Bacterial DNA gyrase

▎药明康德内容团队编辑 GSK今天宣布，美国FDA已接受其潜在"first-in-class"口服抗生素gepotidacin的新药申请（NDA），用于治疗患有单纯性尿路感染（uUTI，也称为急性膀胱炎）成年或青少年（≥12岁）女性患者，患者体重须≥40公斤。FDA授予该申请优先审评资格，并预计在2025年3月26日前完成审评。根据新闻稿，若获批，gepotidacin将成为20多年来首个用于治疗uUTI的新型口服抗生素药物。 超过一半的女性一生中会罹患uUTI，其中约30%的女性会发生复发。由于耐药细菌引起的uUTI病例不断增加，可能导致更高的治疗失败率，因此急需开发新的治疗方法。 该新药申请得到了关键性3期EAGLE-2和EAGLE-3试验积极结果的支持。在这些研究中，与目前uUTI标准疗法nitrofurantoin抗生素相比，gepotidacin在治疗确诊的uUTI成年与青少年女性患者中展现非劣效性，这些患者已知对nitrofurantoin应答。 ▲Gepotidacin分子结构（图片来源：PubChem） 在EAGLE-3试验中，gepotidacin与活性对照药物相比具有统计学显著优势，58.5%（n=162/277）的gepotidacin组患者治疗成功，而此数值在活性对照药物组中为43.6%（n=115/264，差异14.6%，95% CI：6.4~22.8）。在EAGLE-2试验中，50.6%（n=162/320）的gepotidacin组患者显示出治疗成功，而此数值在活性对照组中为47.0%（n=135/287，差异4.3%，95% CI：-3.6~12.1）。 Gepotidacin在EAGLE-2和EAGLE-3试验中的安全性和耐受性结果与先前试验一致。 Gepotidacin是一款具有全新作用机制的抗生素，它可以口服，并具有双重作用机制，能同时选择性地结合并抑制DNA促旋酶和DNA拓扑异构酶IV，从而诱发在复制进程的DNA发生单链断裂，进而达到杀死病原体的目的。 ▲欲了解更多前沿技术在生物医药产业中的应用，请长按扫描上方二维码，即可访问“药明直播间”，观看相关话题的直播讨论与精彩回放 参考资料： [1] Gepotidacin accepted for priority review by US FDA for treatment of uncomplicated urinary tract infections in female adults and adolescents. Retrieved October 16, 2024 from https://www.gsk.com/en-gb/media/press-releases/gepotidacin-accepted-for-priority-review-by-us-fda-for-treatment-of-uncomplicated-urinary-tract-infections-in-female-adults-and-adolescents/ 免责声明：药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。 版权说明：本文来自药明康德内容团队，欢迎个人转发至朋友圈，谢绝媒体或机构未经授权以任何形式转载至其他平台。转载授权请在「药明康德」微信公众号回复“转载”，获取转载须知。 分享，点赞，在看，聚焦全球生物医药健康创新

▎药明康德内容团队报道 今日（10月16日），丹诺医药宣布完成逾3亿人民币E轮融资的首批交割。这轮融资由中山投控旗下中山创投和AMR Action Fund (AMR基金) 共同领投，所获资金用于支持核心新药研发管线，包括治疗幽门螺杆菌感染新药候选物TNP-2198和治疗植入医疗器械感染新药候选物TNP-2092的后期临床试验和商业化。 “我们非常高兴获得中山创投和AMR基金的支持，” 丹诺医药创始人、董事长和首席执行官马振坤博士表示。“丹诺医药致力于解决细菌耐药和耐受带来的双重挑战，为尚缺乏合理治疗手段的细菌感染和菌群代谢相关疾病提供解决方案。这轮融资将支持丹诺医药加速推进治疗幽门螺杆菌感染新药候选物TNP-2198的商业化，以及治疗植入医疗器械感染新药候选物TNP-2092的后期临床试验。” “丹诺医药专注于细菌感染和菌群代谢相关疾病领域新药研发，治疗幽门螺杆菌感染的首创新药产品TNP-2198已经完成III期临床实验，并且多个在研新药候选物也已经进入后期临床试验阶段，”中山创投董事长张程表示。“丹诺医药采取差异化的产品开发策略，以解决国内外市场未满足需求，具有广阔的市场前景。我们很高兴有机会与全球抗感染领域的头部投资机构AMR基金合作，共同参与这轮投资。” “目前全球抗生素耐药细菌感染的状况令人震惊，并且日趋严重。《柳叶刀》发表的最新数据表明，到 2050 年全球将有近 4000 万人死于抗生素耐药细菌的感染，”AMR 基金首席执行官 Henry Skinner 博士表示。“我们非常高兴为丹诺医药提供资金支持，丹诺团队正在快速推进新型抗菌药物的研发，这些新药产品有希望挽救全球无数患者的生命，并减少耐药细菌感染带来的痛苦。”  丹诺医药专注细菌感染和菌群代谢相关疾病，聚焦在尚缺乏合理治疗手段、并具有巨大市场前景的适应症，目前已经有多个新药候选物进入后期临床试验阶段。丹诺医药采取一线疗法的新药研发策略，以确保商业化成功。 TNP-2198 (利福特尼唑) 是一个对微需氧菌和厌氧菌具有独特多靶点协同作用机制的新药候选物，有望成为30多年以来全球第一个针对幽门螺杆菌感染开发的新药产品，以应对在胃癌高发地区开展幽门螺杆菌感染筛查-根除、预防胃癌策略的需求。丹诺医药已经在中国完成 TNP-2198 的5项1期和2期临床试验，目前3期临床试验已经接近尾声。丹诺医药已经获得美国 FDA 对TNP-2198合格感染性疾病产品（QIDP）和快速通道资格。 TNP-2092 (利福喹酮) 是一个具有独特三靶点协同作用机制的新药候选物，用于应对植入医疗器械感染中抗生素耐药和耐受所带来的双重挑战。丹诺医药已经在中美完成 TNP-2092 注射剂的6项 I期和 II期临床试验，并准备开展一项治疗人工关节感染的国际多中心 III 期临床试验。丹诺医药已经获得美国FDA 对TNP-2092的 QIDP、快速通道资格和孤儿药资格。 参考资料： [1] 丹诺医药新闻稿. 本文由药明康德内容团队根据公开资料整理编辑，欢迎个人转发至朋友圈。转发授权及其他合作需求，请联系wuxi_media@wuxiapptec.com。 免责声明：药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。

