be well tolerated and to significantly improve cognition as measured by the MMSE.

Notably new data were presented at ADPD in a subgroup of patients with clear and cognitive impairment. Our Huntington’s trial included some patients who were not cognitively impaired. We exclude those patients, the treatment effect of Dimebon increased more than 1.5 times to an absent improvement quite similar to what we observed in our Lancet study in Alzheimer’s patients in which non-impaired patients were also excluded.

Based on this finding we will only enroll patients in our Huntington’s trial with clear and cognitive impairment. We believe that this will decrease the risk of our trial by increasing the effect signs of Dimebon in Huntington’s patients.

Aside from our clinical programs we also continue to build upon our body of data supporting Dimebon’s unique mechanism of action. Throughout 2008 and into this year we have presented new data at various medical conferences that provide additional evidence that Dimebon potentially stabilize and improves mitochondrial function in a way that prevents neuron death and dysfunction. (inaudible) appears to be the same from currently available Alzheimer’s disease medication.

At the recent ADPD conference call we presented new research from the Karolinska Institute which for the first time quantified the impact of Dimebon on mitochondrial function. Increased mitochondrial function occurred at extremely low concentration. Pycomolitiv low minimal [ph] concentration indicating very high placebo [ph] effects in mitochondrial.

Importantly we showed for the first time potent [ph] mitochondrial responses in not only stress cells but also normal neuron. We are pleased with the progress we have made in the Dimebon program and continue to work diligent with Pfizer to bring Dimebon to market as soon as possible for patients with Alzheimer’s and Huntington’s disease made access to a drug that has the potential to improve health and their care diverse lower these terrible debilitating illnesses.

I would now like to turn to MDV3100, a novel androgen receptor antagonist which recently completed enrolment in a Phase 1-2 clinical trial for the treatment of Castration-Resistant Prostate Cancer, of course, CRPC, also known as Hormone Refractory Prostate Cancer.

The open label of U.S. Phase 1-2 study enrolled a total of 140 men with prostate cancer who had failed scatter hormonal therapy and many of who failed both hormonal and chemotherapies. Dosage between 30 milligrams and 600 milligrams per day have been evaluated. Patients are continuing on the study as they are followed until they experience an intolerable adverse event or until their disease progresses.

At last month ASCO Genitourinary Cancer Symposium, we presented new positive efficacy and safety data from this trial. Data represented for all 114 patients who have had been followed for 12 weeks or longer in both the chemo naive and post chemotherapy groups. Data from both groups demonstrated that MDV3100 consistently resulted in encouraging anti-tumor activity across those levels on all end points at weak 12 including PSA response rate, radiographic finding, circling tumor cell cancer, CTC and time on treatment.

A substantial percentage of patients in both chemo naive and post chemotherapy groups had greater than or equal to 50% PSA reduction as well as radiographic control. Almost all patients with favorable CTC count of less than five of base line remained favorable at weak 12. This amounted to 89% of chemotherapy naive patients and 100% of post chemotherapy patients.

Importantly, a significant number of patients with unfavorable CTC count of five are higher were converted to favorable at weak 12. This amounted to 73% of chemotherapy naive patients and 40% of post chemotherapy patients. This CTC conversion rate is encouraged in light of a study published in the October 2008 issue of Clinical Cancer Research in which post treatment conversion of unfavorable to favorable CTC count was associated with a 15 month survival benefit in CRPC patients. Thus far the meeting time on treatment in the MDV3100 trial for chemotherapy naive patients and post chemotherapy patients is 276 days and 145 days respectively.

New safety data were also presented which included all 140 patients enrolled in the trial. These data showed MDV3100 to be generally well tolerated at dose up to and including 240 milligrams per day with fatigue the most frequently reported adverse event. Two patients at doses greater than 240 a day were reported to have a witness seizure and one patient had an event which may have been a seizure although the event was not witnessed.

We continue to be encouraged by the MDV3100 data and believe that these results present an excellent benefit risk profile. We remain on track to seek FDA approval to begin a pivotal Phase 3 registration study in CRPC patients in 2009.

