I'd respond to
@meremrtl in his post directly, but he blocked me for politely disagreeing with him on
$NKTR. There's something VERY important that he is VERY wrong about that I'd like to highlight.
It's funny that he recognizes that the 2 solid tumor cases in the
$ABVX trial are mere bad luck/noise. I agree with him that the latency argument for solid tumors argues that these cancers pre-dated the
$ABVX study given that they were slow-growing cancer types identified far too early (6-8 months) to be due to
$ABVX's drug. These are the cases the market has been freaking out about, so...good to see you're an
$ABVX bull, Stephen!
Now the point he is making about colonic dysplasia is very, very (very very very) stupid. He is trying to say that the single case of colonic dysplasia is the worrisome finding in the
$ABVX study. I'll provide data to show you that his take is objectively stupid, so that he doesn't whine about me saying so. I'm not being mean - I'm calling a spade a spade, and of course very smart people can make very stupid points sometimes😉
There was 1 case of colonic dysplasia in the entire P2-P3 program for
$ABVX.
In P3 we have ~310 patient years of exposure across arms (388 patients x ~80% 1 year completion rate). In reality 310 is a slight underestimate as we don't know when the other 20% discontinued, but it wasn't day 0. Still, let's be conservative.
In P2, we have ~130 patients treated across 5-7 years in the long term open label extension. Let's be overly conservative here too, and say 100 patients for 5 years = 500 more patient years.
So, very conservatively, we have ~810 patient years of obefazimod exposure.
1 case of colonic dysplasia. 810PY. That makes the colonic dysplasia event rate 0.12/100 Patient-Years on Obefazimod so far.
What Stephen (very very stupidly) fails to ask is: "What is the expected rate of colonic dysplasia in this patient population at baseline?".
The answer is ~1.77/100PY. ~15x higher than what
$ABVX is showing.
Yeah, the expected background rate of colonic dysplasia in this population (long-term UC patients with median age in the 40s) is ~1.77/100PY, FIFTEEN TIMES HIGHER THAN WHAT IS BEING SEEN IN THE
$ABVX TRIALS.
Colonic dysplasia is actually a relatively common (nonmalignant) event in general, but it is especially common in ulcerative colitis patients because their chronically inflamed colons are at a high risk of accumulating DNA mutations and immune dysfunction that leads to carcinogenesis.
What we are seeing in the
$ABVX trials is actually a DRAMATICALLY lower than expected rate of colonic dysplasia, which is suggestive of A DECREASED RISK OF COLONIC DYSPLASIA AND COLON CANCER due to high levels of disease control.
Really, it's very simple...UC patients have a high risk of colon dysplasia/cancer because their colons are so severely inflamed...$ABVX's obefazimod stops that inflammation, LOWERING their risk of developing it. Not only is this mechanistically supported...the DATA support it as well.
What Stephen is highlighting as the big scary AE for
$ABVX is actually an objective POSITIVE for the company if you have the brain and objectivity to analyze the data. However, some people (like Stephen) are just here to stir the pot! Oh well. The data are very clear, and they are bullish for
$ABVX.
But hey, even Stephen signed off on the "real cancers" as not being a concern! Maybe he is coming around to be an
$ABVX bull himself!
Source data:
journals.lww.com/ajg/fulltex…