In evaluating Nektar after Pfizer's bailing out of Eubera, we have to foucs on relatively early stuff. One such is 118, the oral PEGged naloxol. The obvious competitor in this arena is Progenics/Wyeth's methylnaltrexone. Both are aimed at opioid induced constipation, and neither crosses the blood brain barrier to interfere with pain relief. MTNX is being developed in IV, SC, and oral forms, though the oral formulation is only in P2. The former two formulations appear near to market. Here's a summary:
progenics.com
And here's the P3 results:
Message 21122790
The .3mg/kg dosing works out to about 250mgs per dose for MNTX, depending on patient weight. So, while this isn't quite an apples to apples comparison, 118's safety and tolerability up to 1000mg appears to give it a therapeutic window that is plenty wide enough, so, so far, so good. I have seen no numbers regarding GI transit time, so we kind of have to take their word on the efficacy metric. Posters from the AAPM meeting are not yet available online, and I'm not sure that the ACCP posters ever are.
Anyhow, 118 will hit the market somewhat later than oral MNTX, so the question is . . . what advantages does it have? Right now, I don't know. A superior fast follower can dominate the market . . .
Cheers, Tuck |
