Gene therapy has become one of the hottest fields in biomedicine, with two treatments approved in the US already and several more on the way. But surprise news this week regarding Zolgensma, the recently approved spinal muscular atrophy treatment, cast a cloud over its progress.
The FDA revealed that Novartis subsidiary AveXis had “manipulated” data underlying the review of Zolgensma, and only told the agency after it had approved the treatment in May. The FDA won’t take Zolgensma off the market—it remains convinced of its safety and effectiveness—but it could sue those involved, or alter its opinion of the data pending an investigation.
Novartis promptly and fiercely defended Zolgensma’s clinical track record, and its own actions over the past months, among them an internal investigation and plans to fire people involved in the alleged malfeasance. But the mess leaves several unanswered questions as the FDA conducts its query. Among them: How deep did the data manipulation go? What will the fallout be for patients and families clamoring to get Zolgensma? How does it affect the decisions of payers who are forming policies to cover the drug’s $2 million price tag? And will there be any ripple effects for other gene therapy developers?
As the first gene therapy to ever go head to head with an established product—Spinraza, from Biogen (NASDAQ: BIIB)—Zolgensma is already making history. But what happens next could be every bit as important.
Biotech had a few more twists and turns this week. We’ve got those details and much more below.
GENE THERAPY REVELATIONS…
—The FDA said that data underlying the approval of the spinal muscular atrophy gene therapy Zolgensma had been “manipulated” by its developer, Novartis (NYSE: NVS) subsidiary AveXis. The issue concerned mouse testing that supports the process Novartis uses to make Zolgensma, not patient data, and the FDA said it “remains confident” that the treatment should stay on the market. But an investigation is underway and the agency may “amend [its review] as appropriate.”
—A day after the announcement, Novartis held a conference call with analysts defending its actions. CEO Vas Narasimhan said that despite the fact that the company learned of the falsified data before Zolgensma was approved and didn’t tell the FDA until afterwards, the company “tried to do the right thing” and is getting rid of the AveXis scientists to blame for the fiasco. Here’s more from STAT.
—The nonprofit spinal muscular atrophy patient advocacy group Cure SMA has also begun its own investigation. It has asked Novartis and AveXis for a report on the nature of the manipulated data, and whether they were presented to patients and families.
—Meanwhile, it was a tumultuous Thursday for another gene therapy developer, Sarepta Therapeutics (NASDAQ: SRPT). The FDA’s adverse event database showed that a patient in a trial of its Duchenne muscular dystrophy gene therapy was hospitalized in February with rhabdomyolysis, a breakdown in muscle tissue that can lead to serious health problems. Shares quickly fell 13 percent, but then began to bounce back after Sarepta called the disclosure “erroneous.” The patient didn’t end up with any serious health problems, and may not have even gotten the gene therapy, Sarepta said.
…AND MORE SURPRISES
—Less than two weeks ago, Amarin (NASDAQ: AMRN) said it was “unlikely” that the FDA would schedule an advisory panel meeting to debate whether it could expand the label of its prescription grade fish oil pill Vascepa to include claims that it can cut the risk of heart disease. On Thursday, the FDA did just that, setting a Nov. 14 meeting and delaying a decision on Amarin’s drug until “late December.” Shares plummeted about 20 percent.
—On a conference call, Nektar Therapeutics (NASDAQ: NKTR) executives disclosed that some patients taking its cancer drug bempegaldesleukin in clinical trials got “suboptimal” product and that may have affected its results. The disclosure “reduces our confidence in the clinical signal and will likely diminish investor confidence in Nektar management,” wrote SVB Leerink analyst Daina Graybosch, and shares fell 31 percent.
THIS WEEK IN CELL THERAPY
—German drug maker Bayer agreed to acquire BlueRock Therapeutics, a company developing cell therapies for Parkinson’s and a variety of other diseases. BlueRock is one of multiple companies Bayer has started and funded with Versant Ventures; it’s paying $240 million up front, and potentially $360 million more, to buy out BlueRock’s remaining shares.
—The Centers for Medicare and Medicaid Services finalized a policy to cover pricey CAR-T cancer immunotherapies nationwide. But CMS administrator Seema Verma told the Washington Post that the agency is “extremely concerned” about how the healthcare system will pay for the pricey therapies over the long term.
THIS WEEK IN THE CLINIC
—An experimental drug from Allakos (NASDAQ: ALLK) met all of its goals in a Phase 2 trial in patients with either eosinophilic gastritis or eosinophilic gastroenteritis, two rare gastrointestinal disorders. Shares nearly tripled, from $31.05 to $83.81 apiece.