Acurx Announces Positive Extended Clinical Cure Data for Ibezapolstat from Phase 2b Clinical Trial in CDI Patients
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Insights
The recent findings from Acurx Pharmaceuticals' Phase 2b clinical trial of ibezapolstat present a significant step forward in the treatment of Clostridioides difficile infection (CDI), a bacterial infection that can cause severe diarrhea and more serious intestinal conditions. The reported 100% non-recurrence rate among patients treated with ibezapolstat who were observed for up to three months post-treatment is a promising indicator of the drug's efficacy. This data is especially compelling when considering the high recurrence rates associated with CDI, which is a major challenge in current treatment paradigms.
The trial's focus on Extended Clinical Cure (ECC) is an important metric, as it encompasses both the immediate treatment success and the durability of the response, which is critical for patient quality of life and healthcare costs. The favorable microbiome data, indicating the preservation of healthy gut bacteria, is also noteworthy, as it suggests a potential advantage over traditional antibiotics like vancomycin, which can disrupt gut microbiota balance.
The advancement to Phase 3 clinical trials will be a crucial test of ibezapolstat's effectiveness on a larger scale and its potential to become a standard treatment for CDI. Its prior FDA QIDP and Fast-Track Designation underscore the unmet medical need and the regulatory agency's interest in expediting the development of promising treatments for serious conditions like CDI.
The announcement from Acurx Pharmaceuticals regarding the positive data from their Phase 2b trial is likely to have a favorable impact on the company's stock valuation. Investors typically respond positively to successful trial results, especially when they show potential for a drug to address a significant unmet medical need. The progression to Phase 3 trials is another positive signal that can lead to investor optimism about the drug's commercial prospects.
It is important to note that the financial implications of successful Phase 3 trials and subsequent FDA approval could be substantial. The market for CDI treatments is considerable, given the prevalence of the infection and the need for more effective therapies. Acurx's focus on a new class of small molecule antibiotics could position them as a leader in this space, with ibezapolstat potentially capturing a significant market share if approved.
However, investors should also consider the inherent risks associated with clinical trials. While the data is promising, Phase 3 trials are more comprehensive and may reveal new challenges. The company's financial health and ability to fund these trials, along with navigating the regulatory process, will be critical factors to watch.
The healthcare sector is a significant contributor to the economy and advancements in medical treatments can have a broad economic impact. The development of new antibiotics like ibezapolstat could lead to reduced healthcare costs by lowering the incidence of CDI recurrence, which is associated with prolonged hospital stays and increased medical expenses. Successful treatments can also improve workforce productivity by reducing the duration and severity of illness.
From a broader economic perspective, the success of companies like Acurx Pharmaceuticals could stimulate investment and job creation in the biopharmaceutical industry. It may also encourage further research and development in antibiotic resistance, a growing concern in global health. The potential international expansion of Phase 3 clinical trials signifies the global demand for effective CDI treatments and the economic opportunities in international markets.
However, the economic benefits are contingent upon the drug's eventual market success, which will depend on various factors including clinical outcomes, regulatory approval, market competition and the ability of healthcare systems to adopt new treatments.
- In the Phase 2b trial,
100% (5 of 5) of ibezapolstat-treated patients who agreed to observation for up to three months following Clinical Cure of CDI experienced no recurrence of infection - Further analyses will be forthcoming as data become available regarding effects on bile acid metabolism and pharmacokinetic data
- Preparation is underway for meetings with FDA, European Medicines Agency and other global regulatory agencies and advancement to international Phase 3 clinical trials
- Ibezapolstat has previously received FDA QIDP and Fast-Track Designation
According to Dr. Garey: "CDI has long-term consequences including poor quality of life for the patient. It's exciting to see that the ibezapolstat Phase 2b study followed patients for an extended time period to assure that the ibezapolstat cure and anti-recurrence effects are long-lasting and durable. This adds to the exciting microbiome data showing replenishment of healthy microbiota that we have seen in our prior studies."
