Pneumococcal 15-valent Conjugate Vaccine(Merck & Co.)

October 16, 2024 6:45 am ET STRIDE-8 results presented at IDWeek build on the proven clinical profile of CAPVAXIVE, marking the latest Phase 3 study evaluating CAPVAXIVE to demonstrate robust immune responses in adults CAPVAXIVE covers the serotypes responsible for approximately 84% of invasive pneumococcal disease cases in adults 50 and older RAHWAY, N.J.--(BUSINESS WIRE)-- Merck (NYSE: MRK), known as MSD outside of the United States and Canada, today announced results from STRIDE-8, a Phase 3 trial evaluating CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine), at IDWeek 2024 in Los Angeles, California. The trial evaluated the immunogenicity, safety and tolerability of CAPVAXIVE compared to PCV15 (pneumococcal 15-valent conjugate vaccine) in combination with PPSV23 (pneumococcal 23-valent polysaccharide vaccine) in vaccine-naïve adults 18-64 years of age with certain chronic conditions that put them at an increased risk of pneumococcal disease. Key findings from the STRIDE-8 trial include: CAPVAXIVE was immunogenic for all 21 serotypes (or strains) included in the vaccine, as measured by serotype-specific opsonophagocytic activity (OPA) geometric mean titers (GMTs) (primary immunogenicity objective) and immunoglobulin G (IgG) geometric mean concentrations (GMCs) (secondary immunogenicity objective) at Day 30; Immune responses elicited by CAPVAXIVE were comparable to PCV15 followed by PPSV23 for the 13 common serotypes and higher for the eight serotypes unique to CAPVAXIVE, as measured by serotype-specific OPA GMTs and IgG GMCs 30 days post-vaccination; The proportions of participants with adverse events (AEs), including injection-site, systemic, and vaccine-related AEs, were numerically lower in the V116 + placebo group than in the PCV15 + PPSV23 group. “Adults with chronic medical conditions, such as kidney disease or diabetes, are particularly vulnerable to invasive pneumococcal disease, which may increase their risk of severe illness,” said Dr. Walter Orenstein, professor emeritus of medicine, epidemiology, global health and pediatrics at Emory University and member of Merck’s Scientific Advisory Committee. “These data further demonstrate that the broad serotype coverage CAPVAXIVE provides can help prevent invasive disease among vulnerable adults.” CAPVAXIVE is indicated for: Active immunization for the prevention of invasive disease and pneumonia caused by Streptococcus pneumoniae serotypes 3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15B, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F and 35B in adults individuals 18 years of age and older; Active immunization for the prevention of pneumonia caused by S. pneumoniae serotypes 3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F and 35B in individuals 18 years of age and older. The indication for the prevention of pneumonia caused by S. pneumoniae serotypes 3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F and 35B is approved under accelerated approval based on immune responses as measured by opsonophagocytic activity (OPA). Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial. CAPVAXIVE should not be administered to individuals with a history of a severe allergic reaction (e.g., anaphylaxis) to any component of CAPVAXIVE or to diphtheria toxoid; see additional Select Safety Information below. “The data presented during IDWeek build on the robust clinical profile of CAPVAXIVE and illustrate the importance of improving equitable access for those at high risk for invasive pneumococcal disease,” said Dr. Macaya Douoguih, Therapeutic Area Head, Vaccines Clinical Research, Merck Research Laboratories. “Our commitment to prioritizing research and advancements that benefit populations at highest risk of invasive pneumococcal disease remains critical.” In addition to STRIDE-8, Merck also presented results from a targeted literature review of the clinical and economic burden of pneumococcal disease in U.S. adults. The findings concluded that Black adults and adults in rural areas with lower levels of education and income face higher disease burden and lower rates of pneumococcal vaccination. Data from a modeling study evaluating the health impact of the introduction of CAPVAXIVE in U.S. adults were also presented. The modeling study concluded that the use of CAPVAXIVE in adults reduced IPD incidence by 33.9% in the U.S. after 10 years, in the setting of continued pediatric PCV vaccination. This equated to approximately 14,000 fewer cases with CAPVAXIVE than PCV20 (pneumococcal 20-valent conjugate vaccine) after 10 years. CAPVAXIVE is specifically designed to help protect adults against the serotypes that cause the majority of invasive pneumococcal disease (IPD) cases. Based on CDC data from 2018-2021, the serotypes covered by CAPVAXIVE are responsible