16 October 2024 Application supported by positive results from pivotal phase III EAGLE-2 and EAGLE-3 trials 26 March 2025 assigned as action date for FDA decision Gepotidacin could be the first in a new class of oral antibiotic treatment for uUTIs in over 20 years GSK plc (LSE/NYSE: GSK) today announced that the US Food and Drug Administration (FDA) has accepted the New Drug Application (NDA) for gepotidacin, an investigational, first-in-class oral antibiotic with a novel mechanism of action for the treatment of female adults (≥40 kg) and adolescents (≥12 years, ≥40 kg) with uncomplicated urinary tract infections (uUTIs). The FDA has granted Priority Review for this application and assigned a Prescription Drug User Fee Act (PDUFA) action date of 26 March 2025. Over half of all women are affected by uUTIs in their lifetime1, with approximately 30% suffering from recurrent disease which can cause significant patient burden, including discomfort and restriction of daily activities.2 New treatments are needed as the number of uUTIs caused by drug-resistant bacteria is increasing and can result in higher treatment failure rates.3 Gepotidacin is a late-stage antibiotic in GSK’s growing infectious disease portfolio and could be the first in a new class of oral antibiotics for uUTIs in over 20 years. The NDA is supported by positive results from the pivotal phase III EAGLE-2 and EAGLE-3 trials. In these studies, gepotidacin demonstrated non-inferiority to nitrofurantoin, the current standard of care for uUTI, in female adults (≥40 kg) and adolescents (≥12 years, ≥40 kg) with a confirmed uUTI and a uropathogen susceptible to nitrofurantoin. In EAGLE-3, gepotidacin achieved statistically significant superiority versus nitrofurantoin, demonstrating therapeutic success in 58.5% (162/277) of participants compared to 43.6% (115/264) for nitrofurantoin (treatment difference 14.6%, 95% CI (6.4, 22.8)). In EAGLE-2, gepotidacin demonstrated therapeutic success in 50.6% (162/320) of participants compared to 47.0% (135/287) for nitrofurantoin (treatment difference 4.3%, 95% CI (-3.6, 12.1)). The safety and tolerability profile of gepotidacin in the EAGLE-2 and EAGLE-3 phase III trials was consistent with previous trials of gepotidacin. The most commonly reported adverse events (AEs) in gepotidacin participants were gastrointestinal (GI). Diarrhoea was the most common (16% of participants), followed by nausea (9%). Of the participants who reported GI AEs in the gepotidacin group, the maximum severity were mild (69% Grade 1) and moderate (28% Grade 2). Participants with Grade 3 GI events accounted for 3% of all patients with GI events and occurred in <1% of all participants. There was one drug-related serious adverse event in each treatment arm (gepotidacin and nitrofurantoin) across the two trials. The development of gepotidacin has been funded in part with federal funds from the US Department of Health and Human Services, Administration for Strategic Preparedness and Response, Biomedical Advanced Research and Development Authority (BARDA), under Other Transaction Agreement number HHSO100201300011C and with federal funds awarded by the Defense Threat Reduction Agency under agreement number HDTRA1-07-9-0002. About the EAGLE (Efficacy of Antibacterial Gepotidacin Evaluated) phase III programme The global phase III clinical programme for gepotidacin in adults and adolescents consists of three trials: EAGLE-2 and EAGLE-3 (non-inferiority uUTI trials) compared the efficacy and safety of gepotidacin (1,500mg administered orally twice