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Acurx Sponsored and Participated in the Peggy Lillis Foundation Inaugural CDI Scientific Symposium and Presented Ibezapolstat Ph2b Clinical Data Update

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Acurx Pharmaceuticals (NASDAQ: ACXP) participated in the Peggy Lillis Foundation's Inaugural CDI Scientific Symposium, presenting updated Phase 2b clinical data for ibezapolstat. The company is preparing to advance its lead antibiotic candidate into international Phase 3 clinical trials for C. difficile Infection (CDI) treatment. Dr. Kevin Garey presented microbiome results showing ibezapolstat promotes beneficial bacteria growth while avoiding harmful Proteobacteria overgrowth. The FDA has agreed on key elements for two Phase 3 pivotal trials, requiring approximately 450 subjects in the Modified Intent-To-Treat population, randomized 1:1 between ibezapolstat and vancomycin.

Acurx Pharmaceuticals (NASDAQ: ACXP) ha partecipato al Simposio Scientifico Inaugurale della Peggy Lillis Foundation sulla CDI, presentando dati aggiornati della fase 2b per l'ibezapolstat. L'azienda si sta preparando ad avanzare il suo principale candidato antibiotico verso studi clinici internazionali di fase 3 per il trattamento dell'infezione da C. difficile (CDI). Il Dr. Kevin Garey ha presentato risultati sul microbioma che mostrano come l'ibezapolstat promuova la crescita di batteri benefici evitando al contempo la proliferazione di Proteobacteria dannose. La FDA ha concordato su elementi chiave per due studi clinici pivotali di fase 3, richiedendo circa 450 soggetti nella popolazione Modified Intent-To-Treat, randomizzati 1:1 tra ibezapolstat e vancomicina.

Acurx Pharmaceuticals (NASDAQ: ACXP) participó en el Simposio Científico Inaugural de la Fundación Peggy Lillis sobre CDI, presentando datos actualizados de la fase 2b para el ibezapolstat. La empresa se está preparando para avanzar su principal candidato a antibiótico hacia ensayos clínicos internacionales de fase 3 para el tratamiento de la infección por C. difficile (CDI). El Dr. Kevin Garey presentó resultados sobre el microbioma que muestran que el ibezapolstat promueve el crecimiento de bacterias beneficiosas mientras evita el crecimiento excesivo de Proteobacterias dañinas. La FDA ha acordado elementos clave para dos ensayos pivotal de fase 3, requiriendo aproximadamente 450 sujetos en la población de Modified Intent-To-Treat, randomizados 1:1 entre ibezapolstat y vancomicina.

Acurx Pharmaceuticals (NASDAQ: ACXP)는 페기를 리리스 재단의 초청 CDI 과학 심포지엄에 참여하여 ibezapolstat의 2b상 업데이트된 임상 데이터를 발표했습니다. 이 회사는 C. difficile 감염 (CDI) 치료를 위한 국제 3상이 임상 시험으로의 주력 항생제 후보를 진전시킬 준비를 하고 있습니다. Kevin Garey 박사는 ibezapolstat이 유익한 박테리아 성장을 촉진하면서 유해한 프로테오박테리아의 과다 성장을 피하는 것을 보여주는 미생물군 결과를 발표했습니다. FDA는 ibezapolstat와 반코마이신 간의 1:1 무작위 배정으로, Modified Intent-To-Treat 인구에서 약 450명의 피험자를 요구하는 두 가지 주요 3상 시험의 주요 요소에 동의했습니다.

Acurx Pharmaceuticals (NASDAQ: ACXP) a participé au premier symposium scientifique sur la CDI de la Peggy Lillis Foundation, présentant des données cliniques mises à jour de la phase 2b pour l'ibezapolstat. L'entreprise se prépare à faire avancer son candidat antibiotique principal vers des essais cliniques internationaux de phase 3 pour le traitement de l'infection à C. difficile (CDI). Le Dr Kevin Garey a présenté des résultats sur le microbiome montrant que l'ibezapolstat favorise la croissance de bactéries bénéfiques tout en évitant la prolifération excessive de Proteobacteria nuisibles. La FDA a accepté des éléments clés pour deux essais pivotants de phase 3, nécessitant environ 450 sujets dans la population Modifié Intent-To-Treat, randomisés 1:1 entre ibezapolstat et vancomycine.

