Schizophrenia drug Cobenfy could treat Alzheimer’s disease

Bristol Myers Squibb estimates that Alzheimer’s disease is the largest market for its recently approved schizophrenia drug, Cobenfy, which is expected to ultimately generate billions of dollars in revenue.

In an interview, company executives said each treatment use they are studying for Cobenfy has multibillion-dollar potential, including for Alzheimer’s disease psychosis, agitation and cognitive impairment. Alzheimer’s disease, bipolar disease and autism. But Alzheimer’s disease is “the very big market here,” Bristol Myers Squibb Chief Financial Officer David Elkins told CNBC Tuesday at the JPMorgan Health Care conference in San Francisco.

There are nearly 6 million patients in the United States with Alzheimer’s disease, and about half of them suffer from psychosis or symptoms such as hallucinations and delusions, Elkins said. Cobenfy could be first drug specifically approved for Alzheimer’s-related psychosis, marketing chief says Officer Adam Lenkowsky.

Atypical antipsychotics – drugs used to treat a range of psychiatric disorders – are often used to treat psychosis in patients with Alzheimer’s disease, although they are not approved for this purpose. But these treatments can increase the risk of death, which is not the case with Cobenfy, according to Bristol Myers Squibb.

Meanwhile, Alzheimer’s-related agitation, a symptom that can cause a patient to feel restless and worried, is estimated to affect about 60 to 70 percent of patients with the disease, according to some studies.

Bristol Myers Squibb said Monday it plans to release initial data from a late-stage trial of Cobenfy in the treatment of Alzheimer’s disease-related psychosis in the latter part of the year, which is earlier than foreseen. The company also plans to start phase three trials in Alzheimer’s disease agitation, cognition and bipolar disorder in 2025, while autism studies will begin in 2026.

JPMorgan analyst Chris Schott expects Cobenfy sales to reach approximately $5 billion by 2030, with peak sales potential in the range of $10 billion for multiple therapeutic uses , according to a research note published Tuesday. This is a huge boon for Bristol Myers Squibb, which faces pressure to offset the potential loss of revenue from top-selling treatments that will cause their patents to expire.

It’s a full circle for Cobenfy, which became the first new type of treatment for the estimated 3 million U.S. adults with schizophrenia in decades after winning approval in September. The drug comes from Bristol Myers Squibb’s $14 billion acquisition of biotech company Karuna Therapeutics in late 2023.

But the origin of this drug lies in the treatment of Alzheimer’s disease.

Eli Lilly initially tested part of the drug – xanomeline – in the 1990s to reduce cognitive decline before abandoning it due to serious side effects such as nausea, vomiting, diarrhea and diarrhea. constipation. Xanomeline activates certain so-called muscarinic receptors in the brain to decrease dopamine activity without causing the side effects associated with antipsychotics.

Andrew Miller, founder and former president of research and development at Karuna Therapeutics and now an advisor at Bristol Myers Squibb, saw the potential of xanomeline in neuroscience and theorized combining xanomeline with a second existing drug – trospium – to reduce these side effects. He then launched Karuna to develop the combination as a treatment for schizophrenia.

Other breakthrough treatments for Alzheimer’s disease have recently entered the market, including Biogenic And Eisai’s Leqembi and Elie LillyIt’s Kisunla. These treatments work in part by clearing toxic plaques in the brain called amyloids, a hallmark of Alzheimer’s disease, to slow the decline of memory and thinking in patients in the early stages of Alzheimer’s disease.

But as people progress in their illness, they experience symptoms such as psychosis and agitation, said Elkins of Bristol Myers Squibb.

“That’s where Cobenfy fits in,” he said. “If you can get rid of the psychosis and agitation, people’s cognition improves. Just imagine, for caregivers and the healthcare system as a whole, the impact this drug could have on these patients and their loved ones. It’s really exciting when you think about it in this context.