Here is some medical dialogue concerning TXB and Novastan, the prospects for this drug are superb. The TXB pipeline is strong.
Bosentan and tezosentan
Bosentan and tezosentan are both endothelin antagonists being developed by Actelion, a Swiss start-up. Genentech has just signed a co-promotion deal for tezosentan, which is only active by injection, and which is a short-acting non-specific endothelin receptor antagonist. By contrast, bosentan is orally active, but likewise is not subtype specific. I think it is significant that other companies are advancing their endothelin antagonist programs, but I also think that in principle sitaxentan, being orally active, relatively long acting, and subtype specific, will be a superior drug. Bosentan is about 10 years old, and I think was developed by Roche, if memory serves.
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Let's get beyond the Novastan approval for a moment. The key step for Novastan beyond approval and HITTS, is how it does against Hiriudin (ie. cost/benefit and broader application.) Hiriudin, when combined with Heperin (sp?) is very effective.
My sources are telling me this trial will be the key test for Novastan (after approval) and from a marketing perspective, Novastan is a little behind the eight ball as Hiriudin has been approved for the last ten months and is now accepted by physicians.
Therefore the only way Novastan becomes a wide application drug beyond HITTS is to be used in in place of Heperin or Heperin/Hiriudin if it is more effective and cheaper for the broader MI eligible groups. Also, have you heard that Novastan causes more bleeding or less? Thoughts..................
Thanks in advance. regards.
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As I said in a previous post, hirudin is an irreversible thrombin inhibitor whereas Novastan is reversible. Therefore, in principle, Novastan should be easier to control. Likewise, in principle, the risk of bleeding should be lower with a reversible inhibitor like Novastan. How this is all going to translate into reality in the clinic is difficult to say at this point, but it is pertinent that several papers have indicated that bleeding is not a major problem with Novastan. As for the value of combining Novastan and hirudin vs. the value of combining hirudin and heparin--this would require an extremely complicated clinical trial to produce an answer. Comparing combinations of drugs (e.g. A + B) means that you have to compare (A + B) against (A) alone and (B) alone. Comparing (A + B) against (A + C)is going to be much more complicated. |
