I know we are all excited about the rise in the share price. Well, there is something much more to be excited about than the upcoming approval of Remstemcel-L for aGVHD.
Note: I have created this new thread because this is not about MIS-C (C as in Children).
Background: Everyone is aware of Mesoblast's EAP for Compassionate Use of Remestemcel-L in MIS-C associated with COVID-19 that came out on July 6, 2020 (for newbies: http://investorsmedia.mesoblast.com/static-files/983e69d0-7470-44a1-a72f-8c0dd33d98f7
It's for patients aged between two months and 17 years who may receive one or two doses of remestemcel-L within five days of referral under the EAP.
I analyzed the inclusion criteria here in a previous post ---> Post #:45995252
MIS-C (in children) started out with a handful of cases but is now fast increasing to nearly 600:
https://www.cdc.gov/mis-c/cases/index.html
And they are cropping up all over, now in 40 US states and the DC area.
Well, MIS is not being confined to children anymore. Here are cases popping up in adults as well:
1) a 45 year old man in NY as reported in the Lancet
2) a 21 year old man admitted to a University College London hospital as reported in Lancet Rheumatology
(MIS is called PIMS-TS in the UK)
3) a 36-year-old woman at Maimonides Medical Center in Brooklyn, NY as reported in the American Journal of Emergency Medicine
4) Northwell Health’s Long Island Jewish Medical Center in New York and the University of California, San Diego, have also reported adult cases.
These may seem like isolated, small number of cases, but remember folks:
COVID-19 started as just ONE isolated case in WA state in the US
MIS-C also started as a handful of cases but is now close to 600 in the US
So my educated guess is that MIS in adults is taking wings. Bad for people but good for Mesoblast.
What is remarkable, and this is what gets me excited about Mesoblast's EAP for MIS in adults is this quote:
"Of particular interest to cardiologists, the patient in the case that Gnirke and colleagues detail in their report had elevated troponin, ST elevation on ECG, global hypokinesis of the LV wall with an ejection fraction of 40% on echocardiography, and angiographically normal coronary arteries". That quote is from this article below:
https://www.tctmd.com/news/covid-19s-kawasaki-mis-c-diagnosis-cropping-adults
Reason for my excitementis because in Mesoblast's EAP for MIS-C (Children), one of the inclusion criterion is:
"Participants must have demonstrable cardiac involvement (reduced left ventricular [LV] ejection fraction ≤50%) and at least one other organ involvement (renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological)".
If you are connecting the dots, Remestemcel-L is targeting reduced left ventricular [LV] ejection fraction ≤50%.
(along with at least one other organ involvement) which is the same condition in children and adults.
I have asked this question before in an earlier post but I guess no one picked up on it yet:
Riddle me this: Wasn't REVASCOR the therapy for cardiac (heart) involvement? Makes you wonder why REMESTEMCEL-L is being used in the EAP for MIS-C with cardiac involvement as an inclusion criterion. Does it mean REMESTEMCEL-L can do it all? Hmmm.
In any case, the current share price reflects only what is to come for aGVHD therapy.
It does not reflect Remestemcel-L for MIS-C or COVID-19 ARDS or what I believe a host of other things Remestemcel-L will address.
The applications for Remestemcel-L keep increasing.
How many label extensions will Ryoncil/Remestemcel-L end up having? That is the MULTI-BILLION dollar question.
Remestemcel-L a panacea for inflammation. There, I said it. And inflammation is the link between all diseases.
We are not even in the first innings yet with Remestemcel-L. So save your parties (your liver) and enthusiasm for bigger things to come.
My sentiment about Mesoblast is still a "Buy" because we are at a mere fraction of where we will be in the near future.
PS: All opinions are strictly my own. Nothing I say should be construed as financial advice or predictions of share price. Do your own research before investing money in the stock market.
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