This is the significant commercial opportunity, but at this point, it's doubtful Entereg gets there. Without OBD, Glaxo's interest in Entereg will wane. Don't be surprised to see the Big Pharma giant back out of its Adolor partnership.
Picking Progenics
It's nerve-wracking to recommend a buy on a biotech stock in this volatile market, but Progenics at around $18 is compelling, because the stock has the potential to move into the $30s.
Similar to Adolor, Progenics and partner
Wyeth(WYE Quote - Cramer on WYE - Stock Picks) are also developing a drug that treats severe constipation stemming from opioid use. The drug is called methylnaltrexone, or MNTA, and it's a variation of naltrexone, a drug approved and used to treat opioid and alcohol dependence.
(For the chemists out there, adding a "methyl" group to the naltrexone molecule prevents the drug from getting into the brain, allowing it to work in the gut without mucking up the painkilling effects of opioids.)
MNTA has been filed with the FDA for treating advanced medical illness. These are nursing home and hospice patients in the advanced stages of disease who require heavy doses of painkillers. An FDA approval decision was expected this month, but was pushed back until April so the agency can review more safety data.
As with Entereg, there is a risk that the FDA wants more safety data from MNTA, but I think that scenario is unlikely because naltrexone is well understood and considered safe by the FDA. Phase III studies of MNTA have been positive, without the mixed efficacy data and safety issues that cropped up in Entereg studies.
Before we hear from the FDA on MNTA's approval, Progenics and Wyeth should release results from phase III studies of MNTA as a treatment for POI, the same indication sought by Adolor. I expect these studies to be positive. And since MNTA is given by injection, it will be favored by hospitals because it's easier to inject a post-surgical patient than getting the patient to swallow a pill like Entereg.
Like Adolor, Progenics is also pursuing a chronic use indication for MNTA for use in patients who take opioids chronically to deal with back pain or other disease. It's too early to be convinced that MNTA (in an oral formulation) can crack this market, but the efficacy and safety data for the drug have been clean so far, better than Entereg.
If you're interested in this new class of bowel drugs, go with Progenics over Adolor.
Adam Feuerstein
RSS
