Hold onto your hats, pharmaceutical investors! Johnson & Johnson (), an American multinational pharmaceutical company, has finally received it’s data from Invokana, which is a popular SGLT-2 inhibitor used to treat type 2 diabetes.
SGLT-2 inhibitors are increasing in demand.
Right now, Invokana, a SGLT-2 inhibitor, is in position to push traditional DPP-4 inhibitors, such as Merck’s (NYSE:$MRK) Januvia to the side. DPP-4 inhibitors work in the pancreas and liver while SGLT-2 inhibitors do not, which is where these two inhibitors differ. SGLT-2 inhibitors, such as Invokana, will prevent the absorption of glucose in the kidneys and will encourage glycemic balance in order to allow the body to get rid of any excess glucose via the urine. Furthermore, SGLT-2 inhibitors have shown positive side effects, including weight loss and lowered systolic blood pressure. This is especially important when it comes to type 2 diabetes as a number of diabetics will experience issues with weight and hypertension. As a result, SGLT-2 inhibitors could be used to help patients overcome these issues, regardless of the fact that SGLT-2 inhibitors aren’t made specially for weight loss or lowering a patient’s blood pressure.
With that said, most investors interested in pharmaceutical stocks as well as doctors and patients had been waiting to find out if Johnson & Johnson’s CANVAS and CANVAS-R cardiovascular (CV) studies had shown a CV advantage over the placebo. If there was a reduction in CV death, heart attack, and nonfatal stroke, Invokana could obtain a competitive edge over its rivals, DPP-4 inhibitors.
If you’re new to the world of pharmaceutical companies, you should know that J&J’s Invokana was actually chasing after Eli Lilly (NYSE:$LLY) and Boehringer Ingelheim’s Jardiance. Jardiance, for example, illustrated a 14% reduction in CV events in the EMPA-REG OUTCOME long-term cardiovascular study. Interestingly, Jardiance sales have not had a lot of success getting the ball rolling. For Eli Lilly, sales amounted to $74 million in Q1. Despite being up 94% year-over-year, this number is below the $284 million that Invokana sold globally in the first quarter of 2017.
What were the results?
The New-Jersey based company disclosed on Monday, June 12, that there was an accumulated reduction in CV risks of 14%. This matched Boehringer Ingelheim’s Jardiance.
Additionally, Invokana reduced the risk of nonfatal heart attack and nonfatal stroke by 15% and 10%. If that wasn’t enough, Invokana also reduced the risk of hospitalization correlated to heart failure by 33%. The SGLT-2 inhibitor also illustrated positive effects on blood pressure and helped patients lose weight. Bruce Neal, principal investigator of J&J’s CANVAS and CANVAS-R studies, stated: “The CANVAS results are important because they show clear benefit of canagliflozin over current standard-of-care treatments. Furthermore, the CANVAS Program showed consistent reductions across all components of the primary study outcome –CV death, MI and stroke – indicating efficacy of canagliflozin for all the main CV risks likely to affect patients with diabetes.”
Sounds promising, right? Well unfortunately, it wasn’t all good news.
Here comes the bad.
One minor mistake is that Invokana’s reduction of CV deaths were not as high compared to Jardiance. Invokana reduced the risk by 13%, while Jardiance reduced CV death risk by 38%.
Aside from a backseat in regards to CV death risk, data noted that there is a major side-effect when taking Invokana. According to data disclosed in May, Invokana led to a higher risk of leg and foot amputations, in comparison to the placebo. Patients taking Invokana showed foot and leg amputations to the equivalent of 5.9 out of every 1,000 patients and 7.5 out of every 1,000 patients in two studies. This is compared to 2.8 out of every 1,000 patients and 4.2 out of every 1,000 patients for the placebo.
Johnson & Johnson released a report on Monday stating the the risk of amputation mostly “occurred in patients with a prior history of amputation or peripheral vascular disease.” Regardless, J&J’s Invokana will now have an amputation risk stamped on the box while their counterpart Jardiance does not.
What’s the takeaway?
Now that the long-awaited results have been released, what does this mean for Invokana, Jardiance, investors, and more importantly, type 2 diabetics?
First and foremost, SGLT-2 inhibitors are providing patients with improvements in both systolic blood pressure and weight loss. Also, there was some cardiovascular risk reduction, which is bad news for Januvia, as the weight-neutral drug did not show any reduction in CV risks in its study.
As of right now, J&J’s Invokana has the advantage of being the first to provide improvement in nonfatal myocardial infarction and stroke, which will help allow it to lead the market. That said, don’t overlook the fact that J&J’s SGLT-2 inhibitor has a warning of amputation risk on the box.
On the whole, data results illustrated promising news for both diabetics and investors interested in pharma stocks. First, data suggests that Invokana is a positive medication treatment for those suffering from type 2 diabetics, and second, Invokana will maintain the status of a blockbuster drug for years to come, which is good for investors wanting to start investing in pharmaceutical companies.
Featured Image: twitter
