From February but worth reading again re-listened to Wednesday’s webcast and I understood indirectly that Fibrogen was out of the race for IPF and could offer at the best a complement to existing therapies. I also understood that Prometic has a leading compound…better than Nintedanib!
Let me explain: Fibrogen compound (FG-3019) targets only the CTGF (connecting tissue growth factor) while the PBI-4050 targets the CTGF and several other factors at once. This is specifically what Dr. Martin Kolb likes about PBI-4050, it attacks on several pathways and even more than Nintedanib who does it on 7 to 8 ways. So, even if FG-3019 has been successful in PH2 clinical trials, it is specifically because it has been given in combination with Nintedanib and Pirfenidone. Their study was designed this way, for patients who already are receiving one of the two drugs available. So, if the FG-3019 is not administered alone, as the PBI-4050 was in PH2 and will be in PH3, it will not be able to become the “Standard of Care” and surpass the results of its competitors. At the best it will become a well-tolerated supplement.
Regarding the future of IPF, PBI-4050, Ryplazim, Nintedanib and Pirfenidone, this is what Dr. Martin Kolb had to say Wednesday:
«I am a physician scientist, I work with a lot of different companies, I have a research lab, I do basic science, I do animal models and mechanism of disease, I also have a large clinic and follow about 1000 patients with different fibrotic lung diseases, about 250 of them are on the approved drugs, so I think I know what patients need and what we, as a community, need to make this disease better. » (I think this sets how credible he is.)
«I’m pretty sure that in 15 or 20 years we’ll have different color pill that stop IPF and other chronic diseases and this is why we are working so hard» (He means that the solution for treating IPF will be a drug cocktail, not a miracle one, like we see now for AIDS)
« Those 2 drugs (Nintedanib and Pirfenidone) they don’t stop the disease, they slow it down, they have very comparable effects, but they have a very different side effect profile, so when I see a patient, I give them the choice, will you pick diarrhoea or vomiting? »
«The side effect spectrum is really what determines, in my clinic, the choice of a drug. »
« We know that just about a third of all patients with IPF are actually on one of these drugs because they hesitate. » (Between diarrhoea and vomiting, 2/3 choose none)
« Patients have a lot of comorbidities as well and they make it challenging to tolerate high effect rich drugs (…) that’s another reason for looking at something that is much better tolerated. » (Phase 2 trial of PBI-4050: Very well tolerated whether used alone or in combination. Most TEAE was diarrhoea, with the lowest frequency in the PBI-4050 alone group)
« There’s a few posters presented on meetings (about PBI-4050) I’ve seen the stuff, that looks pretty cool and what this drug does, it interferes with a lot of different pathways (…) and we know from the research that folks at Prometic have done is that this molecule interferes with a lot of them. » (Meaning that if the drug targets only one pathway, the disease will overcome the treatment…so that’s not the case for PBI-4050 witch targets multiple pathways)
« If you have these chronic disrupting diseases (like IPF), you want to have 2 strategies, stop the destruction and support the rebuilt, and PBI-4050 is active in both of these things. » (I will copy a part of the Prometic corporate presentation: The biology of healing: We are the company that can effectively address the entire healing process in a groundbreaking way using both small molecule drugs and plasma protein therapies.)
« As a scientist I want to read about: what does a drug do? When I talk to my fellow expert in the field they don’t know much about PBI-4050, because there’s not much published. » (The MOA will be publish starting mid-February. There will be 15 to 18 publications in scientific journals. 15 to 18? What do we need to understand? That PBI-4050 interacts against fibrosis on 15 to 18 pathways? Simple speculation here.)
To conclude, Prometic has a lot to offer! There’s no doubt in my mind that PBI-4050 will become the standard of care, because of its efficacy but mainly for its safety profile! People with IPF will have choice between: diarrhoea, vomiting or PBI-4050! Really? It’s becoming obvious that Prometic has the lead in the race. Let’s wait and see! That’s my bet.
GLTA