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Expert Interview

Slingshot members are talking to an expert! The topic is:

After its recent IPO we look at Crinetics’ lead pipeline candidate, CRN00808, in treating Acromegaly

Ticker(s): CRNX, NVS, IPN.PA

Who's the expert?

An endocrinologist with experience in treating Acromegaly.

Interview Questions

Please tell us about your experience in the area of Acromegaly, how many patients have you seen with this disease, the demographics of the disease, what is the prefered method of treatment and why?

Added By: c_admin

What differentiates CRN00808 from other drugs with the ability to suppress serum IGF-1 and GHRH-stimulated GH levels? Do you see CRN00808 as having a significant advantage over existing therapies?

Added By: c_admin

Is the elevation of pancreatic enzymes in the Phase 1 trial of CRN00808 concerning to you?

Added By: c_admin

Do you currently prescribe octreotide or lanreotide? What % of the patients on those drugs do not result in stabilisation of the IGF-1 levels?

Given that CRN00808’s Phase 2 is going to target those particular unresponsive patients, do you see a need for it in this space?

Added By: c_admin

What would make you switch from octreotide to CRN00808? Given the pretty severe adverse events on octreotide, like pancreatitis and hepatitis, and the prevalence of other milder symptoms such as hypothyroidism, cardiac conduction changes, gastrointestinal reactions, hyperglycemia in more than 10% of the patients, do you see CRN00808 as a potential safer choice to make for your patients?

Added By: c_admin

The half-life of CRN00808 is 42 to 50 hours, whereas Sandostatin’s (octreotide) is 1.7 hours, and natural somatostatin is broken down in the body within minutes. Is this reason for concern, that the drug might produce far more prolonged effects than required? Or are there benefits to it, compared to octreotide? Do you see it as a once-daily administration drug?

Added By: c_admin

What % of the patients cannot sustain an injectable therapy of octreotide, lanreotide, or pasireotide, due to the harsh nature of the adverse side effects, vs how many of them are simply unresponsive?

Added By: c_admin

What are the pros and cons of CRN00808 being oral, vs octreotide/ lanreotide injectables?

  • Are there effects on the liver of taking daily oral hormone therapy? 
  • How does safety and adverse effects compare, injectable vs oral? 
  • Patient convenience? (ie. At home vs in office visit, and Somatuline Depot(lanreotide) formulation, which is a once/month injection)

Added By: c_admin

Have you used Novartis’ Pasireotide LAR once-monthly injection since its approval for Acromegaly in 2014? What has been your experience with it? How does it improve on the first generation of SSAs?

Added By: c_admin

In 2016, the FDA rejected Chiasma’s ($CHMA) Mycapssa (oral octreotide). One of the reasons cited was there wasn’t a sufficiently long duration in the Phase 3 to ensure that control of disease activity is stable at the time point selected for the primary efficacy assessment. How would CRNX’s case be different than that?

Added By: c_admin

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