In summary we are pleased with our recent progress and remain focus on rapidly developing our novel product candidates as we believe that they have the potential to effectively treat serious diseases.

I will now turn the call over to Pat who will review the financial results for the quarter and year end.

Patrick Machado

Thanks, David, and good afternoon, everyone. Today, we released our financial results for the fourth quarter and year ended December 31, 2008. I will review some of the highlights and refer you to the press release issued earlier today for the full details.

Revenue for the fourth quarter and full year of 2008 was 12.6 million, consisting of partial recognition of the nonrefundable upfront payment of 225 million, fee from Pfizer in October 2008. The upfront payment was recorded as deferred revenue upon receipt and is being recognized on a straight line basis over the estimated performance period of our obligation under the collaboration agreement with Pfizer, which we presently expect to complete in the first quarter of 2012.

For the 12 months ended December 31, 2008, total operating expenses were 76.8 million, compared to total operating expenses of 33.8 million for the same period in 2007. These figures include non-cash stock-based compensation expense of 8.5 million in the year ended December 31, 2008 compared with 5.9 million for the same period in 2007.

Beginning October 21st 2008 Pfizer became responsible for 60% of all Dimebon related development and commercialization costs in the U.S. and 100% of such costs outside the U.S. The parties will make quarterly true up payments as necessary to ensure that each bears its applicable share of costs.

For the fourth quarter of 2008, the true up payment payable to Medivation was $3.5 million. Medivation presents these costs sharing true up patients in the applicable expense line of its statement of operations.

Medivation reported the net loss for the quarter ended December 31, 2008 of 7.9 million or $0.26 per share, compared with a net loss of 9.6 million or $0.34 per share for the same period in 2007.

For the 12 months ended December 31st 2008, the net loss was 62.5 million or $2.12 per share compared with a net loss of 31.7 million or $1.14 per share for the same period in 2007. Cash, cash equivalents and short term investments at December 31, 2008 totaled 221.4 million compared with 43.3 million at December 31, 2007.

Turning now to guidance for 2009, we expect 2009 revenue from our collaboration with Pfizer to be approximately $65 million, representing partial recognition of our $225 million upfront payment received.

We do not expect to recognize any Dimebon related milestone payments in 2009. We expect the total operating expenses for 2009 net of cost sharing payments from Pfizer will be between $130 million and $140 million, which includes non-cash stock-based compensation expense of approximately $10 million.

With that I will turn the call back over to David.

David Hung

Thanks, Pat. As you’ve heard we’ve accomplished a lot over the past several months. In fact in a little more than four years Medivation has positioned itself to be in Phase 3 testing in all three of its development programs with a total of investments of only about $120 million.

Given these very turbulent financial times we hope that our track record has and will continue to inspire investor confidence in our company. As we have done these last four years we continue to be focused on growing the company, hitting our milestones and retaining our financial strength.

We are pleased with the significant value that we’ve been able to create for our shareholders and markets that are currently at 12 year level. We hope to sustain this growth with the expansion of existing programs and the development of new programs and partnerships well into the future.

With Dimebon we’ve demonstrated perhaps the stronger Alzheimer’s data yet seen with any compound which is evaluated by the publication, The Lancet, we have conducted the first well-controlled data shell and improvement and combination in Huntington’s patients, we secured acceptance from the FDA to allow our first Dimebon trial to serve as one of two registrational trials in Alzheimer, we have just completed the successful end of Phase 2 meeting with FDA and proceedings in a pivotal Phase 3 Huntington’s trial utilizing the primary combination end point against which we demonstrated significant activity in our Phase 3 trial.

We have executed a world class partnership with Dimebon in both Alzheimer’s and Huntington’s diseases. Finally we’ve showed creativity with MDV3100 which is now also headed for Phase 3 and represents another potential partnership opportunity.

We are one of the few well-capitalized companies in the bulk of industry and we have not wavered from our vision to bring help to seriously ill patients and their families and to return most value to our shareholders. We have steady news both ahead and we expect to achieve all of the filing milestones in 2009.