Acurx Pharmaceuticals (NASDAQ: ACXP) nahm am Ersten CDI-Wissenschaftssymposium der Peggy Lillis Foundation teil und präsentierte aktualisierte Daten aus der Phase 2b für ibezapolstat. Das Unternehmen bereitet sich darauf vor, seinen führenden Antibiotika-Kandidaten in internationale Phase 3-Studien zur Behandlung von C. difficile-Infektionen (CDI) voranzubringen. Dr. Kevin Garey präsentierte Mikrobiom-Ergebnisse, die zeigen, dass ibezapolstat das Wachstum von nützlichen Bakterien fördert und gleichzeitig das übermäßige Wachstum von schädlichen Proteobakterien vermeidet. Die FDA hat sich auf wichtige Elemente für zwei wegweisende Phase-3-Studien geeinigt, die ungefähr 450 Probanden in der Modified Intent-To-Treat-Population erfordern, die im Verhältnis 1:1 zwischen ibezapolstat und Vancomycin randomisiert sind.

Positive
  • FDA agreement reached on Phase 3 trial design and NDA requirements
  • Favorable microbiome results showing potential for reduced CDI recurrence
  • FDA QIDP and Fast-Track Designation previously received
  • Planned expansion into international markets (EU, UK, Japan, Canada)
Negative
  • Large Phase 3 trial requirement of 450 subjects indicates significant resource commitment
  • Must demonstrate non-inferiority to existing treatment (vancomycin) before testing superiority

Insights

This news about Acurx Pharmaceuticals' ibezapolstat Phase 2b data presentation and Phase 3 preparation is impactful for investors. The key developments include:

  • FDA agreement on Phase 3 trial design with 450 subjects in the Modified Intent-To-Treat population
  • Promising microbiome data showing preservation of beneficial bacteria and favorable bile acid ratios, suggesting potential for reduced CDI recurrence
  • International expansion plans with upcoming regulatory submissions in EU, UK, Japan and Canada
  • Fast-Track and QIDP designations from FDA already secured

The microbiome data differentiates ibezapolstat from vancomycin, the current standard of care. The planned superiority analysis in Phase 3, if successful, could position ibezapolstat as a preferred treatment option in the $1+ billion C. difficile market. The international regulatory strategy could significantly expand the drug's commercial potential.

  • Acurx is proud to sponsor this inaugural Scientific Symposium of the Peggy Lillis Foundation (PLF) for C. Diff Education & Advocacy
  • An update of ibezapolstat Ph2b clinical and microbiome results was presented
  • Preparation continues to advance ibezapolstat into international Phase 3 clinical trials for treatment of C. difficile Infection (CDI)
  • Acurx continues preparation to submit requests for regulatory guidance to initiate clinical trials in the European Union to be followed by Japan, Canada and the United Kingdom
  • Ibezapolstat has previously received FDA QIDP and Fast-Track Designation from FDA

STATEN ISLAND, N.Y., Nov. 18, 2024 /PRNewswire/ -- Acurx Pharmaceuticals, Inc. (NASDAQ: ACXP) ("Acurx" or the "Company"), a late-stage biopharmaceutical company developing a new class of small molecule antibiotics for difficult-to-treat bacterial infections, with its lead antibiotic candidate, ibezapolstat, preparing to advance to international Phase 3 clinical trials to treat patients with C. difficile Infection (CDI). The Company today announced its support and participation in the Inaugural Peggy Lillis Foundation (virtual) Scientific Symposium, held on Friday, November 15, 2024.

Acurx's Executive Chairman, Bob DeLuccia, delivered opening remarks for the symposium which assembled experts and thought leaders from around the world to present state-of-the art updates regarding C difficile Infection and therapeutic options. Topics covered included epidemiology, bacterial physiology, risk factors for infections, and new and emerging treatment modalities. The Symposium also included testimonials from patients who survived CDI.