for more cases of IPD in adults compared to PCV20. In adults 50 years of age and older, CAPVAXIVE covers the serotypes responsible for approximately 84% of IPD cases, compared to approximately 52% covered by PCV20; In adults 65 years of age and older, CAPVAXIVE covers the serotypes responsible for approximately 85% of IPD cases, compared to approximately 51% covered by PCV20. These values are based on CDC epidemiologic data and do not reflect the efficacy of the respective vaccines. There are currently no studies comparing the efficacy of CAPVAXIVE and PCV20. The Phase 3 program for CAPVAXIVE spanned multiple studies, including STRIDE-3 ( NCT05425732 ), STRIDE-4 ( NCT05464420 ), STRIDE-5 ( NCT05526716 ), STRIDE-6 ( NCT05420961 ), STRIDE-7 ( NCT05393037 ), STRIDE-8 ( NCT05696080 ), STRIDE-9 ( NCT05633992 ) and STRIDE-10 ( NCT05569954 ). Summary of Findings from Select Studies Presented at IDWeek Data from STRIDE-8 (Abstract #P-45) STRIDE-8 ( NCT05696080 ) is a Phase 3, randomized, double-blind, active comparator-controlled clinical study, evaluating the immunogenicity, safety and tolerability of CAPVAXIVE in adults 18-64 years of age with increased risk for pneumococcal disease (including adults who experienced diabetes mellitus, heart disease, kidney disease, liver disease and lung disease) who had not previously received a pneumococcal vaccine (n=518). Immunogenicity of CAPVAXIVE was compared with sequential administration of PCV15 followed by PPSV23. Participants were randomized 3:1 to receive a single dose of CAPVAXIVE on Day 1 followed by placebo at Week 8, or a single dose of PCV15 on Day 1 followed by a single dose of PPSV23 at Week 8. Primary objectives included serotype-specific OPA GMTs and IgG GMCs at Day 1 and 30-days post-vaccination (Day 30 for CAPVAXIVE + placebo and Week 12 for PCV15 + PPSV23). Safety was evaluated as the proportion of participants with adverse events. Results showed that: CAPVAXIVE was immunogenic for all 21 serotypes included in the vaccine, as measured by OPA GMTs and IgG GMCs at Day 30; Immune responses elicited by CAPVAXIVE were comparable to PCV15 and PPSV23 for the 13 common serotypes (3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 17F, 19A, 20A, 22F and 33F) with higher responses for the eight serotypes unique to CAPVAXIVE (15A, 15C, 16F, 23A, 23B, 24F, 31 and 35B) as measured by serotype-specific OPA GMTs and IgG GMCs 30 days post-vaccination; The proportions of participants with AEs, including injection-site, systemic, and vaccine-related AEs, were numerically lower in the V116 + placebo group than in the PCV15 + PPSV23 group. Results from Disparities and Inequities in Pneumococcal Disease Burden Targeted Literature Review (Abstract # P-242) A targeted literature review was conducted on the clinical and economic burden of pneumococcal disease in U.S. adults, with a focus on the disparities and inequities by race, geography, urbanicity, income, education and employment. Of 4,609 identified publications (published from January 2012 – July 2024), 12 studies were evaluated. Key findings showed that disparities in burden from pneumococcal disease exist in the U.S., particularly among Black adults and those living in rural areas with lower education and income. Detailed findings included: Black adults had the highest incidence and longest length of hospital stay due to IPD compared to other racial groups; Areas categorized as less urban displayed higher mortality rates for pneumococcal pneumonia; Vaccination rates were lower among Black adults compared to white adults; Vaccination rates were also low among adults who lived in rural areas with lower levels of income and education. The study concluded that more research is needed to further examine disparities and inequities in the burden of pneumococcal disease. Results from Modeling Study Quantifying the Impact of Introducing a New Adult-Focused PCV in the United States (Abstract #P-58) A modeling study evaluated CAPVAXIVE in comparison to PCV20 to quantify the health impact of both vaccines in U.S. adults. The compartmental model captured pneumococcal carriage transmission in the presence of age- and serotype-specific pneumococcal vaccines and was calibrated to the corresponding IPD data in the U.S. The model was then used to quantify the impact of both CAPVAXIVE and PCV20 on overall IPD incidence in adults of all ages, accounting for continued pediatric PCV vaccination. Analysis assumed pediatric vaccination continued at 82% coverage with an 80/20 mix of PCV20/PCV15 in infants and that 57% of adults aged 65 and older would have received a PCV in the last 10 years. Results showed that while the continued use of both CAPVAXIVE and PCV20 led to reductions in IPD incidence when compared to current disease rates, the use of CAPVAXIVE led to fewer overall cases than the use of PCV20 after 10 