First, complete enrollment in the Phase 3 connection study in Alzheimer’s patients. Second, begin enrollment in the Phase 3 Concert trial evaluating Dimebon in combination with Aricept. Third, begin two Phase 3 studies of Dimebon in moderate to severe Alzheimer’s patients in order to broaden and further differentiate Dimebon’s potential neighborhood and maximize the commercial potential.

Four, initiate our Phase 3 study in Huntington’s disease. Five, seek FDA approval to enter into a Phase 3 registration study of MDV3100 in CRPC patients. And six, support new data on our programs at the upcoming medical conferences. With that we would be happy to answer your questions. Operator, please poll for questions.

Question-and-Answer Session

Operator

(Operator instructions). We will go first to Kim Lee [ph] with Wedbush Morgan.

Kim Lee – Wedbush Morgan

Good afternoon. Thanks for taking my questions. I have a couple of questions here. The first is what are the trial designs for the two additional Phase 3 Dimebon trials in moderate to severe patients?

David Hung

Lynn?

Lynn Seely

Sure. Thanks, Kim. We are planning two trials. One of them will have 500 patients; the other will have 600 patients. One will be looking at patients on already taking memantine and the other will be looking at patients taking Donepezil.

Kim Lee – Wedbush Morgan

Okay, great. And this is – so this is already background therapy it’s Dimebon plus or versus placebo they all have background therapy.

Lynn Seely

That’s correct.

Kim Lee – Wedbush Morgan

Okay. And now will these two trials also be part of your registration trial if you decide to register early for or apply for early marketing approval in 2011?

Lynn Seely

So we along with Pfizer are putting ourselves in position to be able to file in an earlier to file strategy if we choose to do so with a connection study and the already completed Lancet study along with the safety study that we just described. These moderate to severe studies will be part of the full file package that we discussed to be filed in 2011.

Kim Lee – Wedbush Morgan

Okay, great. And on financial modeling question here. Will the $65 million in revenue from Pfizer, from the Pfizer collaboration be recognized directly as licensing revenue on the top line?

Patrick Machado

It will be recognized as collaboration revenue, Kim, on the top line?

Kim Lee – Wedbush Morgan

Okay. Thanks a lot.

Operator

We will go next to Michael Yee with RBC Capital Markets.

Michael Yee – RBC Capital Markets

Hi, great, thanks. Dave, a couple of questions David. In regards to the 750 patient study that safety study you’re talking about, is this a six month, is a one year study? What are the primary and secondary end points and are they stratified by the background drug in regards to thepharided [ph] background anti-dementia drugs?

Lynn Seely

This has a two cohort design; the first cohort of patients will be followed for six months. The second cohort of patients will be followed for three months again in order to allow us to complete the study in an expeditious fashion. These patients will be allowed a variety of background treatments and it is purely a safety and tolerability study in terms of end point.

Michael Yee – RBC Capital Markets

Okay, so if you were to – how are you thinking about enrollment timing and data timing? I assume this would be available then for read outs in 2010 and you would therefore be able to file in 2010 if needed?

Lynn Seely

I think that again we haven’t said precisely when this will be done but the purpose of this trial is to allow for filing as early as possible.

Michael Yee – RBC Capital Markets

Okay. And then in regards to the expenses I assume that this is a reflection of your 40% share of your obligations. But does that include starting enrollment for MDV3100 as well? Is that some of the assumptions in this expense structure?

Patrick Machado

Yes, Mike, that’s correct.

Michael Yee – RBC Capital Markets

Okay, and then also in regards to the reimbursement back from Pfizer, the true up, is that just netted against your R&D and SG&A so you never actually reported broken out, it’s just netted?

Patrick Machado

It will be broken out as a disclosure in the footnote but for on the face of the financials it will be presented net in the applicable expense line.

Michael Yee – RBC Capital Markets

Okay. Thank you.

Operator

(Operator instructions). We will go next to Corey Davis with Natixis.