Kevin Garey, PharmD, MS, FIDSA, Professor and Chair, University of Houston College of Pharmacy, Principal Investigator for microbiology and microbiome aspects of the ibezapolstat clinical trial program, and Acurx Scientific Advisory Board member, delivered a presentation entitled: "Ibezapolstat Preserves Key Clostridium Leptum Species: Microbiome Results from the Phase 2, Randomized, Double-Blind Study."

According to Dr. Garey: "In contrast to patients dosed with vancomycin, ibezapolstat has consistently shown in the phase 1 and 2 studies that it promotes the growth of beneficial Actinobacteria important for short chain fatty acid production and Clostridiales important for bile acid homeostasis. At the same time, it does not promote the overgrowth of potentially harmful Proteobacteria." He further added: "Ibezapolstat showed a favorable secondary to primary ratio of bile acids which is linked to a lower recurrence rate of CDI. I'm excited to see this new antibiotic advance to phase 3 clinical trials for the treatment of acute C. difficile Infection, particularly considering the favorable effects on bile acid homeostasis, which could lead to a reduction in CDI recurrence, a current unmet medical need with currently marketed antibiotics."

Robert J. DeLuccia, Executive Chairman of Acurx, stated: "As a leader in the field with the first new class of antibiotics in decades now preparing to enter Ph3 international trials for the treatment of acute CDI and reduction of recurrence, we are very excited to have sponsored this event to support the PLF and to present an update on ibezapolsat's Ph2b data, particularly during November being CDC-designated as Cdiff Awareness month." Dr. Garey's presentation is available on the Acurx Pharmaceuticals website at www.acurxpharma.com.

Acurx has previously announced that it had a successful FDA End-of-Phase 2 Meeting and Phase 3 Readiness for ibezapolstat for the Treatment of C. difficile Infection. Agreement with FDA was reached on key elements to move forward with its international Phase 3 clinical trial program. Agreement was also reached with FDA on the complete non-clinical and clinical development plan for filing of a New Drug Application (NDA) for marketing approval. Planning continues to advance ibezapolstat into international Phase 3 clinical trials for treatment of C. difficile Infection (CDI). Acurx is also preparing to submit requests for regulatory guidance to initiate clinical trials in the European Union, to be followed by requests to be submitted in the United Kingdom, Japan and Canada.

Key elements for the two Phase 3, non-inferiority, pivotal trials were confirmed and included agreement on the protocol design, patient population, primary and secondary endpoints, and size of the registration safety database. Based on FDA recommendations, and in anticipation of an EMA Scientific Advice Meeting, the primary efficacy analysis will be performed using a Modified Intent-To-Treat (mITT) population consistent with EMA requirements. This will result in an estimated 450 subjects in the mITT population, randomized in a 1:1 ratio to either ibezapolstat or standard-of-care vancomycin, enrolled into the initial Phase 3 trial. The trial design not only allows determination of ibezapolstat's ability to achieve Clinical Cure of CDI as measured 2 days after 10 days of oral treatment, but also includes assessment of ibezapolstat's potential effect on reduction of CDI recurrence in the target population. In the event non-inferiority of ibezapolstat to vancomycin is demonstrated, further analysis will be conducted to test for superiority.

About the Peggy Lillis Foundation  
The Peggy Lillis Foundation (PFL) is building a nationwide C. DIFF (Clostridioides difficile) awareness movement by educating the public, empowering advocates and shaping public policy. Currently, PLF is going beyond its early beginnings as a patient advocacy group to raise awareness of Cdiff, but now is building a broader foundation by uniting researchers, clinicians, and the medical community, along with all advocates to share groundbreaking research findings, foster collaboration and ultimately enhance cdiff patient outcomes.
For more information about PLF please visit: https://cdiff.org/

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. from study centers in the United States. In the Phase 2a trial segment, 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 (100% cured infection at End of Treatment).