Robert J. DeLuccia, Executive Chairman of Acurx, stated: "This Extended Clinical Cure data showing that no ibezapolstat-treated patient who achieved Clinical Cure and consented to three months of post-treatment observation experienced a recurrence of CDI during this period further strengthens the ibezapolstat lineage of clinical success building on our previously reported Phase 2 results of
David P. Luci, President & CEO of Acurx, stated: "Ibezapolstat continues to demonstrate success compared to a standard of care, oral vancomycin, to treat patients with CDI. We anticipate continued favorable differentiation between the two therapeutic options in 2024. We expect to leverage this success in a
About the Ibezapolstat Phase 2 Clinical Trial
The completed multicenter, open-label single-arm segment (Phase 2a) study was followed by a double-blind, randomized, active-controlled, non-inferiority, segment (Phase 2b) at 28 US clinical trial sites which together comprise the Phase 2 clinical trial.(see https://clinicaltrials.gov/ct2/show/NCT04247542). This Phase 2 clinical trial was designed to evaluate the clinical efficacy of ibezapolstat in the treatment of CDI including pharmacokinetics and microbiome changes from baseline and continue to test for anti- recurrence microbiome properties seen in the Phase 2a trial, including the treatment- related changes in alpha diversity and bacterial abundance and effects on bile acid metabolism.
The completed Phase 2a segment of this trial was an open label cohort of up to 20 subjects from study centers in the United States. In this cohort, 10 patients with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally, twice daily for 10 days. All patients were followed for recurrence for 28± 2 days. Per protocol, after 10 patients of the projected 20 Phase 2a patients completed treatment (
In the now completed Phase 2b trial segment, 32 patients with CDI were enrolled and randomized in a 1:1 ratio to either ibezapolstat 450 mg every 12 hours or vancomycin 125 mg orally every 6 hours, in each case, for 10 days and followed for 28 ± 2 days following the end of treatment for recurrence of CDI. The two treatments were identical in appearance, dosing times, and number of capsules administered to maintain the blind. The Company previously reported that the overall observed Clinical Cure rate in the combined Phase 2 trials in patients with CDI was
The Phase 2b clinical trial segment was discontinued due to success. The Company made this decision in consultation with its medical and scientific advisors and statisticians based on observed aggregate blinded data and other factors, including the cost to maintain clinical trial sites and slow enrollment due to COVID-19 and its aftermath. The Company had determined that the trial performed as anticipated for both treatments, ibezapolstat and the control antibiotic vancomycin (a standard of care to treat patients with CDI), with high rates of clinical cure observed across the trial without any emerging safety concerns. Accordingly, an Independent Data Monitoring Committee was not required to perform an interim analysis of this Phase 2b trial data as originally planned. The Company anticipated that this decision would allow the Company to advance this first-in-class, FDA QIDP/Fast Track-designated antibiotic product candidate to Phase 3 clinical trials more expeditiously.
The Phase 2b trial was originally designed to be a non-inferiority (NI) trial and later amended to include an interim efficacy analysis with review by an Independent Data Monitoring Committee (IDMC). The decision to end the trial early based on blinded clinical observations obviated the need for an interim analysis, IDMC review, and NI assessment. The Company determined, in consultation with its clinical and statistical experts, that presenting clinical cure rates for the primary efficacy endpoint is the most appropriate representation for the clinical activity of ibezapolstat in treating CDI.
In the Phase 2 clinical trial, the Company will also evaluate pharmacokinetics (PK) and microbiome changes and test for anti-recurrence microbiome properties, including the change from baseline in alpha diversity and bacterial abundance, especially overgrowth of healthy gut microbiota Actinobacteria and Firmicute phylum species during and after therapy. Phase 2a data demonstrated complete eradication of colonic C. difficile by day three of treatment with ibezapolstat as well as the observed overgrowth of healthy gut microbiota, Actinobacteria and Firmicute phyla species, during and after therapy. Very importantly, emerging data show an increased concentration of secondary bile acids during and following ibezapolstat therapy which is known to correlate with colonization resistance against C. difficile. A decrease in primary bile acids and the favorable increase in the ratio of secondary-to-primary bile acids suggest that ibezapolstat may reduce the likelihood of CDI recurrence when compared to vancomycin.