years, with a 33.9% reduction across all ages versus a 28.9% reduction, respectively. These results equated to approximately 14,000 fewer cases of IPD in adults with CAPVAXIVE than with PCV20. Findings also showed that despite a greater number of cases in the serotypes not included in CAPVAXIVE when compared to adult PCV20 use, indirect protection of adults from pediatric vaccination resulted in continued declines in these serotypes from present values. About CAPVAXIVE CAPVAXIVE is Merck’s approved 21-valent pneumococcal conjugate vaccine indicated for active immunization for the prevention of invasive disease and pneumonia in adults 18 years of age and older. CAPVAXIVE is specifically designed to help address Streptococcus pneumoniae serotypes predominantly responsible for adult invasive pneumococcal disease (IPD), including eight unique serotypes, 15A, 15C, 16F, 23A, 23B, 24F, 31 and 35B compared to other pneumococcal vaccines. CAPVAXIVE is administered as a single dose. Select Safety Information for CAPVAXIVE Do not administer CAPVAXIVE to individuals with a history of a severe allergic reaction (eg, anaphylaxis) to any component of CAPVAXIVE or to diphtheria toxoid. Individuals with altered immunocompetence, including those receiving immunosuppressive therapy, may have a reduced immune response to CAPVAXIVE. The most commonly reported (>10%) solicited adverse reactions in individuals 18 through 49 years of age who received CAPVAXIVE were: injection-site pain (73.1%), fatigue (36.0%), headache (27.5%), myalgia (16.4%), injection-site erythema (13.8%), and injection-site swelling (13.3%). The most commonly reported (>10%) solicited adverse reactions in individuals 50 years of age and older who received CAPVAXIVE were: injection-site pain (41.2%), fatigue (19.7%), and headache (11.0%). Vaccination with CAPVAXIVE may not protect all vaccine recipients. About Pneumococcal Disease Pneumococcal disease is an infection caused by a bacteria called Streptococcus pneumoniae . There are about 100 different types (referred to as serotypes) of pneumococcal bacteria, which can affect adults differently than children. Pneumococcal disease can be invasive or non-invasive. Non-invasive pneumococcal illnesses include pneumonia (when pneumococcal disease is confined to the lungs), whereas invasive pneumococcal illnesses include pneumococcal bacteremia (infection in the bloodstream), bacteremic pneumococcal pneumonia (pneumonia with bacteremia) and pneumococcal meningitis (infection of the coverings of the brain and spinal cord). Pneumococcal pneumonia is a type of bacterial pneumonia, which is the most common clinical presentation of pneumococcal disease in adults. It’s estimated that over 150,000 adults are hospitalized from pneumococcal pneumonia each year in the U.S. Merck’s Commitment to Pneumococcal Disease Protection Merck has been at the forefront of pneumococcal disease prevention through vaccination for more than four decades and remains committed to helping to protect people of all ages from this disease. Merck’s ongoing pneumococcal vaccine development program is designed to provide options that address the specific needs of different populations, including infants and children, healthy adults and at-risk sub-groups. This approach recognizes that disease burden in pediatric and adult populations is often driven by different bacterial strains, or serotypes, and aims to address unmet needs by offering vaccine options that target serotypes posing the greatest global risk to each population. To learn more about Merck’s pipeline, visit www.merck.com . About Merck At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world – and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit www.merck.com and connect with us on X (formerly Twitter) , Facebook , Instagram , YouTube and LinkedIn . Forward-Looking Statement of Merck & Co., Inc., Rahway, N.J., USA This news release of Merck & Co., Inc., Rahway, N.J., USA (the “company”) includes “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the company’s management and are subject to significant risks and uncertainties. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements. Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the company’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the company’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions. The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s Annual Report on Form 10-K for the year ended December 31, 2023 and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site ( www.sec.gov ). Please see Prescribing Information for CAPVAXIVE (Pneumococcal 21-valent Conjugate Vaccine) at https://www.merck.com/product/usa/pi_circulars/c/capvaxive/capvaxive_pi.pdf and Patient Information/Medication Guide for CAPVAXIVE at https://www.merck.com/product/usa/pi_circulars/c/capvaxive/capvaxive_ppi.pdf . Media Contacts: Julie Cunningham (617) 519-6264 julie.cunningham@merck.com Chrissy Trank (640) 650-0694 chrissy.trank@merck.com Investor Contacts: Peter Dannenbaum (732) 594-1579 peter.dannenbaum@merck.com Alexis Constantine (732) 594-1578 alexis.constantine@merck.com Source: Merck & Co., Inc.

