Mark Smith, Finch Therapeutics CEO

FDA slaps hold on Finch's mi­cro­bio­me C. dif­fi­cile treat­ment, as biotech blames Covid-19 and old man­u­fac­tur­er

Drug­mak­ers work­ing on treat­ments for C. dif­fi­cile in­fec­tions are hav­ing a bad week.

Just one day af­ter Pfiz­er re­port­ed its C. dif­fi­cile vac­cine can­di­date did not hit the pri­ma­ry end­point in a Phase III study, Finch Ther­a­peu­tics is find­ing it­self in a sim­i­lar po­si­tion. The biotech said Tues­day its mi­cro­bio­me treat­ment for the in­fec­tion was placed on clin­i­cal hold by the FDA last week, with reg­u­la­tors seek­ing more in­fo on Finch’s screen­ing pro­to­cols.

News of the hold sent Finch shares $FNCH down about 14% af­ter Mon­day’s clos­ing bell.

Like Pfiz­er, Finch blamed the Covid-19 pan­dem­ic for its trou­bles, point­ing to an FDA safe­ty alert from March 2020 over the po­ten­tial SARS-CoV-2 trans­mis­sion risk through mi­cro­bio­me treat­ments. In con­junc­tion with the alert, reg­u­la­tors put Finch’s IND and then-man­u­fac­tur­er on par­tial hold so as to add Covid-19 test­ing to any donor ma­te­r­i­al re­ceived af­ter Dec. 1, 2019.

As Finch tells it, re­searchers were able to con­tin­ue dos­ing in an on­go­ing Phase II tri­al, us­ing donor sam­ples be­fore that date. In Jan­u­ary 2021, the man­u­fac­tur­er, Open­Bio­me, was re­leased from clin­i­cal hold and Finch then bought the man­u­fac­tur­ing tech two months lat­er. In No­vem­ber, Finch be­gan dos­ing par­tic­i­pants in a Phase III tri­al us­ing the same screen­ing meth­ods it says were used by Open­Bio­me and sub­se­quent­ly ac­quired.

But the FDA reached out in Jan­u­ary, os­ten­si­bly with some ques­tions, and sent the clin­i­cal hold no­tice on Feb. 24. As a re­sult, Finch is paus­ing en­roll­ment in that Phase III study, its sec­ond piv­otal study look­ing to eval­u­ate the mi­cro­bio­me treat­ment.

Finch did note that some pa­tients were dosed in this piv­otal study while the hold was in ef­fect. The com­pa­ny said in a press re­lease it is con­duct­ing a re­view of the mat­ter. End­points News has reached out for com­ment and will up­date ac­cord­ing­ly.

Pre­vi­ous­ly, the ther­a­py dubbed CP101 passed its first Phase III test with nom­i­nal sta­tis­ti­cal sig­nif­i­cance, hit­ting the pri­ma­ry end­point of a sus­tained clin­i­cal cure through week 8. Be­tween treat­ment and place­bo, Finch re­port­ed a 33.8% rel­a­tive risk re­duc­tion, good for a p-val­ue of p=0.0488.

The treat­ment re­mained durable too, the com­pa­ny said, not­ing 73.5% of par­tic­i­pants sus­tained the cure ef­fects through 24 weeks, com­pared to 59.4% on place­bo. Finch’s ther­a­py proved more sta­tis­ti­cal­ly sig­nif­i­cant here, notch­ing a p-val­ue of p=0.0347.

Where Finch goes from here is not yet clear, as the com­pa­ny said it’s still eval­u­at­ing how long a de­lay could be in its topline read­out. Finch is al­so test­ing CP101 in chron­ic he­pati­tis B, with stud­ies cur­rent­ly in the pre­clin­i­cal phase, and it’s al­so not clear how these stud­ies might be im­pact­ed.

Though Finch is in for some chop­py wa­ters ahead, it’s ar­guably in a more fa­vor­able po­si­tion than Pfiz­er or Sum­mit Ther­a­peu­tics, which is de­vel­op­ing an an­tibi­ot­ic for C. dif­fi­cile in­fec­tions. Nei­ther Pfiz­er nor Sum­mit record­ed sta­tis­ti­cal­ly sig­nif­i­cant Phase III re­sults and Finch al­ready has one un­der its belt.

Image courtesy of The Janssen Pharmaceutical Companies of Johnson & Johnson.

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Photo: Ida Marie Odgaard/Ritzau Scanpix/Sipa USA/Sipa via AP Images

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