Lehman Bros reiterates Buy on AGPH:
Headline: Biotechnology: AIDS Treatment Update from ICAAC Conference
Author: CA Butler,PhD/R.Rouse (212)526-4410
Company: AGPH, BCHE, VRTX
Industry: BIOTEC
Today's Date : 09/30/97
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* A large number of clinical data from the HIV/AIDS arena is being presented
this week at the ongoing 37th Interscience Conference on Antimicrobial Agents
and Chemotherapy (ICAAC) meetings in Toronto.
* Below we highlight some of the key announcements of the day as it relates to
the stocks in our universe.
* We believe, based on data presented to date, that that triple combination
cocktails will persist as the most commonly prescribed and that PIs will
remain a key ingredient.
* Accordingly, we reaffirm our 1-Buy ratings on Agouron and BioChem Pharma as
well as our 2-Outperform on Vertex.
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SUMMARY ---
AGOURON (AGPH, $46 1/2, 1-Buy)
Volatility was clearly exhibited in the stock of Agouron yesterday. Important
to note in the presentations, however, were comments relating to protease
inhibitor (PI) failures and consequently failures of Agouron's Viracept,
Nelfinavir. Two papers presented at the late-breaker session were of
particular interest.
Deeks, et al. (Univ. of California, San Francisco) presented data to observe
long-term virologic activity of PI therapy in a university-based public health
clinic. The eligible patients in the study numbered 430, yet only 137 were
followed (the full trial duration) after having taken anti-HIV therapy that
included protease inhibitors Indinavir from Merck (MRK, $101 9/16, not rated)
or Ritonavir from Abbott (ABT, $64 7/16, not rated). The results demonstrated
that 47% (64/137) of patients treated with proteases had a durable and potent
response, while 53% (73/137) had evidence of drug failure after 12 months of
therapy. Predictions of drug failure include low CD4 count at baseline,
unusually high viral load at baseline, prior RTI therapy, and failure to
change RTI therapy upon addition of a PI to the cocktail, and finally non-compliance.
The conclusion of the study predicts that virologic failure to
Indinavir or Ritonavir is more common in the clinical setting than reported in
clinical trials. The stage of disease and suboptimal dosing of drugs also
predicted failure, but the conclusion appeared to support NIH guidelines that
emanated in June suggesting early and aggressive treatment; this might bode
well for the use of PIs early and always as part of a treatment regimen.
A second study by Torres, et al. (St. Vincent's Hospital in Newark) also
produced interesting results, though due to the small patient size and lack of
genotypic and phenotypic data to support the conclusion it is suspect. Torres
presented an analysis of serum viral load in patients previously naive to PI
therapy who, following resistance to drug treatment that included Viracept,
nelfinavir, went on to other PIs. In 8 patients observed who failed the drug,
subsequent treatment with either Saquinavir or Indinavir resulted in only 25%
of patients being sensitive to the second PI. One might conclude that the
resistance profile of Nelfinavir is not sufficiently unique to allow broad
susceptibility the subsequent PI therapy. Without accompanying genotypic
data, though, it is our view that the study's conclusion may be aggressive.
Moreover, these data do not appear to be consistent with those of Henry, et
al. (St. Paul Medical Center) that will be presented on Wednesday which
predicts in 9 patients that failed Nelfinavir allows susceptibility to
treatment with a cocktail involving other PIs (Saquinavir and Indinavir).
Agouron also presented data from other studies including 52 week data on 297
patients having taken 750 mg of Viracept tid' in combination with AZT and
3TC. The mean reduction in viral load was in excess of 99% and was reduced to |