As major multinational corporations (MNC) report their financial results for the second quarter of 2024, pharmaceutical industry leaders such as Astrazeneca, Roche, Sanofi, Johnson & Johnson and Novartis have announced their financial results for the first half of 2024 (H1). As of August 6, according to the operating income data of the first half of the year, the ranking of the top ten enterprises in the global pharmaceutical industry has been settled, and the specific ranking is as follows: Quarterly and Half-Yearly Revenue and Year-Over-Year Growth Rate Chart for the Second Quarter and Full Year 2024 Rank Company 2024 Q2 Revenue (Billion USD) YoY Growth 2024 H1 Revenue (Billion USD) YoY Growth 1 Johnson & Johnson 224.5 4.3% 438 3.3% 2 Roche 178.19 13.9% 337.19 5.0% 3 Merck 161.12 7.2% 318.87 8.0% 4 Pfizer 132 2.0% 281.62 -11.0% 5 AbbVie 144.62 4.3% 267.72 3.7% 6 AstraZeneca 129.38 13.3% 256.17 18.0% 7 Novartis 125.1 11.0% 243 11.0% 8 Bristol-Myers Squibb 122.01 9.0% 240.66 7.0% 9 Sanofi 117.22 10.2% 230.20 8.4% 10 GlaxoSmithKline 100.38 13.0% 194.12 12.0%   With the gradual fading of the novel coronavirus epidemic in 2023, the revenue pattern of the global large pharmaceutical companies has ushered in a new round of change. Entering 2024, the impact of the epidemic on business operations has significantly weakened, and pharmaceutical companies have gradually returned to the normal development track. From the performance point of view, in the first half of 2024, in addition to Pfizer, the revenue of the remaining nine pharmaceutical companies generally showed an increase.   Against this backdrop, Johnson & Johnson has solidified its position as the top global pharmaceutical and medical device company in terms of revenue. According to the financial data for the first half of 2024, Johnson & Johnson's overall revenue reached $43.83 billion, an increase of 3.3%. From the perspective of treatment segment segmentation, the tumor segment is particularly strong, and its revenue has surpassed the autoimmune diseases segment to become the largest revenue contribution of Johnson & Johnson. Specifically, revenue from the oncology segment reached $5.09 billion in the second quarter, up 15.7% year over year; In the autoimmune diseases segment, revenue in the same period was $4.722 billion, a growth rate of only 5%.   In terms of product lines, Darzalex in oncology, with its $5.57 billion in sales, successfully surpassed Stelara in autoimmune diseases ($5.536 billion in sales) to become the top-selling product in the first half of 2024. In addition, two new oncology drugs, BCMA CAR-T therapy Carvykti and dual antibody product Tecvayli, also showed strong growth momentum, with sales reaching $343 million and $268 million, respectively, with year-on-year growth rates of 81.5% and 70.2%.   In order to further strengthen its competitiveness in the field of oncology and immunization, Johnson & Johnson continues to increase investment in innovative drugs. In the first half of 2024, J&J completed a number of important acquisitions. Among them, the $2 billion acquisition of AmbrxBiopharma brought several ADC pipelines to the company; The $850 million acquisition of Proteologix and the $1.25 billion acquisition of a subsidiary of NumabTherapeutics further strengthen the company's portfolio of dual antibody products in the field of autoimmune diseases.   Roche showed solid growth in the first half of 2024, with total revenues of CHF 29.848 billion (US $33.719 billion), up 5% year-on-year. Among them, the pharmaceutical business, as the core driver, contributed 22.637 billion Swiss francs (about $25.573 billion) in revenue, and China revenue achieved double-digit growth to reach 1.609 billion Swiss francs (about $1.818 billion).   In pharmaceuticals, the oncology segment continued to play a leading role, contributing 9.619 billion Swiss francs ($10.867 billion), or 42.5% of total revenue, to Roche, which remained at 4% despite a slight slowdown in year-on-year growth. In contrast, the ophthalmology business showed strong growth with revenues of CHF 1.891 billion, up 54% year on year, and although it currently accounts for only 8.4% of total revenues, its potential cannot be ignored.   Specific to the product level, the ophthalmological double antibody Vabysmo (Pharisimumab) performance is particularly outstanding, the first half of the sales revenue of up to 1.794 billion Swiss francs (about 2.027 billion US dollars), an increase of 93%, almost doubled, successfully ranked among Roche's top 5 best-selling drugs. In addition, Ocrevus (Orizumab), Hemlibra (Emetzizumab), Evrysdi (Rispran), Phesgo (Trastuzumab + pertuzumab), Polivy (Vipostuzumab), Xolair (Omazumab), Alecensa (Aletinib) and other drugs also remained strong Growth trend.   