Corey Davis – Natixis

Thanks very much. The trigger points for what will dictate whether you file the NDA early or not is there certain pre-agreed upon threshold or circumstances between you and Pfizer that says if the data from connection is X then we go ahead and file or is it still up in the air and you’ll make the decision after you get the results?

Lynn Seely

Certainly we have had discussions and are in agreement with our partners but this will be a decision that we made at the time when we see the data.

Corey Davis – Natixis

Okay. And I might have missed this in all the different studies being presented but what are the minimum number of patients you will meet on Dimebon for six months and a year and which study specifically gets you the one year numbers?

Lynn Seely

The ICH. standard requirements are to have 100 patients treated for one year with Dimebon. We already have met that requirement. There is a requirement for 1500 patients treated with the drug at the time of filing and that’s what we believe we will be able to meet with a large number of Phase 1 studies we’ve done with lancet study, the connection study and the safety study.

Corey Davis – Natixis

Great. Thank you.

Operator

And we will go next to Bill Tanner with Leerink Swann.

Bill Tanner – Leerink Swann

Thanks. David, just on the potential for there to be an accelerated filing just kind of curious how you guys think about relative to the data that would be available on a filing on the lancet study and the connection study and the safety study? I mean, you would basically have essentially six months worth of data or six months exposure, is that correct? Just thinking about how you guys sort of think about the ability to get, the ability to get some pricing that going to be at a premium to the existing therapies, just curious your thoughts on that?

David Hung

Lynn, do you want to answer that?

Lynn Seely

Sure. I think that the data we have presented already to-date from the lancet trial show quite robust findings across end points and which is clearly different from what the currently marketed drugs have. And that if these findings are confirmed and the connection study we feel that that would be a differentiated product. In addition, of course, in the lancet publication there are the 12 month data. So I think that if the data are robust then we would consider that something that we would consider. And then after that we are having a quite robust program to ensure that we maximize what we believe to be tremendous potential of this drug.

Bill Tanner – Leerink Swann

Just some follow-up on that then. So the conversations that Medivation had or Pfizer has had potentially with payers or at least the impression is that data from the lancet study would sway people’s perception that this is actually a disease modifying that the 18 month data from that set of patients from the lancet study would be adequate, is that thinking?

Lynn Seely

I’m not sure I quite understood your question. Could you restate that?

Bill Tanner – Leerink Swann

Well, I mean, you are going to have six months worth of data from the connection study and then you got potentially 18 month data from the lancet study so the presumption I guess is that that lancet study would sway payers to thinking that the drug actually has potentially a disease modifying effect or certainly a long lasting effect and you got data from albeit a fairly small trial.

Lynn Seely

I think at this point in time the trials that we have designed, the six month trials that we have designed and which we will be taking for approval are designed to gain a symptomatic claim. We are with this announcement describe in a 12 month trial that will help us establish again the longer term effect.

David Hung

Bill, we do believe that data we have completed in the lancet hopefully that we were producing connection already show a number of attributes that are fairly unique, number one. As you know from the lancet study we improved all five out of five end points so we had quiet broad effects that included the AL ADS Com [ph] civic plus, the ADC and ADL, MMSE and the MPI. If you also look at the sign and durability of those effects we think that they’re also find to attract. So we think that our lancet study and the phase, the connection trial which we help to replicate the result show a profile of that drug that’s quite favorable again with an excellent safety profile as well.

Bill Tanner – Leerink Swann

Right. So then the contemplation would not be to get the symptomatic claim and price it at ex and then supplement, file an SNDA with other 12 months data and then hope that you could actually raise the price.

David Hung

I think it’s a better way to discuss things like that. I think we are going to wait for our connection results and will make a decision based on what we see with connection at that point.

Bill Tanner – Leerink Swann

Okay. Thanks.

Operator

We’ll go next to Raghuram Selvaraju with Hapoalim Securities.

Raghuram Selvaraju – Hapoalim Securities

Yes, can you hear me?

David Hung

Yes.

