Innovation Pharmaceuticals Inc (IPIX)

[CallMeCrazy]

Brilacidin has no serious competitor--as yet!
Doesn’t it seem kind of odd that an antibiotic (Orbactiv), as effective as vancomycin, with a single-dose therapy, would take 7 years to reach peak U.S. sales of $150 million? Given the bacterial resistance problem, wouldn’t the 1-day dosing aspect make this drug more valuable?

My short answer to both questions is--not really! Vancomycin belongs to the glycopeptide class and Oritavancin (Orbactiv) is a lipoglycopeptide and, thus, belongs to the same class as vancomycin. That Orbactiv belongs to this class suggest to me that it carries some of the bacterial resistance ‘baggage” that comes with this class.

Antibiotic resistance for the glycopeptide class was identified in 1986. More specifically, there are 3 classes of vancomycin-resistant staphylococcal aureus, but the one I find most interesting is the class called vancomycin-intermediate staphylococcal aureus (VISA), because it is also called GISA (glycopeptide intermediate staphylococcal aureus) which indicate it is resistant to all glycopeptide antibiotics. This suggest that even before Orbactiv hits the market there is already a class of bacteria resistant to it. A one dose regimen of Orbactiv used against one of these strains might even aggravate the problem of antibiotic resistance. I am not a scientist nor do I have a particularly strong background in science, but my reading of the relevant literature logically suggest this could happen.

Bacterial strains in the VISA/GISA class have a thickened cell wall and seem to have figured out how to impede the effectiveness of glycopeptide antibiotics.

The ‘holy grail’ in antibiotics is said to be a single-dose therapy, but I don’t think this is exactly correct. If a person with GISA is misdiagnosed as MRSA and prescribed Orbactiv then the bacterial resistance problem could be worsened, because what doesn’t kill them makes them stronger. Once Brilacidin achieves single-dosing I think it will represent the true ‘holy grail’, because, along with single-dosing, there is no known bacterial resistance. I believe it is these 2 attributes, single-dosing and no known resistance that constitutes the ‘holy grail’ and none of Brilacidin’s adversaries possess both.