On the other hand, Merck also achieved impressive results in the first half of 2024. The company's total revenue reached $31.887 billion, an increase of 8%, and pharmaceutical revenue reached $28.415 billion, an increase of 9%. Revenue in the second quarter was $16.1 billion, up 7 percent from a year earlier. This increase was mainly due to the excellent performance of K-drug (Pabolizumab) and HPV vaccine.   As a star product of Merck, K drug sales reached 14.217 billion US dollars in the first half of this year, achieving a double-digit high growth of 18%, and is expected to break through the 30 billion US dollars mark for the whole year. At the same time, HPV vaccines also maintained a stable sales performance, Gardasil/Gardasil 9 sales reached $4.727 billion, an increase of 7%.   In addition, the company's oncology products such as Welireg (HIF-2α inhibitor) and Reblozyl (Rottsip), as well as the anti-cytomegalovirus infection drug Prevymis (Lytamovir) and 15-valent pneumococcal vaccine Vaxneuvance, also achieved double-digit or higher growth.   However, it is worth noting that Merck's main revenue is still highly dependent on K drugs and HPV vaccines. Among them, K drug sales accounted for nearly half of the company's total revenue. Although K-drug is still in a period of rapid growth, its patent will expire in 2028, when it will face the risk of declining sales. At the same time, the HPV vaccine market is increasingly competitive, and Merck's HPV vaccine sector revenue is not indestructible.   As a result, MSD is actively pursuing a second growth curve. Since the beginning of this year, the company has continuously introduced new potential products and pipelines through acquisitions, including pneumonia conjugate vaccine, the new drug Sotatercept for pulmonary hypertension, a new generation of RSV neutralizing antibodies, TL1A antibodies, and neoantigen mRNA vaccines, with a view to achieving more diversified revenue sources in the future.   Among the world's top 10 multinational pharmaceutical companies, Pfizer has been the most affected by the COVID-19 pandemic. In 2023, due to the sharp decline in sales of new coronavirus vaccine Comirnaty and anti-new coronavirus drug Paxlovid, the company failed to continue the brilliant performance of over 100 billion dollars in 2022, not only lost the top position in the industry, but also withdrew from the top three ranks. Entering 2024, although the first half of the revenue decline is still as high as 11%, showing that the company has not completely rid of the negative impact of the fading of the new coronavirus dividend, but the second quarter performance has shown signs of recovery. Financial data show that in the first half of 2024, the company's total revenue was 28.162 billion US dollars, down 11% year-on-year; In the second quarter, revenue reached $13.2 billion, up 2% from the same period last year and exceeding market analysts' expectations ($12.96 billion). If the contribution of COVID-19 vaccines and oral COVID-19 drugs is not included, the revenue growth in the second quarter was more significant, reaching 14%, which is the first time since the global coronavirus epidemic gradually eased in the fourth quarter of 2022, Pfizer achieved positive quarterly revenue growth, marking the company has adjusted to a good state and embarked on a new journey.   From the perspective of business structure, in the first half of 2024, the revenue of COVID-19 product Paxlovid was 2.286 billion US dollars, down 46% year-on-year; Comirnaty's revenue was $548 million, down 88% year over year. Despite the continued decline in revenue from COVID-19 products, the company's oncology business has achieved rapid growth, reaching $7.505 billion in revenue in the first half of the year, up 23% year-on-year. Among them, the breast cancer blockbuster CDK4/6 inhibitor Ibrance (Pipercilil), despite a slight decline in sales (-8%), still topped oncology drug sales with $2.184 billion in revenue. Androgen receptor signaling inhibitor Xtandi (Enzaluamide) and third-generation ALK inhibitor Lorbrena (Loratinib) also saw growth of 20% and 46%, respectively, with revenues of $913 million and $332 million, respectively.   In addition, ADCs such as Vyndaqel (chlorobenzolic acid), Eliquis (Apoxaban) and Nurtec ODT/Vydura, which were acquired through the Seagen acquisition, also began to contribute to the company's revenue. Abbvie also showed solid growth in the first half of 2024, with total revenue of $26.772 billion, up 3.7% year-on-year. In terms of therapeutic areas, autoimmune diseases, neuroscience, and oncology were the three pillars of the company's revenue, generating $12.342 billion (+0.6%), $4.127 billion (+15.6%), and $3.177 billion (+11%), respectively.   