Raghuram Selvaraju – Hapoalim Securities

Okay. A couple of things on the clinical development first. With respect to the moderate to severe Alzheimer’s trial, could you just clarify with the patients who are going to be on memantine or on Dimebon they are not going to be on both together they are going to be on one or the other?

Lynn Seely

That’s correct.

Raghuram Selvaraju – Hapoalim Securities

Okay, and have you clarified the term of these studies and what the primary and secondary end points are going to be?

Lynn Seely

So at this point we just discussed they will be a six month study.

Raghuram Selvaraju – Hapoalim Securities

With respect to what we have seen previously with I guess the only therapies that are approved to treat moderate to severe Alzheimer’s disease do you believe that a six months statistical significant impact would be sufficient for Dimebon to be considered an effective therapy in this patient population.

Lynn Seely

We do. We have designed what we believe is a program that will gain approval for the moderate to severe indication in the U.S. and Europe.

David Hung

Ron, you probably know Dimebon was approved also based on six months, seven months data, right.

Raghuram Selvaraju – Hapoalim Securities

Okay.

Rohan Palekar

Ron, its Rohan. I think we got to look at the totality of the program because the concept trial will also be looking at moderate patients going out 12 months.

Raghuram Selvaraju – Hapoalim Securities

Have you clarified an MMSE scoring range for the moderate to severe study?

Lynn Seely

We are still in discussions about that.

Raghuram Selvaraju – Hapoalim Securities

Okay. And then with respect to the Huntington’s program you mentioned that discussions with the European regulators were ongoing and you had some comments about that. So I was wondering if there has been any indication yet from those discussions as to whether it would be necessary to launch a European trial or if they would be willing to accept a single Phase 3 trial in order to get Dimebon approved for Huntington’s disease in Europe as well?

Lynn Seely

This trial will be performed both in North America as well as in Europe.

Raghuram Selvaraju – Hapoalim Securities

Okay. So I guess we will see what they have to say once the results are out, right?

Lynn Seely

Yes.

Raghuram Selvaraju – Hapoalim Securities

Okay. And then just a couple of quick financial questions if I may. What were the weighted average shares outstanding at the end of the fourth quarter?

Patrick Machado

The outstanding shares, Ron, were just over 30 million. The weighted average outstanding for the year was about 29.5.

Raghuram Selvaraju – Hapoalim Securities

Okay, and then with respect to the projected operating expenses, you guided between 130 million and 140 million for 2009. Is that correct?

Patrick Machado

Correct.

Raghuram Selvaraju – Hapoalim Securities

And does that – that does not include the collaboration revenue; it just includes the reimbursement from Pfizer for ongoing expenses, right?

Patrick Machado

That is correct.

Raghuram Selvaraju – Hapoalim Securities

Okay. That’s it. Thank you very much.

Operator

And we will go next to Boris Peaker with Rodman & Renshaw.

Elemer Piros – Rodman & Renshaw

Hi, this is Elemer Piros; can you hear me, please?

David Hung

Yes.

Elemer Piros – Rodman & Renshaw

David, I don’t know if you discussed this in the past but what are your plans vis-à-vis MDV3100? Do you plan to partner it before initiating Phase 3 trials or do you think you could take it all the way to the end?

David Hung

Rohan, do you want to answer that?

Rohan Palekar

Sure, I think we had quite a successful experience thus far with partnering in our Dimebon program. That certainly something that we’re open to with respect to 3100. However, the figures that we guided for ‘09 are based on the conservative assumption that the project remains unpartnered. If we are able to strike a deal with someone on terms that we consider to be attractive we will be quite open to that.

Elemer Piros – Rodman & Renshaw

Okay. Okay. Thank you. And in the connection study, would you please remind us how many patients do you plan to have altogether? And just in rough terms how many we have actually enrolled?

Lynn Seely

So we are planning to enroll 525 patients total and we have stated that we will complete enrollment in 2009 and we are certainly on track to accomplish that.

Elemer Piros – Rodman & Renshaw

Okay. And at the end what percent of those total five hundred some odd would come from the U.S. Lynn, just approximate what is your goal, 10%, 20%?