In the Phase 2b trial segment, which was discontinued due to success, 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 96% (25 out of 26 patients), based on 10 out of 10 patients (100%) in Phase 2a in the Modified Intent to Treat Population, plus 15 out of 16 (94%) patients in Phase 2b in the Per Protocol Population, who experienced Clinical Cure during treatment with ibezapolstat. Ibezapolstat was well-tolerated, with three patients each experiencing one mild adverse event assessed by the blinded investigator to be drug- related. All three events were gastrointestinal in nature and resolved without treatment.

There were no drug-related treatment withdrawals or no drug-related serious adverse events, or other safety findings of concern. In the Phase 2b vancomycin control arm, 14 out of 14 patients experienced Clinical Cure. The Company is confident that based on the pooled Phase 2 ibezapolstat Clinical Cure rate of 96% and the historical vancomycin cure rate of approximately 81% (Vancocin® Prescribing Information, January 2021), we will demonstrate non-inferiority of ibezapolstat to vancomycin in Phase 3 trials in accordance with the applicable FDA Guidance for Industry (October 2022).

In the Phase 2 clinical trial (both trial segments), the Company also evaluated 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. The company also recently reported positive extended clinical cure (ECC) data for ibezapolstat (IBZ), its lead antibiotic candidate, from the Company's recently completed Phase 2b clinical trial in patients with CDI. This exploratory endpoint showed that 12 patients who agreed to be followed up to three months following Clinical Cure of their infection, 5 of 5 IBZ patients experienced no recurrence of infection. In the vancomycin control arm of the trial, 7 of 7 patients experienced no recurrence of infection. ECC success is defined as a clinical cure at the TOC visit (i.e., at least 48 hours post EOT) and no recurrence of CDI within the 56 ± 2 days post EOT (ECC56) and 84 ± 2 days post EOT (ECC84) in patients who consented to extended observation. 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. Furthermore, ibezapolstat-treated patients showed lower concentrations of fecal primary bile acids, and higher beneficial ratio of secondary to primary bile acids than vancomycin-treated patients.

About Ibezapolstat
Ibezapolstat is the Company's lead antibiotic candidate planning to advance to international Phase 3 clinical trials to treat patients with C. difficile Infection (CDI). 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 U.S. Food and Drug Administration (FDA) as a Qualified Infectious Disease Product (QIDP) for the treatment of patients with CDI and will be eligible to benefit from the incentives for the development of new antibiotics established under the Generating New Antibiotic Incentives Now (GAIN) Act. In January 2019, FDA granted "Fast Track" designation to ibezapolstat for the treatment of patients with CDI. The CDC has designated C. difficile as an urgent threat highlighting the need for new antibiotics to treat CDI.

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 U.S. hospitals (Lessa, et al, 2015, New England Journal of Medicine). Recent estimates suggest C. difficile approaches 500,000 infections annually in the U.S. and is associated with approximately 20,000 deaths annually. (Guh, 2020, New England Journal of Medicine). Based on internal estimates, the recurrence rate for the antibiotics currently used to treat CDI is between 20% and 40% among approximately 150,000 patients treated. We believe the annual incidence of CDI in the U.S. approaches 600,000 infections and a mortality rate of approximately 9.3%.

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). In the Ph2b trial, ibezapolstat-treated patients showed lower concentrations of fecal primary bile acids, and higher beneficial ratio of secondary to primary bile acids than vancomycin-treated patients.

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-positive 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, 2023, 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.

FAQ

What are the key findings from Acurx's (ACXP) ibezapolstat Phase 2b trial?

The trial showed ibezapolstat promotes beneficial Actinobacteria growth and maintains bile acid homeostasis, while avoiding harmful Proteobacteria overgrowth, suggesting potential for lower CDI recurrence rates.

How many patients will be enrolled in Acurx's (ACXP) Phase 3 ibezapolstat trials?

The initial Phase 3 trial will enroll approximately 450 subjects in the Modified Intent-To-Treat population, randomized 1:1 between ibezapolstat and vancomycin.

What regulatory designations has Acurx's (ACXP) ibezapolstat received from the FDA?

Ibezapolstat has received both QIDP (Qualified Infectious Disease Product) and Fast-Track Designation from the FDA.

Acurx Pharmaceuticals, Inc.

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