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Silence Therapeutics Plc (SLN): Our View on Upcoming Ph.2 SANRECO Readout, +Mgmt Commentaries
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Silence Therapeutics Plc (SLN): Our View on Upcoming Ph.2 SANRECO Readout, +Mgmt Commentaries
Goldman Sachs Silence Therapeutics Plc (SLN)
Ph. 2 SANRECO readout in PV is a key near-term catalyst
Rusfertide’s 44% placebo-adjusted response rate (capturing Hct control and
absence of PHL) will be the bar. In our discussion with SLN, mgmt sees rusfertide’s
(RUS) Ph. 3 VERIFY trial data as the benchmark for divesiran. Recall that rusfertide’s Ph.
3 VERIFY results (details in Exhibit 3 below), showed that RUS + PHL +/- CRT achieved
highly statistically significant proportion in responder rates (defined as absence of PHL
eligibility measured by Hct level) compared to the placebo arm (77% versus 33%;
p<0.0001) as well as a reduction in phlebotomies versus placebo (-32%; p<0.0001) and
improvements in Hct control and patient-reported outcomes (both significant) with an
encouraging safety profile (AEs were primarily Gr1-2 injection site reactions; no SAEs
were deemed related to the drug). While SLN is leveraging a slightly different primary
endpoint in SANRECO (primarily based on Hct<45% control between weeks 18-36 vs.
VERIFY’s 20-32 weeks without phlebotomy use), we believe a placebo-adjusted efficacy
of a similar magnitude to RUS’s 44% on its primary endpoint will be needed to validate
DIV’s profile and competitiveness towards a best-in-class profile. However, we caution
that divesiran’s 18-week period is more stringent than VERIFY’s shorter 12-week period
to show Hct control.
High placebo effect is potential. While we believe Divesiran (DIV)’s treatment effect as
shown in the Ph. 1 study is encouraging, we foresee risk for meaningful placebo effect in
the Ph. 2 trial based on RUS’ Ph. 3 VERIFY study that showed 33% pbo effect and higher
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