Lynn Seely

So U.S. enrollment has gone quite well and there will be a substantial percentage from the U.S. At this point obviously I can’t say what percent. What we have been required from the FDA is that we have a significant percentage of sites in the U.S. and that certainly we have already achieved.

Elemer Piros – Rodman & Renshaw

Okay.

David Hung

Half of our sites already are in the U.S.

Elemer Piros – Rodman & Renshaw

Half? Okay. Thank you very much.

Operator

(Operator instructions). We’ll go next to Raymond Myers with Emerging Growth Equities.

Raymond Myers – Emerging Growth Equities

Yes, thank you, good afternoon. First wanted to ask you about your recruitment capabilities. It’s taken almost a year to enroll the first study and now that you are starting some additional studies. One might wonder whether there might be some overlap of the existing studies. How are you going to work with that recruitment?

Lynn Seely

As you might expect with our partner we have a global reach and this is a large world with a lot of Alzheimer’s disease patients so we don’t anticipate being able to enroll these studies without competing against ourselves, if you will. And I would say, Ray, certainly, there is no question that the hardest study to enroll is the one that we’re enrolling now because it’s not on any background of anti-dementia drugs, other trials will accept patients who are currently being treated and they are stable on their background treatment. So we anticipate that they will represent lower rather than higher hurdle.

Raymond Myers – Emerging Growth Equities

To that point that the follow on studies are actually easier to enroll, might there be a conflict if you are enrolling a difficult to enroll study simultaneously with a study that has a much lower bar for enrollment?

Lynn Seely

Needless to say we’ve taken that into consideration and have geographically distributed our sites such that we won’t compete against ourselves.

Raymond Myers – Emerging Growth Equities

Okay, that makes sense. One alternative hypothesis would be that you are very nearly complete with the enrollment of the first study.

Lynn Seely

We are certainly on track to complete enrollment of the study in 2009.

Raymond Myers – Emerging Growth Equities

Okay. Won’t put words in your mouth but that was my hypothesis. Let’s see. The 750 patient safety study, why are you starting enrollment of that prior to having any data from the first connection study? Or do you have some indication from the connection study that would suggest that it may be favorable and therefore it’s worthwhile investing early ahead of the full study data?

Lynn Seely

I think our focus is essentially on getting this drug to patients as quickly as possible and the ICH guidelines are that 1,500 patients are required to file and we want to make sure that we are in a position to file at the soonest possible time.

Raymond Myers – Emerging Growth Equities

And does that 750 patient study serve any purpose if you were to decide to continue with all the other three or four additional studies or would it be superfluous at that point?

Lynn Seely

Clearly, the true benefit of that study is to support an earlier than anticipated filing.

Raymond Myers – Emerging Growth Equities

At this stage before you have the complete data, certainly don’t even have complete enrollment of the first study, but before you have any complete data, do you have – is there any indication at all that you would have that, that study is favorable and therefore support spending the money on a study that would have no use if you didn’t decide to go forward sooner?

Lynn Seely

Ray, that trial as you know is blinded and we certainly don’t speculate on ongoing trials.

Raymond Myers – Emerging Growth Equities

Okay. Just trying. Well, good luck with everything, it sounds very promising.

Lynn Seely

Thank you.

Operator

We will now take a follow up from Boris Peaker with Rodman and Renshaw.

Elemer Piros – Rodman & Renshaw

This is Elemer Piros. Pat, would you please help us just to get a little better breakdown between R&D and SG&A, of the 130 to 140, roughly what proportion of that would be spent on R&D, please?

Patrick Machado

I guess, I would get on a very, very roughly probably two-thirds R&D, one-third SG&A.

Elemer Piros – Rodman & Renshaw

Thank you so much. That’s all what I need.

Operator

And at this time we have no further questions from the phone line. So I would like to turn the call back over to Dr. David Hung for any additional or closing remarks.

http://seekingalpha.com/article/126282-medivation-inc-q4-2008-earnings-call-transcript?page=-1

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Matters of the mind

Tuesday, December 15th, 2009

NORRISTOWN — There is no cure or long-term treatment for Alzheimer’s disease, a neurodegenerative condition that destroys brain cells and inevitably leads to memory loss and death.