About Ibezapolstat
Ibezapolstat is a novel, orally administered antibiotic being developed as a Gram-Positive Selective Spectrum (GPSS™) antibacterial. It is the first of a new class of DNA polymerase IIIC inhibitors under development by Acurx to treat bacterial infections. Ibezapolstat's unique spectrum of activity, which includes C. difficile but spares other Firmicutes and the important Actinobacteria phyla, appears to contribute to the maintenance of a healthy gut microbiome.
In June 2018, ibezapolstat was designated by the
About Clostridioides difficile Infection (CDI). According to the 2017 Update (published February 2018) of the Clinical Practice Guidelines for C. difficile Infection by the Infectious Diseases Society of America (IDSA) and Society or Healthcare Epidemiology of America (SHEA), CDI remains a significant medical problem in hospitals, in long-term care facilities and in the community. C. difficile is one of the most common causes of health care- associated infections in
About the Microbiome in C. difficile Infection (CDI) and Bile Acid Metabolism
C. difficile can be a normal component of the healthy gut microbiome, but when the microbiome is thrown out of balance, the C. difficile can thrive and cause an infection. After colonization with C. difficile, the organism produces and releases the main virulence factors, the two large clostridial toxins A (TcdA) and B (TcdB). (Kachrimanidou, Microorganisms 2020, 8, 200; doi:10.3390/microorganisms8020200.) TcdA and TcdB are exotoxins that bind to human intestinal epithelial cells and are responsible for inflammation, fluid and mucous secretion, as well as damage to the intestinal mucosa.
Bile acids perform many functional roles in the GI tract, with one of the most important being maintenance of a healthy microbiome by inhibiting C. difficile growth. Primary bile acids, which are secreted by the liver into the intestines, promote germination of C. difficile spores and thereby increase the risk of recurrent CDI after successful treatment of an initial episode. On the other hand, secondary bile acids, which are produced by normal gut microbiota through metabolism of primary bile acids, do not induce C. difficile sporulation and therefore protect against recurrent disease. Since ibezapolstat treatment leads to minimal disruption of the gut microbiome, bacterial production of secondary bile acids continues which may contribute to an anti-recurrence effect. Beneficial effects of bile acids include a decrease in primary bile acids and an increase in secondary bile acids in patients with CDI, which was observed in the Company's Ph2a trial results and previously reported (CID, 2022).
About Acurx Pharmaceuticals, Inc.
Acurx Pharmaceuticals is a late-stage biopharmaceutical company focused on developing a new class of small molecule antibiotics for difficult-to-treat bacterial infections. The Company's approach is to develop antibiotic candidates with a Gram-positive selective spectrum (GPSS®) that blocks the active site of the Gram+ specific bacterial enzyme DNA polymerase IIIC (pol IIIC), inhibiting DNA replication and leading to Gram-positive bacterial cell death. Its R&D pipeline includes antibiotic product candidates that target Gram-positive bacteria, including Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE) and drug-resistant Streptococcus pneumoniae (DRSP).
To learn more about Acurx Pharmaceuticals and its product pipeline, please visit www.acurxpharma.com
Forward-Looking Statements
Any statements in this press release about our future expectations, plans and prospects, including statements regarding our strategy, future operations, prospects, plans and objectives, and other statements containing the words "believes," "anticipates," "plans," "expects," and similar expressions, constitute forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by such forward-looking statements as a result of various important factors, including: whether ibezapolstat will benefit from the QIDP designation; whether ibezapolstat will advance through the clinical trial process on a timely basis; whether the results of the clinical trials of ibezapolstat will warrant the submission of applications for marketing approval, and if so, whether ibezapolstat will receive approval from the FDA or equivalent foreign regulatory agencies where approval is sought; whether, if ibezapolstat obtains approval, it will be successfully distributed and marketed; and other risks and uncertainties described in the Company's annual report filed with the Securities and Exchange Commission on Form 10-K for the year ended December 31, 2022, and in the Company's subsequent filings with the Securities and Exchange Commission. Such forward- looking statements speak only as of the date of this press release, and Acurx disclaims any intent or obligation to update these forward-looking statements to reflect events or circumstances after the date of such statements, except as may be required by law.
Investor Contact: Acurx Pharmaceuticals, Inc.
David P. Luci, President & CEO
Tel: 917-533 1469
Email: davidluci@acurxpharma.com
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SOURCE Acurx Pharmaceuticals, Inc.
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