Cassava Science and The Numbers. $SAVA Simufilam

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For $SAVA it has been good to be known by Mr. Market. Just look at the share price performance. Nevertheless, the numbers are not that astounding as the price performance would have it.

Since most of my research has been dealing with MMSE scores, and I am most aquatinted with MMSE ranges for Alzheimer’s I tend to bring data into the MMSE scores to carry out analysis. I found a calculator for MMSE, ADAS-Cog and CDR-SOB scales in the paper, link provided here https://www.tandfonline.com/doi/full/10.1080/13854046.2015.1119312

Drawing lines and measuring the scales, I got that the initial MMSE score of 25 MMSE points for the trial baseline. Compare it with the published by $SAVA 22.1 MMSe initial score but then the readout from the plot is saying that 15.5 ADAS-Cog corresponds to MMSE 25 points. There can be a misinterpretation on my part as different measures of ADAS-Cog exists and the used by $SAVA is ADAS-Cog11 battery. Nevertheless the mean improvement is just 0.7 MMSE points as the scale of 30 MMSE to 70 ADAS-Cog would suggest. The published mean improvement of 50 patients was -1.6 ADAS-Cog11, no MMSE scale results were given.

Also in the press release $SAVA said that the label of Aricept (Donepzepil) gave the yearly decline to be 6 to 12 points on ADAS-Cog scale. Using the plot given above and chosing the values of 8 as mean. Starting with the ADAS-Cog score of 16 and going additional 8 points we have a correspponding decline on MMSE scale of ~3.0 points (from 25 to 22 MMSE). A quick and dirty measure of statistical effectiveness is the Effect Size, Cohen’s d. We are not given enough data to do so. In this case we resort to making educated guesses or what others call assumptions.

If we say that the MMSE score for 50 patients over 26 weeks was +0.7 with Standard Deviation +/-2.5 (comparable to SD SuperResponders in 57 week data for $AVXL) and take the ADNI MMSE -2.2 SD +/-2.0 as placebo then the Effect Size for $SAVA interim reading is: ~0.40. This is much better than ~0.28 achieved by Donezepil which was approved in 2004. This is not an absolute value of efficacy. It is provided here to give insight, not to be definitive guide.

For the worst and the best Effet Size in $AVXL Phase2b/3 trial for Blarcamesine in Alzheimer’s see my previous post https://wp.me/p2IvqX-ck .

I can also cite here Cohen’s d Effect Size taking into consideration already existing data and the results of genetic analysis of the patients in Phase 2a Alzheimer’s trial for Blarcamesine (Anavex2-73). The poster was displayed at AAIC 2018 Alzheimer’s Accociation meeting.

The Effect Size range can be read off this plot. You can download the PDF of the poster here.

Looking at $SAVA or $AVXL one can see that new generation of Alzheimer’s drugs are going into approval. $SAVA at this point might be the champion in valuation but $AVXL provides more value to investors.

Disclosure, I am long $AVXL.