The few drugs available on the market today only treat symptoms, not the underlying, disabling cause of the disease.

But after years of research, Dr. Cherian Verghese, a certified physician investigator and medical director of Keystone Clinical Studies in Norristown, believes drugs that attack Alzheimer’s in its early stages are enticingly within reach.

“At Keystone we conduct studies on medicines that affect the brain; basically neurology and psychology,” Verghese said, sipping a mid-afternoon cup of coffee at Starbucks.

“For 20 or 30 years we have done research without any new understanding of what is going on, and now we’re looking at it from at least three or four different approaches.”

Alzheimer’s will surely be one of the “defining diseases” for the coming decade, “globally, nationally, and even locally,” Verghese said. “The prevalence is rising. Currently, 5.2 million Americans have Alzheimer’s, and it is expected to quadruple by the year 2040. About 5 percent of the population over 65 has it, and this percentage roughly doubles with every five years of age, such that by age 85, nearly 50 percent could develop Alzheimer’s.”

With its roughly 16 percent elderly population, Montgomery County is above the national average of around 11 percent, he noted.

“And even Pennsylvania has a higher percentage of elderly people than the rest of the country. There are a  few reasons for that, with many of our families staying in the same neighborhood here; they don’t go far. There are very stable communities here and we have a lot of retirement communities.  “All of this is impressionistic, however; not fact.”

His pride in the Keystone State partly inspired the name of his company, Verghese added.

“We wanted to fly the Pennsylvania flag in the national spotlight, but we also see ourselves as the connection between the pre-clinical world — the drug-development world — and the clinical world of patients.”

As they are supervised by the Food and Drug Administration, all approved drugs must undergo clinical trials for safety and effectiveness, Verghese explained.

“Every drug we have now, including Prozac, went through the same testing at one time,” he said.

While Keystone also conducts clinical trials on drugs to treat depression, bipolar disorder and other conditions, its focus is on developing drugs to treat the “ticking time bomb” that is Alzheimer’s.

“Many baby boomers will have Alzheimer’s. The Medicare cost alone of Alzheimer’s was $91 billion in 2005, and it is expected to go to $160 billion in 2010. This does not count the cost of other insurance plans, Medicaid  and indirect costs. Experts fear that just this one illness can result in the bankruptcy of our health care system.

“Worldwide, it is felt to be among the most disabling and burdensome illnesses. In 2005 we spent $10 billion and that will go up to $116 billion by 2010 … a 65 percent jump.”

Because the disease is incurable, currently available drugs are simply used to modify it somewhat, Verghese said.

“They don’t change the course of the illness. For example, the statins we take for heart disease are disease modifers. Once statins come on board, the incidence and problems of heart disease have gone down dramatically.

We have no such thing with Alzheimer’s. The medications that are available for regular clinical treatment have a very modest effect. They have a small, short-lived effect of improving memory in some persons with AD. However, they have no effect on other aspects like personality change and problems with communication. The downward progression of the illness continues uninterrupted.”

But his research tells him there is a light shining at the end of the tunnel, Verghese noted.

“A lot of the historical factors are now coming together. The exact cause of Alzheimer’s is not known. But it has been known for over 100 years now that the main change in the brain is the accumulation of a sticky protein called amyloid. There are many other changes, like the presence of neurofibrillary tangles inside cells, inflammatory changes, and progressive cell death.

“There is no doubt that beta amyloid is the first part of the cascade of the things going wrong that will cause AD.”

Keystone Clinical Studies is conducting clinical trials on drugs that remove amyloids from the brain, Verghese said.

“Very high technology methods have been used to understand the structure and genesis of amyloid at a molecular level. Highly specific antibodies have been designed to break up the amyloid, and these compounds are in clinical trials currently.

