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Roche Makes Strides in Race Against Merck


The latest battle in the war against diabetes.

When comparing drugs, it's best to compare oranges to oranges, but occasionally companies release results of studies that compare oranges to apples. Or in the case of the latest results on diabetes drugs released Wednesday morning by Roche (RHHBY.PK), GLP-1 agonists to DPP-4 inhibitors. The oranges to apples comparison isn't necessarily a bad one; both are still fruit after all. See also For Big Pharma, Diabetes Means Big Business.

The Swiss-based company announced partial results from one leg of its T-emerge study, a series of trials comparing its diabetes drug -- taspoglutide -- with competitors, placebos, and even different classes of drugs in the diabetes arena.

The stakes are high. Type 2 diabetes affects 180 million people worldwide and is expected to jump to 360 million by 2030. It's a preventable condition that tends to affect older, overweight patients and it's a leading cause of blindness, amputation, kidney failure, and stroke. The International Diabetes Federation estimates the disease will cost the world economy at least $376 billion next year, or 11.6% of total world health care expenditure.

This latest study is complex, but important. Taspoglutide is a GLP-1 agonist, a newer class of diabetes drugs that works like the naturally occurring GLP-1 compound in the body to slow glucose absorption in the gut and thus allow a Type 2 diabetic's slow insulin response to catch up. Unlike the naturally occurring compound, the agonists aren't easily broken down by the body's enzymes. The GLP-1 agonist class also attaches to an appetite receptor in the brain and decreases hunger, leading to weight loss in patients. The Roche drug is a once-weekly injectible.

The results of the two phase 3 studies showed that taspoglutide outperformed a placebo and Merck's (MRK) Januvia. The trial against a placebo included 373 patients, while the Januvia study included 636 patients. The most frequent side effects with taspoglutide were nausea and vomiting. Roche will likely release the complete results of the three T-emerge studies already finished at the American Diabetes Association meeting next June. Five other T-emerge studies are currently being conducted to prove taspoglutide's effectiveness as a diabetes treatment. (See also: For Big Pharma, Diabetes Means Big Business)

Januvia, which launched in 2006 and had worldwide sales of $491 million during the third quarter of 2009, is a DPP-4 inhibitor. Unlike the GLP-1 agonists that mimic the natural actions of the compound, DPP-4 inhibitors lower the body's blood sugar by blocking the DPP-4 enzyme from breaking down GLP-1 and thus creating higher insulin levels. Januvia is a once-daily pill.
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