Bristol-Myers, J&J and Bayer Presenting Key Study Results at Heart Meeting

Investors should keep an eye on developments at the European Society of Cardiology meeting, which is underway in Barcelona. News about a new type of heart drug being tested by Bristol-Myers Squibb Co. (

BMY, Financial), Johnson & Johnson (JNJ, Financial) and Bayer AG (XTER:BAYN, Financial) could potentially move the shares of the three pharmaceutical giants.

Interim study results of Bristol and Johnosn & Johnson’s milvexian and Bayer’s asundexian will be shared at the scientific gathering. Both oral drugs are known as factor XI inhibitors, which are potentially safer anticoagulants because factor XI deficiency or inhibition protects against blood clots with little or no bleeding.

Positive results from the clinical trials are especially important given Bristol and Johnson & Johnson’s mega-blockbuster thinner Elquis is set to come off patent in the next several years, as is the Bayer medication Xarelto. The importance of having successors waiting in the wings becomes apparent when you consider that Elquis revenues were up 16% in the second quarter to $3.2 billion, accounting for more than 60% of Bristol’s sales for the period.

Bristol has a collaboration agreement with Pfizer Inc. (

PFE, Financial) for Elquis that started in 2007. Profits and losses are shared equally on a global basis except in certain countries where Pfizer commercializes Eliquis and pays Bristol a sales-based percentage.

Xarelto, meanwhile, is Bayer’s top-selling pharmaceutical product, recording sales of more than $4.3 billion in 2021.

Persons at risk of developing a blood clot are often treated with an anticoagulant. However, anticoagulants may heighten the risk of bleeding. XI inhibitors could prove invaluable if they are able to reduce or eliminate that side effect. This advantage would make the class of drugs a treatment option for patients who could not be treated with an anticoagulant, according to Bayer.

Looking at the prevalence of cardiovascular disease, the commercial opportunity comes into focus. Cardiovascular disease is the leading cause of death worldwide. An estimated 85% of these deaths are due to heart attack or stroke, which are often caused by blood clots that block blood vessels in the heart or brain.

Overall, of the factor XI agents being tested, Berenberg analysts think milvexian and asundexian are likely to be the most commercially successful, with peak sales of $10 billion and $3.6 billion. However, the analysts think the chances of their being successful are about 50%, reported Evaluate.

Berenberg thinks factor XI developers have to pinpoint their targets, either going for bigger indications such as stroke prevention in atrial fibrillation, for which Eliquis and Xarelto are already used, or smaller patient groups with high unmet needs.

A dark horse in the race is privately held Anthos Therapeutics, a Novartis AG (

NVS, Financial) spinoff that recently moved its anti-factor in phase 3 studies. It is speculated that Anthos might make a nice acquisition for Pfizer, which does not have its own drug in clinical development.