Guzzi62
6 시간 전
Very good summary, thanks.
However, that one isn't correct as far as I know, quote: 3. The trial failed to meet the ADCS-ADL functional primary endpoint, which is required by the EMA (Citation missing).
It was or is a requirement by the FDA, but they were talking about removing it.
The second co-primary endpoint of activities of daily living scale (ADCS-ADL), was trending positive but did not reach significance. Anavex is questioning whether this miss is due to the scale being less sensitive for early Alzhimer’s disease. (see link)
It did reach the endpoint in the OLE (doesn't count though).
https://www.clinicaltrialsarena.com/news/anavex-seek-ema-approval-shaky-results/?cf-view&cf-closed
boi568
8 시간 전
Let's review the bidding on the MAA being considered by the EMA, and set out the factors favoring an approval recommendation, and the factors favoring disapproval, to see where things stand. (Keep in mind that the EMA is using a benefit/risk model, so the lower the risk, the lower threshold for benefit):
Factors favoring an approval recommendation
1. The blarcamesine 2b/3 trial demonstrated unprecedentedly clinically meaningful, cognitive efficacy against Alzheimer's Disease.
2. The 2b/3 trial also demonstrated efficacy in the CDR-SB scale, equal to the best competitor but reaching that point more quickly.
3. Blarcamesine has shown no safety issues in the 2b/3 trial or any other trial, including the Rett pediatric trial.
4. Adverse treatment events in titration phase are minor, manageable, and pass quickly (9.6 percent transient dizziness in the OLE).
5. After 48 weeks, brain volume MRI values (a prespecified measurement), show a dramatic reduction in volume decline, with particularly strong results in the areas of the brain most associated with early AD; in those areas, there was little to no volume loss, perhaps even a volume gain. (Not an formal biomarker, albeit a compelling and unprecedented outcome).
6. Anavex reported in narrative terms there was and favorable plasma-based AB 42/40 ratio response. (Unclear if this is a formal biomarker or not, depending upon the type of plasma test used.)
7. Anavex found, without pre specification, a strong association between the presence of the collagen gene COL24A1 WT and cognitive performance among the dosed arm of the 2b/3. (Not a formal biomarker, but intriguing in light of the role of the collagen gene to promote neuronal growth).
8. Publication of a peer-reviewed, favorable article in a leading Alzheimer's journal with 58 signatories, including Marwan Sabbagh.
9. The Anavex OLE successfully used an early start/delayed start analysis (recognized by the EMA) to support the argument that blarcamesine is a disease modifying treatment for AD.
10. There is a great unmet need in the EU for an effective AD drug, medically, socially and financially.
11. Anavex's trial design and analyses support a solid scientific underpinning to its first in class MOA, including trial results that tie the drug to its Sigma 1 receptor target.
12. There is also recent and growing scientific literature increasingly recognizing the immunological significance of the Sigma 1 receptor.
13. Anavex has enlisted experienced and respected staff, such as Kun Jin, Marwan Sabbagh, and David Goldberger to support the MAA process.
14. The week after an 80 day letter was to have been sent to Anavex by EMA reviewers indicating whether or not the application is likely to be considered approvable or not, Anavex apparently sent its lobbyist Nell Robowe to DC to meet with Sen. Cruz's office to provide support for his legislation to quickly piggyback FDA approvals upon EMA approvals. In the same period of time, CEO Missling costlessly exercised his large options, adding to his equity position in Anavex stock. Neither of these events is consistent with the company having received a disapproval indication from the likely 80 day letter.
15. At this stage in the MAA review process, over 80 percent and perhaps over 90 percent (depending on the time period examined) of MAA applications receive an approval application.
Factors favoring a disapproval recommendation
1. Anavex cannot receive an EMA approval recommendation on the basis of only one Phase 3 trial (notwithstanding its acceptance for MAA review). (Citation missing)
2. Upon review, the 2b/3 trial will be found to be inadequately sized for such a major indication as Alzheimer's, requiring a second, properly sized Phase 3 trial.
3. The trial failed to meet the ADCS-ADL functional primary endpoint, which is required by the EMA (Citation missing).
4. Anavex may fail to satisfy a requirement that current analyses have not taken into account, such as a manufacturing or data integrity issue.
georgejjl
8 시간 전
Tom Bishop, BI Research: "We’re hoping for some word from Europe around mid-year or is that the timeline?" Christopher Missling: "We will expect the review to take 210 days since filing... We expect the feedback for the review to complete by the end of this year."
Bishop asked about upcoming events. Missling outlined the anticipated schizophrenia trial readout for ANAVEX 3-71 in the first half of 2025, the detailed ATTENTION-AD data presentation in April, and updates on the Parkinson’s disease program.
Bishop inquired about support from stakeholders. Missling explained that the company is receiving increasing advocacy support due to the unmet need for Alzheimer's treatments and ongoing discussions with pharmaceutical companies regarding marketing and partnerships.
When asked about the crystalline patent, Missling emphasized its significance, noting that it protects the composition of matter used in prior clinical studies and extends coverage until 2039.
https://www.msn.com/en-us/money/savingandinvesting/anavex-projects-ema-feedback-on-alzheimer-s-drug-by-year-end-2025/ar-AA1yUiFd
Good luck and GOD bless,
123tom
14 시간 전
Steve, do you count Elliott Waves ? I'm looking at the 5 day/5 minute chart. Others as well. From the 7.27 bottom to today's pop and drop around 9 dollars, I'm seeing the first rally wave 7.27 to around 8.75 area. (the 8.75/8.85 is a shoulder resistance step now)
We could call that first rally Wave 1. The Wave 2 pullback to 8.08. And now we would be looking at the developing Wave 3 , if that's happening. Your mention of low volume here ... is not feeling like a Wave 3 in that regard.
8.08 runs 1 dollar, and turns down from 9.07 to the present, 8.60 area.
A good Wave 3 with volume and momentum, might be what we'd see if we get good news very soon. Would that timing coincide in the next week or two, we might see a big jump like you're anticipating. At the moment I'm watching the current pullback to see if 8.50 area holds as good support And also watching to see if resistance 8.80 shows any strength. There's a dollar target for either side. 8.80 down to 7.80, or 8.50 up to 9.50.
That's about all I'm watching right now.
Swing Wave support bullish/neutral bias holding 8.50 area looking upward. Bearish/neutral bias watching for 8.75 shoulder to roll over and tumble back to test 8.00/7.90/7.80 area. Just some targets I'm looking at.
Hoskuld
15 시간 전
I think you already know the answer to that question. If "doc" had any expertise, education, or experience then he wouldn't be asking slanted questions of ChatGPT. We all know that AI is the perfect example of "garbage in, garbage out": ask a slanted question then you get a slanted answer. For example, 12X weighed in with his ChatGPT info purported that the US FDA would LOVE 2-73 submission now because, well, all the US sites in the -004 trial! (there were none.)
The OLE data looked good. And the COL24A1 variant data looked good, too. Will it be enough for approval? I don't know. There is a good chance it will be because the EMA already knew that was all the ammo Anavex could bring to the shooting match, but accepted the submission anyway. I don't think the EMA would waste their time if the data was not enough.
I can understand the criticism of the trials and size - I make the same criticisms all the time. But, the EMA was nonplussed. Go Europe!