Hoechst, Astra, Others Race to Make New Drugs for Bone Disease
Bloomberg News
September 15, 1998, 5:15 a.m. ET
Hoechst, Astra, Others Race to Make New Drugs for Bone Disease
Berlin, Sept. 15 (Bloomberg) -- Eli Lilly & Co. and Merck &
Co. grabbed the spotlight with positive news on new drugs at
Europe's biggest gathering of osteoporosis experts, but other
companies will soon have their turn with even newer drugs.
The two U.S. drugmakers released new data showing how well
their drugs build bone mass and prevent fractures in a disease
that affects 200 million women worldwide. Doctors said these and
even newer treatments now give them an unprecedented range of
treatment options for the illness.
Soon, Hoechst AG, Novo Nordisk A/S, Astra AB, SmithKline
Beecham Plc, Roche Holding AG and Servier SA could release data
on more advanced drugs in treating osteoporosis. The global
drugmakers are looking to grab a chunk of a $2.3 billion market
that experts predict will soar as more people live longer and
elect to take new drugs for what is now considered a widely
undertreated illness.
''These new treatments are extremely welcome to meet the
diversity of osteoporosis,'' said Pierre D. Delmas, president of
the European Foundation for Osteoporosis, speaking at the
European Congress on Osteoporosis. ''Four years ago, the only
treatment that was shown effective was hormone replacement
therapy.''
After menopause, women can lose a third or more of their
bone mass, sometimes within five years, leaving them susceptible
to bone breaks. The World Health Organization says a woman's risk
of an osteoporosis fracture are greater than her combined risk of
breast, cervical and ovarian cancer.
New Drugs
For years, women took American Home Products Corp.'s
Premarin or other estrogen drugs to replace lost natural
production of hormones following menopause. While effective in
treating post-menopausal disorders such as osteoporosis and pain,
HRT can cause vaginal bleeding and breast pain while slightly
increasing risk of breast and uterine cancer. Doctors say a
majority of women quit using estrogens within two years after
starting.
In recent years, new drugs called bisphosphonates found a
ready market for women at risk from osteoporosis, particularly
those who couldn't tolerate HRT. The top seller is Fosamax,
seventh-biggest selling drug at Merck, the world's largest
drugmaker. New data released at the Berlin conference showed that
Fosamax reduced hip fractures by 56 percent and spinal fractures
by 49 percent in a major clinical trial. Fosamax, however, causes
gastrointestinal difficulties that prompt many patients to quit,
doctors say. Germany's Hoechst, the world's No. 9 drugmaker, aims
to surmount that with Actonel, a drug discovered by Procter &
Gamble Co. that Hoechst says may get U.S. approval next year.
''This drug is going to be the major competitor to
Fosamax,'' predicted David Hosking, a bone specialist at
Nottingham City Hospital, central England, who directed clinical
trials of Actonel. He said Actonel acts like Fosamax in building
bone and may not give stomach problems.
''Fosamax's Achilles heel is that the incidence of
gastrointestinal side-effects is quite high,'' agreed Michael
McClung, a Portland, Oregon, physician who also tested Actonel,
chemically called risedronate. ''We saw no gastrointestinal
intolerance in risedronate.'' He added that early clinical trials
found no stomach problems with Fosamax either, however.
Roche Version
Roche Holding AG of Switzerland, Europe's fifth-biggest
drugmaker, said it hopes to trump Merck and Hoechst with a new
bone-building bisphosphonate called Bondronate. Roche aims to
make a version of the drug that can be taken by injection every
three months, avoiding stomach problems entirely. One doctor said
that method may not find favor with patients, however.
''It will be a very individual decision whether a woman
wants to be injected or take a pill every day,'' said Steven R.
Cummings, assistant dean of research at the University of
California, San Francisco, and a women's health expert. ''I think
it will be great when they make a weekly dosing version of
Fosamax.''
Eli Lilly's new high-tech estrogen drug Evista, which was
hailed by some doctors as a major advance in treating
osteoporosis, could also face competition in coming years with
other hormone drugs coming to market. Both Danish drugmaker Novo
Nordisk and SmithKline Beecham are in late-stage clinical trials
of so-called selective estrogen receptor modulators, or serms.
SmithKline, the world's eighth-biggest drugmaker, counts its
idoxifene serm as one of four major products that will drive
future growth for the London-based drugmaker. Like Lilly's
Evista, idoxifene has the potential not only to protect against
osteoporosis, but also lowers levels of cholesterol and may
protect against breast cancer, both major killers of women.
Those drugs could soon face competition from other drugs
called parathyroid hormones in late-stage clinical development
from Lilly, the world's 10th-biggest drugmaker, and Swedish
drugmaker Astra AB. The European Foundation for Osteoporosis'
Delmas said the drugs appear to have a much greater ability to
stimulate bone-building cells than any previously.
Also moving into the osteoporosis market is French drugmaker
Servier, which is in clinical tests of another kind of drug
called strontium, which also may have the effect of building
bone.
--Dane Hamilton in the London newsroom (44-171) 330-7727/ph
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