Bristol-Myers, Alder Drug for Rheumatoid Arthritis Passes Key Test

Four years ago, the CEO of Bothell, WA-based Alder Biopharmaceuticals declared that his company’s experimental rheumatoid arthritis drug would someday give multibillion-dollar products from Amgen and AbbVie a “run for their money.”

Today, some more clinical trial data trickled out to suggest that Alder’s partner, Bristol-Myers Squibb, is maneuvering into a position to compete in the next few years.

New York-based Bristol-Myers (NYSE: [[ticker:BMY]]) said today that an experimental drug licensed from Alder, called clazakizumab or “claza” for short, met its goal of reducing rheumatoid arthritis pain and symptoms in a mid-stage clinical trial of 418 rheumatoid arthritis patients. People on the lowest dose of the once-monthly injectable drug from Bristol-Myers and Alder did better than those on higher doses of the same drug, and overall response rates on the low dose were similar to those seen among patients who got AbbVie’s adalimumab (Humira), the world’s best-selling pharmaceutical.

On a couple of different scoring systems, roughly twice as many patients on the Bristol/Alder drug went into remission, when compared with the AbbVie drug, researchers said. About 8.3 percent to 13.3 percent of patients on varying doses of the new Bristol-Myers/Alder drug reported some form of serious side effect, compared with 5.1 percent for those on the standard 40 milligram dose of the AbbVie drug. Results were reported today at the American College of Rheumatology meeting in San Diego. (See the full study abstract, with data tables, here).

“We think this drug offers promise to help more patients with RA to get into disease remission,” says Pushkal Garg, Bristol-Myers’s vice president of immunoscience development. “About 70 percent of patients treated today don’t get into remission. It’s our aspiration to put more of them into remission.”

Bristol-Myers obtained the worldwide commercial rights to the Alder drug, formerly known as ALD518, for non-cancer uses back in November 2009 for $85 million upfront and potentially $1 billion in future milestone payments. The Alder drug is an antibody designed to tamp down excessive inflammatory reactions by binding with a protein molecule known as IL-6. The drug is a “fast-follower” behind another antibody, Roche’s tocilizumab (Actemra), which works a bit differently, by specifically binding with a receptor on IL-6.

The new category of IL-6 inhibitors also represents a new way of treating autoimmune diseases, beyond the class of drugs that work by inhibiting another protein called TNF, the target of Amgen’s etanercept (Enbrel) and AbbVie’s adalimumab (Humira). While those drugs have been hugely lucrative—AbbVie’s product generated $9.3 billion in worldwide sales alone in 2012—they don’t work for everybody. The Alder antibody is also made in a yeast-based production system that’s supposed to be faster and cheaper than other biotech drugmaking platforms, so it’s conceivable that if its drug wins FDA approval, Bristol-Myers could charge a lower price and still maintain a high profit margin on par with the anti-TNF drugs. The Bristol/Alder drug could also offer a convenience advantage, in that it is delivered in a once-monthly injection, while the AbbVie product requires an injection every other week.

Alder and Bristol-Myers reported on some promising clinical results with their drug three years ago at the European League Against Rheumatism (EULAR) meeting, but that was with an earlier-generation antibody designed to be given through an intravenous infusion. Since the market-leading drugs are given as subcutaneous injections that patients can give themselves just under the skin, the Bristol-Myers/Alder drug had to be made into a similar subcutaneous formulation to be competitive.

The results reported today are from a randomized Phase 2b study that examined a variety of doses with the new subcutaneous form of the drug.

Here’s how the study was set up:

Patients in this study were randomly assigned into

Author: Luke Timmerman

Luke is an award-winning journalist specializing in life sciences. He has served as national biotechnology editor for Xconomy and national biotechnology reporter for Bloomberg News. Luke got started covering life sciences at The Seattle Times, where he was the lead reporter on an investigation of doctors who leaked confidential information about clinical trials to investors. The story won the Scripps Howard National Journalism Award and several other national prizes. Luke holds a bachelor’s degree in journalism from the University of Wisconsin-Madison, and during the 2005-2006 academic year, he was a Knight Science Journalism Fellow at MIT.