Biogen ALS Failure Highlights Clinical Trial Frustrations

the drug into a Phase 3 trial because an analysis after the trial ended revealed better results when the outcomes were combined with historical data of an unspecified number of patients on placebo—a very unusual type of data analysis for clinical trials.

Perrin said he wasn’t keen about the design of the NP001 Phase 2 trial, but he still agrees with the decision to keep testing the drug: “NP001 needs another shot with a larger trial. I wouldn’t throw it out.” He is more enthusiastic about tirasemtiv, an experimental drug from Cytokinetics  (NASDAQ: [[ticker:CYTK]]) of South San Francisco, CA, that is meant to boost muscle strength by amplifying the response of muscles to nerve signals. As Xconomy reported in November, Cytokinetics started enrolling approximately 400 patients in a Phase 2b trial for the drug in October. “They are doing the right type of trial,” Perrin enthused. “This drug looks pretty exciting.”

Meanwhile, Perrin worries that the Biogen Idec failure will be a setback for the whole field of ALS research. He realizes that a larger Phase 2 trial would not likely have saved the drug, “but we would have known earlier that this wasn’t the right one. A lot of patient and financial resources were wasted.” The setback with dexpramipexole “is certainly not going to help drug development [for ALS]. If it were successful I think investment in the disease would have gone up.” Instead, he fears pharmaceutical companies will shy away from ALS because they will figure it doesn’t make sense to pour money into such a risky target.

But Biogen Idec isn’t quite ready to throw in the towel. At the JP Morgan Healthcare Conference in San Francisco on Monday, CEO George Scangos told investors that the failure of dexpramipexole “has not dampened our determination to do something about this disease. We continue to work on the biology to come forward with rationally designed compounds.” He highlighted the company’s $10 million investment in a research collaboration searching for new disease targets.

Perrin’s ALS Institute also continues to explore other approaches, and on January 8 announced a collaboration with to-BBB, a Dutch company, to develop potential treatments that can cross the blood-brain barrier, which can block drugs from reaching the brain.

Desperate patients can only hope that some of this research finally pays off.

Author: Catherine Arnst

Catherine Arnst is an award- winning writer and editor specializing in science and medicine. Catherine was Senior Writer for medicine at BusinessWeek for 13 years, where she wrote numerous cover stories and wrote extensively for the magazine’s website, including contributing to two blogs. She followed a broad range of issues affecting medicine and health and held primary responsibility for covering the battle in Washington over health care reform. Catherine has also written for the Boston Globe, U.S. News & World Report and The Daily Beast, and was Director of Content Development for the health practice at Edelman Public Relations for two years. Prior to joining BusinessWeek she was the London-based European Science Correspondent for Reuters News Service. She won the 2004 Business Journalist of the Year award from London’s World Leadership Forum, and in 2003 was the first recipient of the ACE Reporter Award from the European School of Oncology for her five-year body of work on cancer. She holds a bachelor’s degree in journalism from Boston University.