To: Biomaven who wrote (9422 ) 11/6/2003 7:57:18 AM From: rkrw Read Replies (1) | Respond to of 52153 Seems PFE has a call option on the espr program. Reuters Pfizer in wings for star HDL-cholesterol role Wednesday November 5, 7:07 pm ET By Ransdell Pierson NEW YORK, Nov 5 (Reuters) - Esperion Therapeutics Inc. has grabbed the spotlight with a drug that helps clear clogged arteries, but Pfizer Inc. could steal the show if it exercises its right to co-market the medicine and succeeds with its own experimental drug that bolsters "good" HDL cholesterol. Researchers on Tuesday said patients who took Esperion's (NasdaqNM:ESPR - News) injectable experimental drug, ETC-216, for only five weeks reduced their artery plaque by 4.2 percent -- the first time any drug had appreciably reversed atherosclerosis. The medicine, which mimics HDL, must now be tested in larger trials to demonstrate more clearly its effectiveness and whether the reduction in plaque actually protects people from future heart attacks and stroke. New York-based Pfizer inherited the right to co-market ETC-216 when earlier this year it bought Pharamcia Corp. -- which had helped Esperion develop the medicine. Pfizer already dominates the cholesterol field with Lipitor, a member of the statin family of medicines that reduce "bad" LDL cholesterol and cut the risk of heart attacks and stroke by up to 30 percent. Lipitor is the world's best selling medicine, with annual sales approaching $10 billion. Not resting on its laurels, Pfizer recently began late-stage trials of a pill that combines Lipitor with an HDL-raising compound called torcetrapib which works by blocking the so-called cholesteryl ester transfer protein. In earlier studies, the Pfizer pill raised HDL levels by over 50 percent and slashed LDL by up to 60 percent. Pfizer has provided no other information from the studies, but has said the drug provides the potential to reverse atherosclerosis. "Our hope is that an agent like this will be the next blockbuster in cholesterol control," said Charles Shear, a senior Pfizer research executive. "The ultimate goal is to reverse the progression of atherosclerosis." Although statins have greatly improved outcomes for heart patients since they were introduced 15 years ago, Shear said new approaches like the Lipitor/torcetrapib pill are needed because heart disease remains by far America's biggest killer. "Pfizer is already in the forefront of cholesterol treatment with Lipitor and now has the opportunity to take the lead in HDL therapies with torcetrapib and their option on Esperion's drug," said Sena Lund, an analyst at Cathay Financial LLC. Lund said Pfizer next year will have the option to co-market ETC-216 in the United States, adding that its sales could be huge if the drug proves potent and safe in late-stage trials. "Anything that can reverse coronary plaque could be a multi-billion dollar drug." "Doctors would start patients with a drug like ETC-216 to clear the arteries and then put them on statin pills long-term to keep their bad cholesterol under control," Lund said. Mark Monane, a biotech analyst for Needham & Co. Inc., said it is far too early to know which companies will emerge with successful HDL therapies, but added that Esperion is a good bet because it is developing four different HDL-raising medicines. HDL is an important predictor of heart attack and stroke. The lower the HDL, the higher the risk for problems. A significant percentage of people with heart disease, in fact, have normal levels of LDL but low levels of protective HDL. "In the future, more and more trials will test the benefits of lowering LDL along with boosting HDL," said Sidney Smith, a professor of medicine at the University of North Carolina and past president of the American Heart Association. He said such a combined approach might cut the risk of heart attack by up to 50-percent, and that the risk could be pushed lower yet if the same patients also adopt healthier habits such as quitting smoking and exercising more. Other companies developing HDL-raising therapies include Lipid Sciences Inc. (NasdaqNM:LIPD - News) of Pleasanton, California and Avant Immunotherapeutics Inc. (NasdaqNM:AVAN - News), which is based in Needham, Massachusetts.