HIV pa­tients will have to wait a while longer for a long-act­ing vi­ral sup­pres­sion reg­i­men as the FDA has re­ject­ed Vi­iV Health­care’s NDA for the month­ly in­jec­tion of cabote­gravir and rilpivirine.

Reg­u­la­tors hand­ed the GSK sub­sidiary a com­plete re­sponse let­ter days be­fore the orig­i­nal PDU­FA date on De­cem­ber 29. While Vi­iV had been ex­pect­ing a smooth sail to the fin­ish line based on glow­ing clin­i­cal re­sults, the CRL cit­ed con­cerns with chem­istry man­u­fac­tur­ing and con­trols.

“There have been no re­port­ed safe­ty is­sues re­lat­ed to CMC and there is no change to the safe­ty pro­file of the prod­ucts used in clin­i­cal tri­als to date,” Vi­iV added in a short state­ment.

Kim Smith

A de­lay here with the month­ly in­jec­tion of cabote­gravir and rilpivirine al­so means that Vi­iV will have to push back on the planned sN­DA fil­ing for the 2-month­ly reg­i­men, which was slat­ed for the first quar­ter of 2020.

Gilead’s block­buster cock­tails, both dou­blets and triplets, have been im­mense­ly suc­cess­ful at keep­ing HIV to un­de­tectable lev­els, but they have still left pa­tients sad­dled with the bur­den of tak­ing dai­ly pills — which Vi­iV said is not on­ly in­con­ve­nient but al­so car­ries an emo­tion­al bur­den. With their new for­mu­la­tion of their own ex­per­i­men­tal cabote­gravir (in­te­grase in­hibitor) and J&J’s rilpivirine (non-nu­cle­o­side re­verse tran­scrip­tase in­hibitor), Vi­iV was look­ing to shake up the treat­ment land­scape and carve out a big­ger share from the Gilead-dom­i­nat­ed mar­ket.

The long-act­ing reg­i­men is de­signed for pa­tients who are al­ready vi­ro­log­i­cal­ly sup­pressed, have nev­er ex­pe­ri­enced vi­ro­log­i­cal fail­ures, and have not de­vel­oped re­sis­tance to ei­ther of the in­gre­di­ents. Vi­iV head of R&D Kim Smith has es­ti­mat­ed that around 10% to 15% of all pa­tients in the clin­ic would be can­di­dates.

Two late-stage stud­ies in­volv­ing 1180 pa­tients sug­gest­ed that their in­jec­tion was just as ef­fec­tive as stan­dard an­ti­retro­vi­ral ther­a­py in vi­ro­log­ic sup­pres­sion, with sim­i­lar rates of re­sis­tance at 1%. And as they fol­low up on a Phase IIb tri­al, re­searchers found that 83% of pa­tients re­main vi­ral­ly sup­pressed at the three-year mark.

That, along­side sim­i­lar­ly pos­i­tive da­ta for the 2-month­ly reg­i­men, would have made a ground­break­ing treat­ment op­tion. The com­pa­ny said it’s work­ing close­ly with the FDA to fig­ure out the next steps.

In a bewildering twist to the long-suffering market for antibiotics — there has actually been a bidding war for an antibiotic company: Tetraphase.

It all started back in March, when the maker of Xerava (an FDA approved therapy for complicated intra-abdominal infections) said it had received an offer from AcelRx for an all-stock deal valued at $14.4 million.

The offer was well-timed. Xerava was approved in 2018, four years after Tetraphase posted its first batch of pivotal trial data, and sales were nowhere near where they needed to be in order for the company to keep its head above water.

Lonza chairman Albert Baehny took his time headhunting a new CEO for the company, making it absolutely clear he wanted a Big Pharma or biotech CEO with a good long track record in the business for the top spot. In the end, he went with the gold standard, turning to Roche’s ranks to recruit Pierre-Alain Ruffieux for the job.

Ruffieux, a member of the pharma leadership team at Roche, spent close to 5 years at the company. But like a small army of manufacturing execs, he gained much of his experience at the other Big Pharma in Basel, remaining at Novartis for 12 years before expanding his horizons.

Another Big Pharma is entering the Covid-19 antibody hunt.

AbbVie has announced a collaboration with the Netherlands’ Utrecht University and Erasmus Medical Center and the Chinese-Dutch biotech Harbour Biomed to develop a neutralizing antibody that can treat Covid-19. The antibody, called 47D11, was discovered by AbbVie’s three partners, and AbbVie will support early preclinical work, while preparing for later preclinical and clinical development. Researchers described the antibody in Nature Communications last month.

→ Merck — one of the last big pharma bastions in the beleaguered field of antibiotic drug development — on Friday said the FDA had signed off on using its combination drug, Recarbrio, with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia. The drug could come handy for use in hospitalized patients who are afflicted with Covid-19, who carry a higher risk of contracting secondary bacterial infections. Once SARS-CoV-2, the virus behind Covid-19, infects the airways, it engages the immune system, giving other pathogens free rein to pillage and plunder as they please — the issue is particularly pertinent in patients on ventilators, which in any case are breeding grounds for infectious bacteria.