In the autoimmune diseases segment, although Humira (Adalimumab) has failed to reverse the downward trend in performance, with a decline of about 32% to $5.084 billion, full-year revenue is expected to fall below the $10 billion mark. However, the company's two star products in the field, Skyrizi (Lisencizumab) and Rinvoq (Upatinib), have maintained strong growth momentum, achieving revenue of $4.735 billion (+46.6%) and $2.523 billion (+60.4%), respectively, of which Skyrizi is expected to break the $10 billion revenue mark by the end of the year. In the oncology segment, Imbruvica continued to lose market share, with first-half revenue down 6.4% year-on-year to $1.671 billion; Venclexta, on the other hand, maintained steady growth, with first-half sales of $1.251 billion (+16%). In addition, the new blood cancer product CD3/CD20 dual antibody Epkinly since the FDA approved the market in May last year, sales have also doubled, from $31 million in the first half of 2023 to $63 million in the first half of this year. At the same time, the FRα ADC drug Elahere (Somituximab) acquired by the company in the acquisition of ImmunoGen late last year also contributed $192 million to the company's revenue in six months.   In the neuroscience segment, with the exception of Duodopa, a drug for Parkinson's disease, which showed negative growth, all products achieved steady growth. Although Qulipta's sales volume is not large ($281 million in revenue in the first half of the year), the growth rate is as high as 73.2%, becoming the fastest growing product in the field. Other products such as Ubrelvy, Botox Therapeutics and Vraylar also saw varying degrees of growth. Looking ahead, as AbbVie's pipeline in neuroscience continues to advance and its layout is optimized, the company is expected to continue to expand its market advantage in this field.   Novartis continues to deepen its commitment to nuclear medicine and invests in small nucleic acids and gene therapy. In the first half of 2024, Novartis achieved total revenue of $24.3 billion, an increase of 11%, of which sales in the China market reached $2.1 billion, an increase of 29%.   In the therapeutics segment, Novartis is showing strong growth. Oncology revenue reached $6.984 billion, up 14% year-over-year; Cardiovascular/renal metabolism revenue of $4.111 billion, up 37% year-over-year; Immunization revenue was $4.403 billion, up 21% year on year; Revenue in the neuroscience segment was $2.234 billion, up 39% from a year earlier.   Within these areas, several of Novartis's core products performed well, such as Entresto (sacubactril valsartan) revenue of $3.777 billion, up 30% year-over-year; Kesimpta (Oftolumab) revenue of $1.436 billion, an increase of 64%; Cosentyx revenue of $2.852 billion, up 21% year-over-year; Kisqali (Ribosili) revenue of $1.344 billion, an increase of 48%.   In addition, Novartis's layout in the field of nuclear drugs has also achieved significant results. In the first half of the year, Pluvicto and Lutathera generated revenue of $655 million (+45%) and $344 million (+16%), respectively, for a combined revenue of nearly $1 billion. Meanwhile, sales of Leqvio, a long-acting PCSK9 siRNA lipd-lowering drug, reached $333 million, up 135% year-over-year, making it Novartis' fastest growing new drug category. Gene therapy products also performed well, with Zolgensma, which treats spinal muscular atrophy (SMA), reporting first-half revenue of $644 million, up 6 percent year-on-year.   It is worth noting that Novartis has shown a unique vision in product development and M&A strategy. Unlike other multinational pharmaceutical companies (MNC), Novartis's products and research pipeline are less involved in ADC, PD-1, GLP-1 and other hot tracks. Instead, Novartis prefers to focus on the development of cutting-edge technologies and innovative therapies, such as nuclear drugs, small nucleic acids, cell and gene therapies (CGT). Although the combined revenue of these emerging areas is still less than 10% of total revenue, Novartis's future development prospects will be broader as the market matures in the future.   In addition, the top 10 MNCS such as Astrazeneca, Sanofi, GlaxoSmithKline, Bristol-Myers Squibb also achieved positive revenue growth in the first half of 2024. With the intensification of market competition, each MNC is actively adjusting its strategy, some grasp the hot spots of The Times to expand the advantages of the field, some choose to avoid homogenized competition, and some focus on the core business by cutting off non-core assets. All these efforts are in order to stand out in the fierce market competition, looking forward to the second half of the MNC can continue to bring wonderful performance.