daily for five days) to nitrofurantoin (100mg administered orally twice daily for five days) with 1531 and 1605 female adults and adolescents with uncomplicated urinary tract infections, respectively. Across both trials, the duration of follow-up for participants was approximately 28 days, and the primary endpoint was the combined clinical and microbiological response at the Test-of-Cure (ToC) visit (days 10-13) in patients with qualifying uropathogens susceptible to nitrofurantoin. EAGLE-1 (non-inferiority urogenital gonorrhoea trial) compared the efficacy and safety of gepotidacin to ceftriaxone plus azithromycin in 628 patients with uncomplicated urogenital gonorrhoea caused by Neisseria gonorrhoeae. About gepotidacin Gepotidacin, discovered by GSK scientists, is an investigational bactericidal, first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a distinct binding site, a novel mechanism of action and for most pathogens, provides well-balanced inhibition of two different Type II topoisomerase enzymes. This provides activity against most target uropathogens (such as E. coli and S. saprophyticus), and N. gonorrhoeae, including isolates resistant to current antibiotics. Efficacy and safety in patients have been demonstrated in uUTI and gonorrhoea phase III clinical trials, including those with drug-resistant pathogens. Due to the well-balanced inhibition, gepotidacin target-specific mutations in both enzymes are needed to significantly affect susceptibility to gepotidacin. Therefore, leading to a lower potential for resistance development. GSK in infectious diseases GSK has pioneered innovation in infectious diseases for over 70 years, and the Company’s pipeline of medicines and vaccines is one of the largest and most diverse in the industry, with a goal of developing preventive and therapeutic treatments for multiple disease areas or diseases with high unmet needs globally. GSK’s expertise and capabilities in innovation, access and stewardship position the Company uniquely to help prevent and mitigate the challenge of antimicrobial resistance. In antimicrobials, in addition to gepotidacin, GSK entered into an exclusive licence agreement with Spero Therapeutics, Inc. in September 2022 to add tebipenem HBr, a late-stage antibiotic and potential treatment for complicated urinary tract infections (cUTIs), to the pipeline and are currently enrolling for PIVOT-PO, a phase III trial. In March 2023, GSK announced an exclusive licence agreement with Scynexis for Brexafemme (ibrexafungerp tablets), a first-in-class antifungal for the treatment of vulvovaginal candidiasis (VVC) and reduction in the incidence of recurrent VVC. About GSK GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together. Find out more at gsk.com. Cautionary statement regarding forward-looking statements GSK cautions investors that any forward-looking statements or projections made by GSK, including those made in this announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those projected. Such factors include, but are not limited to, those described under Item 3.D “Risk factors” in GSK’s Annual Report on Form 20-F for 2023, and GSK’s Q2 Results for 2024. References You might also like