Innovation Pharmaceuticals Inc (IPIX)

[biodoc]

olden_grumpini, I think you're missing some important points.

First, it's very difficult to compare in vitro potency with clinical potency. Note that achievable serum Brilacidin concentrations were significantly higher in ABSSSI clinical studies.

Of note, the IC50 (0.565 µM) and IC90
(2.63 µM) values for brilacidin observed in the Calu-3 cell line are well below clinically
achievable concentrations based on pharmacokinetics observed in Phase 2 clinical trials
with brilacidin for the treatment of Acute Bacterial Skin and Skin Structure Infections
(ABSSSI) based on relative concentrations.

Second, there's a concentration effect in the in vitro studies. That is, Brilacidin is more effective as an anti-viral in this cell population at higher concentrations. We do not know the shape of this curve and what actually happens in vivo. Pharmacodynamics are not elucidated with relatively simple in vitro concentration studies. At serum concentrations comparable to Brilacidin for ABSSSI, the anti-viral activity may be greater than Remdesivir's. We don't know.

Third, and perhaps most important, Brilacidin and Remdesivir in combination appear more potent as an antiviral for Covid than either alone. The ongoing Phase 2 trial investigates Brilacidin + Standard of Care compared to Placebo+ Standard of Care. I believe Remdesivir is part of Standard of Care in the study population so all of the Brilacidin dosed patients will also be receiving Remdesivir.

So if there's anti-viral synergy and Brilacidin adds important anti-inflammatory/immunomodulatory properties then we may actually have a real therapeutic.