Merck Releases Positive Data for Phase 3 Trials of Broad-spectrum Antibacterial Relebactam Combination Therapy

April 24, 2018 Source: Sina Pharmaceutical

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Recently, Merck announced that the company's beta-lactamase inhibitor Relebactam and imipenem / cilastatin combination of the key phase III study has obtained positive experimental data. The results of the trial showed that the combination regimen was effective in treating imipenem-sensitive South African susceptible bacterial infections (primary endpoint) compared to the imipenem/cilastatin regimen, and also had lower nephrotoxicity in treatment. To the end).

The company subsequently stated that it will submit a new drug application to the US Food and Drug Administration (FDA) based on the above positive test results, expecting to obtain regulatory approval for fixed-dose combination drug of imipenem/cilastatin and Relebactam. In 2014, Relebactam (MK-7655) officially entered the FDA rapid approval channel. The injection can be used for urinary tract infections, complex abdominal infections, and nosocomial bacterial pneumonia. At the same time, it is certified as a qualified infectious disease product (QIDP). The certification aims to encourage pharmaceutical companies to develop new antibiotics. The incentives include a five-year delay in product patents and a rapid approval channel. The positive results of this release are expected to make Merck, a new antibiotic drug, available as soon as possible.

Dr. Amanda Paschke, senior chief scientist of clinical research in infectious diseases at Merck Research Laboratories, said, "Infections caused by Gram-negative bacteria are still a major problem for hospitalized patients, and the prevalence of global carbapenem-resistant pathogens is increasing. This indicates that there is a need for effective new Gram-negative antibacterial drugs. We look forward to the introduction of a combination of imipenem/cilastatin and Relebactam to further strengthen Merck's long-term commitment to fight infectious diseases."

The results of the RESTORE-IMI 1 study of the combination therapy were presented at the 28th European Conference on Clinical Microbiology and Infectious Diseases (ECCMID) 2018, April 21-24 in Madrid, Spain. The study was a multicenter, randomized, double-blind, controlled trial comparing imipenem/cilastatin, ebastatin (IMI / REL) with colistin, imipenem/west The efficacy and safety of statin (COL + IMI) for imipenem-insensitive bacteria.

Developed by Merck, Relebactam is a novel beta-lactamase inhibitor belonging to the diazabicyclooctane inhibitor with broad-spectrum anti-beta lactamase activity, including class A (extended data beta-lactamase and KPC) and C (AmpC enzyme). For imipenem-resistant Gram-negative strains, the strain is more sensitive to imipenem when combined with relebactam.

Many of the most commonly used antibiotics are members of the beta lactam family of compounds, and the bacteria evolve to produce beta lactamase to degrade these antibiotics. Scientists continue to develop inhibitors that block the activity of these beta-lactamases, and the pathogens of cockroaches adapt to produce new enzyme proteins that overcome these inhibitors, and some bacteria can even withstand strong carbapenem antibiotics. It was once called the "last line of defense" of infection.

The first approved new inhibitor of this type was avibactam developed by Actavis (which was subsequently acquired by Allergan). In a phase 2 clinical trial, the combination of avibactam and the antibiotic ceftazidime is effective against a variety of serious infections, and the US FDA has approved its listing, sold under the trade name Avycaz. In addition, the FDA has awarded the Medicines Company's fast-track qualification for the combination of the inhibitor vaborbactam and the antibiotic meropenem, with indications for urinary tract infections.

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