Vivus Obesity Pill Wins FDA Panel Nod; NeuroSearch Surges
Feb. 23 (Bloomberg) -- Vivus Inc. gained the most in 12 years after the company's pill Qnexa won the backing of a regulatory panel, moving the drug a step closer to gaining U.S. approval as the first new obesity treatment in 13 years.
Vivus jumped 78 percent to $18.73 at the close of New York trading, its biggest single-day increase since December 1999. Competitor Orexigen Therapeutics Inc. also rose after the Food and Drug Administration advisers voted 20-2 yesterday that Qnexa's benefits outweigh its risks.
While the FDA isn't required to follow the panel's recommendation, it often does. Several panel members said Qnexa would be prescribed for millions "if not tens of millions" of people, wrote Christopher James, a New York-based analyst for MLV & Co., in a note to investors today.
Qnexa "has the highest efficacy in terms of weight loss," compared with other obesity drugs, said Sanjay Kaul, a professor in the David Geffen School of Medicine at UCLA Cedar Sinai Medical Center and a panel member, during yesterday's meeting. "That shifts the balance in terms of requiring a post-approval study rather than a pre-approval study."
Patients that took Qnexa in studies lost 10 percent of their body weight on average, Vivus said on its website.
Once approved, Qnexa carries the potential to become "the next Lipitor," MLV's James wrote. Lipitor, made by New York- based Pfizer Inc., is a cholesterol pill that had $10.7 billion in sales in 2010 before losing patent protection last year.
One of Three
Qnexa is one of three medications vying for the first U.S. approval of a prescription weight-loss treatment since Swiss drugmaker Roche Holding AG's Xenical in 1999.
The FDA plans to have advisers discuss in March the possibility of requiring heart-risk studies for all weight-loss drugs. Panel members yesterday discussed whether Vivus should conduct such a study before or after approval. The FDA is due to decide on Qnexa, which it rejected in 2010, by April 17.
Orexigen, which is developing Contrave for obesity, rose 14 percent to $3.66 and Arena Pharmaceuticals Inc., testing lorcaserin for the same ailment, fell 1.7 percent to $1.78. NeuroSearch A/S and Novo Nordisk A/S, Danish companies developing obesity drugs, also gained.
Trading in Vivus stock was halted yesterday before the FDA panel vote. NeuroSearch, which is developing tesofensine for obesity, climbed 5.6 percent to 17 kroner and Novo Nordisk, which is studying its Victoza diabetes drug as a weight-loss treatment, climbed 1.5 percent to 796.50 kroner in Copenhagen.
Attractive Target
Vivus may be a more attractive target for a partnership and acquisition, wrote Steve Yoo, an analyst for Leerink Swann in New York, in a note to investors. Vivus has been looking to sell the rights to its erectile dysfunction drug Avanafil, and "it would not be too much of a stretch to convert those discussions into a more wide-ranging discussion," he wrote.
Regulators raised concerns that Qnexa may contribute to a greater risk of heart ailments and birth defects. The medicine combines the appetite suppressant phentermine with topiramate, an antiseizure and migraine drug. The Mountain View, California- based company has proposed a post-approval trial to assess Qnexa in reducing major heart complications in obese, at-risk patients. The trial would involve 11,300 patients and take four and a-half years.
Analysts say the drug, if approved, may generate $448 million in sales in 2015.
Topiramate
Topiramate is the active ingredient in Johnson & Johnson's Topamax. The anticonvulsant is also associated with confusion, difficulty with concentration and memory loss.
Vivus's analysis of heart risks for Qnexa was "somewhat reassuring," though the significance of an observed increase in heart rate was "uncertain," FDA staff said Feb. 17 in a report.
More than one-third of U.S. adults are obese, and another third are overweight, according to the Centers for Disease Control and Prevention. The obesity rate among adults has more than doubled since 1980 to 72 million people.
Obesity raises the risks of diabetes, heart attacks and stroke, and costs the U.S. economy an estimated $147 billion a year in medical expenses and lost productivity, according to the Atlanta-based CDC.
Orexigen, based in La Jolla, California, and San Diego- based Arena also are seeking approval for their obesity medicines, which the FDA refused to approve without more data on safety risks.
Claims Data
Vivus examined medical claims data and found five oral clefts in a group of 1,740 children whose mothers had taken topiramate alone in the first trimester of pregnancy, for a prevalence rate of 0.29 percent, the company said Dec. 21 in a statement. That compared with a rate of 0.16 percent in the group whose mothers had taken antiseizure drugs, including topiramate, before pregnancy.
Vivus plans to finish the results in the third quarter of this year, after the April 17 deadline for the FDA to decide whether to approve the drug. The risk of oral clefts hasn't been fully answered by the interim data, FDA staff said.
The FDA asked Vivus in January to remove wording from Qnexa's proposed prescribing label advising women with the potential to become pregnant against taking it. The FDA staff said in the Feb. 17 report severely restricting Qnexa isn't practical because topiramate also treats other serious conditions.
Restrictions Considered
Panel members, meeting yesterday at FDA headquarters in Silver Spring, Maryland, suggested the agency should consider restricting topiramate used for seizures and migraines for women of childbearing age.
"I just can't get my mind around why it would be different," said Lamont Weide, chief of diabetes and endocrinology at the Truman Medical Centers Diabetes Center in Kansas City and a member of the panel.
Russell Katz, director of FDA's neurology products division, said the agency hasn't considered restricting the drug because there aren't many options for migraine prevention.
Vivus has suggested restricting distribution of Qnexa to less than 10 large mail-order pharmacies with pharmacists trained in dispensing the drug, Barbara Troupin, senior director of global medical affairs at the company, said.
In addition to Roche's Xenical, London-based GlaxoSmithKline Plc's Alli, a half-dose version of Xenical's active ingredient, won FDA clearance in 2007 as the first diet drug available without a prescription.
To contact the reporter on this story: Anna Edney in Washington at aedney@bloomberg.net
To contact the editors responsible for this story: Adriel Bettelheim at abettelheim@bloomberg.net Reg Gale at rgale5@bloomberg.net
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