The ACC skinny: Amgen's PCSK9 outcry, AZ's SGLT2 death cuts, Xarelto's aspirin beat

At the American College of Cardiology meeting over the weekend, pharma-watchers got a view of data on cholesterol meds, diabetes drugs and clot-fighters.

The PCSK9 cholesterol drugs got top billing at the American College of Cardiology meeting this year, but that doesn’t mean other studies didn’t rate. One next-gen anticoagulant (Xarelto) trounced aspirin at staving off venous blood clots, while another (Eliquis) stood head and shoulders above its in-class rivals on bleeding-related costs.

Meanwhile, a heart failure drug (Entresto) cut blood sugar in diabetics in a post-hoc analysis, and a group of diabetes meds (the SGLT2 class) slashed death rates—and heart failure hospitalization risks—in a real-world study of 300,000 patients.

Here’s a roundup of FiercePharma and FierceBiotech’s coverage, PCSK9s and more.

  • Pitted against aspirin in a head-to-head study, Bayer and Johnson & Johnson’s warfarin-alternative drug Xarelto beat aspirin at reducing the rate of recurrent, potentially fatal blood clots. It's another set of positive data for the next-gen anticoagulant as it works to strengthen its case against rivals from Bristol-Myers Squibb and Pfizer, Boehringer Ingelheim and Daiichi Sankyo. Story
     
  • A massive data analysis showed that a newer class of diabetes drugs took a big bite out of heart failure hospitalizations—and an even bigger one out of all-cause mortality. The real-world study suggests that Eli Lilly and Boehringer Ingelheim’s Jardiance isn’t the only one of the SGLT2 meds that cuts heart risks. And the results stand to have a “substantial impact” on prescribing habits, if AstraZeneca’s U.S. president sees his predictions come true. Article
     
  • Amgen has its PCSK9 outcomes data, and it’s planning some new pay-for-performance deals to offer payers on its in-class drug, Repatha. But, despite some impressive-sounding numbers—including a 33% cut to heart attack and stroke risks after a year of therapy—the data may not be enough to change coverage much, analysts said. Stay tuned: Doctors, pharma companies and cost experts are still digesting the data. Analysis
     
  • Novartis’ heart failure med Entresto beat an older drug at reducing blood sugar levels in HF patients with diabetes, a new analysis shows. Entresto isn’t a diabetes drug, of course, and as much as Novartis would like to broaden use of the slow-starting med, it doesn’t envision trying to market Entresto for blood sugar control. Instead, the new data suggest that cardiologists need to keep an eye on blood sugar levels in diabetic Entresto patients, in case their meds need adjusting, the study’s lead author said. Report
     
  • Johnson & Johnson and Bayer’s Xarelto (rivaroxaban), Boehringer Ingelheim’s Pradaxa (dabigatran) and Pfizer and Bristol-Myers Squibb’s Eliquis (apixaban) all topped warfarin on some safety measures in a recent real-world study. But only one of the next-gen anticoagulants showed it could save the healthcare system hundreds of dollars per patient in the process. News