“There has been some restrained excitement in scientific circles regarding a compound called Dimebon, after the publication of an article last year, in a major medical journal, The Lancet. In a one-year long study, Dimebon prevented deterioration and maybe even improved memory and other functions like behavior and global function. In the scientific world, the results of studies need to be confirmed again in other studies before they are accepted as a real fact and not an observation by chance in one study.”

Dimebon is going through large-scale Phase III clinical trials at Keystone, which if positive, could lead to approval from the FDA for regular clinical use of the medication, Verghese said.

Patients are welcome to participate in future trials for potential treatments of both Alzheimer’s and depression.

Verghese explained that the clinical trial process is divided into two parts: the pre-clinical phase of animal research, before the drug is given to people, and the clinical phase.

“The clinical portion is divided into four phases: safety, proof of concept — does it actually improve the condition? — and third is the big study that gets a drug approved. Phase IV is after the drug is approved, with post-marketing studies to find out how it is working. Keystone takes part in phase two, three and four studies.

“We are doing a lot of outreach efforts to get the word out,” Verghese added. “We’ve talked to doctors, visited senior centers … I would like to get the word out to people that there are options and treatments available.”

As Keystone’s primary investigator, Verghese becomes a patient’s primary physician, he said.

“It’s like the family doctor referring a patient to a cardiologist, who looks after the cardiology part but everything else falls under the family doctor. So I would look after the Alzheimer’s part, the depression part, depending on what kind of study is being done. We work very closely with family doctors because it’s important to know what medicines the patient is on.”

With the sound of the cappuccino machine going full throttle in the background, Verghese was asked what he thought of recent studies that suggest coffee drinking might prevent Alzheimer’s.

“There is no discussion in the scientific community to this extent,” he said. “None of the nutritional approaches have been shown to have an effect in rigorous clinical trials with sound methodology and good statistics.   “There is any number of products that are marketed, some with ‘studies’ to back up. However, there are studies and then there are studies. There is a product that is marketed in Europe, which is made by taking pigs’ brains, dissolving them with enzymes, and then administering the resultant mixture intravenously to patients with Alzheimer’s.

“They say it works, and have a few studies to show that it does. Would I give it to any of my patients? No.”

To contact Keystone Clinical Trials, call 610-277-8073.

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MDVN Starts New Alzheimer’s Trials

Saturday, December 12th, 2009

Earlier this month, Medivation, Inc. (MDVNAnalyst Report) and Pfizer, Inc. (PFEAnalyst Report) initiated two phase III studies, CONTACT and CONSTELLATION, with Dimebon in patients with moderate-to-severe Alzheimer’s disease (AD). Dimebon is being developed in collaboration with Pfizer for the treatment of Alzheimer’s and Huntington diseases.

The CONTACT study will assess the potential benefits of adding Dimebon to ongoing treatment with Pfizer’s Aricept on neuropsychiatric symptoms and activities of daily living. Meanwhile, the CONSTELLATION study will evaluate the effects of adding Dimebon to Forest Lab’s (FRXAnalyst Report) Namenda, another standard of care, on cognition, memory and activities of daily living.

Preclinical studies indicate that Dimebon has the potential to protect brain cells from damage and enhance brain cell survival, by stabilizing and improving mitochondrial function. Dimebon’s mechanism is distinct from currently available Alzheimer’s medications.

Dimebon is currently in seven studies which are evaluating the safety and efficacy of the candidate across all stages of Alzheimer’s disease, both as monotherapy as well as in combination with currently available Alzheimer’s treatments, and in Huntington disease.

Dimebon’s unique mechanism of action and efficacy seen in clinical trials could make it a significant player in the worldwide Alzheimer’s market, which represents huge commercial potential. It is estimated that the market is currently worth about $5 billion.

Dimebon has successfully completed the first of two pivotal trials required to gain marketing approval in the U.S. for mild-to-moderate Alzheimer’s disease. A second confirmatory phase III study, CONNECTION, is currently ongoing. We expect to see top-line results from this study in the first half of 2010. Positive results should allow Medivation to go ahead with the filing of the new drug application (NDA) for the Alzheimer’s indication in 2011.

We currently have a Neutral recommendation on Medivation.

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