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Arena Pharmaceuticals, Inc. Message Board

  • jeremiahthirtythreeone jeremiahthirtythreeone Aug 28, 2013 8:41 AM Flag

    The Importance of APD811

    PAH is a progressive, fatal disease if untreated. Death rate per annum has been increasing from 5.2 to 5.4 per 100,000. In addition, the hospitalization rate has increased more than two-fold (40.8 to 90.1 per 100,000). Symptomatic pateints who don't recieve treatment survive only about 3 years.

    Early treatment is recommended because advanced disease may be less responsive to treatment. For example, multiple trials of epoprastenol (a prostanoid - same class as ADP811) has shown improved survival compared to historical controls. A meta-analysis of 21 randomized trials demonstrated that treatment with a prostanoid (again same class as ADP811) improved mortality compared to controls.

    What are the options. The most effective treatmens are prostanoids. There are three presently available- intravenous epoprostenol (Flolan), intravenous treprostinil (Remodulin), and inhaled iloprost ((ventavis). All of these have disadvantages of a short half life which means they have to be given continously over short periods of time.

    Problems with each:

    Epoprostenol (Flolan):
    Cost: $100,00 per year
    Must be delivered through a permanently implanted central venous catheter using a portable infusion pump which can result in thrombosis, pump malfunction, and interruption of infusion. These catheters can also contribute to mortality via these malfunctions of the pump.
    Most insures and both medicaid and medicare reimburse these costs

    Treprostinil (Remodulin)
    Cost: $120,000 to $160,000 per year
    Can be given intravenously or subcutaneously but subcutaneouns injection causes severe pain at the injection site
    Most insurers including medicaid and medicare pay for it

    Iloprost (Ventavis)
    Cost: $ 145,633 per year
    It is inhaled vs intravenous administration but the main disadvantage is the need for frequent inhalation - 6-9 times per day.

    Therefore if there is an oral medication that is just as effective would be a tremendous advantage

    Daniel
    UCLA MD

    Sentiment: Strong Buy

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