Leerink Bets Abbott's Niaspan Beat Merck/Schering's Zetia in Mystery Trial

Wall Street analysts at Leerink Swann are betting that Abbott Labs' Niaspan did indeed beat Merck/Schering-Plough's Zetia in the ARBITER 6 imaging study. That was the study that was suddenly and mysteriously halted without explanation, causing a rash of speculation.
Leerink Swann consulted its proprietary network of docs and consultants, put some jigsaw pieces together, and then guessed at the part of the picture that is missing. Seamus Fernandez and Kathryn C. Alexander note that because the researchers plan to publish their results in a a "top" medical journal, they believe the trial was not halted because of futility or trial design error. This suggests a "definitive" outcome, the pair write.

If Zetia received the superior result, then this would be a surprise, Leerink says. The prior data favors Niaspan, they believe. A pro-Niaspan result would have limited commercial reverberations -- because so few people were enrolled in the study -- unless they are published in a really big journal, Leerink says.

This factor reminds us of the flap over Sanofi-Aventis' Lantus, in which BNET suggested that relatively few experts hold vast sway over the commercial fate of some drugs. Indeed, Leerink ended its note on that refrain:

... significant headline risk exists if a negative result for Zetia is picked up by mainstream media & championed by Nissen. The likelihood that Zetia outperformed Niaspan strikes us as low, but this would be a major surprise relative to expectations. Even Steve Nissen, Zetia's most vocal critic, stated to the media that a positive outcome for Zetia would convince him that Zetia is an effective treatment for atherosclerosis.